Fixation of the Anterior Mallear Ligament: Diagnosis and Consequences for Hearing Results in Stapes Surgery
In the search for possible causes of unfavorable results after stapes surgery, the study reported here focused on the anterior mallear ligament, since it has been previously reported that partial mallear fixation (PMF) leads to functional failure in 38% of cases of stapes revision surgery. The aims...
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| Veröffentlicht in: | Annals of otology, rhinology & laryngology rhinology & laryngology, 2003-04, Vol.112 (4), p.348-355 |
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| creator | Huber, Alexander Koike, Takuji Nandapalan, Vel Wada, Hiroshi Fisch, Ugo |
| description | In the search for possible causes of unfavorable results after stapes surgery, the study reported here focused on the anterior mallear ligament, since it has been previously reported that partial mallear fixation (PMF) leads to functional failure in 38% of cases of stapes revision surgery. The aims of the study were to identify effective methods for the diagnosis of PMF and experimentally assess the conductive hearing loss that results from PMF. The study included vibration amplitude measurements of the ossicles by laser Doppler interferometry (LDI) in 19 patients and 5 fresh human temporal bone (TB) specimens. Analysis of their dynamic behavior was performed by finite element modeling (FEM). Similar, significant changes of manubrium vibration patterns for PMF were found by FEM calculations, in TB experiments, and in patients. We could identify PMF either before operation, using LDI, or during operation, by manual palpation. In the TB experiments and FEM calculations, the attenuation of the stapes displacement due to an isolated PMF was approximately 10 dB and frequency-dependent. Untreated anterior mallear ligament fixation produced a persistent air-bone gap of approximately 10 dB after stapedioplasty. |
| doi_str_mv | 10.1177/000348940311200409 |
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The aims of the study were to identify effective methods for the diagnosis of PMF and experimentally assess the conductive hearing loss that results from PMF. The study included vibration amplitude measurements of the ossicles by laser Doppler interferometry (LDI) in 19 patients and 5 fresh human temporal bone (TB) specimens. Analysis of their dynamic behavior was performed by finite element modeling (FEM). Similar, significant changes of manubrium vibration patterns for PMF were found by FEM calculations, in TB experiments, and in patients. We could identify PMF either before operation, using LDI, or during operation, by manual palpation. In the TB experiments and FEM calculations, the attenuation of the stapes displacement due to an isolated PMF was approximately 10 dB and frequency-dependent. Untreated anterior mallear ligament fixation produced a persistent air-bone gap of approximately 10 dB after stapedioplasty.</description><identifier>ISSN: 0003-4894</identifier><identifier>EISSN: 1943-572X</identifier><identifier>DOI: 10.1177/000348940311200409</identifier><identifier>PMID: 12731630</identifier><identifier>CODEN: AORHA2</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Acoustic Impedance Tests ; Adult ; Aged ; Audiometry, Pure-Tone ; Auditory Threshold - physiology ; Biological and medical sciences ; Biomechanical Phenomena ; Bone Conduction - physiology ; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology ; Female ; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics ; Hearing Loss, Conductive - diagnosis ; Hearing Loss, Conductive - etiology ; Humans ; Interferometry - instrumentation ; Laser-Doppler Flowmetry - instrumentation ; Ligaments - surgery ; Male ; Malleus - surgery ; Medical sciences ; Middle Aged ; Models, Theoretical ; Non tumoral diseases ; Otorhinolaryngology. Stomatology ; Otosclerosis - complications ; Otosclerosis - physiopathology ; Otosclerosis - surgery ; Preoperative Care ; Severity of Illness Index ; Stapes Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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The aims of the study were to identify effective methods for the diagnosis of PMF and experimentally assess the conductive hearing loss that results from PMF. The study included vibration amplitude measurements of the ossicles by laser Doppler interferometry (LDI) in 19 patients and 5 fresh human temporal bone (TB) specimens. Analysis of their dynamic behavior was performed by finite element modeling (FEM). Similar, significant changes of manubrium vibration patterns for PMF were found by FEM calculations, in TB experiments, and in patients. We could identify PMF either before operation, using LDI, or during operation, by manual palpation. In the TB experiments and FEM calculations, the attenuation of the stapes displacement due to an isolated PMF was approximately 10 dB and frequency-dependent. Untreated anterior mallear ligament fixation produced a persistent air-bone gap of approximately 10 dB after stapedioplasty.</description><subject>Acoustic Impedance Tests</subject><subject>Adult</subject><subject>Aged</subject><subject>Audiometry, Pure-Tone</subject><subject>Auditory Threshold - physiology</subject><subject>Biological and medical sciences</subject><subject>Biomechanical Phenomena</subject><subject>Bone Conduction - physiology</subject><subject>Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology</subject><subject>Female</subject><subject>Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics</subject><subject>Hearing Loss, Conductive - diagnosis</subject><subject>Hearing Loss, Conductive - etiology</subject><subject>Humans</subject><subject>Interferometry - instrumentation</subject><subject>Laser-Doppler Flowmetry - instrumentation</subject><subject>Ligaments - surgery</subject><subject>Male</subject><subject>Malleus - surgery</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Models, Theoretical</subject><subject>Non tumoral diseases</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Otosclerosis - complications</subject><subject>Otosclerosis - physiopathology</subject><subject>Otosclerosis - surgery</subject><subject>Preoperative Care</subject><subject>Severity of Illness Index</subject><subject>Stapes Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Maxillofacial surgery. Dental surgery. Orthodontics</topic><topic>Hearing Loss, Conductive - diagnosis</topic><topic>Hearing Loss, Conductive - etiology</topic><topic>Humans</topic><topic>Interferometry - instrumentation</topic><topic>Laser-Doppler Flowmetry - instrumentation</topic><topic>Ligaments - surgery</topic><topic>Male</topic><topic>Malleus - surgery</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Models, Theoretical</topic><topic>Non tumoral diseases</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Otosclerosis - complications</topic><topic>Otosclerosis - physiopathology</topic><topic>Otosclerosis - surgery</topic><topic>Preoperative Care</topic><topic>Severity of Illness Index</topic><topic>Stapes Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. 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The aims of the study were to identify effective methods for the diagnosis of PMF and experimentally assess the conductive hearing loss that results from PMF. The study included vibration amplitude measurements of the ossicles by laser Doppler interferometry (LDI) in 19 patients and 5 fresh human temporal bone (TB) specimens. Analysis of their dynamic behavior was performed by finite element modeling (FEM). Similar, significant changes of manubrium vibration patterns for PMF were found by FEM calculations, in TB experiments, and in patients. We could identify PMF either before operation, using LDI, or during operation, by manual palpation. In the TB experiments and FEM calculations, the attenuation of the stapes displacement due to an isolated PMF was approximately 10 dB and frequency-dependent. Untreated anterior mallear ligament fixation produced a persistent air-bone gap of approximately 10 dB after stapedioplasty.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>12731630</pmid><doi>10.1177/000348940311200409</doi><tpages>8</tpages></addata></record> |
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| ispartof | Annals of otology, rhinology & laryngology, 2003-04, Vol.112 (4), p.348-355 |
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| subjects | Acoustic Impedance Tests Adult Aged Audiometry, Pure-Tone Auditory Threshold - physiology Biological and medical sciences Biomechanical Phenomena Bone Conduction - physiology Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology Female Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics Hearing Loss, Conductive - diagnosis Hearing Loss, Conductive - etiology Humans Interferometry - instrumentation Laser-Doppler Flowmetry - instrumentation Ligaments - surgery Male Malleus - surgery Medical sciences Middle Aged Models, Theoretical Non tumoral diseases Otorhinolaryngology. Stomatology Otosclerosis - complications Otosclerosis - physiopathology Otosclerosis - surgery Preoperative Care Severity of Illness Index Stapes Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the ear, the auditive nerve and the facial nerve Tissue Fixation - methods Vibration |
| title | Fixation of the Anterior Mallear Ligament: Diagnosis and Consequences for Hearing Results in Stapes Surgery |
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