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John W. House - One of the best experts on this subject based on the ideXlab platform.

  • Stapedectomy versus stapedotomy comparison of results with long term follow up
    Laryngoscope, 2002
    Co-Authors: Howard P House, Marlan R Hansen, Abdul Aziz Al A Dakhail, John W. House
    Abstract:

    Objective/Hypothesis To compare the effectiveness and long-term stability of hearing results between Stapedectomy and small fenestra stapedotomy in patients with conductive hearing loss due to otosclerosis. Study Design Retrospective review of prospectively collected audiometric data. Methods The hearing results and complication rates of 209 ears with long-term follow-up that underwent either Stapedectomy or stapedotomy by the senior author (h.p.h.) between 1961 and 1989 were compared. Forty-two patients underwent Stapedectomy in one ear and stapedotomy in the opposite ear, permitting a paired case review of the results in these patients. The techniques were compared with respect to initial and late hearing results and change of the results over time. Results Patients undergoing Stapedectomy and stapedotomy were followed for an average of 11.5 and 6.0 years, respectively. There were no statistically significant differences in initial or late postoperative pure-tone average (PTA), PTA air–bone gap, speech discrimination scores, or incidence of sensorineural hearing loss between the two groups. Ears treated by stapedotomy showed statistically better initial and late postoperative 4-kHz air-conduction threshold and initial 4-kHz air–bone gap, but the gap difference was not significant with late follow-up. There was no significant difference in the percentage of patients with air–bone gap closure within 10 dB for any frequency other than 4 kHz at the initial postoperative test. Importantly, the successful outcomes in both groups were stable over long-term follow-up. Results were the same when comparing the two procedures in patients having undergone both. Conclusion These results show that, in the hands of an experienced surgeon, either technique provides satisfactory and stable long-term results.

  • tympanosclerosis of the stapes hearing results for various surgical treatments
    Otolaryngology-Head and Neck Surgery, 1992
    Co-Authors: Neil A Giddings, John W. House
    Abstract:

    When tympanosclerosis involves the tympanic membrane or the lateral ossicles, treatment is usually straightforward and uncomplicated. When the stapes is involved, therapy Is more controversial and may be more difficult. We report our results in 154 patients who underwent different surgical procedures for tympanosclerosis of the stapes. Followup was up to 10 years. Pure-tone average threshold was significantly improved (P < 0.05) in patients who underwent mobilization procedures or Stapedectomy for definitive treatment. The air-bone gap was less than 20 dB at 6 months postoperative in 72% of patients and less than 30 dB in 90%. At 6 months, 2 years, and 5 years there were no statistically significant differences in hearing results between Stapedectomy and mobilization patients, some of whom were followed for up to 10 years. No patient had a profound hearing loss after surgery. Surgical treatment for tympanosclerosis of the stapes is a safe procedure, with hearing results similar to those of surgery for oth...

Franklin M Rizer - One of the best experts on this subject based on the ideXlab platform.

  • revision Stapedectomy for incus erosion long term hearing
    Otolaryngology-Head and Neck Surgery, 1998
    Co-Authors: Lawrence W Krieger, William H Lippy, Arnold G Schuring, Franklin M Rizer
    Abstract:

    One of the most common ossicular problems in revision Stapedectomy is the eroded incus. Revision surgery has been reported as successful in 70% to 80% of cases at 1 year. Little is written about long-term results or the association of erosion with various prostheses. We evaluated 83 cases from 1 to 20 years, including multiple revisions. In 23 cases the erosion was seen at initial Stapedectomy. Surgery was performed with the patient under local anesthesia, with the use of the Lippy modified prosthesis. Initial success was seen in 72% (41/57), satisfactory results in 90%, no change in 5%, and none worse. At 10 years, success had declined to 50% (7 of 14), with 80% satisfactory. The numbers for multiple revisions were lower. Success in nonrevision cases was 90% (21 of 23), dropping to 86% at 10 years, with satisfactory results in 100%. The type of prosthesis associated with erosion was a crimped wire in 34% (24 of 70), a plastic strut in 23%, and a Robinsion prosthesis in 17%. We conclude that the risk of incus erosion appears less with the Robinson prosthesis. The Lippy modified prosthesis yields good long-term results, particularly when erosion is seen at initial Stapedectomy. Results worsen with subsequent revision.

Andrew T Sabin - One of the best experts on this subject based on the ideXlab platform.

Lawrence W Krieger - One of the best experts on this subject based on the ideXlab platform.

  • revision Stapedectomy for incus erosion long term hearing
    Otolaryngology-Head and Neck Surgery, 1998
    Co-Authors: Lawrence W Krieger, William H Lippy, Arnold G Schuring, Franklin M Rizer
    Abstract:

    One of the most common ossicular problems in revision Stapedectomy is the eroded incus. Revision surgery has been reported as successful in 70% to 80% of cases at 1 year. Little is written about long-term results or the association of erosion with various prostheses. We evaluated 83 cases from 1 to 20 years, including multiple revisions. In 23 cases the erosion was seen at initial Stapedectomy. Surgery was performed with the patient under local anesthesia, with the use of the Lippy modified prosthesis. Initial success was seen in 72% (41/57), satisfactory results in 90%, no change in 5%, and none worse. At 10 years, success had declined to 50% (7 of 14), with 80% satisfactory. The numbers for multiple revisions were lower. Success in nonrevision cases was 90% (21 of 23), dropping to 86% at 10 years, with satisfactory results in 100%. The type of prosthesis associated with erosion was a crimped wire in 34% (24 of 70), a plastic strut in 23%, and a Robinsion prosthesis in 17%. We conclude that the risk of incus erosion appears less with the Robinson prosthesis. The Lippy modified prosthesis yields good long-term results, particularly when erosion is seen at initial Stapedectomy. Results worsen with subsequent revision.

Clough Shelton - One of the best experts on this subject based on the ideXlab platform.

  • Stapedectomy in congenital stapes fixation are hearing outcomes poorer
    Otolaryngology-Head and Neck Surgery, 2004
    Co-Authors: Becky Massey, Todd A Hillman, Clough Shelton
    Abstract:

    OBJECTIVE: To evaluate outcomes of Stapedectomy surgery for congenital stapes fixation.STUDY DESIGN: Retrospective chart review.METHODS: The charts of 463 stapedectomies performed by 1 surgeon from 1996 to 2003 were reviewed. Patients with a history of childhood hearing loss and operative findings consistent with congenital fixation of the stapes were included. Patients with a history of trauma or chronic otitis media and those with otosclerosis were excluded. Thirty-six patients underwent Stapedectomy for congenital fixation. Revision cases and those with inadequate postoperative bone or air conduction data were excluded. Inclusion criteria were met for 25 patients. Operative findings and hearing outcomes were evaluated.RESULTS: The study group was comprised of 25 stapedectomies. Closure of the air-bone gap to less than 10 dB was achieved in 48% of cases, and 80% had closure within 20 dB. A gap of more than 30 dB remained in 3 cases. There were 2 cases of sensorineural hearing loss with worsening of the ...