scholarly journals Post-operative hearing among patients with labyrinthine fistula as a complication of cholesteatoma using “under water technique”

2021 ◽  
Author(s):  
K. Thangavelu ◽  
R. Weiß ◽  
J. Mueller-Mazzotta ◽  
M. Schulze ◽  
B. A. Stuck ◽  
...  
Keyword(s):  
Inner Ear ◽  
Bone Conduction ◽  
Vestibular Function ◽  
Complete Removal ◽  
Hearing Tests ◽  
Viable Option ◽  
Labyrinthine Fistula ◽  
Significant Difference ◽  
The Matrix ◽  
Canal Wall Down

Abstract Introduction During surgery in patients with labyrinthine fistula the mandatory complete removal of the cholesteatoma while preserving inner ear and vestibular function is a challenge. Options so far have been either the complete removal of the cholesteatoma or leaving the matrix on the fistula. We evaluated an alternative “under water” surgical technique for complete cholesteatoma resection, in terms of preservation of postoperative inner ear and vestibular function. Methods From 2013 to 2019, 20 patients with labyrinthine fistula due to cholesteatoma were operated. We used the canal wall down approach and removal of matrix on the fistula was done as the last step during surgery using the “under water technique”. The pre and postoperative hearing tests and the vestibular function were retrospectively examined. Results There was no significant difference between pre and post-operative bone conduction thresholds; 20% experienced an improvement of more than 10 dB, with none experiencing a postoperative worsening of sensorineural hearing loss. Among seven patients who presented with vertigo, two had transient vertigo postoperatively but eventually recovered. Conclusion Our data show that the “under water technique” for cholesteatoma removal at the labyrinthine fistula is a viable option in the preservation of inner ear function and facilitating complete cholesteatoma removal.

Surgical Treatment of Labyrinthine Fistula Caused by Cholesteatoma

2000 ◽  
Vol 122 (5) ◽  
pp. 739-742 ◽  
Author(s):  
Antonio Soda-Merhy ◽  
Miguel Angel Betancourt-Suárez
Keyword(s):  
Chronic Otitis Media ◽  
Safe Procedure ◽  
Canal Wall ◽  
Cochlear Function ◽  
Horizontal Semicircular Canal ◽  
Labyrinthine Fistula ◽  
The Matrix ◽  
Preoperative Ct ◽  
Canal Wall Down

In a 144-month period, 27 cases of labyrinthine fistula (LF) were seen, and 360 mastoid operations were performed; the LF prevalence was 7.5%. Primary symptoms were hypoacusis, otorrhea, vertigo, tinnitus, and otalgia. All patients underwent preoperative CT scans and preoperative audiometry. LF diagnosis was made before surgery for 93% of patients on the basis of symptoms, signs, and imaging studies. With respect to surgical technique, the canal-wall-down procedure was performed in 92%, and the canal-wall-up procedure was performed in 8%. In 88% of patients the fistula was located in the horizontal semicircular canal. In 96% of patients the cholesteatoma matrix was removed, and the fistula was sealed; in 4% of patients the matrix was left. With a follow-up of 13 years, vertigo disappeared in 96% of patients, and hearing remained unchanged in 70% of patients. Further complications of chronic otitis media existed in approximately half of the patients with LF. Open surgery with removal of the cholesteatoma matrix and sealing of the fistula with temporalis fascia in a canal-wall-down manner is a safe procedure that can make vertigo disappear and helps to preserve cochlear function.

The late results of 4000 Hz frequency bone conduction after tympanoplasty

2017 ◽  
Vol 71 (5) ◽  
pp. 12-17
Author(s):  
Joanna Janiak-Kiszka ◽  
Wojciech Kaźmierczak
Keyword(s):  
Bone Conduction ◽  
Organ Of Corti ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Late Results ◽  
Canal Wall ◽  
Bone Conduction Threshold ◽  
Significant Difference ◽  
Canal Wall Down

Introduction: Surgical treatment of conductive hearing loss runs the risk of damage to the inner ear in the mechanism of acoustic trauma. Aim: The aim of this study was to evaluate the function of the organ of Corti, expressed as bone conduction threshold at the frequency of 4000 Hz for selected operations: mastoidectomy and canal-wall-down procedure. Material and methods: The material was collected from patients with chronic otitis media in the Department of Otolaryngology and ENT Oncology, Collegium Medicum of Nicolaus Copernicus University in Bydgoszcz in 2004–2009. All patients were examined with pure tone audiometry threshold before surgery and at least three years after surgery. The analyzed group of patients was divided into subgroups depending on the type of operation according to To classification and procedures for resection: mastoidectomy and canal-wall-down procedure. The results were statistically analyzed. Results: In the analyzed period of three years after surgery there was no statistically significant difference between groups, although there were higher values for tympanoplasty type 1 with mastoidectomy compared with tympanoplasty type 1 without mastoidectomy - respectively 25.67 dB and 18.53 dB. In the study, there was no statistically significant the difference in bone conduction threshold for frequency 4000 Hz within the type 2 tympanoplasty according to Tosa comparing canal wall-up and canal-wall-down procedure. Conclusions: Mastoidectomy or canal-wall-down procedure do not affect the bone conduction threshold for a frequency of 4000 Hz after tympanoplasty in long-term observation.

Erbium: Yttrium-Aluminum-Garnet Laser Application in Stapedotomy

2005 ◽  
Vol 133 (6) ◽  
pp. 923-928 ◽  
Author(s):  
Jacopo Galli ◽  
Claudio Parrilla ◽  
Antonella Fiorita ◽  
Maria Raffaella Marchese ◽  
Gaetano Paludetti
Keyword(s):  
Inner Ear ◽  
Yttrium Aluminum Garnet ◽  
Er:Yag Laser ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Clinical Safety ◽  
Erbium Laser ◽  
Significant Difference ◽  
Yttrium Aluminum ◽  
Student’S T

OBJECTIVE: To assess clinical safety and efficacy of the erbium: yttrium-aluminum-garnet (Er:YAG) laser in the stapes surgery; to define and optimize parameters that render the procedure safe for the inner ear. STUDY DESIGN: Retrospective study. MATERIAL AND METHODS: A microscope-integrated Er: YAG laser stapedotomy was performed on 29 patients and a conventional stapedotomy on 41 patients. An early (within 1 to 3 days after stapes surgery) and late (at least 6 weeks) pure-tone bone-conduction threshold audiogram was obtained. RESULTS: No statistically significant differences were found by Student's t test over all measured frequencies between pre- and postoperative bone-conduction thresholds in each group. There was no statistically significant difference for all frequencies between early (3 days) and late postoperative mean bone-conduction thresholds. CONCLUSIONS: The results of our preliminary clinical study showed that erbium laser poses no risk to inner ear function. However, the lack of standardization obliges further investigation to establish safe clinical parameters of the Er:YAG laser. EBM RATING: B-3

scholarly journals Cholesteatoma surgery by open technique with reconstruction together with same session ossiculoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohammed Saad Hasaballah ◽  
Peter Milad ◽  
Ossama Mustafa Mady ◽  
Ahmed Abdelmoneim Teaima
Keyword(s):  
Complete Removal ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Open Technique ◽  
Viable Option ◽  
Effective Option ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Cavity Obliteration ◽  
Cholesteatoma Surgery

Abstract Background This study was designed to evaluate the effect of mastoid cavity obliteration with bone chips and reconstruction of canal wall with tragal cartilage after canal wall down tympanomastoidectomy with cartilage ossiculoplasty in the same session. Sixty-three patients with cholesteatoma underwent the technique mentioned above; patients were followed for 1 year postoperative. Results No cavity problems, median preoperative air bone gap was 32.86 ± 6.24 db, while the median postoperative air bone gap was 21.67 ± 5.99 db. Conclusions Canal wall down mastoidectomy with obliteration of mastoid cavity is an effective option for the complete removal of cholesteatoma and same session cartilage ossiculoplasty is a viable option.

Surgical treatment of labyrinthine fistula caused by cholesteatoma

2000 ◽  
Vol 122 (5) ◽  
pp. 739-742 ◽  
Author(s):  
Antonio Soda-Merhy ◽  
Miguel Angel Betancourt-SuÁRez
Keyword(s):  
Chronic Otitis Media ◽  
Safe Procedure ◽  
Canal Wall ◽  
Cochlear Function ◽  
Horizontal Semicircular Canal ◽  
Labyrinthine Fistula ◽  
The Matrix ◽  
Preoperative Ct ◽  
Canal Wall Down

In a 144-month period, 27 cases of labyrinthine fistula (LF) were seen, and 360 mastoid operations were performed; the LF prevalence was 7.5%. Primary symptoms were hypoacusis, otorrhea, vertigo, tinnitus, and otalgia. All patients underwent preoperative CT scans and preoperative audiometry. LF diagnosis was made before surgery for 93% of patients on the basis of symptoms, signs, and imaging studies. With respect to surgical technique, the canal-wall-down procedure was performed in 92%, and the canal-wall-up procedure was performed in 8%. In 88% of patients the fistula was located in the horizontal semicircular canal. In 96% of patients the cholesteatoma matrix was removed, and the fistula was sealed; in 4% of patients the matrix was left. With a follow-up of 13 years, vertigo disappeared in 96% of patients, and hearing remained unchanged in 70% of patients. Further complications of chronic otitis media existed in approximately half of the patients with LF. Open surgery with removal of the cholesteatoma matrix and sealing of the fistula with temporalis fascia in a canal-wall-down manner is a safe procedure that can make vertigo disappear and helps to preserve cochlear function.

Surgical treatment of labyrinthine fistula in patients with cholesteatoma

2009 ◽  
Vol 123 (S31) ◽  
pp. 64-67 ◽  
Author(s):  
Y Ueda ◽  
T Kurita ◽  
Y Matsuda ◽  
S Ito ◽  
T Nakashima
Keyword(s):  
Surgical Treatment ◽  
Treatment Strategies ◽  
Vestibular Function ◽  
Chronic Otitis Media ◽  
Optimal Management ◽  
Canal Wall ◽  
Temporalis Fascia ◽  
Labyrinthine Fistula ◽  
Hearing Test ◽  
Canal Wall Down

AbstractLabyrinthine fistula is one of the most common complications of chronic otitis media associated with cholesteatoma. The optimal management of labyrinthine fistula, however, remains controversial. Between 1995 and 2005, labyrinthine fistulae were detected in 31 (6 per cent) patients in our institution. The canal wall down technique was used in 27 (87 per cent) patients. The cholesteatoma matrix was completely removed in the first stage in all patients. Bone dust and/or temporalis fascia was inserted to seal the fistula in 29 (94 per cent) patients. A post-operative hearing test was undertaken in 27 patients; seven (26 per cent) patients showed improved hearing, 17 (63 per cent) showed no change and three (11 per cent) showed a deterioration. The study findings indicate that there are various treatment strategies available for cholesteatoma, and that the treatment choice should be based on such criteria as auditory and vestibular function, the surgeon's ability and experience, and the location and size of the fistula.

scholarly journals Is jumbo biopsy forceps comparable to cold snare for diminutive colorectal polyps? – a meta-analysis

2021 ◽  
Vol 09 (01) ◽  
pp. E9-E13
Author(s):  
Sachin Srinivasan ◽  
Peter D. Siersema ◽  
Madhav Desai
Keyword(s):  
Meta Analysis ◽  
Complete Removal ◽  
Colorectal Polyps ◽  
Comparable Efficacy ◽  
Incomplete Resection ◽  
Complication Rates ◽  
Biopsy Forceps ◽  
Significant Difference ◽  
Leave One Out ◽  
Endoscopic Assessment

Abstract Background and study aims Diminutive colorectal polyps are increasingly being detected and it is not clear whether jumbo biopsy forceps (JBF) has comparable efficacy to that of cold snare polypectomy (CSP) for management of these lesions. Methods An electronic literature search was performed for studies comparing resection rates of JBF and CSP for diminutive polyps (≤ 5 mm). The primary outcome was incomplete resection rate (IRR). Secondary outcomes included failure of tissue retrieval and complication rates (post-polypectomy bleeding, perforation etc.). Leave-one-out analysis was performed to examine the disproportionate role of any of the studies. Meta-analysis outcomes and heterogeneity (I2) were computed using Comprehensive meta-analysis software. Results A total of 4 studies (3 randomized controlled trials and 1 retrospective study) with 407 patients and 569 total polyps (mean size of 3.62 mm) was included for analysis. IRR of JBF was slightly higher than that of CSP (10.2 % vs 7.2 %) but this was not statistically significantly different (Pooled OR 1.76; 95 % CI 0.94–3.28; I2 = 0). Leave-one-out analysis showed no significant difference in the pooled OR comparison either. Two of the 4 studies reported 0 % failure of tissue retrieval for JBF and 1 % and 4.3 % for CSP. There were no complications for either group from the 2 studies that reported this outcome. The quality of the included studies was moderate to high. Conclusions This systematic review with only limited data shows that JBF and CSP are not statistically different in completely removing diminutive polyps, although careful endoscopic assessment is needed to ensure complete removal of all polyp tissue.

scholarly journals Assessment of cervical and ocular vestibular evoked myogenic potentials in migraine patients

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Doaa Elmoazen ◽  
Hesham Kozou ◽  
Jaidaa Mekky ◽  
Dalia Ghanem
Keyword(s):  
Vestibular Function ◽  
Vestibular Dysfunction ◽  
Peak Amplitude ◽  
Vestibular Evoked Myogenic Potentials ◽  
Healthy Controls ◽  
Latency Difference ◽  
Significant Difference ◽  
Cervical Vemp ◽  
Vestibular Symptoms ◽  
Function Assessment

Abstract Background Patients suffering from vestibular migraine (VM) are known to have various vestibular test abnormalities interictally and ictally. Recently, vestibular evoked myogenic potentials (VEMPs) have become accepted as a valid method for otolith function assessment. Many studies have identified various vestibular symptoms and laboratory abnormalities in migraineurs. Since migraineurs with no accompanying vestibular symptoms might exhibit subclinical vestibular dysfunction, we investigated vestibular function using ocular and cervical VEMPs in migraine patients. The aim was to study cervical VEMP and occular VEMP in migraineurs with and without vestibular symptoms interictally. Results Migraine and VM patients showed significantly longer P13 latency of cVEMP compared to controls. A statistically significant cVEMP interaural P13 latency difference was found in VM compared to healthy controls. Cervical VEMP N23 latency, peak-to-peak amplitude, interaural N23 latency, and amplitude asymmetric ratio did not show any significant difference in migraine and VM patients compared to healthy controls as well as no significant difference across the three groups regarding oVEMP parameters. Conclusions Abnormal interictal cVEMP results in migraineurs might indicate subclinical vestibulo-collic pathway dysfunction.

scholarly journals Cutaneous and Labyrinthine Tolerance of Bioactive Glass S53P4 in Mastoid and Epitympanic Obliteration Surgery: Prospective Clinical Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Daniele Bernardeschi ◽  
Yann Nguyen ◽  
Francesca Yoshie Russo ◽  
Isabelle Mosnier ◽  
Evelyne Ferrary ◽  
...  
Keyword(s):  
Bioactive Glass ◽  
Inner Ear ◽  
Round Window ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Round Window Membrane ◽  
Prospective Clinical Study ◽  
Local Skin ◽  
Local Skin Reaction ◽  
Bone Conduction Hearing

Objective. To evaluate the cutaneous and the inner ear tolerance of bioactive glass S53P4 when used in the mastoid and epitympanic obliteration for chronic otitis surgery.Material and Methods. Forty-one cases have been included in this prospective study. Cutaneous tolerance was clinically evaluated 1 week, 1 month, and 3 months after surgery with a physical examination of the retroauricular and external auditory canal (EAC) skin and the presence of otalgia; the inner ear tolerance was assessed by bone-conduction hearing threshold 1 day after surgery and by the presence of vertigo or imbalance.Results. All surgeries but 1 were uneventful: all patients maintained the preoperative bone-conduction hearing threshold except for one case in which the round window membrane was opened during the dissection of the cholesteatoma in the hypotympanum and this led to a dead ear. No dizziness or vertigo was reported. Three months after surgery, healing was achieved in all cases with a healthy painless skin. No cases of revision surgery for removal of the granules occurred in this study.Conclusion. The bioactive glass S53P4 is a well-tolerated biomaterial for primary or revision chronic otitis surgery, as shown by the local skin reaction which lasted less than 3 months and by the absence of labyrinthine complications.

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