The Experts below are selected from a list of 1464 Experts worldwide ranked by ideXlab platform
Darius Kohan - One of the best experts on this subject based on the ideXlab platform.
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the malleus to Oval Window revision stapedotomy efficacy and longitudinal study outcome
2018Co-Authors: Peter A Benedict, Darius Kohan, Ling Zhou, Robert PengAbstract:Objective To determine the longitudinal effectiveness of the malleus to Oval Window stapedotomy technique among patients undergoing revision surgery when the incus is unavailable. Study Design Retrospective, case series. Methods Charts of 15 patients who underwent 17 malleus attachment stapedotomies performed by a single surgeon from 2000 to 2015 were reviewed. Surgery was ambulatory, transcanal, with laser technique, and under local anesthesia. Results Of 17 stapedotomies performed, there were nine first revisions, six second revisions, one third revision, and one fourth revision. There were no surgical complications. Mean preoperative air-bone gap (ABG) was 32.3 dB. Mean postoperative ABG at 6 months was 10.7 dB, and at last follow-up was 16.3 dB. Average length of follow-up was 36.5 months. At last follow-up, 100% of first revisions achieved ABG ≤ 20 dB (77.8% ≤ 10 dB), compared to 50% of second revisions with ABG ≤ 20 dB (none ≤ 10 dB), and 0% of third or fourth revisions with ABG ≤ 20 dB. Trend lines for second and third/fourth revisions showed a deterioration (widening) in postoperative ABG by 0.18 and 0.72 dB per month, respectively. The first-revision trend line, conversely, showed negligible change with time, demonstrating the superior durability of first revisions compared to subsequent surgeries. Conclusion The malleus to Oval Window stapedotomy technique is more effective and longer lasting in first-revision surgery compared to subsequent procedures. Standard or implantable amplification devices may be preferable for patients with multiple prior procedures. Level of Evidence 4. Laryngoscope, 2017
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Revision stapes surgery: the malleus to Oval Window wire-piston technique.
2003Co-Authors: Darius Kohan, Alexander SorinAbstract:Objective To determine the effectiveness of the malleus to Oval Window wire-piston revision stapes surgery technique. Study Design A retrospective analysis of 243 stapes procedures performed by the senior author over a 10-year period identified 15 revisions. Five patients underwent a malleus to Oval Window wire-piston technique. All patients were followed for at least 6 months. The surgical outcome including audiologic data and complications are noted. Methods Stapes surgery was performed on an ambulatory basis by way of a transcanal approach under local anesthesia with monitored sedation by the same surgeon using a laser technique and a stapes wire-piston prosthesis. Results Among revision stapes procedures, there was no significant difference in the air-bone gap closure or complication rate between the incus to Oval Window and the malleus to Oval Window techniques. The average preoperative air-bone gap in all revisions was 32 dB, whereas the mean postoperative gap was 10 dB hearing loss. Conclusions In experienced hands, revision stapes surgery using the malleus to Oval Window stapes wire-piston prosthesis is safe and effective.
J. B. Fallon - One of the best experts on this subject based on the ideXlab platform.
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Gentamicin Applied to the Oval Window Suppresses Vestibular Function in Guinea Pigs
2017Co-Authors: E. B. King, R. K. Shepherd, D. J. Brown, J. B. FallonAbstract:Intratympanic gentamicin therapy is widely used clinically to treat the debilitating symptoms of Ménière’s disease. Cochleotoxicity is an undesirable potential side effect of the treatment and the risk of hearing loss increases proportionately with gentamicin concentration in the cochlea. It has recently been shown that gentamicin is readily absorbed through the Oval Window in guinea pigs. The present study uses quantitative functional measures of vestibular and cochlea function to investigate the efficacy of treating the vestibule by applying a small volume of gentamicin onto the stapes footplate in guinea pigs. Vestibular and cochlea function were assessed by recording short latency vestibular evoked potentials in response to linear head acceleration and changes in hearing threshold, respectively, 1 and 2 weeks following treatment. Histopathology was analyzed in the crista ampullaris of the posterior semi-circular canal and utricular macula in the vestibule, and in the basal and second turns of the cochlea. In animals receiving gentamicin on the stapes footplate, vestibular responses were significantly suppressed by 72.7 % 2 weeks after treatment with no significant loss of hearing. This suggests that the vestibule can be treated directly by applying gentamicin onto the stapes footplate.
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gentamicin applied to the Oval Window suppresses vestibular function in guinea pigs
2017Co-Authors: E. B. King, R. K. Shepherd, J. B. Fallon, Daniel BrownAbstract:Intratympanic gentamicin therapy is widely used clinically to treat the debilitating symptoms of Meniere's disease. Cochleotoxicity is an undesirable potential side effect of the treatment and the risk of hearing loss increases proportionately with gentamicin concentration in the cochlea. It has recently been shown that gentamicin is readily absorbed through the Oval Window in guinea pigs. The present study uses quantitative functional measures of vestibular and cochlea function to investigate the efficacy of treating the vestibule by applying a small volume of gentamicin onto the stapes footplate in guinea pigs. Vestibular and cochlea function were assessed by recording short latency vestibular evoked potentials in response to linear head acceleration and changes in hearing threshold, respectively, 1 and 2 weeks following treatment. Histopathology was analyzed in the crista ampullaris of the posterior semi-circular canal and utricular macula in the vestibule, and in the basal and second turns of the cochlea. In animals receiving gentamicin on the stapes footplate, vestibular responses were significantly suppressed by 72.7 % 2 weeks after treatment with no significant loss of hearing. This suggests that the vestibule can be treated directly by applying gentamicin onto the stapes footplate.
Peter J. Taylor - One of the best experts on this subject based on the ideXlab platform.
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Associated tympanic bullar and cochlear hypertrophy define adaptations to true deserts in African gerbils and laminate-toothed rats (Muridae: Gerbillinae and Murinae)
2019Co-Authors: Aluwani Nengovhela, Christiane Denys, José Braga, Frikkie De Beer, Christophe Tenailleau, Peter J. TaylorAbstract:Hearing capabilities in desert rodents such as gerbils and heteromyids have been inferred from both anatomical and ecological aspects and tested with experiments and theoretical models. However, very few studies have focused on other desert‐adapted species. In this study, a refined three‐dimensional morphometric approach was used on three African rodent tribes (Otomyini, Taterillini and Gerbillini) to describe the cochlear and tympanic bullar morphology, and to explore the role of phylogeny, allometry and ecology to better understand the underlying mechanism of any observed trends of hypertrophy in the bulla and associated changes in the cochlea. As a result, desert‐adapted species could be distinguished from mesic and semi‐arid taxa by the gross cochlear dimensions, particularly the Oval Window, which is larger in desert species. Bullar and cochlear modifications between species could be explained by environment (bulla and Oval Window), phylogeny (cochlear curvature gradient) and/or allometry (cochlear relative length, Oval Window and bulla) with some exceptions. Based on their ear anatomy, we predict that Desmodillus auricularis and Parotomys brantsii should be sensitive to low‐frequency sounds, with D. auricularis sensitive to high‐frequency sounds, too. This study concludes that in both arid and semi‐arid adapted laminate‐toothed rats and gerbils there is bulla and associated cochlea hypertrophy, particularly in true desert species. Gerbils also show tightly coiled cochlea but the significance of this is debatable and may have nothing to do with adaptations to any specific acoustics in the desert environment.
Seng Beng Yeo - One of the best experts on this subject based on the ideXlab platform.
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High Resolution Computed Tomography (HRCT) Imaging Findings of Oval Window Atresia with Surgical Correlation.
2020Co-Authors: Hau Wei Khoo, Chih Ching Choong, Seng Beng Yeo, Julian Pn Goh, Tiong Yong TanAbstract:Introduction Isolated Oval Window atresia (OWA) is a rare cause of congenital conductive middle ear deafness and may be overlooked owing to the normal appearance of the external ear. This anomaly has been previously described, although the published numbers with both imaging and surgical findings are few. Our aim is to correlate the imaging features of OWA with intraoperative findings. Materials and methods This is a single-centre retrospective evaluation of patients who were diagnosed with OWA and who received surgery from January 1999 to July 2006. No new case was diagnosed after 2006 to the time of preparation of this manuscript. High resolution computed tomography (HRCT) imaging of the temporal bones of the patients were retrospectively evaluated by 2 head and neck radiologists. Images were evaluated for the absence of the Oval Window, ossicular chain abnormalities, position of the facial nerve canal, and other malformations. Imaging findings were then correlated with surgical findings. Results A total of 9 ears in 7 patients (two of whom with bilateral lesions) had surgery for OWA. All patients had concomitant findings of absent stapes footplate with normal, deformed or absent stapes superstructure and an inferiorly displaced facial nerve canal. HRCT was sensitive in identifying OWA and associated ossicular chain and facial nerve abnormalities, which were documented surgically. Conclusion OWA is a rare entity that can be diagnosed with certainty on HRCT, best visualised on coronal plane. Imaging findings of associated middle ear abnormalities, position of the facial nerve canal, which is invariably mal-positioned, and associated deformity of the incus are important for presurgical planning and consent.
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surgical intervention for congenital absent Oval Window
2014Co-Authors: Woei Shyang Loh, Seng Beng YeoAbstract:Objectives:Congenital absent Oval Window is an uncommon condition that results in significant conductive hearing loss in the pediatric population. Treatment outcomes and results following surgery are still not well established in light of the limited cases that have been published in the literature. This study aims to evaluate the outcomes following surgical intervention of patients with congenital absent Oval Window in a single institution.Methods:This is a retrospective review of patients who underwent surgical exploration and treatment for congenital absent Oval Window from 2000 to 2013 in a single institution.Results:Twelve patients were diagnosed with congenital absent Oval Window. Six of these patients were affected bilaterally. Of the 19 ears affected, 13 were operated on. Eight ears were successfully treated following stapedotomy and insertion of prosthesis. The average pure-tone audiogram for these patients was 62.6 prior to the operation. Following surgery, the average pure-tone level was 22.4. ...
Edwin H Moreano - One of the best experts on this subject based on the ideXlab platform.
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prevalence of facial canal dehiscence and of persistent stapedial artery in the human middle ear a report of 1000 temporal bones
1994Co-Authors: Michael M Paparella, Edwin H Moreano, Daniel Zelterman, Marcos V GoycooleaAbstract:A total of 1000 temporal bones were used to study the prevalence of facial canal dehiscence and of persistent stapedial artery in detail. Of the temporal bones studied, 560 (56%) contained at least one facial canal dehiscence. There was a 76.3% prevalence of bilaterality of this canal wall gap. The most common site of dehiscence was the Oval Window area. The concept of microdehiscence of the facial canal is introduced. One third of the temporal bones observed had a microdehiscence of the facial canal, usually located at the Oval Window area (74.9%) and found bilaterally 40% of the time. The authors found a 0.48% prevalence (5 out of 1045) of persistent stapedial artery. This is the first histological study of temporal bones to report a prevalence of this vascular anomaly.
