Modern surgical treatment of otosclerosis - Helda - Helsinki.fi

More documents

Recommendations

Info

5.2 Outpatient surgery (II) Results and comments Eleven (12%) of 94 patients had to stay overnight at hospital. Two of the patients who had undergone stapedotomy were required to stay at hospital because they otherwise would have been alone during the night following surgery. One patient from both groups was required to stay due to surgery that had been scheduled late in the day. Only seven patients (7%) had a medical reason for inpatient treatment. These seven patients experienced vestibular symptoms and nausea; six belonged to the stapedectomy group and one to the stapedotomy group. Vestibular symptoms diminished during the night following surgery, and all patients were discharged on the first postoperative day. The differences in outpatient failure due to vestibular symptoms were significant (p=0.05) between the two groups. Hearing results were similar in both groups, with no significant differences in mean results or in individual frequencies (Table 3). A postoperative AB-GAP of less than 10 dB was achieved in 70% (33/47) of stapedectomy patients and in 83% (39/47) of stapedotomy patients. Two patients (4%) had an AB-GAP over 20 dB in the stapedectomy group and one (2%) in the stapedotomy group. Outpatient failure had no impact on hearing results. After surgery, no patients suffered from significant (over 10 dB) SNHL. Five patients (11%) had mild SNHL (5-8 dB) in the stapedectomy group compared with only two (4%) in the stapedotomy group (6 and 7 dB). The groups did not differ significantly (p=0.24) from one another. Statistically significant differences were present in outpatient failures due to vestibular symptoms, but hearing results did not differ between the groups. Both techniques can be used successfully, but stapedotomy is the preferred method in an outpatient setting. 50
Results and comments Table 3. Hearing thresholds (dB) for stapedectomy and stapedotomy patients. AC=air conduction, BC=bone conduction, GAB=AC-BC, GAIN=preGAP-postGAP, Mean= the mean of 0.5 - 4 kHz. Stapedectomy group Frequency Preoperative Postoperative (kHz) AC BC GAP AC BC GAP GAIN 0.125 51.5 26.8 0.25 53.0 6.3 46.6 26.3 7.9 18.4 28.2 0.5 52.9 19.0 33.9 24.5 15.5 9.0 24.9 1 53.4 26.6 26.8 27.0 19.3 7.7 19.1 2 47.2 36.3 10.9 31.0 28.3 2.7 8.2 4 50.2 26.6 23.3 39.7 29.1 10.6 12.7 8 48.6 53.8 Mean 50.9 27.1 23.8 30.6 23.1 7.5 16.3 Stapedotomy group Frequency Preoperative Postoperative (kHz) AC BC GAP AC BC GAP GAIN 0.125 55.7 27.3 0.25 57.2 8.4 48.8 26.7 9.0 17.7 31.1 0.5 56.7 21.0 35.7 25.9 18.4 7.5 28.2 1 54.9 25.3 29.6 26.4 19.1 7.3 22.3 2 49.0 37.6 11.4 30.0 27.9 2.1 9.3 4 51.7 27.6 24.1 39.1 27.8 11.3 12.8 8 51.4 54.8 Mean 53.1 27.9 25.2 30.4 23.3 7.1 18.2 51
Page 1 and 2: Department of Otorhinolaryngology U
Page 3 and 4: To my Family
Page 5 and 6: Stapedius tendon preservation 29 Re
Page 7 and 8: List of original publications The t
Page 9 and 10: Abstract Abstract The era of modern
Page 11 and 12: Tiivistelmä (Finnish summary) Tiiv
Page 13 and 14: 1 Introduction Introduction Otoscle
Page 15 and 16: 2 Review of the literature 2.1 Defi
Page 17 and 18: Clinical otosclerosis Review of the
Page 19 and 20: Review of the literature examinatio
Page 21 and 22: Review of the literature hearing lo
Page 23 and 24: Otosclerosis and Meniere’s diseas
Page 25 and 26: Review of the literature is positiv
Page 27 and 28: Review of the literature and light-
Page 29 and 30: Review of the literature shorter wa
Page 31 and 32: Review of the literature The analys
Page 33 and 34: Review of the literature Twenty-eig
Page 35 and 36: Review of the literature demonstrat
Page 37 and 38: Review of the literature disturb th
Page 39 and 40: Review of the literature images. In
Page 41 and 42: 3 Aims of the study Aims of the stu
Page 43 and 44: Studies III and IV Materials and me
Page 45 and 46: Materials and methods Study III inc
Page 47 and 48: Materials and methods Figure 2. Vis
Page 49: Results and comments improved signi
Page 53 and 54: Results and comments A final follow
Page 55 and 56: Results and comments spontaneous ho
Page 57 and 58: Discussion The patient also would a
Page 59 and 60: Discussion surgeries are suitable f
Page 61 and 62: Discussion Patients with vestibular
Page 63 and 64: 7 Conclusions Conclusions Audiologi
Page 65 and 66: Acknowledgements Most of my writing
Page 67 and 68: References Baloh RW, Honrubia. Clin
Page 69 and 70: References Dahlqvist A, Diamant H,
Page 71 and 72: References Gersdorff M, Nouwen J, G
Page 73 and 74: References Jablokow VR, Kathuria S.
Page 75 and 76: References Markou K, Goudakos J. An
Page 77 and 78: References Perkings RC. Laser stape
Page 79 and 80: References Shabana YK, Ghonim MR, P
Page 81 and 82: References Toner JG, Smyth GDL. Com
Page 83 and 84: Appendix Questionnaire used to asse

Modern surgical treatment of otosclerosis - Helda - Helsinki.fi

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?