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Labyrinthine fenestration for stapes fixation in chronic ear disease others than otosclerosis

Zaugg, Yannick ; Linder, Thomas

In: European Archives of Oto-Rhino-Laryngology, 2015, vol. 272, no. 9, p. 2161-2166

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    Titre
    • Labyrinthine fenestration for stapes fixation in chronic ear disease others than otosclerosis
    Auteur
    • Zaugg, Yannick. Department of ENT, Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois, Avenue du Bugnon 21, 1011, Lausanne, Switzerland
    • Linder, Thomas. Department of ENT, Head and Neck Surgery, Luzerner Kantonspital, 6006, Luzern, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • European Archives of Oto-Rhino-Laryngology, 2015, vol. 272, no. 9, p. 2161-2166. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:332117
    Summary
    The objective of this study is to assess the results of labyrinthine fenestration for fixed stapes in chronic ear disease. Using a prospective database, pre- and postoperative audiometric data from patients undergoing labyrinthine fenestration for fixation of the stapes in chronic ear disease others than otosclerosis between 2002 and 2012 were evaluated. Twenty-three labyrinthine fenestrations in chronic ear disease were performed (17 malleo-stapedotomies, 4 incus-stapedotomies, 1 neo-malleus-stapedotomy, 1 TORP-stapedotomy). Overall, the mean short-term (2months) and long-term (42months) postoperative air-bone gap (0.5-3kHz) were 17.5 and 16.5dB, respectively; long-term air-bone gap of <20dB was obtained in 73% of patients. There was no significant difference in air-bone gap closure between tympanosclerotic and post inflammatory osteogenic fixation of the stapes (p=0.267). Hearing benefit success using the ‘Belfast rule of the thumb' was achieved in 48%. Normal bilateral hearing was achieved in 17% and bilateral symmetric hearing impairment in 26%. Only in 4%, bone conduction worsened by more than 5dB. Labyrinthine fenestration is an option in selected cases of stapes fixation in chronic ear disease and provides hearing gain without significant risk for sensorineural hearing loss. In those already selected cases, hearing benefit success ‘Belfast rule of the thumb' is achieved only in half of the cases. This and the possible alternatives, should therefore be discussed preoperatively.