Sönmez Said, Orhan Kadir Serkan, Baumgartner Wolf-Dieter, Zarowski Andrzej, Özgirgin Nuri Osman, Barbara Maurizio, Röösli Christof, Mösnier Isabelle, Caversaccio Marco, Nguyen Yann, Topsakal Vedat
Department of Otorhinolaryngology, Head Neck Surgery, Medical University of Vienna, Vienna, Austria.
Department of Otorhinolaryngology, Head and Neck Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul, Türkiye.
J Int Adv Otol. 2025 Mar 25;21(2):1-6. doi: 10.5152/iao.2025.241839.
Debates and research about otosclerosis and stapes surgery have continued since the time it was described, and there is still no consensus on many issues. The aim of this article is to report the controversies in the etiology, pathophysiology, diagnosis, imaging, treatment, and management of otosclerosis and address the points of consensus of experts.
In the last session of the Fifth International Otosclerosis and Stapes Surgery Symposium held in Brussels, a round table meeting was held where controversial issues in otosclerosis and stapes surgery were discussed, and a survey was administered to all participants. Nine experienced panelists were interviewed by the moderator on stage, and 166 participants provided their answers interactively through the online voting system.
All of the panelists were experts in their field who had performed more than 1000 cases, and if we take into account the more experienced participants, the results are based on at least 16 968 stapes surgery experiences. While full consensus was reached by the expert panelists on 14 questions, agreement was reached by participants on only 2. The most striking difference between the panelists and attendees was regarding reparative granuloma.
Even if a consensus was reached on some issues, controversies, especially the surgical technique, medical equipment and prostheses used are subjects to both discussion and development. Even the experts who come to present and share knowledge do not always agree. It is strongly recommended that clinicians follow all developments, compare their results with those of others, and use the techniques and materials with which they feel most comfortable for their patients.
自耳硬化症及镫骨手术被描述以来,关于它们的争论和研究一直在持续,在许多问题上仍未达成共识。本文旨在报告耳硬化症在病因、病理生理学、诊断、影像学、治疗及管理方面的争议,并阐述专家们的共识要点。
在布鲁塞尔举行的第五届国际耳硬化症及镫骨手术研讨会的最后一场会议上,召开了一次圆桌会议,讨论耳硬化症及镫骨手术中的争议问题,并对所有参会者进行了一项调查。主持人在台上对九位经验丰富的小组成员进行了访谈,166名参会者通过在线投票系统交互式地给出了他们的答案。
所有小组成员都是各自领域的专家,都进行过1000多例手术,如果把更有经验的参会者也算上,结果是基于至少16968次镫骨手术经验得出的。虽然专家小组就14个问题达成了完全共识,但参会者只就2个问题达成了一致。小组成员和与会者之间最显著的差异在于修复性肉芽肿方面。
即使在一些问题上达成了共识,但争议仍然存在,特别是在手术技术、使用的医疗设备和假体方面,这些都有待讨论和发展。即使是前来展示和分享知识的专家也并非总是意见一致。强烈建议临床医生关注所有进展,将自己的结果与他人的结果进行比较,并为患者使用他们感觉最得心应手的技术和材料。