Clinical aspects of otosclerotic ossicular chain fixations.

Abstract:

:Otosclerosis is a human-specific ear disease characterised by complex bone-remodelling with multifactorial aetiology. It affects the bony labyrinth capsule and consequently fixates the stapes to the oval window rim. The fixation of the ossicular chain leads to a decrease in the middle ear's acoustic impedance-fitting and amplifier function that leads to conductive hearing loss. The process is progressive and when it involves the inner ear structures, it deteriorates the sensorineural function as well. The course of the illness can be prevented or delayed if hearing reconstructive surgery is performed on time. The development of stapes surgery spans the 20th century, and despite the major surgical steps - laid down by Shea and Marquet in the 1960s - are quite conservative, fine adjustments are still being made mainly due to technical progress. Several studies confirm that stapedotomy remained the first-to-offer therapeutic option in otosclerosis. With an adequate surgical technique, significant improvement can be achieved in the air conduction threshold, the air-bone gap may be minimalized or ceased over the speech frequencies, which significantly improves the quality of life of the patients. In this quest, we reviewed the Hungarian and the international literature as well in context with otosclerosis, with special attention to the newest methods in diagnostics and treatment management. Orv Hetil. 2020; 161(19): 780-788. :Az otosclerosis egy komplex csontremodellinggel járó multifaktoriális, humánspecifikus fülbetegség. A csontos labyrinthust érinti, aminek következtében típusosan a stapes rögzül az ovális ablakban. A betegség során kialakult hallócsontláncolati fixatio által csökken a középfül akusztikusimpedancia-illesztő, -erősítő funkciója, így jellemzően vezetéses típusú halláscsökkenés jön létre. A halláscsökkenés progresszív, a későbbiekben a belső fül érintettségének jeleként sensorineuralis komponenssel egészül ki. Mindezen folyamat egy időben elvégzett hallásjavító műtéttel megelőzhető vagy jelentősen lassítható. A stapessebészet fejlődése átíveli a XX. századot, és bár a főbb, Shea és Marquet által már az 1960-as években lefektetett műtéti lépések meglehetősen konzervatívak, finom módosítások, elsősorban a technikai fejlődésnek köszönhetően, még ma is folyamatosan történnek. Számos tanulmány igazolja, hogy otosclerosisban továbbra is a stapedotomia az elsőként választandó terápiás eljárás. Megfelelő műtéti technikával a légvezetéses hallásban jelentős javulás érhető el, a beszédfrekvenciákon a csont–lég-köz minimalizálható, illetve zárható, ami a betegek életminőségét jelentősen javítja. A jelen közleményben az otosclerosissal kapcsolatban fellelhető magyar és nemzetközi szakirodalmat tekintjük át, kitérve a kórfolyamat legújabb diagnosztikus és kezelési lehetőségeire is. Orv Hetil. 2020; 161(19): 780–788.

journal_name

Orv Hetil

journal_title

Orvosi hetilap

authors

Kriston F,Rovó L,Kiss JG,Jarabin JA

doi

10.1556/650.2020.31701

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

780-788

issue

19

eissn

0030-6002

issn

1788-6120

journal_volume

161

pub_type

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