Treatment using diffuse laser energy of cochlear and vestibular fistulas caused by cholesteatoma

2019 ◽  
Vol 133 (2) ◽  
pp. 102-105
Author(s):  
S Basu ◽  
J Hamilton
Keyword(s):  
Laser Energy ◽  
Bone Conduction ◽  
Entire Group ◽  
Residual Rate ◽  
Hearing Results ◽  
Second Stage ◽  
Bone Conduction Threshold ◽  
Average Change ◽  
Cochlear Hearing Loss ◽  
Fistula Site

AbstractObjectiveTo measure the outcomes of laser treatment of cholesteatoma covering cochlear and vestibular fistulas.MethodsCholesteatoma matrix over the fistula was denatured; the power density was sufficient only to gradually heat, but not vaporise, the keratin-forming matrix. The denaturing speed was controlled so that the integrity of the fistula cover was maintained. The change in bone conduction threshold and the residual rate of cholesteatoma at the fistula were measured.ResultsThirty-six fistulas were assessed. There were seven cochlear fistulas. All were 5 mm or less in maximum length. For the entire group, the average change in bone conduction threshold was −0.3 dB. For cochlear fistulas, the average change in bone conduction was + 0.2 dB. The distribution of hearing results for the entire group was Gaussian; the apparent changes in hearing could be attributed to errors associated with testing. All patients underwent second-stage surgery. In all cases, the cholesteatoma was completely cleared from the fistula site. There were no facial palsies.ConclusionLaser denaturing of cholesteatoma matrix over fistulas measuring 5 mm or less of vestibular apparatus and the cochlea is effective at eliminating cholesteatoma, and is not associated with cochlear hearing loss or facial palsy.

Comparing intermediate-term hearing results of NiTiBOND and Nitinol prostheses in stapes surgery

2021 ◽  
pp. 1-4
Author(s):  
A Koukkoullis ◽  
I Gerlinger ◽  
A Kovács ◽  
Z Szakács ◽  
Z Piski ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Success ◽  
Bone Conduction ◽  
Hearing Results ◽  
Bone Conduction Threshold ◽  
Hearing Thresholds ◽  
Group 3 ◽  
Group 2 ◽  
Air Conduction

Abstract Objective To statistically analyse the hearing thresholds of two cohorts undergoing stapedotomy for otosclerosis with two different prostheses. Method A retrospective study was conducted comparing NiTiBOND (n = 53) and Nitinol (n = 38) prostheses. Results Average follow-up duration was 4.1 years for NiTiBOND and 4.4 years for Nitinol prostheses. The post-operative air–bone gap was 10 dB or less, indicating clinical success. The p-values for differences between (1) pre- and post-operative values in the NiTiBOND group, (2) pre- and post-operative values in the Nitinol group, (3) pre-operative values and (4) post-operative values in the two groups were: air–bone gap – p < 0.001, p < 0.001, p = 0.631 and p = 0.647; four-frequency bone conduction threshold – p = 0.076, p = 0.129, p < 0.001 and p = 0.005; four-frequency air conduction threshold – p < 0.001, p < 0.001, p = 0.043 and p = 0.041; three-frequency (1, 2 and 4 kHz) bone conduction threshold pre-operatively – p = 0.639, p = 0.495, p = 0.001 and p = 0.01; and air conduction threshold at 4 kHz: – p < 0.001, p < 0.001, p = 0.03 and p = 0.058. Conclusion Post-operative audiological outcomes for NiTiBOND and Nitinol were comparable.

Factors Associated With Hearing Outcomes After Stapedotomy in Taiwanese Patients With Clinical Otosclerosis

2021 ◽  
pp. 014556132110376
Author(s):  
Pei-Hsin Chen ◽  
Kai-Nan Lin ◽  
Hsiu-Yin Lin ◽  
Rui-Bin Yu ◽  
Pi-Yun Liu ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Success Factors ◽  
Bone Conduction ◽  
Hearing Results ◽  
Hearing Sensitivity ◽  
Surgical Success ◽  
Factors Associated ◽  
Male Patients ◽  
Hearing Outcomes ◽  
Stratified Analysis

Objective: To examine the clinical factors associated with the effectiveness of stapedotomy in improving hearing sensitivity in Taiwanese patients with otosclerosis. Methods: In this retrospective study, we reviewed the medical records of 31 patients (36 ears) with otosclerosis undergoing stapedotomy performed by a single surgeon. Preoperative and postoperative hearing results were analyzed to identify factors associated with hearing outcomes after stapedotomy in the Taiwanese population with clinical otosclerosis. Results: Compared with preoperative pure tone averages (PTAs), stapedotomy significantly improved postoperative air conduction (AC) thresholds ( P < .0001), bone conduction (BC) thresholds ( P = .025), and air-bone gaps (ABGs; P < .0001). Postoperative closure of ABGs less than 10 or 20 dB was achieved in 16 (44.4%) and 33 (91.7%) of 36 surgical ears. Improvement in postoperative AC thresholds and ABGs and the size of preoperative ABGs were significantly correlated (r = .650, P < .001 and r = .745, P < .001, respectively). Gender-stratified analysis indicated a stronger correlation between improvement in postoperative AC thresholds and preoperative ABGs in male patients than in female patients (r = .893, P < .001 and r = .476, P = .014, respectively), and in postoperative and preoperative ABGs (r = .933, P < .001 and r = .626, P < .001, respectively). With the more stringent criteria for surgical success, factors including age (≤50 years), type (conductive, BC ≤25 dB), and degree (PTA ≤55 dB) of preoperative hearing loss led to more favorable outcomes. Conclusions: We reported evidence supporting a potential gender difference on hearing outcomes after stapedotomy in Taiwanese patients with otosclerosis. Age, type, and degree of preoperative hearing loss may affect the surgical success rate.

Conductive SISI Test

1974 ◽  
Vol 83 (1) ◽  
pp. 125-127 ◽  
Author(s):  
Vincent W. Byers
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Statistical Difference ◽  
Conductive Hearing Loss ◽  
Bone Conduction ◽  
Sensitivity Index ◽  
Index Test ◽  
Bone Conduction Threshold ◽  
Conductive Hearing

The conductive SISI (short increment sensitivity index) test is an indirect procedure to estimate bone-conduction thresholds for middle ear pathology patients. A series of SISI tests are run, beginning at 20 dB S.L. and increasing in 10 dB S.L. steps, until a 100% SISI score is obtained. The following equation predicts the bone-conduction threshold: [Formula: see text] The results of 25 conductive SISI tests on a conductive hearing loss group indicate that the equation approximates the measured B.C. threshold. There was no statistical difference between the predicated B.C. thresholds (12.4 dB) and measured B.C. thresholds (10.4 dB) for the group.

Bone Conduction Threshold Measurements

1948 ◽  
Vol 20 (2) ◽  
pp. 220-220
Author(s):  
T. V. Frazier ◽  
N. A. Watson
Keyword(s):  
Bone Conduction ◽  
Bone Conduction Threshold

Sensorineural Impairment in Unilateral Otosclerosis

1975 ◽  
Vol 84 (1) ◽  
pp. 11-15 ◽  
Author(s):  
Fred H. Linthicum ◽  
A. S. Lalani
Keyword(s):  
Hearing Loss ◽  
Bone Conduction ◽  
Significant Elevation ◽  
Bone Conduction Threshold ◽  
Mixed Hearing Loss ◽  
Temporal Bones

Audiometric findings were evaluated in a group of patients with clinical unilateral otosclerosis. A comparison was made between bone conduction threshold in the better hearing ear and the ear with the mixed hearing loss. Over 50% of the patients had a significant elevation in the bone conduction thresholds in the ear with clinical otosclerosis as compared to the uninvolved ear. A pair of temporal bones from a patient with unilateral otosclerosis and unilateral mixed hearing loss is presented.

Validating the Excision of Cholesteatoma

1985 ◽  
Vol 93 (3) ◽  
pp. 288-292 ◽  
Author(s):  
Arnold G. Schuring ◽  
William H. Lippy
Keyword(s):  
Surgical Procedures ◽  
Radical Mastoidectomy ◽  
Hearing Results ◽  
Second Stage ◽  
Retraction Pockets ◽  
Third Stage ◽  
Second Procedure ◽  
Lost To Follow Up

In lieu of a radical mastoidectomy, 138 patients underwent a closed tympanomastoidectomy with subsequent staged surgical procedures until the excision of cholesteatoma could be validated. All the patients underwent two surgical procedures, 29% underwent three procedures, and 4% underwent four procedures. The surgical findings at the second procedure were: negative, 41.5%; retraction pockets, 7%; squamous pearls, 14%; recurrent cholesteatoma, 12%; and residual cholesteatoma, 25.5%. At each stage the likelihood of finding any form of cholesteatoma lessens. A conversion from a closed to an open mastoidectomy was necessary for 9% of the patients, and 4% were lost to follow-up. The opportunity to adjust the reconstructed ossicular assembly exists at each stage. With the use of semibiologic prostheses (ossicle cup and columella), the hearing results were: first stage, 67% within 20 dB, 84% within 30 dB; second stage, 77% and 90%; third stage, 77% and 96%.

scholarly journals Hearing gain after myringoplasty in relation to the size of tympanic membrane perforation

2020 ◽  
Vol 25 (1) ◽  
pp. 54-59
Author(s):  
Sutanu Kumar Mondal ◽  
Ashim Kumar Biswas ◽  
Md Mahmudul Huq ◽  
Md Hasan Ali ◽  
Md Kamruzzaman ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Bone Conduction ◽  
Tympanic Membrane Perforation ◽  
Medium Size ◽  
Hearing Gain ◽  
Bone Conduction Threshold ◽  
Large Size ◽  
Membrane Perforation ◽  
Air Conduction

Objectives: To assess hearing gain after successful myringoplasty in relation to the size of tympanic membrane perforation. Methods: This cross-sectional study was done in the department of otolaryngology and head neck surgery, BSMMU, Sahbag, Dhaka during the period of January 2009 to December 2010.A total of 60 patients were under went myringoplasty operation after taking detailed history, clinical examination and investigation. Preoperative and postoperative hearing assessment was done. Analysed data presented by various tables, graphics and figures. Results: In case of small size perforation preoperative mean bone conduction threshold was 7.66 dB, mean air conduction threshold was 34.14 dB and mean air bone gap was 26.48 dB. In case of medium size perforation preoperative mean bone conduction threshold was 9.61 dB, mean air conduction threshold was 44.48 dB. Mean air bone gap was 34.87 dB. In case of large size perforation preoperative mean bone conduction threshold was 13.12 dB, mean air conduction threshold was 59 dB, and mean air bone gap was 45.88 dB. Hearing loss increases with increasing size of perforation. Ahmed and Rahim (1979) showed in the study that hearing loss increases with increasing the size of the perforation which was relevant in the study. After myringoplasty post-operative mean air bone gap was 21.24 dB in small size, 21.74 dB in medium sized and 24 dB in large size. From the record improvement of mean air bone gap or hearing gain was 5.24 dB in small size perforation respectively. The different of air bone gap closure between small and medium size perforation was statistically significant by unpaired’ test. Conclusion: Hearing gain after myringoplasty is better in large size perforation. Bangladesh J Otorhinolaryngol; April 2019; 25(1): 54-59

scholarly journals Carhart Notch 2-kHz Bone Conduction Threshold Dip

2011 ◽  
Vol 137 (3) ◽  
pp. 236 ◽  
Author(s):  
Akinori Kashio ◽  
Ken Ito ◽  
Akinobu Kakigi ◽  
Shotaro Karino ◽  
Shin-ichi Iwasaki ◽  
...  
Keyword(s):  
Bone Conduction ◽  
Bone Conduction Threshold

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.

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