Causse J B, Lopez A, Juberthie L, Olivier J C
J. Causse Clinic--Colombiers/Béziers, France.
Ann Acad Med Singap. 1991 Sep;20(5):618-23.
The Jean-Bernard Causse technique of stapedotomy, derived from Jean René Causse "Teflon-interposition" technique, offers an optimum reconstitution of the function of the annular ligament of the stapes footplate. The quantity and quality of hearing depend significantly, among other things, on the function of the stapes footplate annular ligament. Its impedance keeps the perilymph motion within a physiological acoustic amplitude quantum level unless the movements are so excessive as in barotrauma and acoustic trauma which would have overworked even the annular ligament of a normal footplate. This surgical technique permits snorkling, scuba-diving, airplane landing, eustachian tube dysfunction after surgery as in a normal individual who did not undergo otosclerosis surgery. A comparative study on the postoperative hearing based on 3,000 out of 14,000 cases done by J C Bausse technique, 127 cases with small fenestra technique and 267 cases of complete platinectomy showed too large stapedotomy gives poor high tones and too small stapedotomy poor low tones. Five year follow-up on the hearing loss indicated that total platinoctomy has 1.7 times more alteration of 4 kHz frequency in comparison to the technique reconstituting the annular ligament. Yearly audiogram to check the evolution of cochlear otospongiosis may lead the surgeon to prescribe sodium fluoride if the mid-frequencies are deteriorating and vascular drugs if the high pitch frequencies are deteriorating.
镫骨切除术的让 - 贝尔纳·考斯技术源自让·勒内·考斯的“聚四氟乙烯植入”技术，能对镫骨足板环形韧带的功能进行最佳重建。听力的数量和质量在很大程度上尤其取决于镫骨足板环形韧带的功能。其阻抗能将外淋巴运动保持在生理声学振幅量子水平内，除非运动过度，如在气压伤和声创伤中，即使是正常足板的环形韧带也会不堪重负。这种手术技术允许进行浮潜、水肺潜水、飞机降落，术后咽鼓管功能障碍的情况与未接受耳硬化症手术的正常人一样。基于14000例中的3000例采用J C 鲍斯技术、127例采用小开窗技术和267例采用完全镫骨切除术的术后听力对比研究表明，镫骨切除术开窗过大高音效果差，开窗过小低音效果差。对听力损失的五年随访表明，与重建环形韧带的技术相比，完全镫骨切除术在4千赫频率处的变化多出1.7倍。每年进行听力图检查以监测耳蜗耳海绵化的进展，如果中频恶化，外科医生可能会开氟化钠，如果高频恶化则开血管药物。
