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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.
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.
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.
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.
EN
Introduction: The influence of the mechanics of the middle ear on the function of the inner ear has been studied for many years. Among surgeries performed in the middle-ear area, those restoring full functionality of the system transmitting sound inside the middle ear may be pointed out as those fully restoring the mechanical influence of the middle ear on the function of the inner ear. Aim: The aim of the performed analysis is to find the prognostic importance of measured pre-surgery values of bone conduction on the improvement of hearing in patients operated as a result of middle-ear disorders. Material and methods: The analysis included 271 patients hospitalised and operated on due to otosclerosis or perforation of the tympanic membrane between 2016 and 2019. Only patients who had not had a surgical operation within the middle ear prior to the study were included. An audiological assessment was performed with the use of pure tone thresholds audiometry. Results: A beneficial influence of the performed surgery on the improvement of bone conduction was observed in patients, in which the average threshold value of bone conduction measured before the surgery did not exceed 40 dB. In cases of the perceptive component of hearing impairment being higher than 40 dB, no statistically significant, beneficial influence of a performed stapedotomy or myringoplasty on the change of bone conduction thresholds was observed. Conclusions: The perception component of hearing impairment up to 40 dB indicates bone conduction improvement after surgical restoration of the influence of middle-ear mechanics on the inner ear in patients treated as a result of otosclerosis, as well as of eardrum perforation.
EN
Aim: To evaluate outcomes of stapes surgery in children with congenital stapes fixation and juvenile otosclerosis. Methods: A retrospective chart review was performed from 1987 to 2013 to identify patients under 18 years old who underwent a stapes surgery. Patients' age, gender, pre- and postoperative audiograms, intraoperative findings including aetiology of stapes fixation, prosthesis type, and complications were analysed. Results: 18 children (6 - 17 years old), all with bilateral conductive hearing loss were identified and 34 stapes surgeries were performed (two patients underwent surgery only on one side). The cause of fixation included juvenile otosclerosis in 88% and congenital stapes fixation in 12%. The mean pre-operative air-bone gap (ABG) was 36,24 dB (SD: 10,86) compared to a postoperative mean ABG of 7,74 (SD: 3,3) (p < 0.000). The profound sensorineural hearing loss was not observed in long-term follow-up. Conclusions: Paediatric stapes surgery has comparable results to stapedectomy in adults regardless of the cause of stapes fixation; however, the better hearing outcome was observed for cases of juvenile otosclerosis rather than congenital stapes fixation.
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.
EN
Aim: To evaluate outcomes of stapes surgery in children with congenital stapes fixation and juvenile otosclerosis. Methods: A retrospective chart review was performed from 1987 to 2013 to identify patients under 18 years old who underwent a stapes surgery. Patients' age, gender, pre- and postoperative audiograms, intraoperative findings including aetiology of stapes fixation, prosthesis type, and complications were analysed. Results: 18 children (6 - 17 years old), all with bilateral conductive hearing loss were identified and 34 stapes surgeries were performed (two patients underwent surgery only on one side). The cause of fixation included juvenile otosclerosis in 88% and congenital stapes fixation in 12%. The mean pre-operative air-bone gap (ABG) was 36,24 dB (SD: 10,86) compared to a postoperative mean ABG of 7,74 (SD: 3,3) (p < 0.000). The profound sensorineural hearing loss was not observed in long-term follow-up. Conclusions: Paediatric stapes surgery has comparable results to stapedectomy in adults regardless of the cause of stapes fixation; however, the better hearing outcome was observed for cases of juvenile otosclerosis rather than congenital stapes fixation.
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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