[Otosclerosis: stapedectomy or stapedotomy. A long-term comparative study. Apropos of 1279 cases]. 1994

C Dubreuil, and M Bouchayer, and B Boulud, and P Di Brango, and T Reiss
Service ORL, Centre Hospitalier Lyon sud, Pierre Benite.

The authors report 1279 surgical operations of otosclerosis performed between 1980 and 1992 in 959 operated patients. They chose the autegenous vein or perichondrium interposition TeflonR piston; however this technique has improved over the past few years. The size of the stapedectomy has been diminishing; from total, then partial stapedectomy, at last to 0.8 mm across stapedotomy. The graft has become exclusively from venous origin and the diameter of the piston has been reduced from 0.8 to 0.6 then to 0.4 mm. Seven groups of patients have been examined according to the size of the incision for stapedotomy or stapedectomy and the size of the piston. The audiometric study was realized after one month, one year, three years, fine or even ten years after surgery. Comparative tests were made considering the sex and the age of the patient, the thinness of the graft, and surgical revisions. The audiometric study lied not only upon the audiometric Rinne's closing but also upon the bone conduction variation (postoperative bc-preoperative bc) in the course of time. The evolution of tinnitus, of vertigo has been, as well, the subject of a careful study in time according to the surgical techniques. The study shows that the audiometric results (Rinne's closing, bc evolution) are statically much better with total stapedectomy, then with partial stapedectomy, at last with stapedotomy in the first three postoperative years. The best audiometric results are obtained with wider pistons (0.8 mm diameter) and venous approach. The results regarding tinnitus and vertigos are dissimilar especially during the first operative year. After three years of evolution, the significant audiometric differences tend to reduce and the audiometric results become the same (no significant difference) whatever the surgical technique may be. After three years, simple, calibrated stapedotomy without interposition statically gives similar results in literature. However, each surgical technique may, though rather infrequently, produce some incidents or complications that undoubtedly influence the operator as for the choice of the surgical technique to use.

UI MeSH Term Description Entries
D008297 Male Males
D010040 Otosclerosis Formation of spongy bone in the labyrinth capsule which can progress toward the STAPES (stapedial fixation) or anteriorly toward the COCHLEA leading to conductive, sensorineural, or mixed HEARING LOSS. Several genes are associated with familial otosclerosis with varied clinical signs. Otospongiosis,Otoscleroses,Otospongioses
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001299 Audiometry The testing of the acuity of the sense of hearing to determine the thresholds of the lowest intensity levels at which an individual can hear a set of tones. The frequencies between 125 and 8000 Hz are used to test air conduction thresholds and the frequencies between 250 and 4000 Hz are used to test bone conduction thresholds. Audiometries
D013201 Stapes Surgery Surgery performed in which part of the STAPES, a bone in the middle ear, is removed and a prosthesis is placed to help transmit sound between the middle ear and inner ear. Stapedectomy,Surgery, Stapes,Stapedectomies,Stapes Surgeries,Surgeries, Stapes
D034381 Hearing Loss A general term for the complete or partial loss of the ability to hear from one or both ears. Deafness, Transitory,Hearing Impairment,Hearing Loss, Transitory,Hypoacusis,Transitory Hearing Loss,Deafnesses, Transitory,Hypoacuses,Loss, Hearing,Loss, Transitory Hearing,Transitory Deafness,Transitory Deafnesses,Transitory Hearing Losses

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