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At least 19 recordsLinked to original sources
PubMed2001

Measurement of stapes mobility in guinea pigs and rabbits.

In tympanoplasty, it is essential to know the condition of the stapes. However, it has been difficult to evaluate stapes mobility in routine measurement. With the eye on improving future clinical practice, in this study we developed a new, easy system of measuring stapes mobility quantitatively and, as a first step, applied it to measurement of the relationship between the load and displacement of the stapes in guinea pigs and rabbits. The stapes displacement increased linearly with an increase in load in the small displacement region, and increased nonlinearly in the large displacement region. The slope of the regression line of this stiffness curve in the small displacement region was used as an index of the stapes mobility. The values in the guinea pigs and rabbits were 16+/-7 N/m and 115+/-25 N/m, respectively. A significant difference between the two species was observed.

Animals↗
PubMed2001

[Intraoperative measurement of stapes mobility using a hand-guided electromagnetic probe].

BACKGROUND: The hearing results of otosurgery are still unsatisfactory. Even after successful implantation of middle ear prostheses there often remains an air bone gap of 30 dB or more. As possible reasons dislocation of the prostheses due to scar growth, changes in prostheses' attachment or ventilation disorders are being discussed. Decreased stapes mobility, which has been judged only manually up to now, is supposed to be a further reason. METHOD: We are introducing a new electromagnetic probe. The output signal of this device is proportional to the impedance of the stapes-annular ligament cochlear fluid system at the sensor's resonance frequency (2.4 kHz). The advantage of this system is characterised by its hand-guidance. Injury of the sensitive stapes-annular ligament due to tremor movements of the surgeon can be excluded using a special construction of the sensor head. The maximum force of the sensor's tip onto the stapes during measurement is limited to below 5 mN. RESULTS: Preliminary measurement results of 20 patients are presented with normal and abnormal stapes mobility. These results are compared to the subjective impression of the surgeon, who usually tested the stapes mobility by hand. As a result of our investigations probe measurements can detect more exactly decreased mobility of the stapes than the surgeon. CONCLUSIONS: Our device may help to detect latent stapes fixation caused by chronic inflammation of the middle ear. The intraoperative measurement of stapes mobility may influence the strategy of the surgeon. Furthermore it would be helpful in patient consulting prior to a revision-tympanoplasty with predicting the potential hearing improvement.

Cholesteatoma, Middle Ear↗
PubMed2000

Assessment of stapes mobility by use of a newly developed piezoelectric ceramic device. A preliminary experiment in dogs.

A piezoelectric device was developed for assessment of stapes mobility during middle ear surgery. The device comprises a pair of ceramic bimorph elements: one for activation of the stapes and the other to pick up the vibration as an electric output, which varies in accordance with the stapes mobility, ie, the inverse of the cochlear input impedance (Zsc). The device is compact and easily manipulated even in the narrow surgical field of the ear. However, the measuring range is restricted to between 1 and 10 kHz. Measurement of Zsc was conducted with this device in 5 ears of 5 dogs. The mean magnitude of Zsc increased with frequency in the range from 1 to 10 kHz: 0.95 megohm at 1 kHz and 8.8 megohms at 10 kHz. After fixation of the stapes with dental cement, the magnitude increased to more than 10 megohms, except at 1 kHz. The results suggest that the device is useful in detecting decreases in stapes mobility in patients with chronic otitis media.

Animals↗
PubMed1958

Stapes mobilization for otosclerotic deafness; the monitored peribasal technique.

Direct surgical operation on the stapes footplate region in the treatment of hearing loss due to otosclerosis has been revived. In the last 100 cases of a total series of 600, the peribasal stapes mobilization (stapedolysis) technique was completely successful in 62 per cent, partially successful in 29 per cent and a failure in 9 per cent. Stapes mobilization requires precise microsurgical technique monitored by audiometry during the surgical procedure. It appears that mobilization is the preferred approach to the surgical treatment of otosclerosis, but fenestration of the vestibular labyrinth is an important secondary procedure in some cases. Successful restoration of hearing requires adequate mobility of the footplate coupled with physiological continuity of the drum ossicular chain mechanism.

Audiometry↗
PubMed1999

[Samuel Rosen (1897-1981): the originator of stapes mobilization].

Samuel Rosen originator of the surgical procedure so called mobilization, was second only to Juliusz Lempert as one of the great modern discoverers of new surgical techniques in the treatment of otosclerosis. This was the result of a chance discovery during routine stapes mobility test of the ossiculat chain before fenestration. Rosen having had excellent scientific training and knowledge was well prepared to interpret accidental stapes mobility and so design a new surgical technique. This operation enabled thousands of patients with otosclerosis to regain their hearing. However, he did not receive widespread acclaim in his own country. He received many invitations from abroad, travelled to several countries around the world where he taught stapes mobility testing and demonstrated his surgical procedure. In 1957 he also visited Poland, where he was born. He did not however limit himself to microsurgery of the ear. He created a group of international scientists who on the basis of investigations carried out by some of them, in the quiet noiseless African bush demonstrated that not only hearing is protected and the ageing process of this sensory organ delayed but also the development of arteriosclerosis is slowed down that which is the root cause of more and more cases of heart disease which among other factors can be attributed to the noisy stress ridden world we live in. After much success and fame which he achieved throughout the world, the American Medical Association awarded Sam Rosen a gold medal in 1967. But this too was not widely accepted by all his colleagues in his own country. He died in 1981 in China.

History, 20th Century↗
PubMed2001

Stapes mobilization in otosclerosis.

We performed a retrospective chart study (including surgeon's notes and audiometric results) and an analysis of the archival temporal bones from a patient who had undergone surgery for stapes mobilization in both ears. The stapes footplate was submerged into the vestibule on the right (as a complication of surgery) and absent on the left. One interesting finding was that the patient's hearing had improved on the right despite the presence of the depressed footplate and that the air-bone gap had widened on the left despite the absence of complications on that side.

Aged↗
PubMed1993

Manipulating the mobile stapes during tympanoplasty: the risk of stapedial luxation.

Manipulating the mobile stapes is a central procedure during tympanoplasty, i.e., mounting a prosthesis onto the stapedial head or dissecting cholesteatoma matrix off the oval window niche. An excessive displacement of the stapedial suprastructure as caused by these manipulations with hand-held instruments might result in a rupture of the annular ligament. Bacteria invading through this perilymphatic fistula threaten the inner ear. In experiments with temporal bones, the author investigated the rupture mechanisms of the annular ligament with definite stapedial manipulations. Leaks, which became detectable by exerting pressure on the inner ear fluid, occur only when all suspension fibers are completely ruptured. Further clinical aspects with different directions of stapedial manipulations are demonstrated.

Cochlear Diseases↗
PubMed1996

Prosthesis on a mobilized stapes footplate.

Managing a mobilized footplate in stapedectomy surgery can be challenging. Between 1963 and 1992, 145 footplates were inadvertently mobilized during otosclerosis surgery. After a vein graft, a 4.0-mm Robinson prosthesis was placed on all footplates, making no attempt to remove the footplate. There were 73 thin, blue footplates and 72 thick, white footplates. Hearing results in the thin, blue footplate group was 97% successful and 100% satisfactory at 3 years. No footplate refixed. In the thick, white group, hearing was 60% successful and 72% satisfactory at 6 months. Footplate refixation was found at revision in all but one unsuccessful case. After revision, the thick, white group had 79% successful and 89% satisfactory hearing results at 3 years. No patient in either group was worse. We conclude that placing a vein graft and a Robinson prosthesis is a safe and effective technique for a mobilized footplate. If the footplate is thin and blue, there is little or no risk of refixation. If the footplate is thick and white, approximately 30% will require revision.

Follow-Up Studies↗