The Necrosed Incus in Stapedectomy Revision

Seifi, Alaa El

doi:10.1097/00005537-199604000-00024

Cited by 6 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Aufgrund von rasterelektronenmikroskopischen Aufnahmen eines Teflon-Platinband-Piston (TPP) und eines Goldpiston (GP) sowie anhand von 5 verschiedenen Operationsbeobachtungen wird eine Hypothese aufgestellt, die die bisher selten in Publikationen beschriebene Nekrose des Amboßschenkels durch einen TPP [26] und eine bisher in der Literatur nicht erwähnte mediale Durchwanderung eines TPP durch den langen Amboßschenkel erklären kann. Aufgrund von rasterelektronenmikroskopischen Aufnahmen eines Teflon-Platinband-Piston (TPP) und eines Goldpiston (GP) sowie anhand von 5 verschiedenen Operationsbeobachtungen wird eine Hypothese aufgestellt, die die bisher selten in Publikationen beschriebene Nekrose des Amboßschenkels durch einen TPP [26] und eine bisher in der Literatur nicht erwähnte mediale Durchwanderung eines TPP durch den langen Amboßschenkel erklären kann.…”

Section: Ergebnisseunclassified

Die Arrosion und Nekrose des langen Amboßschenkels nach Otoskleroseoperation

Schimanski¹

1997

HNO

View full text Add to dashboard Cite

The frequency and possible causes of erosion and necrosis of the long process of the incus induced by various types of prostheses following stapes surgery for otosclerosis are discussed. Between 1987 and 1995, 1144 stapes operations were performed including 117 revisions of stapes surgery performed by third parties and 27 revisions performed by the author. For the first time, necrosis of the long process of the incus caused by teflonplatinum piston is described on the basis of findings in five cases, in which the platinum loop had completely transmigrated the incudal process in a medial direction. By using pictures of the teflon-platinum piston and a gold piston taken by a scanning electron microscopy and a comparison between the use of a teflon-wire piston and a gold piston in two operations, an hypothesis is made that the winding grooves in the surface of the teflon shaft together with impaired middle ear mechanics were the main causes of a scar being contracted in the direction of the oval window niche with resulting necrosis of the incudal process. Requirements for an optimum stapes prosthesis are summarized as a result of the operative observations made.

show abstract

Section: Ergebnisseunclassified

Die Arrosion und Nekrose des langen Amboßschenkels nach Otoskleroseoperation

Schimanski¹

1997

HNO

View full text Add to dashboard Cite

show abstract

“…For cases of erosion and minimal compromise of the long process of the incus, standard primary stapes surgery techniques, with a longer wire prosthesis that attaches to the incus higher up on the long process, may be employed. 4,27,29,37 For those cases with a shortened incus, bypass techniques have been described to overcome the incus necrosis. 4,5,9,[26][27][28][29]32,34,38,39 If there is too much erosion of incus to allow the fitting of any prosthesis, a final option is to bypass the incus and attach the prosthesis directly to the malleus.…”

Section: Discussionmentioning

confidence: 99%

“…5 For those cases with a shortened or subtotal LPI necrosis, bypass techniques have been described to overcome the incus necrosis. 4,5,9,[26][27][28][29]32,34,38,39 In 3 cases of partial incus necrosis, a Donaldson type ventilation tube (1.14 diameter mm, Silicone; Xomed-Treace Inc) was reshaped and placed on the residual incus stump to stabilize prosthesis (Figure 1). The ABG closure reduced to 10 dB in 100% of cases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long Process Incus necrosis in Revision Stapedotomy: Retrospective Clinical Study

et al. 2021

View full text Add to dashboard Cite

Objectives: We describe our experience with long process incus (LPI) necrosis in revision stapedotomy and discuss the different management methods proposed in the literature to identify surgical techniques that can lead to satisfactory results over time. Methods: Twenty-two stapedotomy revisions, in 21 patients with the necrosis of the long process of the incus, are performed from 1997 to 2017. In cases of erosion or minimal necrosis of LPI, a new prosthesis of the same type or an angled prosthesis was applied higher on the residual incus stump. In cases of partial necrosis of LPI, a Donaldson type ventilation tube reshaped and placed on the residual incus stump to stabilize prosthesis, or glass ionomer bone cement was used. In cases of subtotal necrosis of LPI, a cup piston prosthesis in polycel was applied on incus residual stump. Pre- and postoperative (≥1 year) pure tone audiometry was performed for all cases. Air conduction threshold, bone conduction (BC) threshold, and air-bone gap (ABG) were documented according to the American Academy of Otolaryngology Head and Neck Surgery Committee of Hearing and Equilibrium guidelines. Results: At 1-year follow-up, postoperative ABG was reduced to ≤10 dB in 13 (59%) cases and ≤20 dB in 19 (86.4%) cases. The mean postoperative ABG significantly decreased in each group. There was no significant change in postoperative BC thresholds, and there were no cases with postoperative SNHL. Conclusion: Excellent functional results can also be achieved in cases of long incus process necrosis. The choice of technique should be considered according to the degree of necrosis. Piston replacement with the same type or angled type prosthesis, in cases of erosion or minimal LPI necrosis, and modified Donaldson type ventilation tube, in cases of partial LPI necrosis, provided excellent hearing results.

show abstract

“…Furthermore, strangulation of mucosal blood vessels ( fig. 1) by the prosthesis might lead to incus necrosis [6][7][8][9][10]. Adequate fixation with ideal acoustic coupling is often not possible [11] and audiometric results remain unpredictable [12].…”

mentioning

confidence: 99%