Labyrinthine fenestration for tympanosclerotic stapes fixation.

Details

Serval ID
serval:BIB_69604DE28C82
Type
Article: article from journal or magazin.
Collection
Publications
Title
Labyrinthine fenestration for tympanosclerotic stapes fixation.
Journal
European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s)
Querat C., Richard C., Martin C.
ISSN
1879-730X (Electronic)
ISSN-L
1879-7296
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
129
Number
6
Pages
297-301
Language
english
Abstract
OBJECTIVES: To report the results obtained in patients with intact tympanic membrane tympanosclerotic stapes fixation treated by labyrinthine fenestration and to discuss the value of this operation.
MATERIALS AND METHODS: Retrospective study of 28 cases of tympanosclerotic stapes fixation operated between 1982 and 2010. Labyrinthine fenestration was performed using a CO(2) laser. In the first group of patients, the columellar effect was restored by stapedectomy with graft interposition and reconstruction was performed by TORP prosthesis and in the second group, stapedotomy was performed with reconstruction by a piston crimped onto the long process of incus (LPI) or the malleus handle (MH).
RESULTS: Postoperatively (2 to 6 months), stapedectomy and reconstruction by TORP prosthesis allowed a gain of the mean Rinne by 18 dB and reconstruction by piston crimped onto the LPI or an MH placed in the stapedotomy orifice allowed a gain of 14 dB. With a follow-up of 3 years, this gain was maintained with the first technique. No case of cophosis or sensorineural hearing loss greater than 20 dB was observed.
CONCLUSION: Labyrinthine fenestration provides an immediate hearing gain in patients with tympanosclerotic stapes fixation with the two techniques used. In the longer term, these good results were maintained with the stapedectomy and TORP prosthesis technique, but the hearing gain was no longer statistically significant in the long-term with the stapedotomy technique because of a limited number of cases. However, only a study based on a larger number of patients would be able to confirm the superiority of TORP compared to stapedotomy. Labyrinthine fenestration, which comprised only a low risk of deterioration of hearing and which did not induce any total hearing loss, must nevertheless be performed only in the case of severe bilateral conductive hearing loss, with an intact tympanic membrane, in patients refusing a hearing aid and informed about the risks of deterioration of hearing.
Keywords
Adolescent, Adult, Aged, Child, Female, Fenestration, Labyrinth, Humans, Male, Middle Aged, Otosclerosis/surgery, Retrospective Studies, Tympanic Membrane/surgery, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
09/02/2016 12:51
Last modification date
20/08/2019 14:24
Usage data