Penatalaksanaan Otosklerosis

Oleh :

dr. Felicia

Penatalaksanaan utama otosklerosis adalah operasi stapes (stapedotomi/stapedektomi). Namun, perlu diperhatikan pula bahwa stapedotomi dikontraindikasikan pada otosklerosis yang aktif dan otosklerosis yang sudah mencapai koklea. Pada keadaan ini dilakukan pemasangan actuator pada tingkap bulat di koklea.[6,18,31]

Pasien dengan batas konduksi tulang atau bone conduction (BC) >30 dB tidak disarankan menjalankan operasi stapes, walaupun air-bone gap (ABG) >25 dB, hal ini karena keuntungan yang dihasilkan dari operasi tersebut tidak terlalu signifikan dan tetap memerlukan alat bantu dengar.[14]

Terapi Farmakologis

Referensi

3. Eshraghi AA, Ila K, Ocak E, et al. Advanced Otosclerosis. Otolaryngol Clin North Am. 2018 Apr;51(2):429–40.
6. Sharma VS, Tez SP, Rao MVS, et al. Audiological Analysis of 62 Patients with Otosclerosis Undergoing Stapedotomy with Slow-speed Microdrill. 2019;7(1):4.
7. Wiatr A, Składzień J, Strek P, et al. Carhart Notch—A Prognostic Factor in Surgery for Otosclerosis: Ear Nose Throat J. 2019 Sep 26. https://journals.sagepub.com/doi/10.1177/0145561319864571
8. Bagger-Sjöbäck D, Strömbäck K, Hultcrantz M, et al. High-frequency hearing, tinnitus and patient satisfaction with stapedotomy: A randomized prospective study. Sci Rep. 2015 Aug 21;5(1):1–10.
12. Cheng HCS, Agrawal SK, Parnes LS. Stapedectomy Versus Stapedotomy. Otolaryngol Clin North Am. 2018 Apr;51(2):375–92.
14. Rapier JJ, Theodoraki GE, Manjaly JG, et al. Stapes Surgery for 121 Patients With Mixed Hearing Loss. Ear Nose Throat J. 2019 Dec 23;014556131988572.
18. Rudic M, Keogh I, Wagner R, et al. The pathophysiology of otosclerosis: Review of current research. Hear Res. 2015 Dec;330:51–6.
31. Zhang S, Wu Y, Liu Z, et al. Hepatic pathology of biliary atresia: A new comprehensive evaluation method using liver biopsy. Turk J Gastroenterol Off J Turk Soc Gastroenterol. 2016 May;27(3):257–63.
32. Yıldız E, Kahveci OK, Ulu Ş, et al. Is there any association between calcium values and otosclerosis? J Surg Med . 2019 May 13. http://dergipark.org.tr/doi/10.28982/josam.561379
39. Ali HI, Khater NH. Otosclerosis and complications of stapedectomy: CT and MRI correlation. Alex J Med. 2018 Sep 1;54(3):197–201.
40. EL Maraghy A, Aboelwafa W, Abdel Monem M, et al. Role of high resolution multislice CT scan in otosclerosis. Egypt J Ear Nose Throat Allied Sci. 2015 Nov 1;16(3):247–54.
42. Blijleven EE, Wegner I, Tange RA, et al. Revision Stapes Surgery in a Tertiary Referral Center: Surgical and Audiometric Outcomes. Ann Otol Rhinol Laryngol. 2019 Nov 1;128(11):997–1005.
45. Liktor B, Szekanecz Z, Batta TJ, et al. Perspectives of pharmacological treatment in otosclerosis. Eur Arch Otorhinolaryngol. 2013 Mar;270(3):793–804.
46. Vicente A de O, Yamashita HK, Cruz OLM, et al. Eficácia da avaliação audiométrica no tratamento medicamentoso da otospongiose. Braz J Otorhinolaryngol. 2012 Apr;78(2):73–9.
47. Jan TA, Remenschneider AK, Halpin C, et al. Third-generation bisphosphonates for cochlear otosclerosis stabilizes sensorineural hearing loss in long-term follow-up. Laryngoscope Investig Otolaryngol. 2017;2(5):262–8.
48. Dwyer-Hemmings L, Manjaly JG, Nash R, et al. Stapes Surgery for Profound Hearing Loss Secondary to Otosclerosis. Ear Nose Throat J. 2019 Jun 1;98(5):273–8.
49. Chang C-J, Wen Y-H, Sun C-H, et al. Treatment of moderate-to-severe otosclerosis with simultaneous piston surgery and incus vibroplasty. Tzu Chi Med J. 2019;31(2):96.
50. Grossöhmichen M, Salcher R, Kreipe H-H, et al. The CodacsTM Direct Acoustic Cochlear Implant Actuator: Exploring Alternative Stimulation Sites and Their Stimulation Efficiency. PLOS ONE. 2015 Mar 18;10(3):e0119601.

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