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[PMID]:29400027
[Au] Autor:Montava M; Curto CL; Mancini J; Collin M; Lavieille JP
[Ti] Título:[Comparison of stapes protheses: A prospective analysis of audiometric results obtained after stapedotomy by implantation of a teflon piston and a Soft-CliP® piston].
[So] Source:Rev Laryngol Otol Rhinol (Bord);136(3):97-102, 2015.
[Is] ISSN:0035-1334
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:A wide variety of pistons are available for stapes surgery in otosclerosis. The objective of this work was to analyze the short-term and medium-term results of Soft-CliP® piston in prima­ry stapes surgery and to compare it with a conventional prosthesis. The study was prospective, monocentric, rando­mi­zed, based on efficiency of Soft-CliP® prosthesis (11 patients) versus Causse® Teflon prosthesis (9 patients) in otosclerosis surgery. Epidemiological data, treatment modalities, pure-tone audiometric results and outcome of patients were studied. Mean follow-up was 10 months. Soft-CliP® placement was statisti­cally longer. The mean postoperative air-bone gap was within 10 dB in 73% and 67% of cases at 2 months and in 82% and 89% of cases at medium-term in Soft-CliP® and Teflon groups respectively. A statistically significant decrease in mean air-bone gap and for all frequencies was observed at 2 months and at medium term, with no difference between the 2 groups. The main result was the demonstration of the reliability and safety of Soft-CliP® prosthesis. With a new design, Soft-CliP® place­ment was easy. The biomechanics of ossicular chain should be better preserved, and the risk of incus erosion and necrosis decreased. A study on a larger population in the long-term would validate these results.
[Mh] Termos MeSH primário: Audiometria
Prótese Ossicular
Otosclerose/cirurgia
Cirurgia do Estribo
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Desenho de Prótese
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180206
[St] Status:MEDLINE


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[PMID]:28964441
[Au] Autor:Kosaner Kliess M; Kluibenschaedl M; Zoehrer R; Schlick B; Scandurra F; Urban M
[Ad] Endereço:MED-EL Medical Electronics Ges.m.b.H., Innsbruck, Austria.
[Ti] Título:Cost-Utility of Partially Implantable Active Middle Ear Implants for Sensorineural Hearing Loss: A Decision Analysis.
[So] Source:Value Health;20(8):1092-1099, 2017 Sep.
[Is] ISSN:1524-4733
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Partially implantable active middle ear implants (aMEIs) offer a solution for individuals who have mild to severe sensorineural hearing loss and an outer ear medical condition that precludes the use of hearing aids. When otherwise left untreated, individuals report a lower quality of life, which may further decrease with increasing disability. In the lack of cost-effectiveness studies and long-term data, there is a need for decision modeling. OBJECTIVE: To explore individual-level variance in resource utilization patterns following aMEI implantation. METHODS: A Markov model was developed and analyzed as microsimulation to estimate the incremental cost utility ratio (ICUR) of partially implantable aMEIs compared with no (surgical) intervention in individuals with sensorineural hearing loss and an outer ear medical condition in Australia. Cost data were derived mostly from the Medicare Benefit Schedule and effectiveness data from published literature. A third-party payer perspective was adopted, and a 5% discount rate was applied over a 10-year time horizon. RESULTS: Compared with baseline strategy, aMEIs yielded an incremental cost of Australian dollars (AUD) 13,339.18, incremental quality-adjusted life-year (QALY) of 1.35, and an ICUR of AUD 9,913.72/QALY. Of the respective number of simulated patients who visited each health state, 75.73% never had a minor adverse event, 99.82% did not experience device failure, and 97.75% did not cease to use their aMEIs. Probabilistic sensitivity analyses showed the ICUR to differ by only 0.95%. CONCLUSIONS: In the Australian setting, partially implantable aMEIs offer a safe and cost-effective solution compared with no intervention and are also well accepted by users.
[Mh] Termos MeSH primário: Perda Auditiva Neurossensorial/cirurgia
Prótese Ossicular/economia
Qualidade de Vida
Anos de Vida Ajustados por Qualidade de Vida
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Austrália
Análise Custo-Benefício
Técnicas de Apoio para a Decisão
Feminino
Perda Auditiva Neurossensorial/economia
Seres Humanos
Reembolso de Seguro de Saúde
Masculino
Cadeias de Markov
Meia-Idade
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171002
[St] Status:MEDLINE


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[PMID]:28688567
[Au] Autor:Govil N; Kaffenberger TM; Shaffer AD; Chi DH
[Ad] Endereço:Department of Otolaryngology, University of Pittsburgh Medical Center, Eye and Ear Institute, Suite 519, 203 Lothrop St, Pittsburgh, PA 15213, USA.
[Ti] Título:Factors influencing hearing outcomes in pediatric patients undergoing ossicular chain reconstruction.
[So] Source:Int J Pediatr Otorhinolaryngol;99:60-65, 2017 Aug.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Ossicular chain disruption in children leads to conductive hearing loss. Few studies have focused on factors influencing successful results in pediatric ossicular chain reconstruction (OCR). We aim to determine whether demographic or surgical factors affect hearing outcomes in pediatric OCR. METHODS: We conducted a retrospective chart review of 120 patients undergoing OCR at our institution, a tertiary care hospital, between 2003 and 2014, with median length of follow-up of 2.2 years (range 0.1-9.3 years). Pediatric patients (<18 years old at time of surgical procedure) who had current procedural terminology (CPT) codes of OCR, and available pre- and post-operative audiograms were included in the study. Demographic information, surgical details, and pre- and post-operative pure-tone averages (PTA), speech reception thresholds (SRT), and air-bone gaps (ABG) were recorded from clinic notes, audiograms and operative reports. Differences between PTA, SRT and ABG pre- and post-operatively, as well as demographic and surgical factors, were evaluated using Wilcoxon rank-sum tests. Factors influencing revision were evaluated using Log-rank tests. RESULTS: A total of 120 patients (123 ears) were included. 35.8% of cases were revised, most commonly due to displaced prostheses. 28.5% of surgeries resulted in normal hearing (PTA ≤25 dB) post-operatively. Post-operative SRT and ABG were significantly better in patients with partial ossicular replacement prosthesis (PORP) compared with those with total ossicular replacement prosthesis (TORP) (p = 0.016, 0.027). Titanium prostheses resulted in better post-operative PTA and larger changes in PTA compared with all other materials (p = 0.034, p = 0.038). CONCLUSIONS: In our experience, children with titanium prostheses had better hearing outcomes than those with other materials, and children with PORP had better hearing outcomes than those with TORP.
[Mh] Termos MeSH primário: Ossículos da Orelha/cirurgia
Perda Auditiva Condutiva/cirurgia
Prótese Ossicular/efeitos adversos
Substituição Ossicular/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seguimentos
Audição/fisiologia
Testes Auditivos
Seres Humanos
Masculino
Estudos Retrospectivos
Titânio/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
D1JT611TNE (Titanium)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170710
[St] Status:MEDLINE


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[PMID]:28555595
[Au] Autor:Iannella G; Marcotullio D; Re M; Manno A; Pasquariello B; Angeletti D; Falasca V; Magliulo G
[Ad] Endereço:Sensory Organs, Sapienza University of Rome, Italy. giannicolaiannella@hotmail.it.
[Ti] Título:Endoscopic vs Microscopic Approach in Stapes Surgery: Advantages in the Middle Ear Structures Visualization and Trainee's Point of View.
[So] Source:J Int Adv Otol;13(1):14-20, 2017 Apr.
[Is] ISSN:1308-7649
[Cp] País de publicação:Turkey
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Comparing the endoscopic and microscopic approaches in stapes surgery, and establishing the surgical approach that allows better results in terms of visualization of the middle ear structures and aids assistant's training. MATERIALS AND METHODS: Twenty-one residents from the first to the fifth year of training in Otolaryngology were enrolled in this prospective study. A questionnaire specifically designed to investigate the understanding of middle ear anatomy, the surgical steps, and a personal opinion about endoscopic stapes surgery was submitted to each resident. RESULTS: Statistical differences between the endoscopic and microscopic approaches were evident about identification of stapes and long process of the incus (p=0.03) and stapes footplate and the oval window (p=0.03). No substantial difference between the two surgical approaches emerged regarding the visualization of the tympanic membrane and the other middle ear structures (p>0.5). A substantial difference in favor of the endoscopic approach emerged regarding the identification of the hole creation in the footplate of the stapes. CONCLUSION: Endoscopic stapes surgery could favor an easier understanding of the surgical technique for assistants in training with little knowledge of the anatomy and surgical steps.
[Mh] Termos MeSH primário: Orelha Média/cirurgia
Internato e Residência
Substituição Ossicular
Otolaringologia/educação
Otoscopia
Cirurgia do Estribo/educação
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Microscopia
Prótese Ossicular
Substituição Ossicular/educação
Otoscopia/métodos
Estudos Prospectivos
Inquéritos e Questionários
Resultado do Tratamento
Membrana Timpânica/cirurgia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE
[do] DOI:10.5152/iao.2017.3322


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[PMID]:28542633
[Au] Autor:Kwacz M; Solyga M; Mrówka M; Kamieniecki K
[Ad] Endereço:Warsaw University of Technology, Institute of Micromechanics and Photonics, Warsaw, Poland.
[Ti] Título:New chamber stapes prosthesis - A preliminary assessment of the functioning of the prototype.
[So] Source:PLoS One;12(5):e0178133, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Piston-stapedotomy is the most common method for hearing restoration in patients with otosclerosis. In this study, we have experimentally examined a prototype of a new chamber stapes prosthesis. The prototype was implanted in a human cadaver temporal bone. The round window vibrations before and after implantation were measured for the acoustic signal (90 dB SPL, 0.8-8 kHz) in the external auditory canal. In comparison with a 0.4-mm piston prosthesis, the chamber prosthesis induced significantly higher vibration of the round window, especially for frequencies above 1.5 kHz. Based on the results, it can be surmised that stapedotomy with a chamber stapes prosthesis could provide better hearing results in comparison with the piston-stapedotomy.
[Mh] Termos MeSH primário: Prótese Ossicular
[Mh] Termos MeSH secundário: Estimulação Acústica
Cadáver
Desenho de Equipamento
Seres Humanos
Lactonas
Otosclerose/fisiopatologia
Otosclerose/cirurgia
Janela da Cóclea/fisiopatologia
Janela da Cóclea/cirurgia
Cirurgia do Estribo/instrumentação
Cirurgia do Estribo/métodos
Osso Temporal/fisiopatologia
Osso Temporal/cirurgia
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Lactones); 0 (vibralactone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0178133


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[PMID]:28397537
[Au] Autor:Le PT; O'Connell BP; Baker AB; Keller RG; Lambert PR
[Ad] Endereço:1 Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
[Ti] Título:Titanium Ossicular Chain Reconstruction Revision Success and Preoperative Factors Predicting Success.
[So] Source:Otolaryngol Head Neck Surg;157(1):99-106, 2017 Jul.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective Determine rates of success after revision titanium ossicular chain reconstruction with either partial or total ossicular replacement prosthesis and assess preoperative factors predicting positive outcomes. Study Design Case series with planned data collection. Setting Tertiary hospital. Subjects and Methods The charts of 76 surgical patients who underwent revision titanium ossicular chain reconstruction from 2003 to 2014 were abstracted from a prospectively maintained database at the Medical University of South Carolina. Postoperative air-bone gap (ABG) after revision surgery at short-term (<6 months) and intermediate to long-term (>1 year) follow-up and preoperative factors associated with postoperative ABG ≤20 dB were recorded. A paired t test or Wilcoxon signed-rank sum test was utilized to compare preoperative, short-term, or intermediate to long-term results. Results Seventy-six patients underwent revision ossiculoplasty and met inclusion criteria. Mean postoperative ABG was 22.5 at short-term follow-up ( P < .0001) and 24.4 at intermediate to long-term follow-up ( P = .003). Postoperative ABG ≤20 dB was achieved in 51.5% of patients. The only preoperative factor associated with postoperative ABG ≤20 dB was location of original primary ossiculoplasty ( P = .01). Conclusions This is one of the larger studies involving revision titanium ossiculoplasty. Revision surgery showed a significant improvement in postoperative ABG. The location of the original ossiculoplasty correlated with success of revision surgery (defined as postoperative ABG ≤20 dB). Patients who had the primary ossiculoplasty at an outside hospital may have better audiometric outcomes than patients who had it at a tertiary hospital.
[Mh] Termos MeSH primário: Prótese Ossicular
Substituição Ossicular/métodos
Reoperação/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Valor Preditivo dos Testes
South Carolina
Titânio
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
D1JT611TNE (Titanium)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170412
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817696303


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[PMID]:28350269
[Au] Autor:Justicz N; Strickland KF; Motamedi KK; Mattox DE
[Ad] Endereço:a Department of Otolaryngology, Head & Neck Surgery , Emory University School of Medicine , Atlanta , GA , USA.
[Ti] Título:Review of a single surgeon's stapedotomy cases performed with a nickel titanium prosthesis over a 14-year period.
[So] Source:Acta Otolaryngol;137(4):442-446, 2017 Apr.
[Is] ISSN:1651-2251
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:CONCLUSION: Stapes surgery with a nickel titanium prosthesis is a safe and well-tolerated procedure that leads to a significant improvement in hearing outcomes. OBJECTIVE: To identify the efficacy and safety of stapedotomy procedures performed with a nickel titanium prosthesis for patients with otosclerosis. METHODS: A review of 431 unique stapedotomies performed over 14 years by a single surgeon at an academic tertiary care center yielded 312 cases with nickel titanium prosthesis that met inclusion criteria of otosclerosis diagnosis, initial surgery in operative ear, and presence of pre-operative and post-operative audiograms. Pure-tone averages (PTA) at baseline and 8 weeks after surgery were calculated over four frequencies; 0.5, 1, 2, and 4 kHz. Average air-bone gaps (ABG) were calculated from pre-operative and post-operative audiograms. RESULTS: Average pre-operative baseline PTA was 56.7 dB in the affected ear. Post-operative PTA was 30.1 dB, a 26.6 dB improvement. Initial average ABG was 29.7 dB, while post-operative ABG averaged 5.4 dB, a 24.2 dB improvement. Surgical success (closure of ABG within 10 dB) was achieved in 263 (84%) patients. Rate of surgical success was not correlated with age, gender, race, or affected ear. Complications included recurrent conductive hearing loss (14), progressive SNHL (4), and post-operative BPPV (3).
[Mh] Termos MeSH primário: Prótese Ossicular/estatística & dados numéricos
Cirurgia do Estribo/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Audiometria
Feminino
Seres Humanos
Masculino
Meia-Idade
Níquel
Estudos Retrospectivos
Cirurgia do Estribo/instrumentação
Titânio
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
12035-60-8 (titanium nickelide); 7OV03QG267 (Nickel); D1JT611TNE (Titanium)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1080/00016489.2016.1258732


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[PMID]:28219477
[Au] Autor:Amith N; Rs M
[Ad] Endereço:Department of Otorhinolaryngology,Jawaharlal Nehru Medical College,Belagavi,India.
[Ti] Título:Autologous incus versus titanium partial ossicular replacement prosthesis in reconstruction of Austin type A ossicular defects: a prospective randomised clinical trial.
[So] Source:J Laryngol Otol;131(5):391-398, 2017 May.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This study aimed to compare the functional and anatomical outcomes of ossiculoplasty using an autograft incus or a titanium partial ossicular replacement prosthesis for reconstructing Austin type A ossicular defects. METHODS: Patients with Austin A ossicular defects were randomly divided into two groups: one group underwent ossiculoplasty with an autologous incus (the autologous incus group) and the other underwent ossiculoplasty with a titanium partial ossicular replacement prosthesis (the titanium prosthesis group). Otoscopic examination and audiological assessment was done pre-operatively and at 3, 6 and 12 months post-operatively. RESULTS: A post-operative average air-bone gap closure of less than 20 dB was seen in 13 patients (65 per cent) in the autologous incus group and 7 (35 per cent) in the titanium prosthesis group. There were fewer post-operative complications in the autologous incus group (20 per cent) than in the titanium prosthesis group (45 per cent). CONCLUSION: Hearing outcomes and graft take up after ossiculoplasty were significantly better when an autologous incus rather than a titanium partial ossicular replacement prosthesis was used to reconstruct Austin type A ossicular defects. The major disadvantages of the titanium prosthesis were unpredictable results and more post-operative complications.
[Mh] Termos MeSH primário: Ossículos da Orelha/anormalidades
Ossículos da Orelha/cirurgia
Bigorna/transplante
Prótese Ossicular
Substituição Ossicular/métodos
Timpanoplastia/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Audiometria
Criança
Feminino
Audição
Perda Auditiva Condutiva/congênito
Perda Auditiva Condutiva/cirurgia
Seres Humanos
Masculino
Meia-Idade
Prótese Ossicular/efeitos adversos
Estudos Prospectivos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Titânio
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
D1JT611TNE (Titanium)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170412
[Lr] Data última revisão:
170412
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117000251


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[PMID]:28189837
[Au] Autor:Greene NT; Jenkins HA; Tollin DJ; Easter JR
[Ad] Endereço:Department of Physiology and Biophysics, University of Colorado School of Medicine, Aurora, CO, USA; Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: nathaniel.greene@ucdenver.edu.
[Ti] Título:Stapes displacement and intracochlear pressure in response to very high level, low frequency sounds.
[So] Source:Hear Res;348:16-30, 2017 May.
[Is] ISSN:1878-5891
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The stapes is held in the oval window by the stapedial annular ligament (SAL), which restricts total peak-to-peak displacement of the stapes. Previous studies have suggested that for moderate (<130 dB SPL) sound levels intracochlear pressure (P ), measured at the base of the cochlea far from the basilar membrane, increases directly proportionally with stapes displacement (D ), thus a current model of impulse noise exposure (the Auditory Hazard Assessment Algorithm for Humans, or AHAAH) predicts that peak P will vary linearly with D up to some saturation point. However, no direct tests of D , or of the relationship with P during such motion, have been performed during acoustic stimulation of the human ear. In order to examine the relationship between D and P to very high level sounds, measurements of D and P were made in cadaveric human temporal bones. Specimens were prepared by mastoidectomy and extended facial recess to expose the ossicular chain. Measurements of P were made in scala vestibuli (P ) and scala tympani (P ), along with the SPL in the external auditory canal (P ), concurrently with laser Doppler vibrometry (LDV) measurements of stapes velocity (V ). Stimuli were moderate (∼100 dB SPL) to very high level (up to ∼170 dB SPL), low frequency tones (20-2560 Hz). Both D and P increased proportionally with sound pressure level in the ear canal up to approximately ∼150 dB SPL, above which both D and P showed a distinct deviation from proportionality with P . Both D and P approached saturation: D at a value exceeding 150 µm, which is substantially higher than has been reported for small mammals, while P showed substantial frequency dependence in the saturation point. The relationship between P and D remained constant, and cochlear input impedance did not vary across the levels tested, consistent with prior measurements at lower sound levels. These results suggest that P sound pressure holds constant relationship with D , described by the cochlear input impedance, at these, but perhaps not higher, stimulation levels. Additionally, these results indicate that the AHAAH model, which was developed using results from small animals, underestimates the sound pressure levels in the cochlea in response to high level sound stimulation, and must be revised.
[Mh] Termos MeSH primário: Cóclea/fisiologia
Audição/fisiologia
Rampa do Tímpano/fisiologia
Rampa do Vestíbulo/fisiologia
Estribo/fisiologia
[Mh] Termos MeSH secundário: Estimulação Acústica
Acústica
Cadáver
Ossículos da Orelha/fisiologia
Orelha Média/fisiologia
Impedância Elétrica
Seres Humanos
Lasers
Prótese Ossicular
Pressão
Modelos de Riscos Proporcionais
Janela da Cóclea/fisiologia
Som
Estribo/anatomia & histologia
Osso Temporal/anatomia & histologia
Osso Temporal/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170213
[St] Status:MEDLINE


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[PMID]:28109505
[Au] Autor:Célérier C; Thierry B; Coudert C; Blanchard M; Loundon N; Garabédian EN; Denoyelle F
[Ad] Endereço:ENT Department, Necker-Enfants Malades Hospital, Paris-Descartes University, Paris, France. Electronic address: Charlotte.celerier@aphp.fr.
[Ti] Título:Results of VSB implantation at the short process of the incus in children with ear atresia.
[So] Source:Int J Pediatr Otorhinolaryngol;93:83-87, 2017 Feb.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE(S): To describe a new and more simple surgical procedure for implanting the Vibrant Soundbridge (VSB) on the short process of the incus in children with ear atresia and atretic plate and present the audiometric results. METHODS: Since 2014, pre- and post-operative audiometric tests with tonal and vocal audiometryat the maximal follow up, respectively 33, 22 and 12 months were performed after VSB implantation at the ENT department, Necker Enfants Malades Hospital, Paris, France. 3 children aged 11, 9 and 15 years with conductive hearing loss due to high grade ear atresia and absent ear canal were implanted. The malformed and fused malleus-incus complex was found to be immobile in two of the subjects, who then underwent a superior tympanotomy to carefully remobilize the malleus. Stapes were mobile in all cases. The FMT clip was customized and crimped on the short process, stabilized by the metallic wire. RESULTS: At the maximum follow-up time, the bone conduction was unchanged, and the mean aided ACPTA was 21 dB, 29 dB and 30 dB, compared to 66 dB, 63 dB and 68 dB unaided, respectively. The word recognition score (WRS) at 65 dB SPL increased from 10%, 10% and 70% (unaided) respectively to 100% (aided). CONCLUSIONS: The long process of the incus is usually very hypoplastic in patients with ear atresia with a fused malleus-incus complex lateral to the stapes. VSB coupling to the long process of the incus or the stapes may be challenging in small mastoids. Coupling to the short process of the incus is comparatively a simple procedure, since there is no need for posterior tympanotomy and has no proximity to the facial nerve. The results of this study are similar to other ear atresia cases in the literature with classic FMT placement on the stapes or long process of the incus. Outcomes should be confirmed in a larger number of patients.
[Mh] Termos MeSH primário: Perda Auditiva Condutiva/congênito
Perda Auditiva Condutiva/cirurgia
Bigorna/anormalidades
Bigorna/cirurgia
Prótese Ossicular
Substituição Ossicular/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Seguimentos
França
Seres Humanos
Substituição Ossicular/instrumentação
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170123
[St] Status:MEDLINE



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