Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-13T02:03:17.620Z Has data issue: false hasContentIssue false
  • English
  • Français

Manubrio-stapedioplasty: new surgical technique for malleus and incus fixation due to tympanosclerosis

Published online by Cambridge University Press:  17 April 2015

L Sennaroglu ,
V Gungor ,
G Atay  and
S Ozer
L Sennaroglu
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
V Gungor*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Ankara Numune Education and Research Hospital, Turkey
G Atay
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
S Ozer
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
*
Address for correspondence: Dr Volkan Gungor, Department of Otorhinolaryngology – Head and Neck Surgery, Ankara Numune Education and Research Hospital, 06230 Altindag, Ankara, Turkey Fax: +90 3123114340 E-mail: vgungor@outlook.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This paper reports the authors' technique of manubrio-stapedioplasty using glass ionomer cement for malleus and incus fixation due to tympanosclerosis.

Methods:

A retrospective case review was conducted of five patients with conductive hearing loss (mean pre-operative air–bone gap of 42.75 dB) treated in a tertiary referral centre. The hearing results of a manubrio-stapedial bone cement ossiculoplasty technique, utilised on the five patients, were analysed. All cases were Wielinga and Kerr tympanosclerosis classification type 2 (attic fixation of the malleus-incus complex with a mobile stapes). The incus and head of the malleus were removed in all patients, and the manubrium was directly connected to the head of the mobile stapes using glass ionomer cement. Patients were evaluated in terms of pre- and post-operative audiometric results; hearing gain and post-operative air–bone gap were the main outcome measures.

Results:

Mean post-operative air–bone gap was 5.25 dB. Four patients had an air–bone gap of less than 10 dB; the remaining patient had an air–bone of 12.50 dB.

Conclusion:

Manubrio-stapedioplasty is an effective method for ossicular reconstruction in cases of malleus and incus fixation due to tympanosclerosis.

Keywords

TympanosclerosisBone CementsConductive Hearing Loss
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 6 , June 2015 , pp. 587 - 590
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Asiri, S, Hasham, A, al Anazy, F, Zakzouk, S, Banjar, A. Tympanosclerosis: review of literature and incidence among patients with middle-ear infection. J Laryngol Otol 1999;113:1076–80CrossRefGoogle ScholarPubMed
2de Carvalho Leal, M, Ferreira Bento, R, da Silva Caldas Neto, S, Caldas, N, Alves Peixoto, C, Delgado Lessa, FJ et al. Influence of hypercalcemia in the formation of tympanosclerosis in rats. Otol Neurotol 2006;27:27–32CrossRefGoogle ScholarPubMed
3Sheehy, JL, House, WF. Tympanosclerosis. Arch Otolaryngol 1962;76:151–7CrossRefGoogle ScholarPubMed
4Forséni Flodin, M, Hultcrantz, M. Possible inflammatory mediators in tympanosclerosis development. Int J Pediatr Otorhinolaryngol 2002;63:149–54CrossRefGoogle ScholarPubMed
5Schiff, M, Yoo, TJ. Immunologic aspects of otologic disease: an overview. Laryngoscope 1985;95:259–69CrossRefGoogle ScholarPubMed
6Forseni, M, Bagger-Sjoback, D, Hultcrantz, M. A study of inflammatory mediators in the human tympanosclerotic middle ear. Arch Otolaryngol Head Neck Surg 2001;127:559–64CrossRefGoogle ScholarPubMed
7Koç, A, Uneri, C. Genetic predisposition for tympanosclerotic degeneration. Eur Arch Otorhinolaryngol 2002;259:180–3CrossRefGoogle ScholarPubMed
8da Costa, SS, Paparella, MM, Schachern, PA, Yoon, TH, Kimberley, BP. Temporal bone histopathology in chronically infected ears with intact and perforated tympanic membranes. Laryngoscope 1992;102:1229–36CrossRefGoogle ScholarPubMed
9Stankovic, MD. Hearing results of surgery for tympanosclerosis. Eur Arch Otorhinolaryngol 2009;266:635–40CrossRefGoogle ScholarPubMed
10Kamal, SA. Surgery of tympanosclerosis. J Laryngol Otol 1997;111:917–23CrossRefGoogle ScholarPubMed
11Martin, C, Timoshenko, AP, Dumollard, JM, Tringali, S, Peoc'h, M, Prades, JM. Malleus head fixation: histopathology revisited. Acta Otolaryngol 2006;126:353–7CrossRefGoogle ScholarPubMed
12Wielinga, EW, Kerr, AG. Tympanosclerosis. Clin Otolaryngol Allied Sci 1993;18:341–9CrossRefGoogle ScholarPubMed
13Emmett, JR, Shea, JJ. Surgical treatment of tympanosclerosis. Laryngoscope 1978;88:1642–8CrossRefGoogle ScholarPubMed
14Austin, DF. Reconstructive techniques for tympanosclerosis. Ann Otol Rhinol Laryngol 1988;97:670–4CrossRefGoogle ScholarPubMed
15Powers, WH, Sheehy, JL, House, HP. The fixed malleus head. A report of 35 cases. Arch Otolaryngol 1967;85:177–81CrossRefGoogle ScholarPubMed
16Plester, D. Tympanosclerosis. J Otolaryngol Soc Aust 1972;3:325–6Google ScholarPubMed
17Gibb, AG, Pang, YT. Surgical treatment of tympanosclerosis. Eur Arch Otorhinolaryngol 1995;252:1–10CrossRefGoogle ScholarPubMed
18Joseph, RB, Gordon, J. Tympanosclerosis. Arch Otolaryngol 1963;77:186–90CrossRefGoogle ScholarPubMed
19O'Reilly, RC, Cass, SP, Hirsch, BE, Kamerer, DB, Bernat, RA, Poznanovic, SP. Ossiculoplasty using incus interposition: hearing results and analysis of the middle ear risk index. Otol Neurotol 2005;26:853–8CrossRefGoogle ScholarPubMed
20Roth, JA, Pandit, SR, Soma, M, Kertesz, TR. Ossicular chain reconstruction with a titanium prosthesis. J Laryngol Otol 2009;123:1082–6CrossRefGoogle ScholarPubMed
21Nguyen, DQ, Lavieille, JP, Schmerber, S. Failure rate and revision surgery in ossiculoplasty with Kurz titanium prosthesis [in French]. Rev Laryngol Otol Rhinol (Bord) 2004;125:157–62Google ScholarPubMed
22Dalchow, CV, Grun, D, Stupp, HF. Reconstruction of the ossicular chain with titanium implants. Otolaryngol Head Neck Surg 2001;125:628–30CrossRefGoogle ScholarPubMed
23Kartush, JM. Ossicular chain reconstruction. Capitulum to malleus. Otolaryngol Clin North Am 1994;27:689–715CrossRefGoogle ScholarPubMed
24Kalcioglu, MT, Tan, M, Fleerakkers, J. The use of bone cement for ossicular chain defects. Eur Arch Otorhinolaryngol 2013;270:2849–55CrossRefGoogle ScholarPubMed
25Bayazit, YA, Ozer, E, Kanlikama, M, Durmaz, T, Yilmaz, M. Bone cement ossiculoplasty: incus to stapes versus malleus to stapes cement bridge. Otol Neurotol 2005;26:364–7CrossRefGoogle ScholarPubMed
26Baglam, T, Karatas, E, Durucu, C. Incudostapedial rebridging ossiculoplasty with bone cement. Otolaryngol Head Neck Surg 2009;141:243–6CrossRefGoogle ScholarPubMed
27Babu, S, Seidman, MD. Ossicular reconstruction using bone cement. Otol Neurotol 2004;25:98–101CrossRefGoogle ScholarPubMed
28Kupperman, D, Tange, RA. Ionomeric cement in the human middle ear cavity: long-term results of 23 cases. Laryngoscope 2001;111:306–9CrossRefGoogle ScholarPubMed
29Granstrom, G, Holmquist, J, Tjellstrom, A. Facial nerve paralysis following repair of the external ear canal with ionomeric cement. Ear Nose Throat J 2000;79:495–8CrossRefGoogle ScholarPubMed
30Leveque, C, Soulie, D, Sarrazin, JL, Hor, F, Desgeorges, M, Cordoliani, YS. Toxic aluminum encephalopathy. Predominant involvement of the limbic system on MRI [in French]. J Neuroradiol 1996;23:168–72Google ScholarPubMed
31Meyer, U, Szulczewski, DH, Barckhaus, RH, Atkinson, M, Jones, DB. Biological evaluation of an ionomeric bone cement by osteoblast cell culture methods. Biomaterials 1993;14:917–24CrossRefGoogle ScholarPubMed
32Renard, JL, Felten, D, Bequet, D. Post-otoneurosurgery aluminium encephalopathy. Lancet 1994;344:63–4CrossRefGoogle ScholarPubMed