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82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

01.06. - 05.06.2011, Freiburg

Investigations on the "lateralization" of pistons after stapes surgery

Meeting Abstract

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  • corresponding author presenting/speaker Ellen Guder - Klinik und Poliklinik für HNO-Heilkunde Universität Rostock, Rostock, Germany
  • author Tino Just - Klinik und Poliklinik für HNO-Heilkunde Universität Rostock, Rostock, Germany
  • author Ursula Vick - Klinik und Poliklinik für HNO-Heilkunde Universität Rostock, Rostock, Germany
  • author Hans Willhelm Pau - Klinik und Poliklinik für HNO-Heilkunde Universität Rostock, Rostock, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Freiburg, 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hno30

doi: 10.3205/11hno30, urn:nbn:de:0183-11hno309

Published: August 3, 2011

© 2011 Guder et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Introduction: There are a few cases of necessary revision stapes surgery, despite an overall high success rate. It is important to differentiate between primary and secondary failure. To explore the reasons for failure in depth, a second exploration of the middle ear is frequently performed. As well as the arrosion of the processus lenticularis, the "lateralization" of the piston is also mentioned in the literature. The purpose of this research is to explore these causes based on our patient population.

Methods: We analysed data concerning revision stapes surgery in our hospital retrospectively from 1991 until 2010. In order to further investigate the cause of “lateralization” we evaluated the location of the prosthesis and its relation to the stapes base intraoperatively. Additionally, light and electron microscopes have been used to examine tissue samples.

Results: 44 operative revisions have been performed. Within those cases, arrosion of the processus lenticularis was present to a variable extent. In addition to the known "lateralization", a distortion of the prosthesis axis was observed. The microscopic samples of the incus showed no signs of any inflammatory or ischemic processes. As described in the literature, a proliferation of connective tissue was observed.

Discussion: Based upon the current literature and our investigations, we believe that the pathomechanism of the "laterized piston syndrome" is due to the traction forces of connective tissue – the stapes is pulled away from the oval window. There is further evidence that a variable growth of connective fibers is found in different types of prosthesis.