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Impact of surgery in otosclerosis on the non-operated ear

100%
Wiatr A., Job K., Składzień J., Wiatr M.
Polish Journal of Otolaryngology
|
2021
|
vol. 75
|
issue 2
15-20
EN
Backgrounds Otosclerosis is an underlying disease of the bony labyrinth. The hearing loss is most often of conductive nature, in some cases the involvement of the bony part of the cochlea results in mixed hearing loss. Aims: The aim of the analysis was to answer the question whether a surgery on one of the ears affects the state of the other ear in the course of otosclerosis. Methods The analysis included 140 patients hospitalized and operated on between 2010 - 2016. Only patients who had not had a surgical operation within the middle ear due to otosclerosis prior to the study were included in it. An audiological assessment was performed with the use of pure tone threshold audiometry taking into account. Results In the group of patients with no Carhart's notch, the mean threshold of bone conduction was statistically lower than before the procedure for the frequencies of 500, 1000 Hz and statistically equal for the frequency of 2000 Hz. The same analysis in the group of patients with Carhart's notch present in the pre-surgical tonal audiogram of the non-operated ear showed a statistically significant lower value of the post-surgical threshold bone conduction value. Conclusion It was confirmed the possibility of improving the hearing of the non-operated ear after the stapedotomy of the opposite ear, in the author's own studies by an average of 5 dB in the low-frequency range.
2
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Impact of surgery in otosclerosis on the non-operated ear

100%
Wiatr A., Job K., Składzień J., Wiatr M.
Otolaryngologia Polska
|
2021
|
vol. 75(2)
15-20
EN
Backgrounds Otosclerosis is an underlying disease of the bony labyrinth. The hearing loss is most often of conductive nature, in some cases the involvement of the bony part of the cochlea results in mixed hearing loss. Aims: The aim of the analysis was to answer the question whether a surgery on one of the ears affects the state of the other ear in the course of otosclerosis. Methods The analysis included 140 patients hospitalized and operated on between 2010 - 2016. Only patients who had not had a surgical operation within the middle ear due to otosclerosis prior to the study were included in it. An audiological assessment was performed with the use of pure tone threshold audiometry taking into account. Results In the group of patients with no Carhart's notch, the mean threshold of bone conduction was statistically lower than before the procedure for the frequencies of 500, 1000 Hz and statistically equal for the frequency of 2000 Hz. The same analysis in the group of patients with Carhart's notch present in the pre-surgical tonal audiogram of the non-operated ear showed a statistically significant lower value of the post-surgical threshold bone conduction value. Conclusion It was confirmed the possibility of improving the hearing of the non-operated ear after the stapedotomy of the opposite ear, in the author's own studies by an average of 5 dB in the low-frequency range.
3
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The surgical treatment results of otosclerosis at the Department of Otolaryngology Silesian Medical University in Zabrze in years 2000–2010

100%
Czerwińska G., Ścierski W., Namysłowski G., Lisowska G., Misiołek M.
Otolaryngologia Polska
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2017
|
vol. 71(2)
17-21
EN
Background: Otosclerosis is a cause of 5–9% of all hearing loss. The most effective treatment of otoslerosis is stapedotomy. Aim: The aim of this study was to evaluate the results of otosclerosis surgical treatment and to examine the impact of disease stage, time of the signs, age and sex on the results. Material and methods: 105 patients who underwent operation due to otosclerosis at the Department of Otolaryngology University Hospital in Zabrze at the age of 18–65 were analyzed. In 25 patients stapedotomy was bilateral. 130 cases of treated ears were included in the statistical analysis. The state of hearing after operation was evaluated with regard to guidance of Hearing and Balance Committee of American Academy of Otolaryngology – Head and Neck Surgery and with consideration of suggestions made by European Academy of Otolaryngology and Neurootology. Mean values of bone and air conduction, air bone gap before, one year after treatment, and at least 4 years after surgery were compared. The influence of stage of the disease in terms of Shambaugh index, lasting of signs, age and sex were evaluated with regard to change of mean hearing loss according to Bell Telephone Laboratories. Results: On the basis of hearing examination evaluating improvement in air and bone conduction and reduction of cochlear reserve, very good and good treatment results were obtained in over 90% of patients in short and long term observations. No influence of disease stage, time of signs lasting, age and sex on the results of treatment – with regard to change in mean hearing loss was shown.
4
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The surgical treatment results of otosclerosis at the Department of Otolaryngology Silesian Medical University in Zabrze in years 2000–2010

100%
Czerwińska G., Ścierski W., Namysłowski G., Lisowska G., Misiołek M.
Polish Journal of Otolaryngology
|
2017
|
vol. 71
|
issue 2
17-21
EN
Background: Otosclerosis is a cause of 5–9% of all hearing loss. The most effective treatment of otoslerosis is stapedotomy. Aim: The aim of this study was to evaluate the results of otosclerosis surgical treatment and to examine the impact of disease stage, time of the signs, age and sex on the results. Material and methods: 105 patients who underwent operation due to otosclerosis at the Department of Otolaryngology University Hospital in Zabrze at the age of 18–65 were analyzed. In 25 patients stapedotomy was bilateral. 130 cases of treated ears were included in the statistical analysis. The state of hearing after operation was evaluated with regard to guidance of Hearing and Balance Committee of American Academy of Otolaryngology – Head and Neck Surgery and with consideration of suggestions made by European Academy of Otolaryngology and Neurootology. Mean values of bone and air conduction, air bone gap before, one year after treatment, and at least 4 years after surgery were compared. The influence of stage of the disease in terms of Shambaugh index, lasting of signs, age and sex were evaluated with regard to change of mean hearing loss according to Bell Telephone Laboratories. Results: On the basis of hearing examination evaluating improvement in air and bone conduction and reduction of cochlear reserve, very good and good treatment results were obtained in over 90% of patients in short and long term observations. No influence of disease stage, time of signs lasting, age and sex on the results of treatment – with regard to change in mean hearing loss was shown.
5
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Short-term audiological outcomes of stapedotomy: microdrill at low revolutions versus manual perforator to perform a small footplate fenestra. A prospective observational study

88%
Palacios-Garcia J., Ropero-Romero F., Aguilar-Vera F., Sanchez-Gomez S.
Polish Journal of Otolaryngology
|
2021
|
vol. 75
|
issue 1
45-50
EN
Introduction: Stapedotomy is currently the surgical technique of choice for treating otosclerosis. Despite this, there is no agreement about the best technique to perform a small fenestra footplate, therefore multiple procedures have been proposed. The aim of this study was to investigate the hearing outcomes of microdrill and manual perforator. Material and Methods: An observational prospective study was carried out on patients who underwent stapedotomy. We analyzed the hearing threshold in two groups of patients according to the way the fenestra footplate was realized by microdrill or manual perforator. Results: A total of 113 patients were evaluated. Postoperative hearing gain of the microdrill group was 23.29 (18.58) dB HL 95% CI (18.40–28.18), while in the manual perforator group, it was 22.67 (12.91) dB HL 95% CI (19.07–26.26). Both groups were statistically significant. Postoperative bone conductive hearing threshold at the frequencies of 0.5, 1 and 2 KHz and postoperative air conductive hearing threshold at the frequencies of 2 and 4 KHz showed statistically significant differences in the manual perforator group. The closure of air-bone gap was higher in the microdrill group with statistically significant differences. Conclusion: Both manual perforator and microdrill have good hearing outcomes at six months after surgery. The manual perforator has better audiological outcomes than microdrill. Hence, the manual perforator is a safe technique and can be used in centers that do not have other methods to make the small fenestra.
6
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Short-term audiological outcomes of stapedotomy: microdrill at low revolutions versus manual perforator to perform a small footplate fenestra. A prospective observational study

88%
Palacios-Garcia J., Ropero-Romero F., Aguilar-Vera F., Sanchez-Gomez S.
|
|
vol. 75(1)
45-50
EN
Introduction: Stapedotomy is currently the surgical technique of choice for treating otosclerosis. Despite this, there is no agreement about the best technique to perform a small fenestra footplate, therefore multiple procedures have been proposed. The aim of this study was to investigate the hearing outcomes of microdrill and manual perforator. Material and Methods: An observational prospective study was carried out on patients who underwent stapedotomy. We analyzed the hearing threshold in two groups of patients according to the way the fenestra footplate was realized by microdrill or manual perforator. Results: A total of 113 patients were evaluated. Postoperative hearing gain of the microdrill group was 23.29 (18.58) dB HL 95% CI (18.40–28.18), while in the manual perforator group, it was 22.67 (12.91) dB HL 95% CI (19.07–26.26). Both groups were statistically significant. Postoperative bone conductive hearing threshold at the frequencies of 0.5, 1 and 2 KHz and postoperative air conductive hearing threshold at the frequencies of 2 and 4 KHz showed statistically significant differences in the manual perforator group. The closure of air-bone gap was higher in the microdrill group with statistically significant differences. Conclusion: Both manual perforator and microdrill have good hearing outcomes at six months after surgery. The manual perforator has better audiological outcomes than microdrill. Hence, the manual perforator is a safe technique and can be used in centers that do not have other methods to make the small fenestra.
7
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Conductive hearing loss after surgical treatment of otosclerosis – long-term observations

75%
Wierzbicka M., Gawęcki W., Bartochowska A., Balcerowiak A., Pietraszek M., Wierzbicka M.
Polish Journal of Otolaryngology
|
2021
|
vol. 75
|
issue 1
1-6
EN
Introduction: For many years, surgical treatment of otosclerosis has been a widely accepted approach. Hearing improvement following stapes surgery is sometimes spectacular, and good treatment results are obtained in many centers in over 90% of patients. However, in the subsequent years after the treatment, some patients develop permanent or progressive conductive hearing loss. Aim: The aim of the study is to present a group of patients with conductive hearing loss after the first otosclerosis surgery and to analyze the causes of its occurrence. Materials and Methods: The retrospective review covered patients who underwent the initial surgery in the years 2000–2009. We analyzed the patients’ medical records from before the end of 2019, which provided results of at least 10 years of postoperative follow-up. The group consisted of 1118 patients aged 14–82, including 802 women and 316 men. Results: Reoperations due to conductive hearing loss were performed on 93 patients, who accounted for 8.3% of the originally operated patients. They were much more common in patients after stapedectomies (19.7%) than in patients after stapedotomy (5.5%). Prosthesis dislocation was found to be the most frequent intraoperative observation (44.1%) and was often associated with erosion or necrosis of the long process of incus (28%). Less frequent reasons for hearing loss were: adhesions around the prosthesis (10.8%), too small hole in the stapes footplate (8.6%), too short prosthesis (8.6%), progression of otosclerosis (7.5%), too long prosthesis (6.4%), presence of a granuloma around the prosthesis (5.4 %), and displacement of incus (4.3%). Conclusions: Surgical treatment of otosclerosis is a widely accepted and good method. It allows to achieve an improvement in hearing in the vast majority of patients treated in this way. Unfortunately, over the years some patients develop recurrent conductive hearing loss. Reoperation creates an opportunity for finding the cause and improving hearing in the majority of cases.
8
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Wideband tympanometry – a new method to evaluate the middle ear

75%
Niemczyk E., Lachowska M.
Polski Przegląd Otorynolaryngologiczny
|
2016
|
vol. 5(1)
65-74
EN
Wideband tympanometry (WBT) is a relatively new assessment method of the middle ear. Using wideband click WBT provides measurements at frequencies from 226–8000 Hz with more diagnostic information without any additional effort. The traditional impedance audiometry offers information acquired only at a single frequency (mostly 226 Hz or 1000 Hz). WBT provides both traditional tympanograms and tympanograms at multiple frequencies as well as new information that is retrieved from resonance frequency, absorbance graph, and averaged wideband tympanogram. WBT seems to be more specific and sensitive method to evaluate a conductive hearing loss than traditional impedance audiometry, and might be helpful in diagnosing such pathologies as: middle ear effusion, negative middle ear pressure, otosclerosis, ossicular discontinuity, tympanic membrane perforation, upper semicircular canal dehiscence. WBT seems to be a very promising additional diagnostic tool used for hearing screening in newborns and diagnosing minor middle ear pathologies that disturb otoacoustic emissions. WBT is considered to be a better predictor for middle ear problems in newborns and infants than 1000 Hz tympanometry. The wideband absorbance measurements can be performed at ambient as well as peak pressure. Ambient pressure absorbance measurements do not require any pressure changes in the external auditory canal, thus it seems to be a perfect method for post-surgical monitoring of middle ear condition. However, WBT has its limitations, it presents large inter-subject variability in both absorbance graphs and resonance frequency values, and therefore WTB should be more extensively studied. WBT see
9
Publication available in full text mode
Content available

Conductive hearing loss after surgical treatment of otosclerosis – long-term observations

75%
Szyfter W., Gawęcki W., Bartochowska A., Balcerowiak A., Pietraszek M., Wierzbicka M.
|
|
vol. 75(1)
1-6
EN
Introduction: For many years, surgical treatment of otosclerosis has been a widely accepted approach. Hearing improvement following stapes surgery is sometimes spectacular, and good treatment results are obtained in many centers in over 90% of patients. However, in the subsequent years after the treatment, some patients develop permanent or progressive conductive hearing loss. Aim: The aim of the study is to present a group of patients with conductive hearing loss after the first otosclerosis surgery and to analyze the causes of its occurrence. Materials and Methods: The retrospective review covered patients who underwent the initial surgery in the years 2000–2009. We analyzed the patients’ medical records from before the end of 2019, which provided results of at least 10 years of postoperative follow-up. The group consisted of 1118 patients aged 14–82, including 802 women and 316 men. Results: Reoperations due to conductive hearing loss were performed on 93 patients, who accounted for 8.3% of the originally operated patients. They were much more common in patients after stapedectomies (19.7%) than in patients after stapedotomy (5.5%). Prosthesis dislocation was found to be the most frequent intraoperative observation (44.1%) and was often associated with erosion or necrosis of the long process of incus (28%). Less frequent reasons for hearing loss were: adhesions around the prosthesis (10.8%), too small hole in the stapes footplate (8.6%), too short prosthesis (8.6%), progression of otosclerosis (7.5%), too long prosthesis (6.4%), presence of a granuloma around the prosthesis (5.4 %), and displacement of incus (4.3%). Conclusions: Surgical treatment of otosclerosis is a widely accepted and good method. It allows to achieve an improvement in hearing in the vast majority of patients treated in this way. Unfortunately, over the years some patients develop recurrent conductive hearing loss. Reoperation creates an opportunity for finding the cause and improving hearing in the majority of cases.
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