Titre
Labyrinthine fenestration for tympanosclerotic stapes fixation.
Type
article
Institution
Externe
Auteur(s)
Querat, C.
Auteure/Auteur
Richard, C.
Auteure/Auteur
Martin, C.
Auteure/Auteur
Liens vers les personnes
ISSN
1879-730X
Statut éditorial
Publié
Date de publication
2012
Volume
129
Numéro
6
Première page
297
Dernière page/numéro d’article
301
Peer-reviewed
Oui
Langue
anglais
Résumé
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.
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.
PID Serval
serval:BIB_69604DE28C82
PMID
Open Access
Oui
Date de création
2016-02-09T11:51:36.085Z
Date de création dans IRIS
2025-05-21T02:32:39Z