Ear Surgical Ear Procedures For many diagnoses that affect the health of the ear and hearing, or the health of structures near the ear, surgery may be an option. The following are some of the many ear related surgical procedures offered at the ENT Faculty Practice. Ear Tubes Ear tubes, also known as tympanostomy tubes or pressure equalization tubes PETs are placed in children and adults to treat problems of recurrent middle ear infections or persistent middle ear fluid or pressure problems that may affect hearing. A small opening is made in the ear drum and a tiny tube is placed through the opening to relieve fluid and pressure problems.
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November Learn how and when to remove this template message The pathophysiology of otosclerosis is complex. The key lesions of otosclerosis are multifocal areas of sclerosis within the endochondral temporal bone.
Histopathologic studies have all been done on cadaveric temporal bones, so only inferences can be made about progression of the disease histologically. There have been many genes and proteins identified that, when mutated, may lead to these lesions.
CHL in otosclerosis is caused by two main sites of involvement of the sclerotic or scar-like lesions. The best understood mechanism is fixation of the stapes footplate to the oval window of the Stapes prothesis. Conductive hearing loss is usually concomitant with impingement of abnormal bone on the stapes footplate.
This involvement of the oval window forms the basis of the name fenestral otosclerosis. The most common location of involvement of otosclerosis is the bone just anterior to the oval window at a small cleft known as the fissula ante fenestram.
The fissula is a thin fold of connective tissue extending through the endochondral layer, approximately between the oval window and the cochleariform process, where the tensor tympani tendon turns laterally toward the malleus.
The mechanism of sensorineural hearing loss in otosclerosis is less well understood.
It may result from direct injury to the cochlea and spiral ligament from the lytic process or from release of proteolytic enzymes into the cochlea.
There are certainly a few well documented instances of sclerotic lesions directly obliterating sensory structures within the cochlea and spiral ligament, which have been photographed and reported post-mortem. Other supporting data includes a consistent loss of cochlear hair cells in patients with otosclerosis; these cells being the chief sensory organs of sound reception.
A suggested mechanism for this is the release of hydrolytic enzymes into the inner ear structures by the spongiotic lesions. Diagnosis[ edit ] Otosclerosis is traditionally diagnosed by characteristic clinical findings, which include progressive conductive hearing loss, a normal tympanic membrane, and no evidence of middle ear inflammation.
The cochlear promontory may have a faint pink tinge reflecting the vascularity of the lesion, referred to as the Schwartz sign.
Caucasians are the most affected race, with the prevalence in the Black and Asian populations being much lower. In clinical practice otosclerosis is encountered about twice as frequently in females as in males, but this does not reflect the true sex ratio.
When families are investigated it is found that the condition is only slightly more common in women. The hearing loss was long believed to grow worse during pregnancy, but recent research does not support this belief. In pure-tone audiometrythis manifests as air-bone gaps on the audiogram i.
As the stapes is ankylosed in otosclerosis, the lateral end of the ossicular chain may still be quite mobile. Therefore, otosclerosis may only slightly reduce the admittance, resulting in either a shallow tympanogram type ASor a normal tympanogram type A.
Otosclerosis increases in the stiffness of the middle-ear system, raising its resonant frequency. This can be quantified using multi-frequency tympanometry. Thus, a high resonant-frequency pathology such as otosclerosis can be differentiated from low resonant-frequency pathologies such as ossicular discontinuity.
If the mobility of the stapes is reduced due to otosclerosis, then stapedius muscle contraction does not significantly decrease the admittance.Our practice includes general ear, nose, and throat, head and neck diseases and surgeries, cosmetic surgery, robotic procedures, in-office balloon sinuplasty, allergy treatment, and hearing solutions.
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Check out our virtual glossary for lots of easy-to-read definitions. The NiTiBOND Stapes Prosthesis is a crimp-free prosthesis, that combines proven properties of CliP Stapes Prostheses with the benefits of shape memory heat activated nitinol. Extensive experience in the development of stapes prostheses, knowledge of the middle ear, creates the basis for a geometry of the unique nitinol loop making it suitable for almost all incus sizes.
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