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Chen PH, Lin KN, Lin HY, Yu RB, Liu PY, Shih WT, Chen JW. Factors Associated With Hearing Outcomes After Stapedotomy in Taiwanese Patients With Clinical Otosclerosis. EAR, NOSE & THROAT JOURNAL 2024; 103:NP76-NP84. [PMID: 34409887 DOI: 10.1177/01455613211037645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine the clinical factors associated with the effectiveness of stapedotomy in improving hearing sensitivity in Taiwanese patients with otosclerosis. METHODS In this retrospective study, we reviewed the medical records of 31 patients (36 ears) with otosclerosis undergoing stapedotomy performed by a single surgeon. Preoperative and postoperative hearing results were analyzed to identify factors associated with hearing outcomes after stapedotomy in the Taiwanese population with clinical otosclerosis. RESULTS Compared with preoperative pure tone averages (PTAs), stapedotomy significantly improved postoperative air conduction (AC) thresholds (P < .0001), bone conduction (BC) thresholds (P = .025), and air-bone gaps (ABGs; P < .0001). Postoperative closure of ABGs less than 10 or 20 dB was achieved in 16 (44.4%) and 33 (91.7%) of 36 surgical ears. Improvement in postoperative AC thresholds and ABGs and the size of preoperative ABGs were significantly correlated (r = .650, P < .001 and r = .745, P < .001, respectively). Gender-stratified analysis indicated a stronger correlation between improvement in postoperative AC thresholds and preoperative ABGs in male patients than in female patients (r = .893, P < .001 and r = .476, P = .014, respectively), and in postoperative and preoperative ABGs (r = .933, P < .001 and r = .626, P < .001, respectively). With the more stringent criteria for surgical success, factors including age (≤50 years), type (conductive, BC ≤25 dB), and degree (PTA ≤55 dB) of preoperative hearing loss led to more favorable outcomes. CONCLUSIONS We reported evidence supporting a potential gender difference on hearing outcomes after stapedotomy in Taiwanese patients with otosclerosis. Age, type, and degree of preoperative hearing loss may affect the surgical success rate.
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Affiliation(s)
- Pei-Hsin Chen
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Taipei City
- * Pei-Hsin Chen, Kai-Nan Lin, and Hsiu-Yin Lin have equal contributions to this study
| | - Kai-Nan Lin
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Taipei City
- * Pei-Hsin Chen, Kai-Nan Lin, and Hsiu-Yin Lin have equal contributions to this study
| | - Hsiu-Yin Lin
- Department of Audiology, Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City
- * Pei-Hsin Chen, Kai-Nan Lin, and Hsiu-Yin Lin have equal contributions to this study
| | - Rui-Bin Yu
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Taipei City
| | - Pi-Yun Liu
- Department of Audiology, Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City
| | - Wan-Ting Shih
- Department of Audiology, Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City
| | - Jeng-Wen Chen
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Taipei City
- Department of Medical Education and Research, Cardinal Tien Hospital, New Taipei City
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei City
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Sharaf K, Müller J. [Revision surgery after stapedectomy]. HNO 2023; 71:535-546. [PMID: 37470870 DOI: 10.1007/s00106-023-01326-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2023] [Indexed: 07/21/2023]
Abstract
Revision stapes surgery is considered to be significantly more demanding than primary stapes surgery, both in terms of the indication and the surgical approach. This article reviews common indications for revision after stapedectomy as well as the surgical approaches and intraoperative findings. A distinction is made between revision surgeries, which are usually carried out because of conductive hearing loss a long time after stapes surgery, and acute or subacute revisions that become necessary in the immediate postoperative course. With the shortening of postoperative observation times under inpatient conditions as a result of increasing economization and the associated shift of the immediate postoperative phase to the outpatient setting, the recognition of postoperative irregularities is also becoming increasingly important for otorhinolaryngologists in private practice, even if they do not perform these highly specialized interventions themselves.
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Affiliation(s)
- Kariem Sharaf
- Klinik und Poliklinik für Hals‑Nasen-Ohrenheilkunde, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland
| | - Joachim Müller
- Klinik und Poliklinik für Hals‑Nasen-Ohrenheilkunde, LMU Klinikum, Marchioninistraße 15, 81377, München, Deutschland.
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Cohen-Vaizer M, Dreyfuss M, Na'ara S, Shinnawi S, Laske R. The Impact of Surgical Expertise on the Cost-Effectiveness of Stapes Surgery. Audiol Neurootol 2023; 28:436-445. [PMID: 37343529 DOI: 10.1159/000530783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/18/2023] [Indexed: 06/23/2023] Open
Abstract
INTRODUCTION Otosclerosis is the primary cause of conductive hearing loss with normal otoscopy. As the condition worsens, certain patients may develop a sensorineural component. Patients with successful surgeries may still need hearing aids, which creates a dilemma for health professionals as there are insufficient data to make informed decisions. This study investigated the influence of the surgeon's proficiency level, individual patient factors (e.g., age at the time of intervention and survival rates), and surgery costs on the cost-effectiveness of stapes surgery. METHODS We performed a cost-effectiveness analysis using an adapted Markov model incorporating annual all-cause mortalities. In addition, we introduced sensitivity analyses to address the effects of surgical expertise on adults with bilateral conductive hearing loss due to otosclerosis. A model was developed based on a decision tree with treatment options and complication scenarios for otosclerosis patients undergoing stapes surgery or receiving hearing aids. Annual all-cause mortality was considered. A sensitivity analysis was performed assigned to different training levels ("experts" and "less experienced") to simulate the effects of surgical experience on the cost-effectiveness of surgical outcomes. Successful surgery was defined as closing of the air-bone gap to 10 dB or less. Based on published data, "experts" were simulated with a 93.7% success rate, and "less experienced" were manufactured with a 68.9% success rate. RESULTS Stapes surgery provides improved quality of life (QoL) compared to hearing aids with lower cumulative costs up to 87 years of age in the case of "expert" surgeons and up to 78 years of age, when performed by "less experienced" surgeons. CONCLUSIONS Primary stapes surgery is highly cost-effective and delivers improved QoL compared to hearing aids with lower cumulative costs. Additionally, undergoing stapes surgical training remains highly cost-effective.
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Affiliation(s)
- Mauricio Cohen-Vaizer
- Department of Otolaryngology Head and Neck Surgery, Rambam Healthcare Campus, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Michael Dreyfuss
- Department of Industrial Engineering and Management, Jerusalem College of Technology, Jerusalem, Israel
| | - Shoorok Na'ara
- Department of Otolaryngology Head and Neck Surgery, Rambam Healthcare Campus, The Technion, Israel Institute of Technology, Haifa, Israel
- Department of Otolaryngology, Head and Neck Surgery, University of California at San Francisco, San Francisco, California, USA
| | - Shadi Shinnawi
- Department of Otolaryngology Head and Neck Surgery, Rambam Healthcare Campus, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Roman Laske
- Department of Otolaryngology, HNO Wiedikon, Zurich, Switzerland
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Long-Term Audiometric Outcomes of a Self-Crimping Stapes Prosthesis With CO 2 Laser Stapedotomy. Otol Neurotol 2022; 43:1005-1010. [PMID: 36026603 DOI: 10.1097/mao.0000000000003662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate our experience with a self-crimping stapes prosthesis. STUDY DESIGN Retrospective case review. SETTING Tertiary referral center. PATIENTS All patients diagnosed with otosclerosis who underwent surgery between June 2013 and June 2020. Inclusion criteria were 18 years or older, isolated stapes ankylosis, and at least 1 year of postoperative audiologic data. INTERVENTIONS CO 2 laser stapedotomy undertaken by the same surgeon using the same CO 2 laser stapedotomy technique and the same prosthesis. MAIN OUTCOME MEASURES Preoperative and postoperative audiologic data including air-bone gap (ABG) measurements, average speech discrimination score and pure-tone averages (PTAs). Postoperative hearing assessments were performed at 3 weeks, 3 months, 6 months, 1 year, and annually thereafter. RESULTS Two hundred fourteen patients were included in the study, of whom 17 had bilateral sequential surgery for a total of 231 ears. Mean preoperative air conduction-PTA was 58.8 dB and mean preoperative bone conduction-PTA 24.2 dB, a preoperative ABG of 34.6 dB. One year postoperatively, mean air conduction-PTA improved to 31.2 dB ( p < 0.0001). ABG showed a significant improvement from 34.6 to 5.5 dB ( p < 0.0001). Closure of the ABG to within 10 dB was achieved in 87% ears at 3 months, in 91% at 6 months, and in 93% at 1 year. There was no significant difference in preoperative and postoperative average speech discrimination score. CONCLUSION The current study demonstrates favorable audiologic outcomes in a large cohort of patients using a self-crimping stapes prosthesis. These results were stable for up to 7 years on follow-up.
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Sakano H, Harris JP. Revision Stapes Surgery. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022; 10:40-48. [PMID: 36204712 PMCID: PMC9533914 DOI: 10.1007/s40136-021-00379-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abstract
Purpose of Review
This review briefly covers the history of stapedectomy, discusses the indications and problems encountered with revision surgery, and provides case examples with solutions.
Recent Findings
Revision surgery is challenging and successful outcome even in the most experienced specialists is 45–71%, which is far less than that of primary surgery.
Summary
Careful evaluation of the reasons for reoperation, anticipation of the common problems, and patient education on reasonable expectations are all very important for success.
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Stapes and Stapes Revision Surgery: Preoperative Air-Bone Gap Is a Prognostic Marker. Otol Neurotol 2021; 42:985-993. [PMID: 34260505 DOI: 10.1097/mao.0000000000003145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Stapes surgery is considered an effective treatment in otosclerosis, but controversy remains regarding predictors of surgical outcome. STUDY DESIGN Retrospective cohort study. SETTING Tertiary referral center. PATIENTS One hundred sixty three cases of stapes surgery between 2012 and 2019 were reviewed. MAIN OUTCOME MEASURES Primary outcome measures were relative hearing improvement (relHI), defined as preoperative minus postoperative air conduction divided by preoperative air-bone gap (ABG), as well as relative ABG closure (relABGc), defined as preoperative ABG minus postoperative ABG divided by preoperative ABG. Univariate and multivariate linear regression analyses were performed to determine independent predictors for these outcomes. RESULTS Higher preoperative bone conduction (BC) and primary surgery (compared with revision) were independently associated with increased relHI (p = 0.001 and p = 0.004, respectively). Lower preoperative BC, higher preoperative ABG, primary surgery, and age were independently associated with increased relABGc (p = 0.0030, p < 0.001, p = 0.0214, and p = 0.0099, respectively). Sex did not predict surgical outcome. In patients with less than 20 dB preoperative ABG, likelihood of negative relABGc was increased (compared with 20-30 dB or >30 dB preoperative ABG, p = 0.0292, Fisher's exact test). This tendency was not significant for relHI (p = 0.074). CONCLUSIONS Our findings demonstrate that calculating HI and ABGc in relation to preoperative ABG can reliably predict outcomes of stapes surgery. Both primary and revision stapes surgery are effective treatment options, but relative improvement is higher in primary cases. Preoperative BC, preoperative ABG, and age predict surgical outcomes as well. Otosclerosis patients with low preoperative ABG, especially less than 20 dB, should be counseled and selected cautiously regarding stapes surgery.
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Salvador P, Costa R, Silva F, Fonseca R. Primary stapedotomy: Influence of prosthesis diameter on hearing outcome. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2021; 72:238-245. [PMID: 34294223 DOI: 10.1016/j.otoeng.2020.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/05/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To evaluate the success rate of primary stapedotomy and to investigate the influence of prosthesis diameter on hearing outcome. MATERIAL AND METHODS Retrospective medical chart review of 125 cases who underwent primary small fenestra stapedotomy, from January 2001 to December 2018. The study population was divided in two groups based on Teflon prosthesis diameter - .6mm (60%, N=75) and .4mm (40%, N=50). Pre- and postoperative (≥12 months) air-conduction (AC), bone conduction (BC) and air-bone gap (ABG) thresholds were compared. RESULTS Postoperative ABG≤10dB and ≤20dB was achieved by 65.7% and 90% of the patients. A functional hearing (PTA-AC≤30dB) was achieved by 59.2% of patients. Sensorineural hearing loss (SNHL, worsening in BC-PTA>10dB) was identified in 7.2% of patients. Comparison of the .6mm- and .4mm-groups, revealed no differences regarding improvements in AC-PTA (22.4 vs. 20.7dB, p=.56), BC-PTA (3.4 vs. 2.3dB, p=.54) and ABG-PTA (19.1 vs. 18.4dB, p=.77). Hearing outcome evaluation identified similar postoperative success rate (.6mm, 79.7% vs. .4mm, 62%, p=.336) and comparable functional hearing (.6mm, 64% vs. .4mm, 52%; p=.197). The incidence of postoperative SNHL was similar between the two pistons (.6m, 5.3% vs. .4mm, 10%, p=.481). CONCLUSION Primary small fenestra stapedotomy is an effective and safe procedure. A postoperative ABG within 10dB was achieved in 67.2% of patients and there was a reduced incidence of sensorineural hearing loss. Hearing outcome was not influenced by diameter of the selected prosthesis. Postoperative bone conduction hearing thresholds did not differ between the groups, which revealed no significant inner ear trauma caused by the larger piston. Although we did not find evidence to suggest one piston over the other, our results showed a trend toward better results with the larger prosthesis.
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Affiliation(s)
- Pedro Salvador
- Department of Otorhinolaryngology, Hospital Senhora da Oliveira, Guimarães, Portugal.
| | - Ricardo Costa
- Department of Otorhinolaryngology, Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Francisco Silva
- Department of Otorhinolaryngology, Hospital Senhora da Oliveira, Guimarães, Portugal
| | - Rui Fonseca
- Department of Otorhinolaryngology, Hospital Senhora da Oliveira, Guimarães, Portugal
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Salvador P, Costa R, Silva F, Fonseca R. Primary stapedotomy: Influence of prosthesis diameter on hearing outcome. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2021. [DOI: 10.1016/j.otorri.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Luryi AL, Schettino A, Babu SC, Bojrab DI, Michaelides EM, Bojrab DI, Schutt CA. Association Between the Duration of Hearing Loss and Hearing Outcomes in Surgery for Otosclerosis. Otolaryngol Head Neck Surg 2020; 164:1094-1099. [PMID: 33048616 DOI: 10.1177/0194599820964726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Hearing loss due to otosclerosis is effectively treated with surgery. The association between duration of hearing loss and surgical outcomes is unknown. STUDY DESIGN Retrospective review. SETTING Large otology referral center. METHODS Patients undergoing primary stapes surgery for otosclerosis from 2005 to 2017 were evaluated according to their self-reported duration of hearing loss. Closure of the air-bone gap (ABG) was the primary outcome measure. RESULTS A total of 580 stapes operations were included. Sixteen percent of patients reported hearing loss for ≤1 year; 25%, >1 to ≤5 years; 24%, >5 to ≤10 years; 24%, >10 to ≤20 years; and 12%, >20 years, respectively. Average pre- and postoperative ABGs were 26.1 and 9.6 dB (P < .0005). Patients with longer duration of hearing loss had worse preoperative ABGs (P < .0005). After surgery, patients with longer duration of hearing loss had a greater reduction in their ABGs (P < .0005) such that the remaining ABG was not associated with duration of hearing loss (P > .05). There were no significant associations between the duration of hearing loss and complication rates or the need for revision surgery. CONCLUSION Otosclerosis is effectively treated with surgery even after a long duration of hearing loss, provided that sensorineural hearing and word recognition are favorable. Although far-advanced otosclerosis has known poorer hearing outcomes after stapes surgery, a long duration of hearing loss is an unreliable surrogate for this.
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Affiliation(s)
- Alexander L Luryi
- Department of Neurotology, Michigan Ear Institute, Farmington Hills, Michigan, USA
| | - Amy Schettino
- Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Seilesh C Babu
- Department of Neurotology, Michigan Ear Institute, Farmington Hills, Michigan, USA
| | - Dennis I Bojrab
- Department of Neurotology, Michigan Ear Institute, Farmington Hills, Michigan, USA
| | - Elias M Michaelides
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University, Chicago, Illinois, USA
| | - Dennis I Bojrab
- Department of Neurotology, Michigan Ear Institute, Farmington Hills, Michigan, USA
| | - Christopher A Schutt
- Department of Neurotology, Michigan Ear Institute, Farmington Hills, Michigan, USA
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Peñaranda D, Moreno S, Montes F, Garcia JM, Rico Z, Peñaranda A. Fifteen-Year Follow-Up of Stapedotomy Patients: Audiological Outcomes and Associated Factors in a Middle Income Country. Audiol Neurootol 2020; 26:53-60. [PMID: 32966975 DOI: 10.1159/000508324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 04/29/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate the short-term (postoperative), medium-term (5 years), and long-term (10 and 15 years) audiometric results of patients who underwent stapedotomy and to determine specific factors associated with better postoperative outcomes. METHODS This study is a retrospective case review of 486 ears with surgically confirmed stapes fixation who underwent microscopic small fenestra stapedotomy. Preoperative, postoperative, and medium- and long-term air conduction (AC), bone conduction (BC), and air-bone gap (ABG) were assessed. Postoperative factors associated with better postoperative outcomes were evaluated. RESULTS At 10- and 15-year follow-ups, ABG, AC, and BC were significantly deteriorated but clinically preserved in comparison with postoperative results. According to a multiple quantile regression, younger age was associated with better postoperative results at 0.25 kHz (p = 0.003) and 4 kHz (p = 0.028) and a smaller preoperative ABG was associated with better audiometric results at 0.25 kHz (p = 0.048), 0.5 kHz (p = 0.001), and 4 kHz (p = 0.001). In addition, younger age (p = 0.001 for AC and p < 0.001 for BC) and preoperative AC PTA (p < 0.001 for AC) were significantly associated with better postoperative AC and BC PTA. CONCLUSIONS Stapedotomy surgery provides short-, medium-, and long-term hearing benefits in our studied cohort. ABG, AC, and BC thresholds obtained after the surgery are clinically preserved in 5-, 10-, and 15-year follow-ups, with an age-expected BC deterioration. Smaller preoperative ABG and younger age were positive predictors for better postoperative ABG. Future research should address long-term subjective and quality of life outcomes.
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Affiliation(s)
- Daniel Peñaranda
- Otolaryngology Department, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia
| | - Sergio Moreno
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Felipe Montes
- Department of Industrial Engineering, Universidad de los Andes, Bogotá, Colombia.,Social and Health Complexity Center, Universidad de los Andes, Bogotá, Colombia
| | - Juan Manuel Garcia
- Otolaryngology Department, Fundación Universitaria de Ciencias de la Salud, Bogotá, Colombia.,Otolaryngology Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Zulehima Rico
- Otolaryngology Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Augusto Peñaranda
- School of Medicine, Universidad de Los Andes, Bogotá, Colombia, .,Otolaryngology Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia,
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Yeh CF, Wang MC, Chu CH, Shiao AS. Predictors of hearing outcomes after stapes surgery in otosclerosis. Acta Otolaryngol 2019; 139:1058-1062. [PMID: 31617779 DOI: 10.1080/00016489.2019.1648866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background: The current surgical treatment of otosclerosis is stapes surgery; however, few studies have reported the predictors of surgical outcomes.Aim/objective: This study aimed to investigate the prognostic predictors for postoperative hearing outcomes.Materials and methods: A total of 181 ears in 152 patients undergoing stapes surgery at a tertiary referral centre in Taiwan from 1996 to 2016 were retrospectively enrolled and preoperative and intraoperative parameters were obtained. Univariate and multivariate analyses were used to determine independent predictors of postoperative hearing outcomes. A regression model was also established. Hearing success was defined as a postoperative air-bone gap (ABG) ≤10 dB.Results: In univariate analysis, the absence of floating footplate during surgery (p = .003) and small preoperative ABG (p = .014) were associated with successful hearing outcomes. Multivariate logistic regression analysis further revealed the absence of floating footplate during surgery (p = .010) and small preoperative ABG (p = .015) remained independent predictors of postoperative hearing success.Conclusions and significance: Preoperative audiometric data and intraoperative finding may provide surgeons and patients with a better insight into surgical outcomes.
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Affiliation(s)
- Chien-Fu Yeh
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Otorhinolaryngology, National Yang-Ming University, Taipei, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Mao-Che Wang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Otorhinolaryngology, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Huei Chu
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Otorhinolaryngology, National Yang-Ming University, Taipei, Taiwan
| | - An-Suey Shiao
- Department of Otolaryngology-Head and Neck Surgery, Cheng Hsin General Hospital, Taipei, Taiwan
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Prospective evaluation of disease-specific quality of life measurements after stapes surgery using Nitinol Head Prostheses. Eur Arch Otorhinolaryngol 2019; 277:377-384. [DOI: 10.1007/s00405-019-05709-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
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Stapes surgery leads to significant improvement in quality of life, independently from the surgical method: evaluation of stapes surgery using different prostheses and different quality of life measurements. Eur Arch Otorhinolaryngol 2019; 276:2975-2982. [DOI: 10.1007/s00405-019-05577-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/17/2019] [Indexed: 12/17/2022]
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Skarżyński H, Kordowska K, Skarżyński PH, Gos E. Results of stapedotomy in otosurgical treatment of adult patients with osteogenesis imperfecta. Auris Nasus Larynx 2019; 46:853-858. [PMID: 31006558 DOI: 10.1016/j.anl.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/16/2019] [Accepted: 04/02/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This is a retrospective study of hearing results and characteristics of osteogenesis imperfecta (OI) patients treated for hearing loss by stapedotomy at tertiary reference center. METHODS This study enrolled 20 patients with a clinical diagnosis of OI- (11M:9F). 18 patients (90%) underwent surgery due to hearing loss in the period 2003-16. The audiometric analysis provides the pure tone audiometry results of stapedotomy in adult patients in 2 periods (≤12 months and >12 months). Air-bone gap (ABG), hearing gain (HG), and changes in air and bone conduction thresholds after surgical treatment were analyzed. RESULTS In short-time follow-up we noted statistically significant improvement in mean AC thresholds and ABG (p < 0.001 for both), change in mean BC thresholds was statistically negligible. Comparing the observation periods short-term and long-term, it was found that AC thresholds, ABG, HG, ABG closure did not significantly change, although BC thresholds and BC closure deteriorated significantly (p < 0.05). CONCLUSION Stapes surgery for OI can be considered as a method of treating the conductive and/or mixed hearing loss suffered by these patients; however, the surgery is more difficult than that for otosclerosis because OI cases often have extremely difficult anatomical conditions. The hearing results of OI stapes surgery differ from typical otosclerosis cases, with the ABG closure not being as good. In addition, sensorineural hearing loss inevitably progresses.
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Affiliation(s)
- Henryk Skarżyński
- Otorhinolaryngology Surgery Clinic, World Hearing Centre, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Mochnackiego 10, 02-042 Warsaw, Poland
| | - Kamila Kordowska
- Otorhinolaryngology Surgery Clinic, World Hearing Centre, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Mochnackiego 10, 02-042 Warsaw, Poland.
| | - Piotr H Skarżyński
- Otorhinolaryngology Surgery Clinic, World Hearing Centre, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Mochnackiego 10, 02-042 Warsaw, Poland; Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Kondratowicza 8, 03-242 Warsaw, Poland; Institute of Sensory Organs, Kajetany, Mokra 1, 05-830 Nadarzyn, Poland
| | - Elżbieta Gos
- Otorhinolaryngology Surgery Clinic, World Hearing Centre, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Mochnackiego 10, 02-042 Warsaw, Poland
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