ORIGINAL RESEARCH
The Effects of Glass-Ionomer Bone Cement Fixation of the Stapes Prosthesis on Audiological Outcomes and Prosthesis Dislocation Incidence
Stapes Protezinin Cam İyonomer Kemik Çimentosu ile Fiksasyonunun Odyolojik Sonuçlara ve Protezin Yerinden Çıkma İnsidansına Etkileri
Received Date : 04 Dec 2022
Accepted Date : 24 Apr 2023
Available Online : 09 May 2023
Onur ERGÜNa, Bilge Hakan YÜCEa, Eda ÇAKMAKb, Işılay ÖZa, Levent Naci ÖZLÜOĞLUa
aDepartment of Otorhinolaryngology, Head and Neck Surgery, Başkent University Faculty of Medicine, Ankara Hospital, Ankara, Türkiye
bDepartment of Audiology, Başkent University Faculty of Health Sciences, Ankara, Türkiye
Doi: 10.24179/kbbbbc.2022-94719 - Makale Dili: EN
KBB ve BBC Dergisi. 2023;31(3):135-9
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The aim of this study is to retrospectively
evaluate the effects of bone cement stabilization of the stapedotomy
prosthesis with respect to audiological results and incidence of prosthesis
dislocation. Material and Methods: A retrospective analysis of
32 cases that were operated using same surgical technique. Surgeries
were done by the same surgeon under general anesthesia. Preoperative
and post operative audiograms between Group-1 and Group-2 were
compared. Demographic data, the surgical status of the contralateral
ear, surgical technique, bone cement fixation status, length of the prosthesis,
intraoperative complications were analysed. Pure tone average
(PTA) gains, air-bone gap (ABG) improvements and 8 kHz hearing
level changes were calculated. Results: Out of 32 stapedotomies, 13
cases had bone cement stabilization. There was no age (p=0.388) or
sex (p=0.704) difference between the groups. Both groups had significantly
improved PTAs (p<0.001) and decreased ABG (p<0.001) values.
But there was no difference between the groups (p=0.701). Also,
there was no difference of 8 kHz hearing levels (p: 0.656). 3 prosthesis
dislocations were seen in the “no bone cement” Group-1 versus no
dislocations in the “bone cement” Group-2. This difference was not
significant (p=0.253). Conclusion: Bone cement stabilization of the
stapedotomy prosthesis is a safe technique. Bone cement stabilization
did not affect audiological outcomes and may offer a reduction in the
incidence of prosthesis dislocation. However, studies with larger patient
series and longer follow-up periods are needed.
Keywords: Bone cements; stapes surgery; glass ionomer cements
ÖZET
Amaç: Bu çalışmanın amacı, stapedotomideki protezin kemik
çimentosu stabilizasyonunun odyolojik sonuçlar ve protez yerinden
çıkma insidansı üzerindeki etkilerini retrospektif olarak değerlendirmektir.
Gereç ve Yöntemler: Aynı cerrahi teknikle opere edilen 32 olgunun
retrospektif olarak analizi yapıldı. Bu ameliyatlar aynı cerrah
tarafından genel anestezi altında yapılmıştır. Ameliyat öncesi ve ameliyat
sonrası odyogramlar Grup 1 ile Grup 2 arasında karşılaştırıldı. Demografik
veriler, karşı taraftaki kulağın cerrahi durumu, cerrahi teknik,
kemik çimentosunun fiksasyon durumu, protez uzunluğu, intraoperatif
komplikasyonlar analiz edildi. Saf ses ortalaması [pure tone averages
(PTA)] kazançları, hava-kemik aralığı [air-bone gap (ABG)] iyileştirmeleri
ve 8 kHz işitme seviyesi değişiklikleri hesaplandı. Bulgular:
Otuz iki stapedotomiden 13’ünde kemik çimentosu stabilizasyonu sağlandı.
Her iki grup arasında yaş (p=0,388) ve cinsiyet (p=0,704) açısından
farkı yoktu. Her iki grupta da anlamlı olarak PTA (p<0,001)
düzeldi ve ABG (p<0,001) değerleri azaldı. Ancak gruplar arasında fark
yoktu (p=0,701). Ayrıca 8 kHz işitme seviyeleri arasında fark yoktu (p:
0,656). “Kemik çimentosu olmayan” (Grup 1) grupta 3 protez yerinden
ayrılması görülürken, “kemik çimentosu” (Grup 2) grubunda hiç
ayrılma görülmedi. Ancak bu fark anlamlı değildi (p=0,253). Sonuç:
Stapedotomide protezin kemik çimentosu ile stabilizasyonu güvenli bir
tekniktir. Kemik çimentosu stabilizasyonu odyolojik sonuçları etkilemedi
ama protezin yerinden çıkma insidansında bir azalma sağlayabilir.
Ancak daha geniş hasta serilerinde ve daha uzun takip sürelerini
içeren çalışmalara ihtiyaç vardır.
Anahtar Kelimeler: Kemik çimentosu; stapes cerrahisi; cam iyonomer sementler
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