Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-10T07:32:13.550Z Has data issue: false hasContentIssue false
  • English
  • Français

Obliquity of the stapes in otosclerosis: intra-operative observations and implications in stapes surgery

Published online by Cambridge University Press:  16 November 2015

V Anand  and
H N Udayabhanu
V Anand*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, MCV Memorial ENT Trust Hospital, Pollachi, Tamil Nadu, India
H N Udayabhanu
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, MCV Memorial ENT Trust Hospital, Pollachi, Tamil Nadu, India
*
Address for correspondence: Dr V Anand, Department of Otorhinolaryngology and Head and Neck Surgery, MCV Memorial ENT Trust Hospital, 115, Palaghat Road, Pollachi (TN) – 642001, India Fax: 0422 223 3591 E-mail: anand@entanand.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To establish the prevalence of stapes obliquity as observed in otosclerosis patients during stapes surgery by a simple method of intra-operative measurement.

Design:

Prospective observational study.

Results:

Intra-operative measurements showed that the mean distance (± standard deviation) between the horizontal segment of the facial nerve and stapes crura in 10 cases of otosclerosis was 0.74 mm (± 0.21 mm), whereas in 10 cases of non-otosclerosis the same distance was 0.20 mm (± 0.00). There was no gap (0 mm) between the stapes crura and inferior border of the oval window niche in otosclerotic ears, whereas in non-otosclerotic ears the same distance was 0.13 mm (± 0.05 mm). The differences were statistically significant (p < 0.0001).

Conclusion:

Obliquity and downward displacement of the stapes occurs in otosclerosis. It has diagnostic value as a new clinical sign in otosclerosis. The findings correlate with late complications and failures in stapes surgery. Methods to avoid these have been suggested.

Keywords

OtosclerosisStapesAnatomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 2 , February 2016 , pp. 134 - 144
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

1Politzer, A. Primary disease of the bony labyrinthine capsule [in German]. Zeitschr Ohrenheil 1893;25:309–27Google Scholar
2Anson, BJ, Bast, TH. Developmental anatomy of the ear. In: Shambaug, GE Jr, Glasscock, ME III, eds. Surgery of the Ear, 3rd edn.Philadelphia: WB Saunders, 1980;5–29Google Scholar
3Glasscock, ME III, Gulya, AJ, eds. Surgery of the Ear, 5th edn.Ontario: Elsevier, 2003Google Scholar
4Swartz, DJ, Loevener, AL. Imaging of the Temporal Bone, 4th edn.New York: Thieme, 2009CrossRefGoogle Scholar
5Ulug, T. Atlas of Temporal Bone Surgery. Stuttgart: Thieme, 2010CrossRefGoogle Scholar
6Shea, JJ Jr, Shea, FP. Stapedectomy for otosclerosis. In: Glasscock, ME III, Gulya, AJ, eds. Surgery of the Ear, 5th edn.Ontario: Elsevier, 2003;517–31Google Scholar
7Ruedi, L. Pathogenesis of otosclerosis. Arch Otolaryngol 1963;78:469–76CrossRefGoogle ScholarPubMed
8Valvassori, GE. Otodystrophies. In: Berrett, A, Brunner, S, Valvassori, GE, eds. Modern Thin-Section Tomography. Springfield, IL: CC Thomas, 1973;109–17Google Scholar
9Valvassori, GE. Radiologic diagnosis of cochlear otosclerosis. Laryngoscope 1965;75:1563–71CrossRefGoogle ScholarPubMed
10Shambaugh, GE. Surgery of the Ear, 2nd edn.Philadelphia: WB Saunders, 1967Google Scholar
11Anson, BJ, Cauldwell, EW, Bast, TH. The fissula ante fenestram of the human otic capsule; developmental and normal adult structure. Ann Otol Rhinol Laryngol 1947;56:957–85CrossRefGoogle ScholarPubMed
12Bast, TH. Development of otic capsule. Residual cartilages and defective ossification and their relation to otosclerotic foci. Arch Otolaryngol 1940;32:771–82CrossRefGoogle Scholar
13Anson, BJ, Cauldwell, EW, Bast, TH. The fissula ante fenestram of the human otic capsule; aberrant form and contents. Ann Otol Rhinol Laryngol 1948;57:103–28CrossRefGoogle ScholarPubMed
14Zhu, F, Sun, M, Zhang, J, Sun, D, Jiang, Y. Location of tympanic segment and mastoid segment of facial nerve and prevention of prosopoplegia in operations [in Chinese]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011;25:314–16Google ScholarPubMed
15Maru, N, Cheita, AC, Mogoanta, CA, Prejoianu, B. Intratemporal course of the facial nerve: morphological, topographic and morphometric features. Rom J Morphol Embryol 2010;51:243–8Google ScholarPubMed
16Lagleyre, S, Calmels, MN, Escude, B, Deguine, O, Fraysse, B. Revision stapes surgery: the “lateralized piston syndrome”. Otol Neurotol 2009;30:1138–44CrossRefGoogle ScholarPubMed
17Ying, YL, Hillman, TA, Chen, DA. Patterns of failure in heat-activated crimping prosthesis in stapedotomy. Otol Neurotol 2011;32:21–8CrossRefGoogle ScholarPubMed
18Myers, NE, Carrau, LR, eds. Operative Otolaryngology Head and Neck Surgery, 2nd edn.Philadelphia: Elsevier, 2008Google Scholar
19Pauw, B, Pollak, A, Fisch, U. Utricle, saccule, and cochlear duct in relation to stapedotomy. A histologic human temporal bone study. Ann Otol Rhinol Laryngol 1991;100:966–70CrossRefGoogle ScholarPubMed
20Nuriozgirgin, O. The problems encountered during stapes surgery and their solutions. Pro Otology (Balkan Journal of Otology and Neuro-Otology) 2004;4:23–7Google Scholar
21Carrasco, NV, Pillsbury, CH. Revision Otologic Surgery, 1st edn.New York: Thieme, 1997Google Scholar
22Tange, RA, de Bruijn, AJ. Dehiscences of the horizontal segment of the facial canal in otosclerosis. ORL J Otorhinolaryngol Relat Spec 1997;59:277–9CrossRefGoogle ScholarPubMed
23Tos, M. Surgical Solutions for Conductive Hearing Loss, 1st edn.New York: Thieme, 2000Google Scholar
24Maier, T, Strauss, G, Bauer, F, Grasser, A, Hata, N, Lueth, TC. Distance measurement in middle ear surgery using a telemanipulator. Med Image Comput Comput Assist Interv 2011;14:41–8Google ScholarPubMed