Hearing results in a consecutive series of 407 patients with otosclerosis undergoing primary stapes surgery were analysed (437 operated ears). Partial stapedectomy was performed in 70 ears (16%), total stapedectomy in 205 ears (47%), in both groups using the House steel wire prosthesis on fascia in the oval window. The remaining 162 ears (37%) underwent stapedotomy using the Fisch 0.4 mm teflon-platinum piston. No case of cochlear loss (> 15 dB) occurred in the total series. The comparison between the three groups one year postoperatively showed that the air-bone gap was smaller for partial and total stapedectomy for all frequencies except 4 kHz. The air-bone gap was calculated as the difference between the preoperative bone conduction and the postoperative air conduction thresholds. Partial and total stapedectomy also showed larger improvements of bone conduction thresholds compared with stapedotomy for all frequencies but 4 kHz. At the 3-year follow-up, the hearing gain for all frequencies (250-8000 Hz) was larger for partial and total stapedectomy. Yet, when comparing the decline of hearing from 1 to 3 year postoperatively, the hearing gain achieved with partial and total stapedectomy seemed to deteriorate at a higher rate, which was considered to be caused by impaired sensorineural function. Our results show that in the short-term perspective partial or total stapedectomy can still compete for better hearing results even at higher frequencies, but stapedotomy seems to yield more stable hearing results over time and should therefore be considered as the method of choice.

The purpose of this study was to develop a procedure for mass spectrometric measurement fitted to analyse the human middle ear gas composition, and to determine the partial pressures of the middle ear gases in adults with healthy ears. To avoid the risks of admixture of the gas sample with atmospheric air we used "on-line" sampling from the middle ear to the analysing equipment, and a new protective technique at the site of puncture. The inlet system was modified to achieve sufficiently low gas consumption. The system had excellent linearity, and model experiments showed that the described procedure gives a very high accuracy. Measurements of the gas composition in the middle ear in 10 adult subjects with healthy ears gave the following values: pO2 = 612.38 +/- 3.97 mmHg, pO2 = 40.85 +/- 3.68 mmHg, pAr = 7.09 +/- 0.08 mmHg and pCO = 52.69 +/- 5.54 mmHg.

No association was found between perforation cause and graft take rate. The underlay technique is safe and reliable, and the retroauricular approach is preferable as it enables good surgical access and has better results.

In cases of retraction type cholesteatoma and related conditions it has been observed that the Eustachian tube may show a reduced ability to withstand respiratory pressure variations. The reduced resistance of the tube may play an important role in the development and course of middle ear disease. In the present study 42 subjects who had middle ear disease of this type and confirmed habitual sniffing behaviour were examined for symptoms and signs that would indicate a patulous tube.Different degrees of malfunction were recognized: in the presence of total closing failure, with an intermittently free transfer of respiratory pressures to the middle ear, the sniffing procedure maintains a negative intratympanic pressure. The condition is identical to the patulous tube. When a suitable surgical technique is used in myringoplasty, there is no correlation be-Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 02/19/15 For personal use only. Arru Otoluryigol86 Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 02/19/15 For personal use only. Acru Ololuryngol86 Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 02/19/15 For personal use only. Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 02/19/15 For personal use only. Acta Otolaryngol Downloaded from informahealthcare.com by McMaster University on 02/19/15 For personal use only.

This article presents a new approach to understanding the physiological functions of the mastoid cell system. It is suggested that the cell system, in combination with the continuous blood ow through the adjacent large vessels, makes up a compound functional unit that serves to protect the sensitive vestibular part of the inner ear from inadequate stimulation by external temperature changes. By virtue of the large surface area of the cell system mucosa with respect to the enclosed gas volume, the mastoid cell system may also work as a pressure regulator. Variations of the bi-directional exchange of uid over the capillary network in the mucosa will change the size of the lumen that is available for the gas in the cell system. Volumes of gas and uid can thus be exchanged to keep the intratympanic pressure within physiological limits. The process is most effective in a cell system with a high area-to-volume ratio.