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European Archives of... Apr 2021This meta-analysis is aimed to review and analyze all available data of intraoperative and postoperative results of endoscopic and microscopic stapes surgery. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This meta-analysis is aimed to review and analyze all available data of intraoperative and postoperative results of endoscopic and microscopic stapes surgery.
METHODS
According to the PRISMA statements checklist, this systematic review and meta-analysis were designed. Data were extracted from public databases, such as PubMed, Cochrane, Web of Science, and more. The quality of studies was evaluated using the MINORS scale. Odds ratios (ORs) and 95% CIs were estimated for binary outcome data, while the mean differences and 95% CIs were estimated for continuous data. I and χ tests were used to quantify statistical heterogeneity. If more than ten studies were included in each analysis, funnel plot would be performed to analysis publication bias.
RESULTS
Twelve studies with 620 patients were included in this meta-analysis. Primary outcomes collected in this meta-analysis included average postoperative auditory gain (APAG), postoperative air-bone gap (ABG), the rate of chorda tympani handling and bone curettage, which all showed a statistically significant difference in favor of endoscopy. While only secondary outcomes about postoperative pain and dysgeusia demonstrated a significantly reduced incidence. Furthermore, there was not any statistically significant difference on postoperative dizziness and average operative time between endoscopy and microscopy.
CONCLUSION
Although there is a need for high-quality pooled data in the future, a consistently superior effect of the endoscopic group was still shown in terms of total effectiveness, when compared to the microscopic group. We have reasons to support the application of endoscopy in stapes surgery. The future of ESS, we believe, is blazing bright.
Topics: Endoscopy; Humans; Microscopy; Operative Time; Otosclerosis; Reference Standards; Retrospective Studies; Stapes; Stapes Surgery; Treatment Outcome
PubMed: 32648030
DOI: 10.1007/s00405-020-06132-2 -
Tomography (Ann Arbor, Mich.) Sep 2022The aim of this research was to assess possible relationships between petrotympanic fissure (PTF) characteristics, malleus position, and temporomandibular joint...
The aim of this research was to assess possible relationships between petrotympanic fissure (PTF) characteristics, malleus position, and temporomandibular joint disorders (TMD). A retrospective study was performed, including patients with TMD. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) examination were used to evaluate temporomandibular joint (TMJ) disc position and condylar bone changes. Fifty-eight TMJs from twenty-nine patients (23:6 females: males) were assessed. Erosive changes (DDR-disc displacement with a reduction of 6 (24%), DDwR-disc displacement without a reduction of 8 (61.5%) vs. normal disc position 3 (15%), = 0.012) and condyle osteophytes production (DDR 6 (24%), DDwR 9 (69.2%) vs. normal condyle 7 (35%), = 0.012) were more frequent in subjects with disc displacement compared to normal disc position; malleus was closer to PTF in cases with erosive changes (median 2.15 interquartile range: (1.85-2.75) vs. 2.75 (2.25-3.15), = 0.029) as well as those with condylar osteophytosis (2.25 (1.91-2.75) vs. 2.75 (2.33-3.32), = 0.015); the PTF length was higher in cases with condylar osteophytosis compared to those without (4.45 (3.50-4.77) vs. 3.67 (3.34-4.28), = 0.039). The disc position and disc shape were not related to PTF or malleus position. Malleus position and PTF dimensions were not associated with the PTF type. In cases with erosive changes and condylar osteophytosis, malleus was closer to PTF.
Topics: Male; Female; Humans; Malleus; Temporomandibular Joint; Retrospective Studies; Temporomandibular Joint Disorders; Temporomandibular Joint Disc; Tongue Diseases
PubMed: 36287803
DOI: 10.3390/tomography8050204 -
JPMA. the Journal of the Pakistan... Feb 2023To determine gender-based morphological variations in malleus.
OBJECTIVE
To determine gender-based morphological variations in malleus.
METHODS
The cross-sectional descriptive study was conducted at the Ear-Nose-Throat and Radiology departments of a public-sector hospital in Karachi, from January 20 to July 23, 2021, and comprised subjects of either gender aged 10-51 years who had intact ear ossicles. They were divided into equal male and female groups. After history and a thorough examination of the ear, high-resolution computed tomography scan of petrous temporal bone was done. The images were studied for malleus, to measure the parameters of its head width, length and shape of manubrium, and total length of malleus for possible morphological variations along gender lines. Data was analysed using SPSS 23.
RESULTS
Of the 50 subjects, 25(50%) were males with mean width of the head 3.04±0.34mm, mean length of manubrium 4.47±0.48mm, and mean total length of malleus 7.76±0.60mm. The corresponding values in 25(50%) females were 3.00±0.28mm, 4.31±0.45mm and 7.41±0.51mm. The total length of malleus between both genders was significantly different (p= 0.031). The shape of manubrium was straight in 10(40%) males and 8(32%) females, and curved in 15(60%) males and 17(68%) females.
CONCLUSIONS
Width of head, length of manubrium and total length of malleus were different in gender terms, but the total length of malleus was significantly different.
Topics: Female; Humans; Male; Malleus; Cross-Sectional Studies; Hospitals, Public; Public Sector; Social Group
PubMed: 36800718
DOI: 10.47391/JPMA.6307 -
Clinical and Experimental... Sep 2016This study was aimed to assess the relationship between the type of temporal bone area involved and conductive hearing loss.
OBJECTIVES
This study was aimed to assess the relationship between the type of temporal bone area involved and conductive hearing loss.
METHODS
We enrolled 97 patients who visited the otolaryngology clinics of Seoul National University Hospital or Boramae Medical Center, Seoul Metropolitan Government-Seoul National University with temporal bone fracture between January 2004 and January 2014. Audiometric parameters, including initial and improved air-bone (AB) conduction gap values, were reviewed in accordance with the temporal bone computed tomography (external auditory canal [EAC], middle ear [ME], mastoid [M], and ossicle [O]).
RESULTS
Patients with ossicular chain involvement exhibited a larger AB gap compared to those with no ossicular chain involvement at 250, 1,000, 2,000, and 4,000 Hz. Among the groups without ossicular chain involvement, the initial AB gap was largest in patients with EAC+ME+M involvement, followed by the ME+M and M-only involvement groups. The greatest improvement in the AB gap was observed in the EAC+ME+M group followed by the ME+M and M-only groups, irrespective of ossicular chain involvement. Improvements in AB gap values were smallest at 2,000 Hz.
CONCLUSION
Conductive hearing loss pattern differed according to the temporal bone area involved. Therefore, areas such as the hematoma and hemotympanum, as well as the fracture line of the temporal bone area, must be evaluated to predict audiologic patterns with otic capsule preserving temporal bone fracture.
PubMed: 27337953
DOI: 10.21053/ceo.2015.01116 -
Journal of Visualized Experiments : JoVE Jan 2017In most mammals, auditory ossicles in the middle ear, including the malleus, incus and stapes, are the smallest bones. In mice, a bony structure called the auditory...
In most mammals, auditory ossicles in the middle ear, including the malleus, incus and stapes, are the smallest bones. In mice, a bony structure called the auditory bulla houses the ossicles, whereas the auditory capsule encloses the inner ear, namely the cochlea and semicircular canals. Murine ossicles are essential for hearing and thus of great interest to researchers in the field of otolaryngology, but their metabolism, development, and evolution are highly relevant to other fields. Altered bone metabolism can affect hearing function in adult mice, and various gene-deficient mice show changes in morphogenesis of auditory ossicles in utero. Although murine auditory ossicles are tiny, their manipulation is feasible if one understands their anatomical orientation and 3D structure. Here, we describe how to dissect the auditory bulla and capsule of postnatal mice and then isolate individual ossicles by removing part of the bulla. We also discuss how to embed the bulla and capsule in different orientations to generate paraffin or frozen sections suitable for preparation of longitudinal, horizontal, or frontal sections of the malleus. Finally, we enumerate anatomical differences between mouse and human auditory ossicles. These methods would be useful in analyzing pathological, developmental and evolutionary aspects of auditory ossicles and the middle ear in mice.
Topics: Animals; Ear Ossicles; Incus; Malleus; Mice; Stapes; X-Ray Microtomography
PubMed: 28117786
DOI: 10.3791/55054 -
Radiologia 2019Fractures of the petrous part of the temporal bone are a common lesion of the base of the skull; most of these fractures result from high-energy trauma. In patients with... (Review)
Review
Fractures of the petrous part of the temporal bone are a common lesion of the base of the skull; most of these fractures result from high-energy trauma. In patients with multiple trauma, these injuries can be detected on CT scans of the head and neck, where the direct and indirect signs are usually sufficient to establish the diagnosis. It is important to these fractures because the temporal bone has critical structures and the complexity of this region increases the risk of error unless special care is taken. This article reviews the key anatomical points, the systematization of the imaging findings, and the classifications used for temporal bone fracture. We emphasize the usefulness of identifying and describing the findings in relation to important structures in this region, of looking for unseen fractures suspected through indirect signs, and of identifying anatomical structures that can simulate fractures. We point out that the classical classifications of these fractures are less useful, although they continue to be used for treatment decisions.
Topics: Cochlea; Ear; Ear Canal; Ear Ossicles; Facial Nerve; Facial Nerve Injuries; Humans; Petrous Bone; Skull Fractures; Symptom Assessment; Temporal Bone
PubMed: 30777299
DOI: 10.1016/j.rx.2018.12.005 -
BMC Medical Imaging May 2024Precision and intelligence in evaluating the complexities of middle ear structures are required to diagnose auriculotemporal and ossicle-related diseases within...
Precision and intelligence in evaluating the complexities of middle ear structures are required to diagnose auriculotemporal and ossicle-related diseases within otolaryngology. Due to the complexity of the anatomical details and the varied etiologies of illnesses such as trauma, chronic otitis media, and congenital anomalies, traditional diagnostic procedures may not yield accurate diagnoses. This research intends to enhance the diagnosis of diseases of the auriculotemporal region and ossicles by combining High-Resolution Spiral Computed Tomography (HRSCT) scanning with Deep Learning Techniques (DLT). This study employs a deep learning method, Convolutional Neural Network-UNet (CNN-UNet), to extract sub-pixel information from medical photos. This method equips doctors and researchers with cutting-edge resources, leading to groundbreaking discoveries and better patient healthcare. The research effort is the interaction between the CNN-UNet model and high-resolution Computed Tomography (CT) scans, automating activities including ossicle segmentation, fracture detection, and disruption cause classification, accelerating the diagnostic process and increasing clinical decision-making. The suggested HRSCT-DLT model represents the integration of high-resolution spiral CT scans with the CNN-UNet model, which has been fine-tuned to address the nuances of auriculotemporal and ossicular diseases. This novel combination improves diagnostic efficiency and our overall understanding of these intricate diseases. The results of this study highlight the promise of combining high-resolution CT scanning with the CNN-UNet model in otolaryngology, paving the way for more accurate diagnosis and more individualized treatment plans for patients experiencing auriculotemporal and ossicle-related disruptions.
Topics: Humans; Tomography, Spiral Computed; Ear Ossicles; Deep Learning; Ear Diseases; Temporal Bone; Adult; Neural Networks, Computer
PubMed: 38724896
DOI: 10.1186/s12880-024-01277-6 -
Frontiers in Endocrinology 2022Intact mineralization of the auditory ossicles - the smallest bones in the body - is essential for sound transmission in the middle ear, while ossicular...
Intact mineralization of the auditory ossicles - the smallest bones in the body - is essential for sound transmission in the middle ear, while ossicular hypomineralization is associated with conductive hearing loss. Here, we performed a high-resolution analysis of the ossicles in vitamin D receptor deficient mice ( ), which are characterized by hypocalcemia and skeletal mineralization defects, and investigated whether local hypomineralization can be prevented by feeding a calcium-rich rescue diet ( ). In mice fed a regular diet ( ), quantitative backscattered electron imaging (qBEI) revealed an increased void volume (porosity, p<0.0001) along with lower mean calcium content (CaMean, p=0.0008) and higher heterogeneity of mineralization (CaWidth, p=0.003) compared to WT mice. Furthermore, a higher osteoid volume per bone volume (OV/BV; p=0.0002) and a higher osteocyte lacunar area (Lc.Ar; p=0.01) were found in histomorphometric analysis in mice. In mice, full rescue of OV/BV and Lc.Ar (both p>0.05 vs. WT) and partial rescue of porosity and CaWidth (p=0.02 and p=0.04 vs. WT) were observed. Compared with mice, a model of X-linked hypophosphatemic rickets, mice showed a lower osteoid volume in the ossicles (p=0.0002), but similar values in the lumbar spine. These results are consistent with later postnatal impairment of mineral homeostasis in mice than in mice, underscoring the importance of intact mineral homeostasis for ossicle mineralization during development. In conclusion, we revealed a distinct phenotype of hypomineralization in the auditory ossicles of mice that can be partially prevented by a rescue diet. Since a positive effect of a calcium-rich diet on ossicular mineralization was demonstrated, our results open new treatment strategies for conductive hearing loss. Future studies should investigate the impact of improved ossicular mineralization on hearing function.
Topics: Animals; Calcium; Ear Ossicles; Hearing Loss, Conductive; Mice; Mice, Knockout; Minerals; Receptors, Calcitriol
PubMed: 35733772
DOI: 10.3389/fendo.2022.901265 -
Otology & Neurotology : Official... Sep 2021To better distinguish NOG-related-symphalangism spectrum disorder (NOG-SSD) from chromosomal 17q22 microdeletion syndromes and to inform surgical considerations in...
OBJECTIVES
To better distinguish NOG-related-symphalangism spectrum disorder (NOG-SSD) from chromosomal 17q22 microdeletion syndromes and to inform surgical considerations in stapes surgery for patients with NOG-SSD.
BACKGROUND
Mutations in NOG cause a variety of skeletal syndromes that often include conductive hearing loss. Several microdeletions of chromosome 17q22 lead to severe syndromes with clinical characteristics that overlap NOG-SSD. Isolated deletion of NOG has not been described, and therefore the contribution of NOG deletion in these syndromes is unknown.
METHODS
Two families with autosomal dominant NOG-SSD exhibited stapes ankylosis, facial dysmorphisms, and skeletal and joint anomalies. In each family, NOG was evaluated by genomic sequencing and candidate mutations confirmed as damaging by in vitro assays. Temporal bone histology of a patient with NOG-SSD was compared with temporal bones of 40 patients diagnosed with otosclerosis.
RESULTS
Family 1 harbors a 555 kb chromosomal deletion encompassing only NOG and ANKFN1. Family 2 harbors a missense mutation in NOG leading to absence of noggin protein. The incus-footplate distance of the temporal bone was significantly longer in a patient with NOG-SSD than in patients with otosclerosis.
CONCLUSION
The chromosomal microdeletion of family 1 led to a phenotype comparable to that due to a NOG point mutation and much milder than the phenotypes due to other chromosome 17q22 microdeletions. Severe clinical findings in other microdeletion cases are likely due to deletion of genes other than NOG. Based on temporal bone findings, we recommend that surgeons obtain longer stapes prostheses before stapes surgery in individuals with NOG-SSD stapes ankylosis.
Topics: Carpal Bones; Foot Deformities, Congenital; Genetic Heterogeneity; Hand Deformities, Congenital; Humans; Stapes; Synostosis; Tarsal Bones
PubMed: 34049328
DOI: 10.1097/MAO.0000000000003176 -
Ear, Nose, & Throat Journal Dec 2010
Topics: Aged; Audiometry, Pure-Tone; Follow-Up Studies; Hearing Loss, Conductive; Humans; Male; Malleus; Otologic Surgical Procedures; Recovery of Function; Risk Assessment; Severity of Illness Index; Treatment Outcome
PubMed: 21174268
DOI: 10.1177/014556131008901207