Management of incus necrosis in revision stapedectomy using hydroxyapatite bone cement.
| Autor: | House JW; House Clinic, Los Angeles, California, U.S.A., Lupo JE, Goddard JC |
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| Jazyk: | angličtina |
| Zdroj: | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2014 Sep; Vol. 35 (8), pp. 1312-6. |
| DOI: | 10.1097/MAO.0000000000000496 |
| Abstrakt: | Objective: Review audiological outcomes after revision stapedectomy using hydroxyapatite cement. Study Design: Retrospective case review. Setting: Tertiary neurotological referral center. Patients: Thirty-seven cases of previously treated otosclerosis where incus erosion was observed during revision stapedectomy. Intervention(s): Hydroxyapatite cement was used to rebuild the eroded incus and stabilize the prosthesis during revision stapedectomy. Main Outcome Measure(s): Pre- and postoperative bone conduction (BC) and air conduction (AC) pure-tone averages (PTA) (0.5, 1, 2, 3 kHz) including high tone BC (1, 2, 4 kHz), air-bone gap (ABG), and speech discrimination scores were measured. Short-term (3 wk) and longer-term (average 12 mo) hearing outcomes were measured. Data are reported according to the most recent guidelines of the AAO-HNS Committee on Hearing and Equilibrium. Results: Among 37 ears undergoing revision stapedectomy with hydroxyapatite cement, the AC PTA was 59.8 dB preoperatively and 34.6 dB postoperatively (p < 0.0001) at latest follow-up. The mean postoperative ABG was 8.8 dB (SD = 8.6, range -1.3-36.3 dB) while a mean improvement of 2.1 dB (SD = 6.5, range -8.33-15.0 dB) of the high tone BC PTA was observed. One revision case was noted during the follow-up period. Conclusion: Hydroxyapatite cement is useful to reconstruct and stabilize the prosthesis in revision stapedectomy when erosion of the long process is encountered. Short- and longer-term hearing results are favorable when compared to previously reported results of revision stapedectomy. |
| Databáze: | MEDLINE |
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