Revision Stapedectomy With Bone Cement

Hudson, Scott K.; Gurgel, Richard K.; Shelton, Clough

doi:10.1097/mao.0000000000000580

Cited by 18 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since dislocations commonly occur towards the inferior, a drop of bone cement applied to the distal end of the LPI would prevent most of the dislocations. 6,9 Applying to both sides of the loop or bridging over the loop could even give better stabilization. But it should not be forgotten that increasing the weight of the ossicular chain could deteriorate high-frequency hearing.…”

Section: Discussionmentioning

confidence: 99%

“…The causes of revision stapedotomy include loose prosthesis, LPI necrosis-mainly due to overtight wire loop prostheses, or dislocations. 6 Bone cement application may prevent loose prostheses and dislocations. If bone cement stabilization is planned, the surgeon may depend on the bone cement for ensuring a tight fixation and avoid overtightening.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 One of the most common causes of hearing deterioration and revision surgery after a successful stapes surgery is the dislocation or loosening of the prosthesis. 6,7 It is well known that a tight stapes prosthesis fixation would result in a more efficient sound energy transfer and better audiological outcomes. 8 Recent studies have reported that stabilization of the prosthesis with bone cement has favorable hearing results in both primary and revision stapes surgeries.…”

mentioning

confidence: 99%

“…8 Recent studies have reported that stabilization of the prosthesis with bone cement has favorable hearing results in both primary and revision stapes surgeries. 6,9,10 Also, bone cement stabilization may have the potential to decrease the prosthesis dislocation risk in the long term.…”

mentioning

confidence: 99%

See 3 more Smart Citations

The Effects of Glass-Ionomer Bone Cement Fixation of the Stapes Prosthesis on Audiological Outcomes and Prosthesis Dislocation Incidence

ERGÜN,

YÜCE,

ÇAKMAK

et al. 2023

KBB ve BBC Dergisi

View full text Add to dashboard Cite

The aim of this study is to retrospectively evaluate the effects of bone cement stabilization of the stapedotomy prosthesis with respect to audiological results and incidence of prosthesis dislocation. Material and Methods: A retrospective analysis of 32 cases that were operated using the same surgical technique. Surgeries were done by the same surgeon under general anesthesia. Preoperative and postoperative audiograms between Group 1 and Group 2 were compared. Demographic data, the surgical status of the contralateral ear, surgical technique, bone cement fixation status, length of the prosthesis, and intraoperative complications were analysed. Pure tone average (PTA) gains, air-bone gap (ABG) improvements, and 8 kHz hearing level changes were calculated. Results: Out of 32 stapedotomies, 13 cases had bone cement stabilization. There was no age (p=0.388) or sex (p=0.704) difference between the groups. Both groups had significantly improved PTAs (p<0.001) and decreased ABG (p<0.001) values. But there was no difference between the groups (p=0.701). Also, there was no difference of 8 kHz hearing levels (p: 0.656). Three prosthesis dislocations were seen in the "no bone cement" Group 1 versus no dislocations in the "bone cement" Group 2. This difference was not significant (p=0.253). Conclusion: Bone cement stabilization of the stapedotomy prosthesis is a safe technique. Bone cement stabilization did not affect audiological outcomes and may offer a reduction in the incidence of prosthesis dislocation. However, studies with larger patient series and longer follow-up periods are needed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

The Effects of Glass-Ionomer Bone Cement Fixation of the Stapes Prosthesis on Audiological Outcomes and Prosthesis Dislocation Incidence

ERGÜN,

YÜCE,

ÇAKMAK

et al. 2023

KBB ve BBC Dergisi

View full text Add to dashboard Cite

show abstract

“…While there were mixed results in early experiences using bone cement in stapes surgery, more recent studies have demonstrated excellent audiologic outcomes in revision cases. 13,[19][20][21][22] In some of the more robust series of 27 to 37 patients, post-operative ABG have ranged from 8.1 dB to 8.8 dB, with short-term closure to within 10 dB seen in 77% and 81% of cases. 13,20 Our study demonstrated similar ABG closures to an average of 9 dB in a larger cohort of 46 patients, and 78% closed to within 10 dB.…”

Section: Discussionmentioning

confidence: 99%

Bone Cement Fixation of Stapedotomy Prostheses: Long-term Outcomes in Primary and Revision Stapes Surgery

Sioshansi

Schettino

Babu

et al. 2020

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

Objectives: To describe audiologic outcomes following hydroxyapatite bone cement fixation of stapedotomy prostheses. Methods: A retrospective case review at a tertiary neurotology referral center was performed of patients undergoing primary or revision stapedotomy between 2010 and 2017. Patients with hydroxyapatite bone cement fixation of stapes prostheses were assessed. Pre- and postoperative hearing was compared, consisting of air conduction (AC) and bone conduction (BC) pure-tone averages (PTA), air-bone gap (ABG), and word recognition scores (WRS). Short and long-term outcomes were assessed. Results: Forty-six patients with otosclerosis underwent stapedotomy with bone cement fixation: 21 primary cases and 25 revision cases, with an average follow-up time of 17 months. Mean AC PTA was 56 dB preoperatively, and 34 dB postoperatively ( P < .0001), while the ABG improved on average from 27 dB to 9 dB ( P < .0001). There was no significant difference in postoperative ABG between primary and revision stapes surgery (6 dB vs 10 dB, P = .07). These results persisted through long-term follow-up in a subgroup of patients with significantly longer follow-up time (mean 44 months). There was no significant change in BC PTA or word recognition scores. Three patients underwent subsequent revisions, one patient developed sensorineural hearing loss. Conclusion: Stapedotomy with bone cement fixation of the prosthesis provides excellent hearing outcomes in both primary and revision treatment of otosclerosis. Results are consistent and stable through long-term follow-up. The use of bone cement should be incorporated into the surgical armamentarium of the otologist for the prevention and treatment of loose-wire syndrome and incus necrosis.

show abstract

Revision stapes surgery for lysis of the long process of the incus: comparing hydroxyapatite bone cement versus malleovestibulopexy and total ossicular replacement prosthesis

Pitiot

Hermann

Tringali

et al. 2015

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

The objective of the study was to report audiological results in revision stapes surgery, comparing hydroxyapatite (HAP) bone cement, malleovestibular (MV) prosthesis, and total ossicular replacement prosthesis (TORP). The study is a retrospective case review conducted in a tertiary referral center. Patients treated for revision stapes surgery from 2010 to 2014, where a lysis of the long process of the incus (LPI) was observed with the use of HAP bone cement, MV prosthesis, or a TORP were included in the study. The main outcomes measured were pre- and postoperative bone conduction (BC) and air conduction (AC) pure-tone averages (PTA) (0.5, 1, 2, 3 kHz), including high frequencies BC (HFBC) (1, 2, 3, 4 kHz) and air-bone gap (ABG). 107 revision stapes surgery were performed in 96 ears. Main cause of failure was LPI lysis in 38 cases (39.6 %). 31 patients were analyzed: HAP bone cement was used in 11 patients (Group I), MV prosthesis in ten patients (Group II), and TORP in ten patients (Group III). The mean post-operative ABG was 10.7 dB (±7.4) (p = 0.003), 10.7 dB (±8.8) (p = 0.001), and 16.9 dB (±9.8) (p = 0.001), respectively. There were no significant differences between groups. In Group I, the mean change in HFBC revealed an improvement of 5.6 dB (±7.9) (p = 0.03), while in Group III there was a significant deterioration of the thresholds of 5.8 dB (±7.6) (p = 0.04). There were no cases of post-operative anacusis. In revision stapes surgery when LPI is eroded, we recommend to perform a cement ossiculoplasty for stabilizing a standard Teflon piston when LPI is still usable, the LPI lengthening with cement being not recommended. When LPI is too eroded, we prefer performing a malleovestibulopexy, and reserve TORP for cases with a bad anatomical presentation.

show abstract

Revision Stapedectomy With Bone Cement

Abstract: Use of hydroxyapatite cement for treatment of incus necrosis in revision stapedectomy provides excellent hearing outcomes and is a reasonable alternative to total ossicular reconstruction prosthesis or malleovestibular prosthesis techniques.

Cited by 18 publications

References 17 publications

The Effects of Glass-Ionomer Bone Cement Fixation of the Stapes Prosthesis on Audiological Outcomes and Prosthesis Dislocation Incidence

The Effects of Glass-Ionomer Bone Cement Fixation of the Stapes Prosthesis on Audiological Outcomes and Prosthesis Dislocation Incidence

Bone Cement Fixation of Stapedotomy Prostheses: Long-term Outcomes in Primary and Revision Stapes Surgery

Revision stapes surgery for lysis of the long process of the incus: comparing hydroxyapatite bone cement versus malleovestibulopexy and total ossicular replacement prosthesis

Contact Info

Product

Resources

About