PubMed · 1734357
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T Balkany. 1992. Hearing and equilibrium.. https://doi.org/10.1177/019459989210600102
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The goal of any chronic ear surgery is to create a dry, safe ear and to preserve or restore hearing as much as possible. Multiple different mastoid procedures exist, each with their own indications, advantages, and disadvantages. A keen understanding of all mastoid procedures allows the surgeon to individualize which procedure is appropriate for each patient. A thorough understanding of the anatomy and dissection techniques allows each of these procedures to be done safely.
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OBJECTIVE: To compare the effectiveness of three surgical techniques for otosclerosis. METHOD: Retrospective analysis was made of patients with otosclerosis who had received surgical treatment during 1993-2005. There were totally 70 patients (76 ears) in which 30 patients (33 ears) underwent total stapedectomy with original stapes, 24 patients (27 ears) underwent small fenestra stapedotomy with Teflon piston artificial stapes and 16 patients (16 ears) underwent stapes mobilization or elevation. Both the hearing results including closure of postoperative air-bone gap and change of postoperative bone conduction threshold at different frequencies and percentages of postoperative vertigo control are compared statistically among three general groups and among two subgroups(stapes mobilization group with 5 cases/ 5 ears and stapes elevation group with 11 cases/ 11 ears). RESULT: There were no statistically significant differences in postoperative speech pure tone average threshold in closing air-bone gap among three groups. Compared with ears treated by otal stapedectomy with original stapes, ears treated by small fenestra stapedotomy and stapes mobilization or elevation, more decreased air-bone gap and lower rates of post-operative sensorineural hearing loss (SNHL) and dizziness at high frequencies were found. CONCLUSION: Although the acceptable effects were found in 3 groups, the better hearing threshold at high frequencies and lower incidence of complications can be obtained in patients with otosclerosis underwent small fenestra stapedotomy and stapes mobilization or elevation. It is suggested that small fenestra stapedotomy with Teflon piston artificial stapes is an ideal surgical treatment for otosclerosis.