Management of Incus Necrosis in Revision Stapedectomy Using Hydroxyapatite Bone Cement
| Autor: | Goddard Jc, House Jw, Lupo Je |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty medicine.medical_treatment Incus Stapes Surgery Hydroxyapatite cement Prosthesis Necrosis Bone conduction Hearing medicine Humans Retrospective Studies Air conduction business.industry Hearing Tests Middle Aged Plastic Surgery Procedures Stapedectomy medicine.disease Bone cement Sensory Systems Surgery Otosclerosis Treatment Outcome Otorhinolaryngology Female Hydroxyapatites Neurology (clinical) business Bone Conduction |
| Zdroj: | Otology & Neurotology. 35:1312-1316 |
| ISSN: | 1531-7129 |
| DOI: | 10.1097/mao.0000000000000496 |
| Popis: | 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: | OpenAIRE |
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