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European Annals of Otorhinolaryngology,... May 2020To evaluate operative comfort and stress in patients undergoing stapedotomy for otosclerosis under local versus general anesthesia. (Comparative Study)
Comparative Study
OBJECTIVES
To evaluate operative comfort and stress in patients undergoing stapedotomy for otosclerosis under local versus general anesthesia.
MATERIAL AND METHODS
Consecutive otosclerosis patients managed over a 9-month period responded to 3 validated questionnaires to assess peri- and post-operative comfort: Glasgow Benefit Inventory, Cohen's Perceived Stress Scale and the Posttraumatic Stress Disorder Checklist Scale. These results and audiometric data were compared between local and general anesthesia groups.
RESULTS
Twenty-one patients were included in the local anesthesia group and 7 in the general anesthesia group, after exclusion of patients with history of otosclerosis surgery. There was no significant inter-group difference on Glasgow Benefit Inventory (P=0.38) or Posttraumatic Stress Disorder Checklist Scale (P=0.86). Perceived Stress Scale scores were higher in the general anesthesia group (P=0.038). In total, 67% of patients reported no discomfort under local anesthesia, and 86% were ready to undergo the procedure under local anesthesia again. There were no significant differences in postoperative symptoms, or in air-bone gap≤10dB (local anesthesia 81%, general anesthesia 71%; P=0.156).
CONCLUSIONS
Local anesthesia in otosclerosis surgery did not increase stress or postoperative symptoms compared to general anesthesia. Audiometric results were not affected by type of anesthesia.
Topics: Adolescent; Adult; Aged; Anesthesia, General; Anesthesia, Local; Female; Humans; Male; Middle Aged; Otosclerosis; Patient Comfort; Retrospective Studies; Self Report; Stapes Surgery; Stress, Psychological; Treatment Outcome; Young Adult
PubMed: 31734143
DOI: 10.1016/j.anorl.2019.10.014 -
Brazilian Journal of Otorhinolaryngology 2018Otospongiosis is temporal bone osteodystrophy, characterized by disordered bone resorption and neoformation in genetically predisposed individuals. Clinically,... (Review)
Review
INTRODUCTION
Otospongiosis is temporal bone osteodystrophy, characterized by disordered bone resorption and neoformation in genetically predisposed individuals. Clinically, otospongiosis is characterized by progressive conductive and/or mixed hearing loss and by tinnitus.
OBJECTIVE
A review of the last two decades of publications that report the degree of tinnitus improvement with stapes surgery.
METHODS
125 articles published in the last 20 years mentioning the relationship between otosclerosis and tinnitus. Literature has always shown that the hearing improvement after stapes surgery was the main result sought and found. However, recent articles has reinforced the need for surgery for the tinnitus improvement. The ideal time to assess tinnitus through different scales is in the sixth month post-operative. The estimated average hearing improvement is 93% and tinnitus is 85.52%.
RESULTS
Summaries of 12 articles were reviewed which fulfilled the search criteria of the survey, and 8 studies were included in the study according the selection criteria. This studies investigating the degree of tinnitus improvement with stapes surgery, using different scales as: tinnitus functional index, visual analog scale, tinnitus functional index and visual analog scale, visual analog scale and "questionnaire asking about tinnitus", Newman's method and Tinnitus Score Advocated by the Japan Audiological Society. The total of the samples of the evaluated articles was of 254 participants.
CONCLUSION
We conclude that stapes surgery is effective for the treatment of tinnitus (average improvement is 85.52%), and hearing loss (average improvement is 93%). When deciding about the surgical indication in patients with otosclerosis, the presence and level tinnitus should be considered as well as the level of hearing.
Topics: Hearing Loss; Humans; Otosclerosis; Reproducibility of Results; Severity of Illness Index; Stapes Surgery; Tinnitus; Treatment Outcome
PubMed: 29339029
DOI: 10.1016/j.bjorl.2017.12.005 -
Radiologia 2016Otosclerosis is a primary osteodystrophy of the temporal bone that causes progressive conductive hearing loss. The diagnosis is generally clinical, but multidetector CT... (Review)
Review
Otosclerosis is a primary osteodystrophy of the temporal bone that causes progressive conductive hearing loss. The diagnosis is generally clinical, but multidetector CT (MDCT), the imaging technique of choice, is sometimes necessary. The objective of this article is to systematically review the usefulness of imaging techniques for the diagnosis and postsurgical assessment of otosclerosis, fundamentally the role of MDCT, to decrease the surgical risk.
Topics: Humans; Magnetic Resonance Imaging; Multidetector Computed Tomography; Otosclerosis
PubMed: 27267384
DOI: 10.1016/j.rx.2016.04.008 -
Journal of Clinical Medicine Feb 2023Otosclerosis is an early adult-onset disease that is associated with 5-9% and 18-22% of all cases of hearing and conductive hearing loss, respectively, and it is...
Otosclerosis is an early adult-onset disease that is associated with 5-9% and 18-22% of all cases of hearing and conductive hearing loss, respectively, and it is suspected to have a viral etiology. However, the role of viral infection in otosclerosis is still inconclusive. This study aimed to investigate whether rubella infection was associated with otosclerosis risk. We conducted a nationwide case-control study in Taiwan. Data were retrospectively analyzed from the Taiwan National health Insurance Research Database. Cases consisted of all patients who were aged ≥6 years and had a first-time diagnosis of otosclerosis for the period between 2001 and 2012. The controls were exact matched to cases in a 4:1 ratio by birth year, sex, and must survive in the index year of their matched cases. Adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated by using conditional logistic regression. We examined 647 otosclerosis cases and 2588 controls without otosclerosis. Among the 647 patients with otosclerosis, 241 (37.2%) were male and 406 (62.8%) were female, with most aged between 40 and 59 years, with a mean age of 44.9 years. After adjusting for age and sex, conditional logistic regression revealed that exposure to rubella was not associated with a significant increase in otosclerosis risk (adjusted OR, 2.0; 95% CI, 0.18-22.06, = 0.57). In conclusion, this study did not show that rubella infection was associated with the risk of otosclerosis in Taiwan.
PubMed: 36902548
DOI: 10.3390/jcm12051761 -
Maedica Jun 2022To translate, adapt and validate in Greek the stapesplasty outcome test (SPOT)-25 quality of life questionnaire for patients with otosclerosis. SPOT-25 was translated...
To translate, adapt and validate in Greek the stapesplasty outcome test (SPOT)-25 quality of life questionnaire for patients with otosclerosis. SPOT-25 was translated to Greek and completed by otosclerosis patients on the day of diagnosis, the day before surgery and three months postoperatively. Fifty controls without any otological history, symptom or finding also completed the questionnaire. Pure-tone average was obtained both preoperatively and three months postoperatively. Test-retest evaluation on 56 patients was accepted. The Greek-SPOT-25 had an excellent internal consistency. All its items and subscales were significantly correlated between test and retest evaluation. Controls had significant lower SPOT-25 scores, and the postoperative scores were significantly lower than preoperative ones. Pure-tone average of four frequencies (PTA4) was significantly correlated to preoperative SPOT-25 total and subscales scores (P<0.001) before surgery and significantly correlated only with the "hearing function" subscale (p<0.05) postoperatively.
PubMed: 36032623
DOI: 10.26574/maedica.2022.17.2.306 -
Journal of Otology Sep 2018Surgical microscopes are still preferred to perform stapes surgery; but the use of the endoscopes would offer much benefits such as good panoramic view and easy...
INTRODUCTION
Surgical microscopes are still preferred to perform stapes surgery; but the use of the endoscopes would offer much benefits such as good panoramic view and easy accessibility to the oval window niche, the stapes and facial nerve. In this study, we aimed to analyze and compare the outcomes and complications of endoscopic versus microscopic stapes surgery.
PATIENTS AND METHODS
This work was done at the Department of Otorhinolaryngology, Faculty of Medicine, Mansoura University, Egypt, between September 2015 and July 2016. The patients; diagnosed as having otosclerosis and full filled the selection criteria; were randomly divided into 2 groups.
RESULTS
The group A (microscopic group) included 28 patients (aged 19-60 years) and the group B (endoscopic group) included 14 patients (aged 22-56 years). Mean follow-up durations were 4.5 months (1-8.5) in the endoscopic group and 5.5 months (1.5-8) in the microscopic group. The difference in preoperative and postoperative air-bone gap in two groups was statistically significant (p = 0.031). But there was no statistical difference for hearing results between two groups and the two techniques have similar audiological outcomes. The main merits of endoscopic stapedotomy are the good quality panoramic image, well identification and visualization of vital structures of the middle ear, minimal handling of chorda tympani nerve if needed with practically no curettage of bony wall.
CONCLUSIONS
The present series shows that it is possible to perform stapes surgery using only the 4mm in diameter and 18cm long endoscopes of different angulations, without major difficulties.
PubMed: 30559773
DOI: 10.1016/j.joto.2017.11.002 -
Otology & Neurotology Open Jun 2022The concurrence of otosclerosis and superior semicircular canal dehiscence (SSCD) presents a diagnostic challenge and failure to differentiate between these 2 diagnoses...
OBJECTIVE
The concurrence of otosclerosis and superior semicircular canal dehiscence (SSCD) presents a diagnostic challenge and failure to differentiate between these 2 diagnoses results in mischaracterization and unsuccessful surgery. The objective of this study is to identify the incidence of SSCD in patients who have computed tomography (CT) evidence of otosclerosis.
STUDY DESIGN
Retrospective chart review.
SETTING
Tertiary referral hospital.
PATIENTS
Adults with CT scan of the temporal bone diagnosed with radiological unilateral or bilateral fenestral otosclerosis from January 1995 to April 2018.
METHODS
Retrospective review of patient imaging from a multi-center tertiary-referral health system from January 1995 to April 2018. Imaging was reviewed to quantify the incidence of SSCD among patients with CT-diagnosed bilateral fenestral otosclerosis. Poor quality imaging was excluded from review.
RESULTS
One-thousand two-hundred eight patients (1214 CT scans) were identified with otosclerosis, of which 373 were diagnosed with fenestral otosclerosis (663 ears) with imaging of sufficient quality for review. This population was predominantly female (57.2%) with bilateral fenestral otosclerosis (78%). Of these, 23 ears (3.5%) had definitive evidence of SSCD, with an additional 15 ears (2.3%) with possible radiographic evidence of SSCD. There was no significant difference in laterality between the SSCD and otosclerosis.
CONCLUSIONS
Among 373 patients with fenestral otosclerosis per CT temporal bone imaging at a tertiary referral hospital, as many as 8.3% of patients had radiographic evidence of SSCD. Given this incidence, it continues to be important to consider SSCD when diagnosing and treating otosclerosis.
PubMed: 38516327
DOI: 10.1097/ONO.0000000000000012 -
The Journal of International Advanced... Apr 2019The stapes surgery has evolved through different eras of technical and technological development. The current standard of care is creating a stapedotomy with piston... (Comparative Study)
Comparative Study Review
The stapes surgery has evolved through different eras of technical and technological development. The current standard of care is creating a stapedotomy with piston placement, and both these aspects have multiple variations and show well-established technological advances. The conventional technique has been fairly standardized,and it offers gratifying results to both the surgeon and the patient. To overcome certain procedural risks and potential complications, the reversal of steps technique was developed and streamlined by Ugo Fisch in the early 1980s. Since its beginning, the technique has been adopted by various centers, and surgical outcomes have been demonstrated to be at par with the conventional technique, with a reduced risk of complications. The aim of the present review is to detail the various surgical nuances and outcomes of this particular technique in a comprehensive narrative manner.
Topics: Clinical Competence; Ear, Middle; Humans; Narration; Otosclerosis; Postoperative Complications; Stapes Surgery; Surgeons; Treatment Outcome
PubMed: 30924781
DOI: 10.5152/iao.2019.6800 -
International Archives of... Jul 2022Tinnitus is experienced by a significant part of the patients suffering from otosclerosis. To assess the prevalence of tinnitus in otosclerosis, its main...
Tinnitus is experienced by a significant part of the patients suffering from otosclerosis. To assess the prevalence of tinnitus in otosclerosis, its main features, and the impact on the daily life. Patients diagnosed with otosclerosis in 2019 in a tertiary hospital were enrolled in the study. Demographic data were retrieved and, besides a regular audiometric evaluation, the patients underwent acuphenometry to assess the psychoacoustic measurements (pitch and loudness), and the Tinnitus Handicap Inventory (THI). In total, 66 patients fulfilled the inclusion criteria, with a female predominance (63.6%; n = 42), and a mean age of 48.7 years. The mean air-bone gap was of 26.3 dB. A total of 72.7% complained of tinnitus; it was mostly unilateral, identified in the low frequencies, namely 500 Hz, with median loudness of 7.5 dB. The median score on the THI score was of 37; most patients had a mild handicap (33.3%, n = 16), followed by those with a severe handicap (22.9%; n = 11). The female gender had a statistically significant association with the presence of tinnitus. The THI scores were higher in middle-aged patients (age groups: 40 to 49 and 50 to 59 years), which was statistically significant. No correlation was found between audiometry results and the prevalence of tinnitus or score on the THI. On the other hand, high-pitched tinnitus, compared to low pitched-tinnitus, was associated with larger air-bone gaps. The prevalence of tinnitus in our population was in line with the prevalences reported in the literature. It caused a catastrophic handicap in 22.9% of the patients. High-pitched tinnitus was associated with higher handicap. Nonetheless, the existence of tinnitus and its severity were not associated with the degree of hearing loss.
PubMed: 35846815
DOI: 10.1055/s-0041-1739967 -
Otolaryngology--head and Neck Surgery :... Jun 2021This study sought to determine whether a history of pregnancy or bilateral oophorectomy is associated with subsequent otosclerosis development or disease severity.
OBJECTIVE
This study sought to determine whether a history of pregnancy or bilateral oophorectomy is associated with subsequent otosclerosis development or disease severity.
STUDY DESIGN
Population-based case-control study.
SETTING
Olmsted County, Minnesota.
METHODS
Women diagnosed with otosclerosis were matched to 3 women without otosclerosis based on age and historical depth of medical records. Associations of prior delivery and bilateral oophorectomy with subsequent development of otosclerosis and with pure-tone average (PTA) at the time of otosclerosis diagnosis were evaluated.
RESULTS
We studied 1196 women: 299 cases of otosclerosis and 897 matched controls. The odds ratio for the association of ≥1 delivery with otosclerosis was 1.16 (95% confidence interval [CI] 0.85-1.60; = .35). Odds ratios for the associations of 1, 2, 3, or ≥4 deliveries with otosclerosis were 1.22 (0.83-1.80), 1.09 (0.71-1.68), 1.28 (0.77-2.12), and 1.00 (0.54-1.84), respectively. The odds ratio for the association of prior bilateral oophorectomy with otosclerosis was 1.12 (0.58-2.18; = .73). In cases with otosclerosis, PTA at diagnosis was not significantly higher for women with ≥1 delivery as compared with those without (median 45 dB hearing loss [HL] [interquartile range {IQR} 36-55] vs 43 [IQR 34-53]; = 0.18) but was significantly higher for women with bilateral oophorectomy compared with those without (median 54 dB HL [IQR 44-61] vs 44 [IQR 34-53]; = .03).
CONCLUSION
These data do not support a relationship between endogenous estrogen exposure and development of otosclerosis. Women with otosclerosis who had a history of pregnancy did not have significantly worse hearing at the time of diagnosis, suggesting that pregnancy is not associated with disease severity.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Case-Control Studies; Estrogens; Female; Humans; Middle Aged; Otosclerosis; Ovariectomy; Parity; Risk Assessment; Severity of Illness Index; Young Adult
PubMed: 33107781
DOI: 10.1177/0194599820966295