An estimation of efficiency of the stapedaplastie at patients with otosclerosis by using different types of protesis

Abstract

Аim of work: To learn the functional results of the stapedoplastie with the use of teflon and combined titanic - teflon prosthetics appliance in terms 3, 6 and 12 months after operative intervention for patients with otosclerosis.

Materials and methods: Work was conducted in the department of ear microsurgery and  otoneurosurgery. A dynamic inspection and surgical treatment was conducted  by 30 patients with otosclerosis in age from 28 to 67, from them 19 - women, 11 - men. The special methods of research were conducted all patients: otomicroscopie, voice-frequency threshold audiometry, impedansometriy. Testimonies to surgical interference were complaints about the decline of rumor, exposure of conductus or mixed hearing loss with a presence bone - air interval in the language range of frequencies no less 20 дБ, normal level of pressure in a drum cavity(from - 100 to 50 дПа) from data of impedansometrie, absence of registration  of the  acoustic reflex of stapes muscle at influence of sounds of uperlevel volume : 80 - on all registered frequencies, normal function of otosalpinx,  absence of uncompensated somatic and used for setting fire pathology. Surgical interference was always conducted on an ear that hears worse. The estimation of functional results of treatment was conducted in terms 3 - 12 months after the operation.

Research results:  For comparison of efficiency of the conducted treatment patients(n=30) are up-diffused on groups depending on material of the used stapedial prosthetic appliances : a 1 group presented by 22 patients  is conducted that stapedoplastie  used of teflon stapedial prosthetic appliance; 2 groups are presented by 8 patients is conducted by the combined titanic prosthetic appliance. Thus, comparing the results of the stapedoplastie to the different types of the stapedial  prosthetic appliances on the indexes of bone-air interval, it is set by us, that more effective in the plan of functional results is the use of titanic prosthetic appliances unlike teflon. It is set that at using titanic-teflon to prosthetic appliance for stapedoplastie the decline of thresholds of rumor expressed for certain is determined on high-frequencies(3-8) of kHz, that it can be contingently a less diameter to prosthetic appliance. Bone – air conductive interval after operative intervention on LFS for patients, that teflon prosthetic appliance was set, was within the limits of 10-20 db for all patients. It is well-proven that after piston stapedoplastie with the use teflon  prosthetic appliance there is the slow closing of bone-air interval of to 10 db in 6 months in 78 % patients after operative intervention comparatively with an early postoperative period. Use combined teflon prosthetic appliance finds out the best results in 3 months after operative intervention with closing of bone-air interval of to 10 db in 96 % patients with reduction of thresholds of  air conductive on all range of frequencies, but exactly at this group of patients results became worse in 12 months in 26 % patients, that we bind to violation of circulation of  blood in the mucous membrane of long sprout of anvil as a result of more dense contact of metallic part to prosthetic appliance with a incus sprout.