Adult ; Female ; Humans ; Male ; Middle Aged ; Otosclerosis ; surgery ; Stapes Surgery ; methods

OBJECTIVE: To evaluate the feasibility, safety and effectiveness of malleostapedotomy based on malleus-oval window technique in otosclerosis with malleus/incus mobility disorder. METHOD: Six cases with malleostapedotomy on stapes footplate fixation accompanied by malleus/incus movements disorder from March 2005 to March 2007 were analyzed retrospectively, when totally 78 cases of conventional stapes surgeries were performed on isolated otosclerosis . The surgical procedures, intraoperative findings and postoperative vertigo as well as pure tone gain were discussed. RESULT: All of the 6 cases showed stapes footplate fixation. Both abnormal incudomalleolar joint and incudostapedial joint were found in 2 cases. It was suspected that previous inflammation resulted in yellowish mucosa, ossicular malformation and stiffness. The third one showed local tympanosclerosis in the attic. In another 2 cases, idiopathic malleus head fixation related to the anterior and superior mallear ligament abnormal were presented while a surgical incudomalleolar joint dislocation prior to the observation happened in the last one. Among these 6 cases, there was no 4.0 Hz notch and postoperative vertigo which needs a further care. Postoperative air-bone gap on 0.5 kHz, 1.0 kHz, 2.0 kHz, 4.0 kHz averaged less than 10 dB. All the patients had been followed up for 3 months. CONCLUSION Malleostapedotomy based on malleus-oval window technique is a safe and effective procedure available for otosclerosis with malleus/incus movement disorder from different origins.
Adult ; Female ; Humans ; Incus ; surgery ; Male ; Malleus ; surgery ; Middle Aged ; Otosclerosis ; surgery ; Retrospective Studies ; Stapes Surgery ; methods ; Treatment Outcome

OBJECTIVETo assess the effect of stapes surgery on advanced otosclerosis (AO).

METHODSIn 300 cases randomly collected of otosclerosis in 1970 to 1999, 68 cases (77ears) were selected for retrospective analysis, which met the criteria of advanced otosclerosis (mixed deafness, with bone-conduction levels exceeding 40 dB and air-conduction levels exceeding 70 dB in 500 - 2000 Hz).

RESULTSThe air-conduction of sixty-eight cases (77 ears) were from 77.32 dB to 53.7 dB (500-2000 Hz) after operation, mean decreased 23.62 dB. Of 71 ears (92.21%) obtained air-conduction improved over 10 dB, of 46 ears (59.74%) gained A-B Gap closure in 10 dB. Air-conduction were from 79.01 dB to 58.23 dB (500 - 4000 Hz) after operation and mean decreased 20.78 dB. Of 68 ears (88.31%) obtained air-conduction improved over 10 dB, of 32 ears (41.56%) gained A-B gap closure in 10 dB. After followed up 5-25 years, of 67 ears were retained stabilization, of 28 ears obtained more improve than postoperation. But 4 ears had drop (all was stapes-elevation and re-improvement after them was reviewed).

CONCLUSIONStapes surgery is effective operation to cured otosclerosis, advanced otosclerosis or far-advanced otosclerosis had greater help to improved hearing.

Adult ; Aged ; Ear Diseases ; surgery ; Female ; Humans ; Male ; Middle Aged ; Otosclerosis ; surgery ; Retrospective Studies ; Stapes Surgery ; methods ; Treatment Outcome

OBJECTIVETo compare the effects of small fenestra stapedotomy with semiconductor diode laser and microdrill in patients with otosclerosis.

METHODSTwenty-six patients (29 ears) undergoing stapedotomy with semiconductor diode laser and 19 patients (21 ears) with microdrill were compared for the hearing results and complication rates.

RESULTSNo statistically significant differences were found in postoperative speech frequency and high frequency pure tone average in closing the air-bone gap between the two groups. The ears treated by stapedotomy with semiconductor diode laser showed significantly better preoperative minus the postoperative air-bone gap and milder dizziness.

CONCLUSIONIn spite of the good hearing outcomes in both groups, small fenestra stapedotomy with semiconductor diodelaser can achieve better results and reduce the incidence of complications.

Adult ; Aged ; Female ; Fenestration, Labyrinth ; methods ; Hearing Tests ; Humans ; Lasers, Semiconductor ; Male ; Middle Aged ; Otosclerosis ; physiopathology ; surgery ; Stapes Surgery ; instrumentation ; methods ; Young Adult

OBJECTIVETo compare the effect of small fenestra stapedotomy and total stapedectomy in patients with otosclerosis.

METHODSTwenty-seven patients (30 ears) undergoing small fenestra stapedotomy and 36 patients (43 ears) receiving total stapedectomy were compared for hearing results and complication rates.

RESULTSNo statistically significant differences were seen in postoperative speech pure tone average in closing air-bone gap between the two groups. The ears treated by small fenestra stapedotomy showed statistically better air-bone gap closure at high frequencies with lower rates of sensorineural hearing loss at high frequencies and milder dizziness.

CONCLUSIONIn spite of the successful hearing outcomes in both groups, small fenestra stapedotomy can achieve better results at high frequencies and reduce the incidence of complications.

Female ; Fenestration, Labyrinth ; methods ; Hearing Loss, Conductive ; etiology ; surgery ; Humans ; Male ; Otosclerosis ; complications ; surgery ; Postoperative Complications ; prevention & control ; Stapes Surgery ; Treatment Outcome

Objective: To analyze the surgical efficacy of patients with mixed hearing loss and otosclerosis with different air bone gap (ABG) before surgery, and to provide reference for the prognosis evaluation of otosclerosis surgery. Methods: The clinical data of 108 cases(116 ears) of otosclerosis who had undergone stapes fenestration technique artificial stapes implantation in Xiangya Hospital of Central South University from November 2013 to May 2020 and had mixed hearing loss before surgery were collected, including 71 women(76 ears)and 37 men (40 ears), with an average age of 38.5 years. According to preoperative pure tone audiometry ABG, they were divided into three groups: group S, 15 dB≤ABG<31 dB, a total of 39 ears; group M, 31 dB≤ABG<46 dB, a total of 58 ears; and group L, ABG≥46 dB, 19 ears in total. The hearing outcomes of three groups of patients at 6-12 months after surgery were compared and analyzed using SPSS 24.0 statistical software. Results: A total of 3 patients (group S: 2 cases; group L: 1 case) experienced severe sensorineural hearing loss after surgery and were not included in the statistical analysis. After surgery, the pure tone hearing threshold of patients with otosclerosis in each group was significantly improved compared to before surgery, with an average air conduction threshold improvement of(21.6±13.4) dB. The difference between before and after surgery was statistically significant(t=17.13, P<0.01). The average bone conduction threshold improved by(3.7±7.6) dB, and the difference was statistically significant before and after surgery(t=5.20, P<0.01). The postoperative ABG was(18.3±9.3) dB, which was significantly reduced compared to preoperative(36.2±8.6)dB. Among the three groups of patients, the L group had the highest improvement in air conduction threshold[(29.9±10.8)dB], while the S group had the lowest improvement[(15.7±11.4)dB]. There was no statistically significant difference in post operative pure tone hearing thresholds between the three groups(P>0.05). The postoperative ABG in group S was the smallest[(16.5±9.0)dB], while in group L, the postoperative ABG was the largest[(20.5±10.0)dB]. Compared with group S, group M and group L still had a large residual ABG at 2 000 Hz after surgery. The bone conduction threshold of both S and M groups improved to some extent after surgery compared to before (P<0.01). Conclusions: Surgery can benefit patients with mixed hearing loss and otosclerosis with different preoperative ABG. Patients with small preoperative ABG have better surgical results and ideal ABG closure at all frequencies after surgery. Patients with large preoperative ABG can significantly increase the gas conduction threshold during surgery, but certain frequencies of ABG may still be left behind after surgery. The improvement effect of surgery on bone conduction threshold is not significant. Patients should be informed of treatment methods such as hearing aids based on their actual situation for selection.
Male ; Humans ; Female ; Adult ; Bone Conduction ; Otosclerosis/surgery* ; Hearing Loss, Mixed Conductive-Sensorineural/surgery* ; Stapes Surgery/methods* ; Treatment Outcome ; Auditory Threshold ; Hearing ; Audiometry, Pure-Tone ; Deafness ; Retrospective Studies

OBJECTIVE: To determine the efficacy of reversal steps stapedotomy in the treatment of otosclerosis. METHOD: From January 2006 to December 2009, a total of 70 patients (81 ears) with otosclerosis who underwent stapedotomy were retrospectively evaluated. Among these 81 ears, 41 ears underwent classical stapedotomy and 40 ears underwent reversal steps stapedotomy. We compared the postoperative results of pure tone tes , the intraoperative complications of stapes and incus and the incidence rate of postoperative vertigo after surgery between the two groups. RESULT: The rate of postoperative air bone gap < or = 20 dB was 70.7% in the classical stapedotomy group and was 80.0% in reversal steps stapedotomy group. There were no significant differences between the two groups (P =0.181). The reversal steps stapedotomy group seem to had less complications of stapes and incus. The incidence rate of postoperative vertigo in reversal steps stapedotomy group significantly lower than in classical stapedotomy group (P = 0.037). CONCLUSION Reversal steps stapedotomy can effectively improve the hearing of patients with otosclerosis and can reduce the complications of stapedotomy.
Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Otosclerosis ; surgery ; Postoperative Complications ; etiology ; Retrospective Studies ; Stapes Surgery ; methods ; Treatment Outcome ; Vertigo ; etiology ; Young Adult

OBJECTIVETo study the long-term effect of stapes surgery on tympanosclerosis and its influence factors.

METHODSThe effect of stapes surgery on tympanosclerosis was retrospectively summed up in 119 patients (149 ears) in General Hospital of people's Liberation Army from April 1984 to March 2002. The Stata 7.0 software was used as a statistical tool.

RESULTSThe average of hearing threshold (hearing level) of air conduction was (50.7 +/- 12.1) dB before operation, and the hearing loss was mostly on low frequency. Following-up the half-year post-operation, the average of hearing threshold of air conduction was (25.6 +/- 15.2) dB. The total successful rate of post-operation half year, 1 year, 2 and 5 years were 50.3%, 45.8%, 41.3% and 34.5%, respectively. Comparing the different operation methods, stapedotomy (piston technique) owned the best effect on hearing recovery (62.5%), then was stapedectomy (43.1%), but the last one was stapediolysis (30.8%). There was significant difference effect among three different operation methods (P < 0.05). The average of hearing threshold of air conduction was steadily within the first five-years following-up (Ridit analysis, P > 0.05), but obviously increased more than 5 years after operation (Ridit analysis, P < 0.05). The influence factors to successful rate were the following-up time post-operation, pathological changes of stapes, operative methods, and complications during operation, respectively.

CONCLUSIONStapes surgery is the effective method to treat tympanosclerosis, but the long-term effect is not good enough as expectation. It is important to select proper operation methods for better hearing results.

Adolescent ; Adult ; Aged ; Ear, Middle ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Otosclerosis ; surgery ; Retrospective Studies ; Stapes Surgery ; methods ; Young Adult