STAPECTOMY V/S STAPEDOTOMY скачать в хорошем качестве

STAPECTOMY V/S STAPEDOTOMY

Difference Between Stapedectomy and Stapedotomy Introduction Stapedectomy and stapedotomy are surgical procedures performed to treat otosclerosis, a condition where abnormal bone growth around the stapes bone leads to conductive hearing loss. These procedures aim to restore sound conduction by improving the mobility of the ossicular chain. Anatomy of the Ear (Brief Overview) • The middle ear contains three ossicles: malleus, incus, and stapes. • The stapes transmits sound vibrations from the tympanic membrane to the inner ear through the oval window. • In otosclerosis, the stapes becomes fixed due to abnormal bone formation, leading to hearing loss. Definition of Procedures 1. Stapedectomy • Involves the removal of the entire or part of the stapes bone. • A prosthesis (such as Teflon, titanium, or hydroxyapatite) is placed to connect the incus to the oval window. • It was the traditional treatment for otosclerosis but has been largely replaced by stapedotomy. 2. Stapedotomy • Instead of removing the entire stapes, a small hole is made in the footplate of the stapes using a microdrill or laser. • A prosthesis is inserted through this hole to transmit sound vibrations. • This method preserves more of the natural middle ear structure. Key Differences Between Stapedectomy and Stapedotomy Feature Stapedectomy Stapedotomy Definition Removal of the stapes Creation of a hole in the stapes footplate Extent of Surgery More invasive (removes bone) Less invasive (preserves more bone) Prosthesis Placement Replaces the entire stapes Sits in a small perforation in the stapes footplate Risk of Complications Higher (due to larger opening) Lower (due to smaller opening) Hearing Outcomes Good but slightly variable More consistent and better hearing results Chance of Perilymph Fistula Higher risk due to larger exposure Lower risk due to minimal trauma Use of Laser Not always used Commonly used to create precise perforations Preferred in Modern Practice Less common More commonly performed Advantages of Stapedotomy Over Stapedectomy • Less Trauma to the Inner Ear: The smaller perforation minimizes damage to the inner ear structures. • Better Hearing Outcomes: Studies show lower risk of sensorineural hearing loss compared to stapedectomy. • Fewer Complications: Less risk of perilymph fistula, vertigo, and tinnitus. • Faster Recovery: Less disturbance to the middle ear structures. Indications for Surgery • Conductive hearing loss due to otosclerosis (with an air-bone gap more than 30 dB). • Intact cochlear function (sensorineural hearing should be relatively preserved). • Failure of hearing aids to provide adequate benefit. Contraindications • Active infection of the middle ear (otitis media). • Severe sensorineural hearing loss (where surgery won’t be beneficial). • Meniere’s disease or vestibular disorders (increased risk of dizziness). Complications (Common to Both Procedures) 1. Hearing loss (Sensorineural or Conductive) – Due to trauma to the inner ear. 2. Vertigo & Dizziness – Temporary but can persist in some cases. 3. Tinnitus (ringing in the ear) – Can worsen postoperatively. 4. Facial Nerve Injury – Rare but possible due to its close anatomical relation. 5. Perilymph Fistula – Leakage of inner ear fluid, requiring revision surgery. Conclusion • Stapedotomy is preferred over stapedectomy due to its less invasive nature, lower complication rate, and better hearing outcomes. • Both procedures require careful patient selection to ensure optimal results. • Advancements in laser technology have made stapedotomy the gold standard for surgical treatment of otosclerosis. Frequently Asked Questions (FAQs) 1. Why is stapedotomy preferred over stapedectomy? • Because it is less invasive, has fewer complications, and provides better hearing outcomes. 2. What type of prosthesis is used in stapedotomy? • Commonly used prostheses include Teflon, titanium, or hydroxyapatite. 3. How long does the surgery take? • Both procedures take about 45 minutes to 1 hour and are usually done under local or general anesthesia. 4. Can hearing loss recur after surgery? • Rarely, but prosthesis displacement or inner ear damage may cause hearing loss. 5. How soon can patients return to normal activities? • Most patients recover within 1–2 weeks, but they should avoid flying, loud noise, and strenuous activities for a few weeks. #science #ear #biology #ent #nose #otolaryngology #tonsils #anatomy #nosebleed #throathealth