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Medicina (Kaunas, Lithuania) Aug 2023Otosclerosis is a pathological condition affecting the temporal bone, and is characterized by remodelling of the labyrinthine bone tissue through a dynamic process of... (Review)
Review
Otosclerosis is a pathological condition affecting the temporal bone, and is characterized by remodelling of the labyrinthine bone tissue through a dynamic process of osteolysis and osteogenesis. This condition progressively leads to hearing loss, tinnitus, and vertigo. Stapedotomy, a surgical procedure involving the removal of the stapes superstructure and its replacement with a prosthesis, is the treatment of choice to improve hearing in individuals with otosclerosis. However, vestibular dysfunction is a significant complication associated with this procedure, which can occur intraoperatively or postoperatively, ranging from the immediate postoperative period to weeks, months, or even years after surgery. This paper aims to provide a comprehensive review of the most important causes of vertigo associated with otosclerosis and stapes surgery with the goal of minimizing the incidence of this complication. Understanding the underlying factors contributing to vertigo in this context is crucial for the prevention and effective management of vertigo in patients undergoing stapedotomy.
Topics: Humans; Otosclerosis; Vertigo; Stapes Surgery; Deafness; Osteogenesis
PubMed: 37629775
DOI: 10.3390/medicina59081485 -
Ear, Nose, & Throat Journal Jan 2021The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult...
The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult and children. There remains a significant underutilization of cochlear implant technology in the United States, and recognition of the potential benefits of cochlear implantation for non-traditional indications is critical for encouraging the evolution of candidacy criteria. Adult cochlear implantation candidacy has progressed from patients with bilateral profound sensorineural hearing loss (SNHL) to include patients with greater degrees of residual hearing, single-sided deafness and asymmetric hearing, and atypical etiologies of hearing loss (eg, vestibular schwannoma, Ménière's disease, and otosclerosis). Indications for pediatric cochlear implantation have similarly evolved from children with bilateral severe to profound SNHL to implanting children at a younger age, including those with residual hearing, asymmetric hearing loss, inner ear malformations, as well as cochlear nerve deficiency. In this editorial, the literature investigating cochlear implantation for nontraditional indications is reviewed with an aim to use the best available evidence to encourage the evolution of candidacy criteria.
Topics: Adult; Child; Cochlear Implantation; Female; Hearing Loss; Humans; Male; Patient Selection; United States
PubMed: 32804575
DOI: 10.1177/0145561320947258 -
Children (Basel, Switzerland) Nov 2022Background. Otosclerosis can occur during childhood, resulting in the early onset of conductive hearing loss. The approach to a child with otosclerosis can present some... (Review)
Review
Background. Otosclerosis can occur during childhood, resulting in the early onset of conductive hearing loss. The approach to a child with otosclerosis can present some difficulties in terms of diagnosis and treatment, and the literature on juvenile otosclerosis (JO) is still relatively limited. Aim. To explore the current approaches to JO, in order to clear the management of this condition and evaluate the outcomes and the possible complications of surgical treatment. Methods. A systematic review was performed according to PRISMA guidelines, searching Medline and Embase from January 2002 through to 30 September 2022. A total of 759 papers were identified but based on specified criteria, nine were included in this study. Results. There were 94 children affected by JO and treated by stapes surgery. According to the available data, Male: Female ratio was 1:3−4, whilst the mean ages ranged from 10 to 16.3 years at the time of stapes surgery. After stapes surgery, the target of ABG < 10 dB was achieved in most of the patients. Overall, the 4 complications were reported (4/94= 4%): stenosis of the external ear canal, deterioration of hearing, anacusis with vertigo, tinnitus. Conclusions. The heterogeneity of the available studies does not allow us to draw straight conclusions on this topic, currently. More data about the natural history of the disease in children could help in approaching the treatment correctly, and possibly in drawing guidelines. Studies with a prolonged follow-up could be helpful for assisting clinicians and families in taking the most favorable decision about treatment.
PubMed: 36421236
DOI: 10.3390/children9111787 -
Ear, Nose, & Throat Journal Mar 2018
Topics: Adult; Hearing Loss; Humans; Male; Otosclerosis; Otoscopy; Tomography, X-Ray Computed
PubMed: 29554394
DOI: 10.1177/014556131809700315 -
Romanian Journal of Morphology and... 2023Otosclerosis is a bone condition affecting the stapes bone within the otic capsule, and its exact cause is still unknown. It is characterized by a lack of proper...
Otosclerosis is a bone condition affecting the stapes bone within the otic capsule, and its exact cause is still unknown. It is characterized by a lack of proper remodeling of newly formed vascular and woven bone, leading to the development of abnormal osteons and the formation of sclerotic bone. Bilateral otosclerosis is seen in 80% of patients and 60% of otosclerosis patients have a family history of the condition. The etiology of this disease is still unknown, there are lots of theories to explain it. The histopathological (HP) studies of otosclerosis showed that osteoblasts, osteoclasts, vascular proliferation, fibroblasts, and histiocytes were observed in the stapes footplate. The onset of the symptoms occurs by the early third decade of life, usually it doesn't start later. In otosclerosis, the energy exerted by sound at the level of the tympanic membrane is reduced in the inner ear due to the fixation and rigidity of the ossicular chain, leading to hearing loss, especially for low frequencies. The primary clinical symptom of otosclerosis is conductive hearing loss but it is important to note that sensorineural hearing loss and mixed hearing loss can also occur as secondary symptoms of the condition. Another symptom present in patients with otosclerosis is tinnitus. The paper carried out a retrospective study of 70 patients diagnosed with otosclerosis in the Department of Otorhinolaryngology of Emergency City Hospital, Timişoara, Romania, between January 2021 to December 2022. Tissue fragments were processed at Service of Pathology by standard Hematoxylin-Eosin staining. The HP diagnosis was completed using Masson's trichrome staining, Giemsa histochemical staining, and immunohistochemical (IHC) reactions with anti-cluster of differentiation (CD)20, anti-CD3, anti-CD4, anti-CD8, anti-CD34, and anti-CD31 antibodies. The microscopic examination showed a chronic diffuse inflammatory infiltrate that consisted predominantly of mature T-lymphocytes, immunohistochemically positive for CD3, CD4 and CD8. There were also present rare CD20-positive B-lymphocytes. Among the lymphocytes, relatively numerous mast cells were identified, highlighted histochemically by the Giemsa staining. They had numerous purple-violet intracytoplasmic granules. In the connective tissue support, a relatively rich vascular network was identified, consisting of hyperemic capillaries, highlighted immunohistochemically with anti-CD31 and anti-CD34 antibodies. Bone tissues trabeculae showed extensive areas of fibrosis. The collagen fibers were highlighted by Masson's trichrome staining, being stained in green, blue, or bluish green.
Topics: Humans; Otosclerosis; Retrospective Studies; Stapes; Hearing Loss, Conductive; Hearing Loss, Sensorineural; Deafness
PubMed: 37518876
DOI: 10.47162/RJME.64.2.09 -
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 -
Ear, Nose, & Throat Journal Feb 2021Otosclerosis is a disease process that usually starts around the oval window, causing fixation of the stapes, resulting in conductive hearing loss. Treatment of the... (Review)
Review
OBJECTIVES
Otosclerosis is a disease process that usually starts around the oval window, causing fixation of the stapes, resulting in conductive hearing loss. Treatment of the conductive hearing loss caused by otosclerosis consists of either rehabilitation with hearing aids or performing surgery. Given the risks of hearing impairment and vertigo associated with the surgery, there has been a desire to advance the practice to minimize the complications. The so-called "non-contact" or "no touch" techniques with the use of various lasers are in current practice. This review article will cover the surgical aspects, the theory behind laser and the various types used in stapes surgery. It will also review the evidence of laser versus conventional stapes surgery and the comparison of different laser types.
METHODS
A literature search up to December 2019 was performed using Pubmed and a nonsystematic review of appropriate articles was undertaken. Keywords used were stapes, surgery, laser, stapedectomy, and stapedotomy.
RESULTS
Overall, there is no evidence to say laser fenestration is better than conventional fenestration techniques; however, with the micro drill, there is an increased risk of footplate fracture and sensorineural hearing loss. There is an increased risk of tinnitus with the laser compared to conventional techniques. Studies have favored the CO laser over potassium titanyl phosphate (KTP) and erbium-doped yttrium aluminium garnet (Erbium-YAG) lasers for postoperative closure of the air-bone gap; and KTP laser has less thermal, mechanical, and sound effects compared with the thulium and carbon dioxide (CO) lasers. There is an increased risk if inner ear complications with the thulium laser.
CONCLUSIONS
It can be deduced that theoretically and practically, the thulium laser is less safe compared to the KTP and CO lasers. The choice of laser used depends on the surgeon's preference, as well as availability, cost, side effects profile, as well as ease of use.
Topics: Hearing Loss, Conductive; Humans; Laser Therapy; Otosclerosis; Stapes Surgery; Treatment Outcome
PubMed: 32603217
DOI: 10.1177/0145561320937828 -
British Medical Journal Jan 1978
Topics: Female; Humans; Ischemia; Otosclerosis; Pregnancy; Pregnancy Complications; Stapes
PubMed: 620199
DOI: No ID Found -
Otolaryngology--head and Neck Surgery :... Apr 2020The effect of pregnancy on otosclerosis is controversial. If pregnancy physiologically increases the risk of progression, females with children would be expected to... (Comparative Study)
Comparative Study Observational Study
OBJECTIVE
The effect of pregnancy on otosclerosis is controversial. If pregnancy physiologically increases the risk of progression, females with children would be expected to receive stapedectomy earlier than childless females and males. Here, we seek to determine whether sex moderates the relationship between number of children and age at stapedectomy.
STUDY DESIGN
Retrospective observational study of national health care claims.
SETTING
2003 to 2016 Optum Clinformatics Data Mart.
SUBJECTS AND METHODS
In total, 6025 privately insured US adults (3553 females, 2472 males) who received stapedectomy for otosclerosis were queried for age and number of children at the time of initial surgery.
RESULTS
The average age at stapedectomy was significantly lower in females than males (46.8 vs 48.1 years; test, < .0001). Females with children had a significantly lower age at surgery compared to childless females (39.3 vs 49.9 years; test, < .0001). Males with children similarly had a significantly lower age at surgery compared to childless males (40.5 vs 51.3 years; test, < .0001). A higher number of children was correlated with lower age for both females (Pearson, = -0.3817, < .0001) and males (Pearson, = -0. 3675, < .0001). Linear regression showed that younger age of surgery could be predicted by female sex and number of children ((3, 6021) = 336.93, < .001, = 0.1437) with no significant interaction between sex and number of children ( = .186).
CONCLUSION
Sex does not moderate the effect of increasing number of children on decreasing age at stapedectomy. Social, rather than biological, factors surrounding parenthood such as increased overall health care utilization may explain prior associations between pregnancy and otosclerosis.
Topics: Age Factors; Female; Humans; Male; Middle Aged; Otosclerosis; Parity; Pregnancy; Retrospective Studies; Sex Factors; Stapes Surgery
PubMed: 32093549
DOI: 10.1177/0194599820907093 -
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