Objective:To assess hyperacusis after stapedotomy and its possible influencing factors.Study design:Prospective,interventional,and longitudinal study.Setting:A tertiary referral center.Patients:Fifty consecutive patie...Objective:To assess hyperacusis after stapedotomy and its possible influencing factors.Study design:Prospective,interventional,and longitudinal study.Setting:A tertiary referral center.Patients:Fifty consecutive patients(35 females,mean age=46.8 years).Intervention:All patients underwent stapedotomy.The validated Portuguese version of the“Hyperacusis Questionnaire”(HQ)was administered before and two weeks and one month after surgery.Results:No hyperacusis was reported by any patient before surgery.At two weeks after surgery,all patients experienced hyperacusis,with a mean HQ at 16.88±6.54(range 4e25).One month after surgery,hyperacusis had already resolved in most patients.Gender,preoperative presentation or surgeon had no influence on HQ scores(p>0.05).Patients with previous contralateral stapedotomy showed lower HQ scores(p=0.001).Audiological parameters improvement measured at one month after surgery(PTA,SRT and contralateral SRT)were associated with HQ higher scores.Conclusion:This study confirms that hyperacusis is a common complaint after stapedotomy that usually resolves in one month after surgery.The HQ highest scores were registered among patients with the highest audiological gain after surgery.This suggests that hyperacusis may be a positive prognostic factor for audiological success after stapedotomy.展开更多
Background: The measurement of the piston length during stapedotomy is important and it may have significant effects on the surgical outcome.Objective: To determine the piston length in a group of otosclerosis patient...Background: The measurement of the piston length during stapedotomy is important and it may have significant effects on the surgical outcome.Objective: To determine the piston length in a group of otosclerosis patients who underwent primary stapedotomy.Material and methods: Between Sep 2013 and Sep 2014, 85 patients with diagnosed otosclerosis underwent primary stapedotomy. Teflon prosthesis of 0.6 mm of diameter was used in all patients. The distance between medial surface of the long process of incus and center point of the stapedial footplate measured. The piston length calculated by adding 0.25 mm for the thickness of footplate and 0.50 mm for placement of the prosthesis into the vestibule.Results: The distance between stapedial foot plate and incus ranged from 3.50 to 4.50 mm. The mean distance was 3.95 ± 0.16 mm. In majority of cases(74.1%) piston length was 4.75 mm followed by 4.50 mm in 15.3% and 5.00 mm in 5.9%. Piston length was 4.25 mm in 3.5% and5.25 mm in only 1.2% of patients. There was no significant post-operative complication and air bone gap closure obtained in all patients.Conclusion: The most common distance between foot plate and incus is 4.00 mm. No case needed a piston longer than 5.25 mm or shorter than4.25 mm.展开更多
BACKGROUND Stapes ankylosis is a rare cause of conductive hearing loss,and stapes suprastructure fixation is extremely rare with fewer than 30 reported cases.Patients usually visit the clinic with non-progressive cond...BACKGROUND Stapes ankylosis is a rare cause of conductive hearing loss,and stapes suprastructure fixation is extremely rare with fewer than 30 reported cases.Patients usually visit the clinic with non-progressive conductive hearing loss that typically began in the early years of life.CASE SUMMARY Herein,we report a case of a 37-year-old female with an isolated stapedial suprastructure fixation.The patient presented with unusual fluctuating auditory symptoms of tinnitus,ear fullness and mixed hearing loss.Pre-operative temporal bone computed tomography findings and operative findings revealed an isolated stapedial suprastructure fixation with monopod stapes caused by elongated pyramidal eminence.The hearing threshold recovered completely,and fluctuating auditory symptoms disappeared after the surgery.CONCLUSION This is the first report of stapedial suprastructure fixation with fluctuating auditory symptoms.Successful results are expected with surgical treatment.展开更多
Stapes fracture causes hearing loss and instability in the middle ear hearing system(MEHS). The material used in the stapes reconstruction restores stapes, but the effects of the nonlinear material parameters on the s...Stapes fracture causes hearing loss and instability in the middle ear hearing system(MEHS). The material used in the stapes reconstruction restores stapes, but the effects of the nonlinear material parameters on the stability of the MEHS are still unknown. To address this challenge, the nonlinear dynamic response and stability of the stapes reconstruction are investigated using a multi-degree-of-freedom mechanical model. The material parameters of the implant are tentatively determined by analyzing the natural frequencies of the undamped system. The dynamical properties of the MEHS are characterized under different external excitations. The approximate solution of the MEHS near the resonant frequency is derived through the multiple-time-scale method(MTSM). The results show that the nonlinear stiffness of the material has little influence on the MEHS in the healthy state, but it causes resonant phenomena between the ossicle and the implant in the pathological state.展开更多
Objective: to study the nursing measures for otosclerosis patients treated with CO2 laser assisted stapes prosthesis. Methods: 85 patients with otosclerosis treated in our hospital from 2018 to 2020 were selected as t...Objective: to study the nursing measures for otosclerosis patients treated with CO2 laser assisted stapes prosthesis. Methods: 85 patients with otosclerosis treated in our hospital from 2018 to 2020 were selected as the research object. All the selected 85 patients were treated with CO2 laser-assisted artificial stapes technique. 85 patients were randomly divided into control group (n = 42) and experimental group (n = 43). The control group received routine nursing while the experimental group received perioperative nursing cooperation. Results: the incidence of complications in the experimental group was significantly lower than that in the control group, and the nursing satisfaction of the patients in the experimental group was significantly higher than that in the control group. The data of each index group were compared, P < 0.05. Conclusion: in the process of CO2 laser-assisted artificial stapes treatment for patients with otosclerosis, perioperative nursing cooperation from preoperative, intraoperative and postoperative can effectively reduce the incidence of complications of patients and improve patients' nursing satisfaction.展开更多
Human temporal bone specimens are used in experiments to measure the sound transfer function of the middle ear.This standard method for the development of middle ear implants requires temporal bones that possess appro...Human temporal bone specimens are used in experiments to measure the sound transfer function of the middle ear.This standard method for the development of middle ear implants requires temporal bones that possess appropriate mechanical properties and structural stability and are free from pathological conditions.A laser Doppler vibrometer is commonly employed to measure the vibration of the stapes footplate.These experiments are typically conducted in the middle ear by leaving the inner ear intact,exposing the stapes footplate through the tympanic cavity,and directing the laser beam onto the footplate.However,previous studies have shown that the influence of inner ear impedance on the middle ear transfer function cannot be ignored,and any surgical manipulation may cause a change in inner ear pressure,resulting in instability in the middle ear transfer function.Therefore,this study aims to eliminate the influence of the inner ear and to establish a new experimental method in human temporal bone specimens that is more suitable for the study of sound conduction in middle ear implants.As a result,a range for middle ear transfer function was developed,which serves as a reference for assessing the conformity of temporal bone specimens to experimental standards,and the stability of this range was demonstrated under experimental conditions.展开更多
Background:Stapes prostheses play a crucial role in improving auditory performance and facilitating the patient's reintegration into social life.However,determining the ideal characteristics of a prosthesis and id...Background:Stapes prostheses play a crucial role in improving auditory performance and facilitating the patient's reintegration into social life.However,determining the ideal characteristics of a prosthesis and identifying the best commercially available option remain challenging.This study aims to compare the outcomes of two different types of prostheses:the MatriX Stapes Prosthesis and the new mAXIS Stapes Prosthesis.Methods:A prospective study was conducted on patients diagnosed with suspected otosclerosis who underwent stapedotomy,receiving either the MatriX or m AXIS prosthesis randomly during surgery.Postoperative follow-ups were conducted for at least one year.Audiometric evaluations were analyzed using statistical tests.Additionally,a systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Metaanalyses(PRISMA)statement.Results:The prospective study included 84 patients,divided into two groups(G1:MatriX,G2:mAXIS).The auditory results were satisfactory for both prostheses,demonstrating their effectiveness in improving hearing thresholds.We observed a gain for air conduction threshold of 26.2 dB vs 21.2 dB with an ABG closure of 20.7 dB vs and 21.2 dB in G1 and G2 respectively.The literature review encompassed 15studies,revealing overall positive outcomes with different prosthetic materials.Conclusions:The study revealed effective auditory improvement with both prostheses,yet no statistically significant differences in air-bone gap closure or average hearing gain.Titanium emerged as the preferred material due to its biocompatibility,lightweight nature,and stability under magnetic resonance imaging.The mAXIS prosthesis is introduced as a cost-effective alternative with favorable intraoperative features.展开更多
目的对耳内镜下激光辅助人工镫骨植入手术的临床疗效进行观察和探讨。方法收集采用耳内镜下激光辅助人工镫骨植入手术32例患者的临床资料,对其听力改善效果进行观察,对该手术方式的临床疗效进行评价。结果 32例人工镫骨植入手术均顺利完...目的对耳内镜下激光辅助人工镫骨植入手术的临床疗效进行观察和探讨。方法收集采用耳内镜下激光辅助人工镫骨植入手术32例患者的临床资料,对其听力改善效果进行观察,对该手术方式的临床疗效进行评价。结果 32例人工镫骨植入手术均顺利完成,言语频率(500Hz、1000Hz、2000Hz、4000Hz)平均气导阈值由术前的57.19±11.06 dB HL下降至术后的36.88±11.51 dB HL,同时骨导阈值无明显升高,平均气骨导差由术前的32.47±8.72 dB HL缩小至术后的11.81±9.15 dB HL。2例发生鼓索神经牵拉,但未发生面瘫及严重感音神经性耳聋等并发症。结论联合耳内镜和Diode激光辅助镫骨底板开窗,进行人工镫骨植入手术,具有损伤小、术野清晰、安全性好和操作精度高等特点,术后患者听力改善明显,具有较好的临床疗效。展开更多
文摘Objective:To assess hyperacusis after stapedotomy and its possible influencing factors.Study design:Prospective,interventional,and longitudinal study.Setting:A tertiary referral center.Patients:Fifty consecutive patients(35 females,mean age=46.8 years).Intervention:All patients underwent stapedotomy.The validated Portuguese version of the“Hyperacusis Questionnaire”(HQ)was administered before and two weeks and one month after surgery.Results:No hyperacusis was reported by any patient before surgery.At two weeks after surgery,all patients experienced hyperacusis,with a mean HQ at 16.88±6.54(range 4e25).One month after surgery,hyperacusis had already resolved in most patients.Gender,preoperative presentation or surgeon had no influence on HQ scores(p>0.05).Patients with previous contralateral stapedotomy showed lower HQ scores(p=0.001).Audiological parameters improvement measured at one month after surgery(PTA,SRT and contralateral SRT)were associated with HQ higher scores.Conclusion:This study confirms that hyperacusis is a common complaint after stapedotomy that usually resolves in one month after surgery.The HQ highest scores were registered among patients with the highest audiological gain after surgery.This suggests that hyperacusis may be a positive prognostic factor for audiological success after stapedotomy.
文摘Background: The measurement of the piston length during stapedotomy is important and it may have significant effects on the surgical outcome.Objective: To determine the piston length in a group of otosclerosis patients who underwent primary stapedotomy.Material and methods: Between Sep 2013 and Sep 2014, 85 patients with diagnosed otosclerosis underwent primary stapedotomy. Teflon prosthesis of 0.6 mm of diameter was used in all patients. The distance between medial surface of the long process of incus and center point of the stapedial footplate measured. The piston length calculated by adding 0.25 mm for the thickness of footplate and 0.50 mm for placement of the prosthesis into the vestibule.Results: The distance between stapedial foot plate and incus ranged from 3.50 to 4.50 mm. The mean distance was 3.95 ± 0.16 mm. In majority of cases(74.1%) piston length was 4.75 mm followed by 4.50 mm in 15.3% and 5.00 mm in 5.9%. Piston length was 4.25 mm in 3.5% and5.25 mm in only 1.2% of patients. There was no significant post-operative complication and air bone gap closure obtained in all patients.Conclusion: The most common distance between foot plate and incus is 4.00 mm. No case needed a piston longer than 5.25 mm or shorter than4.25 mm.
文摘BACKGROUND Stapes ankylosis is a rare cause of conductive hearing loss,and stapes suprastructure fixation is extremely rare with fewer than 30 reported cases.Patients usually visit the clinic with non-progressive conductive hearing loss that typically began in the early years of life.CASE SUMMARY Herein,we report a case of a 37-year-old female with an isolated stapedial suprastructure fixation.The patient presented with unusual fluctuating auditory symptoms of tinnitus,ear fullness and mixed hearing loss.Pre-operative temporal bone computed tomography findings and operative findings revealed an isolated stapedial suprastructure fixation with monopod stapes caused by elongated pyramidal eminence.The hearing threshold recovered completely,and fluctuating auditory symptoms disappeared after the surgery.CONCLUSION This is the first report of stapedial suprastructure fixation with fluctuating auditory symptoms.Successful results are expected with surgical treatment.
基金Project supported by the National Natural Science Foundation of China (Nos. 12072222, 12132010,12021002, 11991032, and 12372019)the State Key Laboratory of Mechanical Behavior and System Safety of Traffic Engineering Structures of China (No. SKLTESKF1901)the Aeronautical Science Foundation of China (No. ASFC-201915048001)。
文摘Stapes fracture causes hearing loss and instability in the middle ear hearing system(MEHS). The material used in the stapes reconstruction restores stapes, but the effects of the nonlinear material parameters on the stability of the MEHS are still unknown. To address this challenge, the nonlinear dynamic response and stability of the stapes reconstruction are investigated using a multi-degree-of-freedom mechanical model. The material parameters of the implant are tentatively determined by analyzing the natural frequencies of the undamped system. The dynamical properties of the MEHS are characterized under different external excitations. The approximate solution of the MEHS near the resonant frequency is derived through the multiple-time-scale method(MTSM). The results show that the nonlinear stiffness of the material has little influence on the MEHS in the healthy state, but it causes resonant phenomena between the ossicle and the implant in the pathological state.
文摘Objective: to study the nursing measures for otosclerosis patients treated with CO2 laser assisted stapes prosthesis. Methods: 85 patients with otosclerosis treated in our hospital from 2018 to 2020 were selected as the research object. All the selected 85 patients were treated with CO2 laser-assisted artificial stapes technique. 85 patients were randomly divided into control group (n = 42) and experimental group (n = 43). The control group received routine nursing while the experimental group received perioperative nursing cooperation. Results: the incidence of complications in the experimental group was significantly lower than that in the control group, and the nursing satisfaction of the patients in the experimental group was significantly higher than that in the control group. The data of each index group were compared, P < 0.05. Conclusion: in the process of CO2 laser-assisted artificial stapes treatment for patients with otosclerosis, perioperative nursing cooperation from preoperative, intraoperative and postoperative can effectively reduce the incidence of complications of patients and improve patients' nursing satisfaction.
文摘Human temporal bone specimens are used in experiments to measure the sound transfer function of the middle ear.This standard method for the development of middle ear implants requires temporal bones that possess appropriate mechanical properties and structural stability and are free from pathological conditions.A laser Doppler vibrometer is commonly employed to measure the vibration of the stapes footplate.These experiments are typically conducted in the middle ear by leaving the inner ear intact,exposing the stapes footplate through the tympanic cavity,and directing the laser beam onto the footplate.However,previous studies have shown that the influence of inner ear impedance on the middle ear transfer function cannot be ignored,and any surgical manipulation may cause a change in inner ear pressure,resulting in instability in the middle ear transfer function.Therefore,this study aims to eliminate the influence of the inner ear and to establish a new experimental method in human temporal bone specimens that is more suitable for the study of sound conduction in middle ear implants.As a result,a range for middle ear transfer function was developed,which serves as a reference for assessing the conformity of temporal bone specimens to experimental standards,and the stability of this range was demonstrated under experimental conditions.
文摘Background:Stapes prostheses play a crucial role in improving auditory performance and facilitating the patient's reintegration into social life.However,determining the ideal characteristics of a prosthesis and identifying the best commercially available option remain challenging.This study aims to compare the outcomes of two different types of prostheses:the MatriX Stapes Prosthesis and the new mAXIS Stapes Prosthesis.Methods:A prospective study was conducted on patients diagnosed with suspected otosclerosis who underwent stapedotomy,receiving either the MatriX or m AXIS prosthesis randomly during surgery.Postoperative follow-ups were conducted for at least one year.Audiometric evaluations were analyzed using statistical tests.Additionally,a systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Metaanalyses(PRISMA)statement.Results:The prospective study included 84 patients,divided into two groups(G1:MatriX,G2:mAXIS).The auditory results were satisfactory for both prostheses,demonstrating their effectiveness in improving hearing thresholds.We observed a gain for air conduction threshold of 26.2 dB vs 21.2 dB with an ABG closure of 20.7 dB vs and 21.2 dB in G1 and G2 respectively.The literature review encompassed 15studies,revealing overall positive outcomes with different prosthetic materials.Conclusions:The study revealed effective auditory improvement with both prostheses,yet no statistically significant differences in air-bone gap closure or average hearing gain.Titanium emerged as the preferred material due to its biocompatibility,lightweight nature,and stability under magnetic resonance imaging.The mAXIS prosthesis is introduced as a cost-effective alternative with favorable intraoperative features.
文摘目的对耳内镜下激光辅助人工镫骨植入手术的临床疗效进行观察和探讨。方法收集采用耳内镜下激光辅助人工镫骨植入手术32例患者的临床资料,对其听力改善效果进行观察,对该手术方式的临床疗效进行评价。结果 32例人工镫骨植入手术均顺利完成,言语频率(500Hz、1000Hz、2000Hz、4000Hz)平均气导阈值由术前的57.19±11.06 dB HL下降至术后的36.88±11.51 dB HL,同时骨导阈值无明显升高,平均气骨导差由术前的32.47±8.72 dB HL缩小至术后的11.81±9.15 dB HL。2例发生鼓索神经牵拉,但未发生面瘫及严重感音神经性耳聋等并发症。结论联合耳内镜和Diode激光辅助镫骨底板开窗,进行人工镫骨植入手术,具有损伤小、术野清晰、安全性好和操作精度高等特点,术后患者听力改善明显,具有较好的临床疗效。
