Does the diameter of the stapes prosthesis really matter? A prospective clinical study

Bernardeschi, Danièle; Seta, Daniele De; Canu, Giuseppina; Russo, Francesca; Ferrary, Évelyne; Lahlou, Ghizlène; Sterkers, Olivier

doi:10.1002/lary.27021

Cited by 17 publications

(9 citation statements)

References 27 publications

(37 reference statements)

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“…On the contrary, a meta-analysis by Laske et al 11 reported that a 0.6-mm piston is associated with significantly better post-operative ABG at low and mid frequencies, compared to a 0.4 mm prosthesis. Bernardeschi et al 28 demonstrated a significant difference in AC gain, AC threshold at 0.125 and 0.25 kHz and BC threshold at 0.25 kHz in favour of the 0.6-mm group. The latter study is one of the few to be designed as a prospective one, on consecutive cohorts, with minimum risk of bias.…”

Section: Discussionmentioning

confidence: 95%

The impact of intra-operative factors in otosclerosis outcomes: retrospective study in a tertiary centre

Quaranta

Piccininni

Romanello

et al. 2019

Acta Otorhinolaryngol Ital

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SUMMARY The aim of the study was to assess results from a large cohort of patients undergoing otosclerosis surgery with respect to the impact of intra-operative variables on post-operative hearing function and complications. We enrolled 384 patients affected by otosclerosis who were subjected to stapes surgery between 2004 and 2013 at a single institution. Surgery was performed in all cases under local anaesthesia, using a manual perforator and/or microdrill. Teflon-piston prosthesis was used in all patients. Audiological data obtained preoperatively and at last follow-up examination (minimum 12 months) were compared. Statistical analysis was performed using the multiple regression model. Peripheral rim otosclerosis and diffuse otosclerosis were associated with better functional results compared to the obliterative pattern (p < 0.05). Mean post-operative Air-Bone Gap was significantly higher in the 0.4 mm, compared to 0.6 mm piston group at 0.5 kHz (p < 0.001) and 1 kHz (p < 0.02); in the stapedotomy group a statistically significant difference was found between 0.4 and 0.6 mm piston groups, in favour of the latter (p < 0.05). No differences were encountered in terms of average hearing threshold and complications. Intra-operative variables cannot be fully predictable and our data could help in stratification of the results and as a landmark for the surgeon’s decisions.

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Section: Discussionmentioning

confidence: 95%

The impact of intra-operative factors in otosclerosis outcomes: retrospective study in a tertiary centre

Quaranta

Piccininni

Romanello

et al. 2019

Acta Otorhinolaryngol Ital

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“…The comparison among pistons of different diameters is a matter of great interest [Quaranta et al, 2019]; however, in our study, the low sample numbers obtained in the subgroups do not allow the achievement of significantly different results. A clear evidence that a 0.6-mm-diameter prosthesis gives better audiological results than 0.4 in larger cohorts has been proven [Laske et al, 2011; Bernardeschi et al, 2018], and it would be interesting to ascertain if this remains stable over time on larger cohorts. A debated topic concerns the natural evolution of the unoperated otosclerotic ear.…”

Section: Discussionmentioning

confidence: 99%

How Long Is Otosclerosis Surgery Effective? Hearing Results after a 22-Year Follow-Up

et al. 2020

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Introduction: Stapes surgery is a safe procedure, with favourable hearing outcome. The objective of the study is to assess the long-term hearing results, addressing the bone conduction (BC) decay and the need for hearing aids in otosclerosis patients. Methods: We enrolled patients who underwent stapes surgery by means of stapedectomy or stapedotomy between 1991 and 2001. All enrolled patients underwent pure-tone audiometry (PTA) between September 2017 and June 2018. A set of questions was administered to record the prevalence of subjective symptoms and the need for hearing aids. Results: Seventy patients were enrolled for a long-term evaluation; 37 patients underwent bilateral surgery; therefore, 107 ears were included in the analysis. The average follow-up period was 22 years. No statistically significant difference was found between early and late post-operative air conduction (AC) PTA (41 vs. 49 dB; p > 0.05) nor between early and late post-operative BC-PTA (29 vs. 37 dB; p > 0.05). A significant difference was observed for AC at 8 kHz (65 vs. 78 dB; p < 0.05) and BC at 2 and 4 kHz (28 vs. 40 dB and 45 vs. 58 dB, respectively; p < 0.05). Conclusions: This is, to our knowledge, the longest mean follow-up time in the literature. A mild decrease in both AC and BC threshold can be expected and the sensorineural decay is more pronounced on the high frequencies. The subjective hearing symptoms and overall sound perception are satisfactory.

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“…Die Verwendung von Prothesen mit einem Pistondurchmesser von 0,4 oder 0,6 mm wird kontrovers diskutiert [41]. Während ein dünnerer Piston aus anatomisch-chirurgischer Sicht Vorteile zu bieten scheint, gibt es zunehmende Hinweise auf einen audiologischen Vorteil, insbesondere bei den tieferen Frequenzen, bei einem Pistondurchmesser von 0,6 mm [3], [21], was auch vereinbar ist mit den kolbenförmigen Schwingungen des Stapes im tieferen Frequenzbereich (siehe Teil 1 dieses Beitrags [25]).…”

Section: Pistondurchmesserunclassified

Diagnostik und operative Therapie der Otosklerose

Plontke¹,

Metasch²,

Zirkler³

et al. 2018

Laryngo-Rhino-Otol

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ZusammenfassungFür die – oft in Diagnostik und Therapie anspruchsvolle – Otosklerose kann bei richtiger Diagnosestellung eine operative oder apparative Hörrehabilitation mit sehr hohen Erfolgschancen in Aussicht gestellt werden. Der erste Teil des Fortbildungsbeitrags umfasste Grundlagen, Diagnostik und Differenzialdiagnostik, im zweiten Teil soll auf therapeutische Aspekte und Nachsorge eingegangen werden.

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Does the diameter of the stapes prosthesis really matter? A prospective clinical study

Abstract: 2b Laryngoscope, 1922-1926, 2018.

Cited by 17 publications

References 27 publications

The impact of intra-operative factors in otosclerosis outcomes: retrospective study in a tertiary centre

The impact of intra-operative factors in otosclerosis outcomes: retrospective study in a tertiary centre

How Long Is Otosclerosis Surgery Effective? Hearing Results after a 22-Year Follow-Up

Diagnostik und operative Therapie der Otosklerose

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