An International Journal of Otorhinolaryngology Clinics

Register      Login

VOLUME 13 , ISSUE 1 ( January-April, 2021 ) > List of Articles

Original Article

Role of Ionomeric Bone Cement in Primary Stapedotomy for Otosclerosis

Mohamed Mostafa, Mohamed Elkahwagi, Ahmed M AbdEl-fattah, Waleed Moneir, Yousef Shabana, Mohamed Ghonim

Citation Information : Mostafa M, Elkahwagi M, AbdEl-fattah AM, Moneir W, Shabana Y, Ghonim M. Role of Ionomeric Bone Cement in Primary Stapedotomy for Otosclerosis. Int J Otorhinolaryngol Clin 2021; 13 (1):1-6.

DOI: 10.5005/jp-journals-10003-1362

License: CC BY-NC 4.0

Published Online: 29-09-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Objective: Crimping of the prosthesis in the primary stapedotomy is a controversial step that can have a great impact on the long-term success of the procedure. The study aims to clarify the role of bone cement in primary stapedotomy with an assessment of the postoperative hearing state. Methods: A prospective randomized clinical study including patients with otosclerosis was conducted. The study population was divided into two equal groups. Group A had primary stapedotomy with crimping of the prosthesis while group B had the procedure with bone cement bridging between the prosthesis and a long process of the incus replacing the crimping step. Data of included patients were collected and included gender, age, family history, and audiological parameters. The outcome measurement was the improved hearing status postoperatively as shown by the 1-month postoperative audiogram. The long-term outcome was the stability of the prosthesis that was measured by the 6-month postoperative audiogram. Results: Sixty patients were included in the study. A statistically significant improvement of the hearing state was present in both groups in all frequencies (p <0.05). The difference in postoperative air-bone gap at 2000 Hz between both groups was statistically significant (p <0.05) with better closure in group B. The follow-up period was 1 year postoperatively in all patients. Conclusion: The use of hydroxyapatite bone cement in primary stapedotomy may have a role in providing stability for the procedure decreasing the incidence of recurrent conductive hearing loss in otosclerosis patients. This can provide a substitute for the problems of malcrimping of the prosthesis.


HTML PDF Share
  1. Bianconi L, Gazzini L, Laura E, et al. Endoscopic stapedotomy: safety and audiological results in 150 patients. Eur Arch Oto-Rhino-Laryngol 2020;277(1):85–92. DOI: 10.1007/s00405-019-05688-y.
  2. Nazarian R, Shea R. History of otosclerosis and stapes surgery. Otolaryngol Clin North Am 2018;51(2):275–290. DOI: 10.1016/j.otc.2017.11.003.
  3. Yeh C, Wang M, Chu C, et al. Predictors of hearing outcomes after stapes surgery in otosclerosis. Acta Otolaryngol 2019;139(12): 1058–1062. DOI: 10.1080/00016489.2019.1648866.
  4. Liu YF, Gupta A, Nguyen SA, et al. Preferences in stapes surgery among American Otological Society otologists. World J Otorhinolaryngol Head Neck Surg 2020;6(1):59–65. DOI: 10.1016/j.wjorl.2019.12.001.
  5. Rask-andersen H, Schart-morén N. Special anatomic considerations in otosclerosis surgery. Otolaryngol Clin North Am 2018;51(2):357–374. DOI: 10.1016/j.otc.2017.11.013.
  6. Watson GJ. Reporting in stapes surgery: are we following the guidelines? J Laryngol Otol 2018;132(6):479–485. DOI: 10.1017/S0022215118000397.
  7. Wegner I, Verhagen JJ, Stegeman I, et al. A systematic review of the effect of piston diameter in stapes surgery for otosclerosis on hearing results. Laryngoscope 2016;126(1):182–190. DOI: 10.1002/lary.25408.
  8. Düzenli U, Çatlı T, Gür H, et al. Sixteen years of experience with otosclerosis revision surgery: report of 105 cases. B-ENT 2019;19–24.
  9. Gillard DM, Harris JP. Cost-effectiveness of stapedectomy vs hearing aids in the treatment of otosclerosis. JAMA Otolaryngol Head Neck Surg 2019;146(1):1–6. DOI: 10.1001/jamaoto.2019.3221.
  10. Rompaey V Van, Zarowski A, Vercruysse J, et al. Usefulness of hydroxyapatite bone cement to overcome crimping problems in primary stapedotomy. Otolaryngol Head Neck Surg 2011;7(2):165–171.
  11. Chen DA, Arriaga A. Technical refinements and precautions during ionomeric cement reconstruction of incus erosion during revision stapedectomy. Laryngoscope 2003;113(5):848–852. DOI: 10.1097/00005537-200305000-00014.
  12. Hudson SK, Gurgel RK, Shelton C. Revision stapedectomy with bone cement : are results comparable to those of standard techniques? Otol Neurotol 2014;35(9):1501–1503. DOI: 10.1097/MAO.0000000000000580.
  13. Lundman L, Strömbäck K, Björsne A, et al. Otosclerosis revision surgery in Sweden : hearing outcome, predictive factors and complications. Eur Arch Oto-Rhino-Laryngol 2020;277(1):19–29. DOI: 10.1007/s00405-019-05652-w.
  14. Elzayat ÃS, Younes A, Fouad A, et al. Hearing outcome with the use of glass ionomer cement as an alternative to crimping in stapedotomy. Otol Neurotol 2017;38(9):1240–1245. DOI: 10.1097/MAO.0000000000001564.
  15. Huber AM, Veraguth D, Schmid S, et al. Tight stapes prosthesis fixation leads to better functional results in otosclerosis surgery. Otol Neurotol 2008;29(7):893–899. DOI: 10.1097/MAO.0b013e318184f4f0.
  16. Ardiç FN, Aykal K, Tümkaya F, et al. Improvement of hearing results by bone cement fixation in endoscopic stapedotomy. J Laryngol Otol 2018;132(6):486–488. DOI: 10.1017/S0022215118000439.
  17. Goebel JA, Jacob A. Use of Mimix hydroxyapatite bone cement for difficult ossicular reconstruction. Otolaryngol Head Neck Surg 2005;132(5):727–734. DOI: 10.1016/j.otohns.2005.01.023.
  18. Javier I, Domenico F, Cecilia V, et al. Endoscopic revision stapes surgery : surgical findings and outcomes. Eur Arch Oto-Rhino-Laryngol 2019;276(3):703–710. DOI: 10.1007/s00405-019-05280-4.
  19. Sainz M, Valdecasas J, Garófano M, et al. Otosclerosis: mid-term results of cochlear implantation. Audiol Neurootol 2007;12(6):401–406. DOI: 10.1159/000106773.
  20. Blijleven EE, Wegner I, Tange RA, et al. Revision stapes surgery in a tertiary referral center: surgical and audiometric outcomes. Ann Otol Rhinol Laryngol 2019;128(11):997–1005. DOI: 10.1177/0003489419853304.
  21. Rouhani MJ, Lavy J. Revision stapes surgery: a novel technique of overcoming erosion of the long process of incus using hydroxylapatite cement and shape memory piston. Otol Neurotol 2019;40(3):301–304. DOI: 10.1097/MAO.0000000000002150.
  22. Ertugay OC, Ata P, Ertugay CK, et al. Association of COL1A1 polymorphism in Turkish patients with otosclerosis. Am J Otolaryngol Neck Med Surg 2013;34(5):403–406. DOI: 10.1016/j.amjoto.2013.02.001.
  23. Ayache D, Earally F, Elbaz P. Characteristics and postoperative course of tinnitus in otosclerosis. Otol Neurotol 2003;24(1):48–51. DOI: 10.1097/00129492-200301000-00011.
  24. Nemati S, Naghavi E, Kaemnejad E, et al. Middle ear exploration results in suspected otosclerosis cases : are ossicular and footplate area anomalies rare ? Iran J Otorhinolaryngol 2013;25(3):155–159.
  25. Wegner I, Berg JWG Van Den, Smit AL, et al. Systematic review of the use of bone cement in ossicular chain reconstruction and revision stapes surgery. Laryngoscope 2014;125(1):1–7. DOI: 10.1002/lary.24897.
  26. Demir B, Binnetoglu A, Sahin A, et al. Long-term outcomes of ossiculoplasty using bone cement. J Laryngol Otol 2019;133(8): 658–661. DOI: 10.1017/S0022215119001300.
  27. Caloway CL, Basonbul RA, Ronner EA, et al. Pediatric endoscopic ossiculoplasty following surgery for chronic ear disease. Laryngoscope 2020;130(12):2896–2899. DOI: 10.1002/lary.28526.
  28. Maxwell AK, Iii WHS, Gopen QS, et al. Failure to close the gap: concomitant superior canal dehiscence in otosclerosis patients. Laryngoscope 2020;130(4):1023–1027. DOI: 10.1002/lary.28167.
  29. Balu R, Kumar M, Govindan P, et al. Small fenestra stapedotomy versus large fenestra stapedectomy in improving hearing ability in patients with otosclerosis: our 10 years experience. Indian J Otolaryngol Head Neck Surg 2019;71(3):304–308. DOI: 10.1007/s12070-019-01710-1.
  30. Alessandrini M, Viziano A. Surgical treatment of otosclerosis leading to changes in postural control and quality of life. Laryngoscope 2020;130(10):2448–2454. DOI: 10.1002/lary.28438.
  31. House JW, Lupo JE, Goddard JC. Management of incus necrosis in revision stapedectomy using hydroxyapatite bone cement. Otol Neurotol 2014;35(8):1312–1316. DOI: 10.1097/MAO.0000000000000496.
  32. Singh P, Goyal A. Our experience with the titanium soft clip piston stapedotomy. Indian J Otolaryngol Head Neck Surg 2013;65(3): 280–282. DOI: 10.1007/s12070-011-0459-4.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.