الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 109 |  |  |
| | | from | 109 | | |
Abstract
Summary
Otosclerosis is a term used to describe a localized disease of the bone derived from the otic capsule and characterized by alternating phases of bone resorption and formation.
The typical clinical features of otosclerosis are gradually increasing hearing loss, most frequently occurring between the third and fifth decade, and often associated with the presence of paracusis and tinnitus.
Unilateral otosclerosis Occurs in approximately15% to 30%of patients. Tinnitus is a common symptom. Vertigo is not a prominent feature although some patients may experience as light and transitory giddiness.
The diagnosis of otosclerotic hearing loss is usually unproblematic. A positive family history is found in about 10% to 60% of the cases.
Clinical bilateral affection is common (80%-90%). There is also tinnitus, paracusis of Willis.
Otoscopy reveals a normal eardrum. Audiometric testing in otosclerosis reveals a conductive hearing loss. An interesting finding in otosclerosis is the deterioration of bone conduction thresholds at middle to high frequencies, the so-called Carhart notch. Tympanometry is generally normal, but sometimes a diminished compliance (A or As). The stapedial reflex is absent in all cases preoperative.
When air conduction thresholds are lower than 30 dB HL no treatment was advised. In patients with moderate to severe hearing loss, and unwilling or unable to undergo surgery, hearing aids often yield good results when cochlear function is well preserved.
In our country there is no known medicine available for treating the stapes fixation due to otosclerosis. Stapes surgery should be performed by surgeons who have special interest in otology. In approximately 90% of the cases, surgery results in a dramatic and prolonged hearing gain with closure of the airbone gap to within 10 dB.
In this work we studied the comparison between Piezosurgery and conventional surgical method in stapedotomy.
This study was conducted on 40 patients who are classified into two groups each group had 20 patients. Piezosurgery was used in group A and conventional tools wee used in group B.
The operation for all patients had been done by Surgical microscope under general anesthesia and Teflon piston was used instead of stapes in all patients.
The patients were performed audiometry before the operation and two months after the operation and they were compared to each other. The patients were followed up after the operation to detect the appearance of any complications related to the use of any of the two methods and recorded them.
The results revealed that there is no preference for Piezosurgery over conventional surgical tools, but it didn’t affect the soft tissues at all, so none of nerves or vessels in the field of the operation were injured. the time elapsed during the use of Piezosurgery was longer than the time elapsed during the use of conventional surgical tools, in addition to the high cost of the Piezosurgery in comparison to conventional surgical tools.