Rajan Dilshan, Cureoglu Sebahattin, Adams Meredith E, Monsanto Rafael
Department of Otolaryngology-Head & Neck Surgery University of Minnesota Minneapolis Minnesota USA.
Laryngoscope Investig Otolaryngol. 2024 Dec 6;9(6):e70045. doi: 10.1002/lio2.70045. eCollection 2024 Dec.
To explore the historical evolution of surgical techniques for otosclerosis treatment, viewed through the lens of human temporal bone pathology to aid in understanding the disease and refining surgical interventions.
A review of historical literature on otosclerosis, surgical techniques, and otopathological findings was conducted. Eight temporal bone specimens from the Paparella Otopathology & Pathogenesis Laboratory, University of Minnesota, and one from the University of California, Los Angeles, were analyzed.
We selected two temporal bones from donors who underwent four different types of surgical procedures for otosclerosis: stapes mobilization, fenestration, stapedectomy, and stapedotomy. One successful and one complication case was selected for each procedure. Histopathological analysis was performed to assess the outcomes and complications associated with each technique.
The study chronicles the progression of otosclerosis surgery from the stapes mobilization to modern stapedectomy and stapedotomy techniques. Initial procedures, like stapes mobilization and fenestration, yielded limited and temporary results with significant complications. The introduction of stapedectomy marked a significant improvement, with better long-term outcomes. Histopathological analysis revealed insights into the causes of surgical failures and complications.
Otosclerosis surgery has evolved significantly, driven by advances in otopathology and surgical technology. While earlier techniques offered limited success, modern procedures like stapedectomy and stapedotomy provide improved outcomes and fewer complications. Ongoing research promises further advancements in the field, improving patient care and surgical efficacy.
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通过人类颞骨病理学的视角，探讨耳硬化症治疗手术技术的历史演变，以助于理解该疾病并优化手术干预措施。
对有关耳硬化症、手术技术及耳病理学发现的历史文献进行了综述。分析了明尼苏达大学帕帕雷拉耳病理学与发病机制实验室的8个颞骨标本以及加利福尼亚大学洛杉矶分校的1个颞骨标本。
我们从接受了4种不同耳硬化症手术的供体中选取了2个颞骨：镫骨松动术、开窗术、镫骨切除术和镫骨足板钻孔术。每种手术选取1例成功病例和1例并发症病例。进行组织病理学分析以评估每种技术的疗效和并发症。
该研究记录了耳硬化症手术从镫骨松动术发展到现代镫骨切除术和镫骨足板钻孔术的过程。像镫骨松动术和开窗术这样的初始手术取得的效果有限且为暂时性的，还伴有严重并发症。镫骨切除术的引入标志着显著的进步，具有更好的长期疗效。组织病理学分析揭示了手术失败和并发症的原因。
在耳病理学和手术技术进步的推动下，耳硬化症手术有了显著发展。虽然早期技术成功率有限，但现代手术如镫骨切除术和镫骨足板钻孔术提供了更好的疗效且并发症更少。正在进行的研究有望在该领域取得进一步进展，改善患者护理和手术疗效。
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