The influence of the footplate-perilymph interface on postoperative bone conduction.
In a prospective study, 165 total stapedectomies and 152 small fenestra stapedotomies were performed by three experienced surgeons between 2001 and 2003. In total stapedectomy, a self-made Schuknecht steel wire connective tissue prosthesis, and in stapedotomy, a 0.6-mm platinum wire Teflon piston was used. The pre- and postoperative bone conduction thresholds were compared at the frequencies 250 Hz, 500 Hz, 1 kHz, 1.5 kHz, 2 kHz, 3 kHz and 4 kHz. The postoperative bone conduction between 250 Hz and 3 kHz was significantly better in the total stapedectomy group than in the stapedotomy group. At 4 kHz, both groups showed a slight decrease in bone conduction but the difference was not statistically significant. Therefore, especially in cases with preoperative moderate sensorineural hearing loss, we recommend total stapedectomy using a Schuknecht steel wire connective tissue prosthesis, which offers a stapes-perilymph interface similar to the normal stapes.
Arnold
Wolfgang
W
Department of Otolaryngology, Head and Neck Surgery, Technical University of unich, Klinikum rechts der Isar, Munich, Germany.
Ferekidis
Elefterios
E
Hamann
Karl-Friedrich
KF
D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D001844:Bone Conduction / Q000502:physiology*; D005276:Fenestration, Labyrinth; D006314:Hearing Loss, Conductive / Q000503:physiopathology / Q000601:surgery; D006319:Hearing Loss, Sensorineural / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000503:physiopathology / Q000601:surgery*; D010498:Perilymph / Q000502:physiology*; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology*; D011446:Prospective Studies; D011474:Prosthesis Design; D013201:Stapes Surgery