Modification of auditory pathway functions in patients with hearing improvement after middle ear surgery

1998 ◽  
Vol 119 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Juha-Pekka Vasama ◽  
Jyrki P. Mäkelä ◽  
Hans A. Ramsay
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Adult Patients ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Pure Tone Average ◽  
The Mean ◽  
Conductive Hearing

We recorded auditory-evoked magnetic responses with a whole-scalp 122-channel neuromagnetometer from seven adult patients with unilateral conductive hearing loss before and after middle ear surgery. The stimuli were 50-msec 1-kHz tone bursts, delivered to the healthy, nonoperated ear at interstimulus intervals of 1, 2, and 4 seconds. The mean preoperative pure-tone average in the affected ear was 57 dB hearing level; the mean postoperative pure-tone average was 17 dB. The 100-msec auditory-evoked response originating in the auditory cortex peaked, on average, 7 msecs earlier after than before surgery over the hemisphere contralateral to the stimulated ear and 2 msecs earlier over the ipsilateral hemisphere. The contralateral response strengths increased by 5% after surgery; ipsilateral strengths increased by 11%. The variation of the response latency and amplitude in the patients who underwent surgery was similar to that of seven control subjects. The postoperative source locations did not differ noticeably from preoperative ones. These findings suggest that temporary unilateral conductive hearing loss in adult patients modifies the function of the auditory neural pathway. (Otolaryngol Head Neck Surg 1998;119:125-30.)

A bifid intra-tympanic facial nerve in association with a normal stapes

2006 ◽  
Vol 120 (5) ◽  
pp. 414-415 ◽  
Author(s):  
J Ahmed ◽  
P Chatrath ◽  
J Harcourt
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Anatomical Variations ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Ossicular Reconstruction ◽  
Conductive Hearing

A rare facial nerve anomaly was incidentally discovered whilst performing a tympanoplasty and ossicular reconstruction on a patient with an acquired unilateral conductive hearing loss. The nerve was seen to bifurcate and straddle a normal stapes superstructure as it ran posteriorly through the middle ear, a unique and as yet unreported combination. This case highlights the importance of vigilance regarding facial nerve anatomical variations encountered during middle-ear surgery thus avoiding inadvertent damage. The purported embryological mechanism responsible for such anomalies of the intra-tympanic facial nerve is discussed.

Effect of Conductive Hearing Loss and Middle Ear Surgery on Binaural Hearing

1986 ◽  
Vol 95 (5) ◽  
pp. 525-530 ◽  
Author(s):  
Joseph W. Hall ◽  
Eugene L. Derlacki
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Auditory Processing ◽  
Conductive Hearing Loss ◽  
Binaural Hearing ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Hearing Thresholds ◽  
Masking Level Difference ◽  
Conductive Hearing

This study investigated whether conductive hearing loss reduces normal binaural hearing advantages and whether binaural hearing advantages are normal in patients who have had hearing thresholds improved by middle ear surgery. Binaural hearing was assessed at a test frequency of 500 Hz using the masking level difference and interaural time discrimination thresholds. Results indicated that binaural hearing is often poor in conductive lesion patients and that the reduction in binaural hearing is not always consistent with a simple attenuation of the acoustic signal. Poor binaural hearing sometimes occurs even when middle ear surgery has resulted in bilaterally normal hearing thresholds. Our preliminary results are consistent with the interpretation that auditory deprivation due to conductive hearing loss may result in poor binaural auditory processing.

scholarly journals Hearing loss in the Saethre-Chotzen syndrome

1996 ◽  
Vol 110 (10) ◽  
pp. 952-957 ◽  
Author(s):  
Robbert J. H. Ensink ◽  
Henri A. M. Marres ◽  
Han G. Brunner ◽  
Cor W. R. J. Cremers
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Canal ◽  
Ear Surgery ◽  
Generation Family ◽  
Ear Infections ◽  
Conductive Hearing

AbstractA three-generation family with Saethre-Chotzen syndrome and an isolated case are presented. The proband presented with conductive hearing loss. His mother and grandmother showed minor features of the syndrome including conductive hearing loss.Symptoms of the craniosynostosis syndromes can include stapes ankylosis, a fixed ossicular chain in a too small epitympanum, and small or even absent mastoids. The proband was treated with a boneanchored hearing aid (BAHA) instead of reconstructive middle ear surgery. Current literature on the results of ear surgery is reviewed. In general, reconstructive middle ear surgery should only be considered if congenital anomalies of the middle ear are the only presenting symptom. In cases with additional anomalies such as atresia of the ear canal or damage due to chronic ear infections, the outcome of reconstructive surgery to correct the anomalous ossicular chain is unsatisfactory. In such cases the BAHA is probably the best solution.

Predictive role of Carhart's notch in pre-operative assessment for middle-ear surgery

2006 ◽  
Vol 121 (3) ◽  
pp. 219-221 ◽  
Author(s):  
H Yasan
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
Stapes Footplate ◽  
Predictive Role ◽  
Conductive Hearing

Objectives: To evaluate the predictive role of the audiometric Carhart's notch for the assessment of middle-ear pathology prior to surgical intervention.Method: In this retrospective analysis, a total of 315 operated ears of 305 patients were evaluated regarding their pre-operative pure tone audiograms and peri-operative findings. The probable relationship between the middle-ear pathologies found and the Carhart's notch found on pre-operative pure tone audiometry was investigated. Patients with conductive hearing loss who obtained at least a 10 dB improvement (at 1 and 2 kHz frequencies) in their bone conduction threshold post-operatively were included in the Carhart's notch group. The pathologies underlying Carhart's notch were compared.Results: Three hundred and fifteen ears of 305 consecutive patients with conductive hearing loss were operated on due to middle-ear pathology. In patients with otosclerosis and tympanosclerosis, a Carhart's notch was seen at 2 kHz in 28 (93 per cent) patients but at 1 kHz in only two (7 per cent). However, in patients with chronic otitis media, a Carhart's notch was seen at 1 kHz in 10 (55 per cent) patients and at 2 kHz in eight (45 per cent) patients.Conclusions: Otitis media with effusion, tympanosclerosis and congenital malformations should be considered in the differential diagnosis of a patient with a Carhart's notch seen on pure tone audiometry. A Carhart's notch at 2 kHz indicates stapes footplate fixation, whereas one at 1 kHz indicates a mobile stapes footplate; the footplate mobility can thus be predicted pre-operatively.

Tympanoscopy to increase the accuracy of diagnosis in conductive hearing loss

1998 ◽  
Vol 112 (2) ◽  
pp. 154-157 ◽  
Author(s):  
Tapio S. Karhuketo ◽  
Heikki J. Puhakka ◽  
Pekka J. Laippala
Keyword(s):  
Decision Making ◽  
Hearing Loss ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Bone Conduction ◽  
Speech Discrimination ◽  
Bone Conduction Threshold ◽  
Pure Tone Average ◽  
Stapedial Reflex ◽  
Conductive Hearing

AbstractThe diagnosis of conductive hearing loss is usually based on audiological methods and radiology. The aim of our study was to show that there is a useful additive method to clarify the findings of diseases with conductive hearing loss.Patients (151 ears) with conductive hearing loss were examined using several methods: otomicroscopy, air- and bone-conduction threshold, pure tone average, speech threshold, speech discrimination, tympanometry and stapedial reflex and tympanoscopy.The management of the patients changed in 17 per cent of cases due to tympanoscopy. In a group with normal tympanic membrane the movement of the stapes during endoscopy was compared to stapedial reflex. Stiff stapes were found more often than an abnormal stapedial reflex.Middle ear endoscopy can increase the accuracy of diagnosis of conductive hearing loss thus enhancing decision making in the case of the patient.

Promontory osteoma mimicking otosclerosis: case report

2019 ◽  
Vol 133 (12) ◽  
pp. 1107-1109
Author(s):  
S Gülşen
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Middle Ear ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
Additional Treatment ◽  
Recent Onset ◽  
History Of ◽  
Conductive Hearing

AbstractObjectiveThis case report presents a middle-ear osteoma mimicking otosclerosis that was located at the promontory. The osteoma was successfully excised using an endoscopic transcanal approach without any complication.Case reportA 21-year-old man presented with a 4-year history of progressive conductive hearing loss (47 dB with a 30-dB air–bone gap) with intermittent tinnitus of recent onset in his right ear. Endoscopic transcanal middle-ear exploration showed that an osteoma located on the promontory was restricting the mobility of the stapes by affecting the anterior crus of the stapes. After transcanal resection of the osteoma, pure tone audiometry improved to 23 dB with a 5-dB air–bone gap. Tinnitus resolved spontaneously without any additional treatment.ConclusionPromontory osteomas, a rare and usually asymptomatic clinical entity, should be taken into consideration in the differential diagnosis in patients with progressive conductive hearing loss and tinnitus with intact stapedial reflexes and normal otoscopic findings.

scholarly journals Hearing Improvement in the Patients Operated on Otosclerosis by Right-Handed Surgeons

2020 ◽  
pp. 014556132096733
Author(s):  
Agnieszka Wiatr ◽  
Jacek Skladzien ◽  
Maciej Wiatr
Keyword(s):  
Hearing Loss ◽  
Human Factor ◽  
Conductive Hearing Loss ◽  
The Self ◽  
Middle Ear Surgery ◽  
Hearing Improvement ◽  
Ear Surgery ◽  
The Right ◽  
Similar Experience ◽  
Conductive Hearing

Background: Otosclerosis is a disease of the osseous labyrinth. The disease causes 5% to 9% of all cases of hearing loss and 18% to 22% of conductive hearing loss. The treatment of choice is a surgery. The hearing improvement after the operation is determined by various factors. Aims/Objectives: The aim of the analysis is to determinate changes in hearing after stapedoplasty in view of surgery side in the patients operated on otosclerosis by right-handed surgeons. Material and Methods: The analysis involved patients hospitalized and operated on otosclerosis between 2012 and 2018. Only patients with their first middle ear surgery due to otosclerosis were included in the study. The patients were operated by 2 right-handed surgeons who used the same surgical technique and had similar experience in otosclerosis surgery. The study included patients who were divided into 2 groups: with self-tightening prosthesis and with manually tightening prosthesis. Results: The procedure performed by right-handed operators on the left side using prostheses requiring manual fixation on the incus was associated with poorer audiometric results compared to the results of surgeries on the right side. In patients with the self-tightening prostheses, the audiometric improvement of hearing was bilaterally comparable independently from operation side. Conclusion: (1) The dependence of hearing improvement on the surgery side was demonstrated in cases of surgeries performed on the left ear by right-handed surgeons, particularly with manually tightening prosthesis. (2) Self-tightening prostheses in stapedotomy limit the human factor, reducing the risk of complications after otosclerosis surgery and provide repeatable hearing improvement.

Unilateral Conductive Hearing Loss Secondary to a High Jugular Bulb in a Pediatric Patient

1997 ◽  
Vol 76 (7) ◽  
pp. 468-469 ◽  
Author(s):  
Michael S. Haupert ◽  
David N. Madgy ◽  
Walter M. Belenky ◽  
John W. Becker
Keyword(s):  
Hearing Loss ◽  
Black Male ◽  
Conductive Hearing Loss ◽  
Incidental Finding ◽  
Jugular Bulb ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
High Jugular Bulb ◽  
Temporal Bones ◽  
Conductive Hearing

A high jugular bulb is not an uncommon otologic anomaly. It may be noted as an incidental finding on physical exam, middle ear surgery, or computed tomography of the temporal bones. Frequently the patient is asymptomatic, but a high jugular bulb can occasionally cause tinnitus or conductive hearing loss. The case of a seven-year-old black male with unilateral conductive hearing loss secondary to a high jugular bulb is presented. The diagnosis, differential diagnosis, and management of a conductive hearing loss associated with a high jugular bulb are discussed.

Ossicular Discontinuity and Exostoses in Proteus Syndrome: A Case Report

2005 ◽  
Vol 114 (3) ◽  
pp. 242-246
Author(s):  
Joni K. Doherty ◽  
Dennis R. Maceri
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Typical Feature ◽  
Proteus Syndrome ◽  
Frequency Range ◽  
Pure Tone Average ◽  
Ossicular Chain Reconstruction ◽  
Conductive Hearing

Proteus syndrome (PS) is a rare hamartomatous disorder characterized by mosaic overgrowth of multiple tissues that manifests early in life and is progressive. The presence of unilateral external auditory canal exostoses in a patient who is not a swimmer or surfer is suggestive of PS. However, hearing loss is not a typical feature. Here, we describe exostoses and ossicular discontinuity with conductive hearing loss in a patient with PS. The treatment consisted of canalplasty and ossicular chain reconstruction. A postoperative reduction was demonstrated in the patient's air-bone gap, from 21 dB to 13 dB for the pure tone average (four frequencies) and from 41 dB to 15 dB in the high-frequency range (6,000 to 8,000 Hz). Causes of ossicular discontinuity are discussed. Routine annual audiometric and otolaryngological evaluation should be considered in all patients with temporal bone inyolvement of PS.

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