No abstract available.
Meningitis, Bacterial* ; Stapes*

BACKGROUND AND OBJECTIVES: A free-beam-type CO₂ laser, which use a micromanipulator mounted on a microscope as the delivery system, has the merit of not being affected by hand tremor at the time of shooting. However, this delivery system has several disadvantages, including a restricted operation range and a risk of incorrect focusing. A fiber-type CO₂ laser uses a hand-held delivery system and has the opposite merits and demerits. We compared the results of stapes surgery with free-beam and fiber type delivery systems. SUBJECTS AND METHODS: The study enrolled 36 patients who underwent stapedotomy with free-beam- (n=26) or fiber- (n=10) type CO₂ lasers. The air-bone (AB) gap closure, bone conduction (BC) change, and operating time were evaluated. The AB gap closure was calculated by subtracting the preoperative BC thresholds from the postoperative air conduction thresholds. The BC change was calculated by subtracting the postoperative BC thresholds from the preoperative BC thresholds. RESULTS: The mean operating time was significantly (p=0.035) shorter in the fiber-type group (72.5±8.2 min) than in the free-beam-type group (80.5±11.4 min). The mean AB gap closure did not differ significantly (p=0.297) between the free-beamand fiber-type groups (5.8±10.1 and 1.4±6.8 dB, respectively). The mean BC change did not differ significantly (p=0.873) between the free-beam- and fiber-type groups (2.4±6.9 and 2.8±5.3 dB, respectively). The hearing outcomes did not differ significantly between the two groups. CONCLUSIONS: Operating times were significantly shorter using the fiber-type CO₂ laser, while hearing outcomes did not differ significantly between the two groups.
Bone Conduction ; Hand ; Hearing ; Humans ; Otosclerosis ; Stapes Surgery* ; Stapes* ; Tremor

Humans ; Otosclerosis/surgery* ; Stapes ; Stapes Surgery/adverse effects* ; Arteries

Humans ; Stapes ; Otosclerosis/surgery* ; Ossicular Prosthesis ; Stapes Surgery ; Incus

Stapes fractures without other ossicle problems are rare and ossicle problems due to explosion pressure are also rare. We describe a very rare case of stapes anterior crural fracture resulting from a land mine explosion. As this case suggests, a close examination of the ossicles is necessary during an exploration tympanotomy.
Bombs ; Explosions* ; Fractures, Bone ; Stapes*

BACKGROUND AND OBJECTIVES: Tympanosclerosis is a nonspecific and irreversible result of chronic inflammation or infection of the middle ear. However, there remains disagreement about how best to surgically treat tympanosclerotic ossicular fixation, with the controversy over its management when stapes is involved. The aim of this study was to evaluate operative findings and hearing results of tympanosclerosis involving the ossicular chain, which in turn would establish better surgical treatment of tympanosclerotic ossicular fixation. SUBJECTS AND METHODS: In this prospective study conducted from Mar 2000 to Dec 2007, 38 patients with tympanosclerosis who had undergone surgical treatment were evaluated. The clinical and operational records and pre- and postoperative pure tone audiograms were reviewed. RESULTS: Operative findings showed stapes fixation is the most common. In 8 patients (21.1%), stapes was mobile, while, in the remaining 30 patients (78.9%), stapes fixation was found. In all cases with stapes fixation, stapes mobilization was possible. Following hearing result reporting guideline by the Korean Otological Society, the success rate of middle ear surgery was 68.4% (26 of 38 patients). In cases with stapes fixation, the success rate was 66.6% (20 of 30 patients), while, in cases with no stapes fixation, the success rate was 75.0% (6 of 8 patients). However, there was no statistical significance between the two groups. CONCLUSION: Stapes fixation was found in 78.9% of tympanosclerotic ossicular fixation. In management of tympanosclerotic stapes fixation, meticulous excision of tympanosclerotic plaques and removal of new bone formation around stapes footplate after adequate exposure could achieve a relatively good hearing result without stapes surgery.
Ear, Middle ; Hearing ; Humans ; Inflammation ; Myringosclerosis ; Ossicular Replacement ; Osteogenesis ; Prospective Studies ; Stapes ; Stapes Mobilization ; Stapes Surgery

BACKGROUND AND OBJECTIVE: During the last decade, the surgical use of alloplasts has become more and more widespread among otologists. But extrusion has been the general problem associated in using alloplasts. This study analyzes the change of' surface and microcomponent of the extruded Polycel prosthesis following a long-term middle ear implantation. MATERIALS AND METHODS: Nine extruded Polycel prosthesis were investigated using scanning electronmicroscopy (SEM) and energy dispersive spectrometer (EDS). RESULTS: They all showed a severe resorption of fibrous encapsulation and partial resorption of the shaft which faced stapes and footplate. The carbon component decreased and nitrogen and oxide increased more than the original Polycel due to microdegradation. CONCLUSION: Consistent microdegradation and resorption may be one of the factors causing extrusion of Polycel.
Carbon ; Nitrogen ; Ossicular Prosthesis* ; Prostheses and Implants ; Stapes

Ossicles are easily injured with head trauma. The most common injury occurs at incudostapedial joint and this separation prevents the consequent injury to inner ear structures. Although stapes crura fractures after head trauma are not uncommon in otologic field, the most are combined injury and isolated crura fractures are uncommon in the clinical field. We have experienced a case of isolated stapedial crura fractures and we report it here with a review of literature.
Craniocerebral Trauma ; Ear, Inner ; Joints ; Stapes

Traumatic ossicular dislocation and fracture occur commonly after head injury. Dislocation of the incudo-stapedial and incudomalleolar joints are more common than isolated fractures of the ossicles. Fractures of the stapes suprastructure are relatively rare. We report two cases of isolated fracture of stapes suprastructure after head injury with a review of literatures, which resulted in excellent outcome after exploratory tympanotomy with ossicular reconstructions were carried out.
Craniocerebral Trauma ; Dislocations ; Head ; Joints ; Stapes

BACKGROUND AND OBJECTIVES: The aim of this study was to analyze the results of malleostapedotomy as primary surgical procedure in stapes fixation. SUBJECTS AND METHOD: This study was a retrospective chart review of 12 patients who underwent primary malleostapedotomy for conductive hearing loss. The intraoperative findings, surgical outcomes including audiologic data and complications were analyzed. RESULTS: Nine patients had ossicular fixation with ossicular anomalies and 3 patients had ossicular fixation alone. The median length of piston wire was 5.5 mm in total length. The preoperative mean bone and air-conduction thresholds were 57.5+/-8.8 (mean+/-SD) dB, 19.7+/-10.3 dB, respectively, and the mean air-bone gap (ABG) was 44.6+/-13.2 dB. After malleostapedotomy, hearings were improved and mean postoperative ABG was 11.1+/-11.3 dB. In eight patients (66.7%), ABG was reduced to 20 dB or less. There was no intraoperative or postoperative complication except for mild postoperative vertigo for 1 or 2 days. CONCLUSION: Malleostapedotomy can be a safe and effective surgical procedure as an alternative of incus stapedotomy in certain cases of absence or anomalous incus long process, and/or immobile incus in patients with stapes fixation.
Hearing Loss, Conductive ; Humans ; Incus ; Postoperative Complications ; Retrospective Studies ; Stapes ; Stapes Surgery ; Vertigo