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The future of stapedectomy — the Singapore problem

Published online by Cambridge University Press:  29 June 2007

H. K. Leong
H. K. Leong*
Affiliation:
Department of Otolaryngology, National University Hospital, Singapore.
*
Address for correspondence: Dr Hoo Kwong Leong, Senior Lecturer and Consultant, Department of Otolaryngology, National University Hospital, 5 Lower Kent Ridge Road, Singapore 0511. Fax: 755-3820
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Abstract

Concern has been expressed in the recent literature regarding the problem of a dwindling number of stapedectomy cases and an increasing number of surgeons trained to do this operation. In Singapore, the problem is made worse by the very low incidence of this disease in its main ethnic groups of Chinese and Malays who together make up more than 90 per cent of the population.

We report here an audit of 47 ears that underwent stapedectomy in a teaching hospital over a six-year period. The hearing results for consultants and surgical trainees were compared. Closure of the air–bone gap to within 10 dB was obtained in 64 per cent of Consultants' cases and 68 per cent of trainees' cases. These results fall short of the 90 to 95 per cent figure reported by experts in this procedure and only comparable to the less satisfactory results of several series recorded by residents in North America.

We conclude that the unsatisfactory results arise from the small number of surgical cases available for each surgeon to improve and maintain his skills in a technically demanding procedure. It is proposed that such cases be directed to those pursuing otology as a subspecialty rather than all otolaryngologists in general.

Keywords

OtosclerosisStapedectomyPhysicians practice patternsEducation, medical, graduate
Type
Audit Article
Information
The Journal of Laryngology & Otology , Volume 109 , Issue 3 , March 1995 , pp. 225 - 229
Copyright
Copyright © JLO (1984) Limited 1995

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References

Austin, D. F. (1980) Stapedectomy with tissue seal. In Controversy in Otolaryngology. (Snow, J. B., ed.), W. B. Saunders Co., Philadelphia, pp 255–265.Google Scholar
Chandler, J. R., Rodriguez-Torro, O. E. (1983) Changing patterns of otosclerosis surgery in teaching institutions. Otolaryngology-Head and Neck Surgery 91: 239–245.CrossRefGoogle ScholarPubMed
Coker, N. J., Duncan, N. O., Wright, G. L., Jenkins, H. A., Alford, B. A. (1988) Stapedectomy trends for the resident. Annals of Otology, Rhinology and Laryngology 97: 103–113.CrossRefGoogle ScholarPubMed
Engel, T. L., Schlinder, R. A. (1984) Stapedectomy in residency training. Laryngoscope 94: 768–771.CrossRefGoogle ScholarPubMed
Hough, J. V. D. (1976) A critique of stapedectomy. Journal of Laryngologv and Otology 105: 15–22.CrossRefGoogle Scholar
Huang, T. S., Lee, P. F. (1988) Surgically confirmed clinical otosclerosis among the Chinese. Otolaryngology–Head and Neck Surgen 114: 538–544.Google ScholarPubMed
Leighton, S. E. J., Robson, A. K., Freland, A. P. (1991) Audit of stapedectomy results in a teaching hospital. Clinical Otolarvngology 16: 488–492.CrossRefGoogle ScholarPubMed
Levenson, M. J., Bellucci, R. J., Grimes, C., Inderman, M., Parisier, S. C. (1987) Otosclerosis surgery in a residency training program. Archives of Otolaiyngology Head and Neck Surgery 113: 29–31.CrossRefGoogle Scholar
McGee, T. M. (1981) Comparison of small fenestra and total stapedectomy. Annals of Otology, Rhinology and Laryngology 90: 633–639.CrossRefGoogle ScholarPubMed
Nager, G. T. (1969) Histopathology of otosclerosis. Archives of Otolaryngology, Head and Neck Surgery 89: 341–363.CrossRefGoogle ScholarPubMed
Nizar, , (1960) The problem of otoscierosis in Indonesia. Madj Kedokt Indonesia 10: 398–399.Google Scholar
Robinson, M. (1981) Total footplate extraction in stapedectomy. Annals of Otology, Rhinology and Laryngology 90: 630–632.CrossRefGoogle ScholarPubMed
Schukneckt, H. E. (1976) Pathology in the Ear. 2nd Edition. Harvard University Press, Cambridge, Mass. pp 351–373.Google Scholar
Shapira, A., Ophir, D., Marshak, G. (1985) Success of stapedectomy performed by residents. American Journal of Otolaryngology 6: 388–391.CrossRefGoogle ScholarPubMed
Shea, J. J. Jr. (1971) A 15-year report on fenestration of the oval window. Transactions of the American Academy of Ophthalmology and Otolarygnology 75: 31–47.Google ScholarPubMed
Smyth, G. D. L., Hassard, T. H. (1978)18 years' experience in stapedectomy. Annals of Otology, Rhinology and Laryngology 87 (suppl. 49): 1–36.Google Scholar