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Year 2012 Vol. 20 No 2
EL-REFAI HUSAM 1, V.P. SITNIKOV 1, T.I. KOLESNIK 2
RESTAPEDOPLASTY AFTER OPERATIONS BECAUSE OF OTOSCLEROSIS
EE “Gomel State Medical University” 1,
ME “Gomel regional specialized clinical hospital” 2,
The Republic of Belarus
Objectives. To improve the restapedoplasty efficiency in patients with otosclerosis.
Methods. During the period of 2008-2011 the analysis of the intraoperative findings in 24 patients who had undergone stapedoplasty because of otosclerosis recently but with unsatisfactory functional outcome was carried out. Before the operation all patients underwent complete complex of clinical-audiological investigation.
Results. The causes of unsatisfactory results of stapedoplasty according to intraoperative findings data are the cicatricial changes in the posterior and superior sections of the tympanic cavity, in the region of the remote bone overhang of the back of the external auditory canal, tympanic membrane retraction and its fusion with the long leg of the incus in 12 patients (50%) patients. Dislocation of prosthesis, short prosthesis, not tight fixation of the prosthesis ring on a long stalk anvil, anvil dislocation occurred in 8 (33,4%) patients. Reossification foci in the oval window are detected in 4 (16,6%) patients.
Excellent and good functional results were achieved in 22 (91,6%) patients. In 2 (8,4%) operated patients hearing has not changed. After reoperation the closure of air-bone interval (ABI) was noted in all patients.
Conclusions. At reoperations because of poor functional results of stapedoplasty besides removing the leading pathogenetic factors responsible for the immobilization of the auditory ossicles, it is necessary to apply individual variants of surgical correction. They include the excision of the scar with the secondary partial reconstruction of the posterior wall of external auditory canal, malleostapedoplasty, reprostheses of the vestibular window, ossiculoplasty with autotissues or the implant.
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246050, Respublika Belarus', g. Gomel', ul. Lange, d. 5, UO “Gomel'skii gosudarstvennyi meditsinskii universitet”, kafedra otorinolaringologii s kursom oftal'mologii,
Al-Refai Hossam, candidate of medical sciences, assistant professor of the chair of otorhinolaryngology with the course of ophthalmology of EE “Gomel State
Sitnikov V.P., doctor of medical sciences, professor of the chair of otorhinolaryngology with the course of ophthalmology of EE “Gomel State
Kolesnik T.I., a head of the otorhinolaryngology department of ME “Gomel regional specialized clinical hospital”.