Partial vs. total footplate removal in stapedectomy: A comparative study

Moon, Cary N.; Hahn, Milege J.

doi:10.1288/00005537-198407000-00010

Cited by 24 publications

(17 citation statements)

References 1 publication

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“…Rosen in his original work had noted that occasional patients experienced a fenestration of the oval window without mobilization of the stapes and had dramatic hearing improvements, a phenomenon later studied by Fernandez et al 57 Interest returned to the concept of partial stapes footplate removal. Moon and Hahn 58 found that with a partial removal of the footplate there was a slight improvement in the hearing in the 2,000‐ to 8,000‐Hz results versus conventional stapedectomy. However, Robinson 59 found no difference between full and partial removal of the footplate using a Robinson prosthesis.…”

Section: History Of Stapes Surgerymentioning

confidence: 99%

Laser‐Assisted Endoscopic Stapedectomy: A Prospective Study

Poe

2000

The Laryngoscope

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Objective: To improve the techniques required to perform a stapedotomy without prosthesis (stapedioplasty). Study Design: New infrared lasers were evaluated for potential use in otological surgery in guinea pigs. A prospective human trial of 34 primary stapes operations using the Argon ion laser was performed, with 11 stapedioplasties and 23 conventional stapedotomies as controls. Methods: Laser-tissue interactions were evaluated for temporal bone and live guinea pig tissues, measuring crater histology and labyrinthine temperature elevations. Patients undergoing stapedioplasty had Argon ion laser cuts with endoscopic assistance made in the anterior crus and footplate to mobilize the posterior segment of the stapes while the anterior portion remained fixed. Results: Diode laser (808-nm) vaporization craters and temperature elevations in the vestibule were suitable for clinical use. Overall, stapedioplasty patients' hearing was improved with air-bone gap closure to a mean of 8.3 dB (SD ؎ 9.8 dB). Conclusions: Patients with anterior footplate otosclerosis are candidates for stapedioplasty preserving the annular ring and stapes tendon and eliminating prosthesis complications. High-resolution small endoscopes, coupled with Argon ion or diode lasers promise to improve stapes visualization, enhancing the ability to perform minimally invasive surgery on the stapes footplate.

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Section: History Of Stapes Surgerymentioning

confidence: 99%

Laser‐Assisted Endoscopic Stapedectomy: A Prospective Study

Poe

2000

The Laryngoscope

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“…Shea performed the first stapedectomy in 1956 [Shea, 1958] and introduced stapedotomy in 1960 [Shea et al, 1962]. The latter procedure has progressively become the treatment of choice for clinical otosclerosis due to a reduced risk of sensorineural hearing loss (SNHL) and better high-frequency gain [Shea, 1982;Fisch, 1982;Moon and Hahn, 1984;Causse et al, 1985;Kürsten et al, 1994;House et al, 2002;Vincent et al, 2006].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Hearing Outcomes following Stapedotomy in Patients with Otosclerosis and Preoperative Small Air-Bone Gap

Alberti¹,

Romero-Farina³

et al. 2017

Audiol Neurotol

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Objectives: To assess the long-term effectiveness of stapedotomies performed on patients with otosclerosis and preoperative small air-bone gaps (ABGs). Methods: Retrospective study comparing the 10-year postoperative hearing outcomes after primary stapedotomies in patients with small (≤20 dB) and large ABGs (> 20 dB). Ninety out of 175 stapedotomies (22 and 68 in the small and large ABG groups, respectively) were monitored with long-term follow-ups. Results: Ten years after the operation, hearing measurements were similar for both groups, although a significant decline of bone conduction thresholds was evident (p = 0.007 and p < 0.001, respectively). An improvement of ≥10 dB in the postoperative ABG (clinical improvement) was achieved only in the large ABG group. Conclusions: Even though long-term hearing levels will evolve similarly in patients with ≤20 and > 20 dB preoperative ABGs, the lack of clinical improvement found in the small ABG group is not in favor of an early surgery.

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“…With the evolution of stapes surgical techniques from the use of microinstruments for stapedectomies to the use of a microdrill and the use of lasers for stapedotomy, the risk of mechanical trauma is lower and the indications increasing. Since the early 1970s, the small-fenestra stapedotomy technique has become a standard because the procedure is less traumatic, reduces the risk of SNHL and provides better high-frequency gain [Fisch, 1982;Moon and Hahn, 1984;House, 1993;Somers et al, 1994]. The minimum ABG seen as an indication for footplate surgery varies among authors; it has been reported within the range of 35-40 dB [Glasscock and Shambaugh, 1990] and 25 dB or greater [Wiet et al, 1986].…”

Section: Introductionmentioning

confidence: 99%

Audiometric Results after Stapedotomy Operations in Patients with Otosclerosis and Preoperative Small Air-Bone Gaps

et al. 2015

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Objectives: The efficacy of stapedotomies performed on patients with small air-bone gaps (<25 dB) was compared with the efficacy of the operation in patients who had otosclerosis with high air-bone gaps (≥25 dB). Methods: This retrospective study evaluates the short-term postoperative air and bone conduction thresholds and air-bone gaps after 182 CO₂ laser stapedotomies. Results: A significantly smaller air-bone gap and lower air conduction thresholds after surgery were observed in the group of patients who underwent surgery with preoperative air-bone gaps of less than 25 dB. Bone conduction thresholds improve in the group with small air-bone gaps after surgery. Conclusions: The results after stapedotomies are good even if the preoperative air-bone gap is small and the overall risk of hearing deterioration due to stapes surgery remains low.

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Partial vs. total footplate removal in stapedectomy: A comparative study

Cited by 24 publications

References 1 publication

Laser‐Assisted Endoscopic Stapedectomy: A Prospective Study

Laser‐Assisted Endoscopic Stapedectomy: A Prospective Study

Long-Term Hearing Outcomes following Stapedotomy in Patients with Otosclerosis and Preoperative Small Air-Bone Gap

Audiometric Results after Stapedotomy Operations in Patients with Otosclerosis and Preoperative Small Air-Bone Gaps

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