Document Detail


Labyrinthine fenestration for tympanosclerotic stapes fixation.
MedLine Citation:
PMID:  23062628     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To report the results obtained in patients with intact tympanic membrane tympanosclerotic stapes fixation treated by labyrinthine fenestration and to discuss the value of this operation.
MATERIALS AND METHODS: Retrospective study of 28 cases of tympanosclerotic stapes fixation operated between 1982 and 2010. Labyrinthine fenestration was performed using a CO(2) laser. In the first group of patients, the columellar effect was restored by stapedectomy with graft interposition and reconstruction was performed by TORP prosthesis and in the second group, stapedotomy was performed with reconstruction by a piston crimped onto the long process of incus (LPI) or the malleus handle (MH).
RESULTS: Postoperatively (2 to 6 months), stapedectomy and reconstruction by TORP prosthesis allowed a gain of the mean Rinne by 18 dB and reconstruction by piston crimped onto the LPI or an MH placed in the stapedotomy orifice allowed a gain of 14 dB. With a follow-up of 3 years, this gain was maintained with the first technique. No case of cophosis or sensorineural hearing loss greater than 20 dB was observed.
CONCLUSION: Labyrinthine fenestration provides an immediate hearing gain in patients with tympanosclerotic stapes fixation with the two techniques used. In the longer term, these good results were maintained with the stapedectomy and TORP prosthesis technique, but the hearing gain was no longer statistically significant in the long-term with the stapedotomy technique because of a limited number of cases. However, only a study based on a larger number of patients would be able to confirm the superiority of TORP compared to stapedotomy. Labyrinthine fenestration, which comprised only a low risk of deterioration of hearing and which did not induce any total hearing loss, must nevertheless be performed only in the case of severe bilateral conductive hearing loss, with an intact tympanic membrane, in patients refusing a hearing aid and informed about the risks of deterioration of hearing.
Authors:
C Querat; C Richard; C Martin
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Publication Detail:
Type:  Journal Article     Date:  2012-10-10
Journal Detail:
Title:  European annals of otorhinolaryngology, head and neck diseases     Volume:  129     ISSN:  1879-730X     ISO Abbreviation:  Eur Ann Otorhinolaryngol Head Neck Dis     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  2013-05-28     Revised Date:  2014-10-30    
Medline Journal Info:
Nlm Unique ID:  101531465     Medline TA:  Eur Ann Otorhinolaryngol Head Neck Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  297-301     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Masson SAS. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Female
Fenestration, Labyrinth*
Humans
Male
Middle Aged
Otosclerosis / surgery*
Retrospective Studies
Tympanic Membrane / surgery*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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