scholarly journals Clinical and audiological evaluation of post traumatic hearing loss

2020 ◽  
Vol 6 (12) ◽  
pp. 2258
Author(s):  
Abhijit Shankar ◽  
Shibu George ◽  
Satheesh Somaraj
Keyword(s):  
Hearing Loss ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Post Injury ◽  
Temporal Bone Fracture ◽  
Mixed Hearing Loss ◽  
Hearing Thresholds ◽  
Post Traumatic ◽  
Conductive Hearing

<p><strong>Background</strong>: Post traumatic hearing loss is one of the most common problems encountered among trauma victims. It can manifest as conductive, sensorineural or mixed hearing loss. It is against this background that the study evaluated the clinical and audiological outcome of 47 patients of trauma.</p><p><strong>Methods</strong>: A descriptive longitudinal study was conducted over a period January 2017 to March 2018. Follow up was done after 3 months of discharge. Study consisted of 47 patients presenting with features of trauma related injuries. After carrying out systematic clinical, audiometric and radiological evaluation, patients were managed conservatively.</p><p><strong>Results</strong>: Of the 47 patients studied, 89.98% were related to road traffic accidents (RTAs); and 76.60% were under the influence of alcohol at the time of trauma. Among the 32 cases of the RTAs involving two wheelers, 29 patients (90.62%) were not using protective devices like helmet. Nearly 90% of patients had temporal bone fracture. Audiological evaluation confirmed hearing loss in 77% of patients at presentation. There was significant improvement of hearing thresholds with 51% attaining normal hearing at follow up with conservative management.</p><p><strong>Conclusions</strong>: Post traumatic hearing loss was very common, conductive hearing loss being the most common type. It resolved over a few days to few weeks post injury. Timely diagnosis and management with early steroid therapy showed encouraging results for patients with traumatic sensorineural hearing loss or mixed hearing loss.</p>

scholarly journals Perilymphatic fistula and pneumolabyrinth without temporal bone fracture: a rare entity

2019 ◽  
Vol 12 (3) ◽  
pp. e228457 ◽  
Author(s):  
Ana Sousa Menezes ◽  
Daniela Ribeiro ◽  
Daniel Alves Miranda ◽  
Sara Martins Pereira
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Temporal Bone ◽  
Bone Fracture ◽  
Round Window ◽  
Sensorineural Hearing ◽  
Temporal Bone Fracture ◽  
Perilymphatic Fistula ◽  
Hearing Thresholds ◽  
Post Traumatic

Post-traumatic pneumolabyrinth is an uncommon clinical entity, particularly in the absence of temporal bone fracture. We report the case of a patient who presented to our emergency department with a headache, sudden left hearing loss and severe dizziness which began after a traumatic brain injury 3 days earlier. On examination, the patient presented signs of left vestibulopathy, left sensorineural hearing loss and positive fistula test, normal otoscopy and without focal neurological signs. The audiometry confirmed profound left sensorineural hearing loss. Cranial CT revealed a right occipital bone fracture and left frontal subdural haematoma, without signs of temporal bone fracture. Temporal bone high-resolution CT scan revealed left pneumolabyrinth affecting the vestibule and cochlea. Exploratory tympanotomy revealed perilymphatic fistula at the location of the round window. The sealing of defect was performed using lobule fat and fibrin glue. He presented complete resolution of the vestibular complaints, though the hearing thresholds remained stable.

A Differential Approach to the Choice of Treatment of Facial Bone Fractures in the Children

10.12737/3564 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-5
Author(s):  
Тихонов ◽  
E. Tikhonov ◽  
Харитонов ◽  
D. Kharitonov ◽  
Гаршина ◽  
...  
Keyword(s):  
High Speed ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Bone Fractures ◽  
Facial Bone ◽  
Differential Approach ◽  
Fractures In Children ◽  
Choice Of Treatment ◽  
Post Traumatic

The choice of treatment of facial bone fractures in the early age remains a challenge for dentists and maxillofacial surgeons due to the peculiarities of child organism. The purpose of this study was to develop a differential approach to the choice of treatment of children´s facial bone fractures taking into account the age of a child, location of injury and possible complications. This paper presents the analysis of current epidemiological situation regarding to facial bone fractures in children in Voronezh city and Voronezh region. It is shown that the most common injuries is a fall from a height of its own growth, i.e. low-trauma; at the same time the number of high-speed traumas, such as road-traffic accidents, high falls, has decreased. The analysis was carried out 58 cases of facial bone fractures in a group of children from 1 month to 16 years being treated in Maxillofacial Department of Voronezh Regional Pediatric Hospital №2. The developed model of differential choice of treatment of facial bone fractures in children allows to choosing the method taking into account a child age, location of injury and severity, as well as possible consequences of surgery. The clinical monitoring has proved the efficacy of the model which gives an opportunity to decrease post-traumatic complications associated with growth and occlusion deformations as well as complications of inflammatory genesis. It was convincingly shown the need for follow-up care of children with facial fracture that the doctor-orthodontist should continue. The presented data of this study about correlation between surgical and conservative treatment of facial bone fractures in children coincide with the worldwide statistics showing the current tendency to a wide application of mini-invasive methods of fractures fragments immobilization.

scholarly journals Evaluation of Clinical Outcome in Traumatic Facial Nerve Paralysis

2021 ◽  
Author(s):  
Abhijit Shankar ◽  
Shibu George ◽  
Satheesh Somaraj
Keyword(s):  
Clinical Outcome ◽  
Facial Nerve ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Objective Evaluation ◽  
Facial Nerve Paralysis ◽  
Temporal Bone Fracture ◽  
Nerve Paralysis ◽  
Tertiary Center

Abstract Introduction The facial nerve is the most commonly paralyzed nerve in the human body, resulting in far-reaching functional, aesthetic and emotional concerns to the patient. Objective Evaluation of the clinical outcome of 47 patients with traumatic facial nerve paralyses, with respect to clinical recovery and audiological sequelae. Methods A descriptive longitudinal study was conducted over 24 months between January 2017 and December 2018 at a tertiary center with detailed clinical, topodiagnostic, audiometric and radiological evaluation and regular follow-up after discharge. Results Road traffic accidents constituted 82.98% of the trauma cases, out of which 76.60% were found to be under the influence of alcohol.Delayed facial paralysis was observed in 76.60% cases. Temporal bone fracture was reported in 89.36%, with otic capsule (OC) sparing fractures forming 91.49% of the cases. Topologically, the injury was mostly at the suprachordal region around the second genu. The majority of the patients (65%) attained full recovery of facial nerve function with conservative medical management. Audiometrically, 77.27% of the patients had hearing loss at the time of presentation, of which 64.71% were conductive in nature; 51.22% attained normal hearing at follow-up visits. Conclusion Early initiation of steroid therapy, concurrent eye care and physiotherapy are the cornerstones in the management of traumatic facial nerve paralysis.

scholarly journals Hearing and Mortality Outcomes following Temporal Bone Fractures

2017 ◽  
Vol 10 (4) ◽  
pp. 281-285 ◽  
Author(s):  
Adam Honeybrook ◽  
Aniruddha Patki ◽  
Nikita Chapurin ◽  
Charles Woodard
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Conductive Hearing Loss ◽  
Bone Fractures ◽  
Ossicular Chain ◽  
Otic Capsule ◽  
Temporal Bone Fracture ◽  
Longitudinal Fractures ◽  
Conductive Hearing

The aim of this article is to determine hearing and mortality outcomes following temporal bone fractures. Retrospective chart review was performed of 152 patients diagnosed with a temporal bone fracture presenting to the emergency room at a tertiary care referral center over a 10-year period. Utilizing Patients’ previously obtained temporal bone computed tomographic scans and audiograms, fractures were classified based on several classification schemes. Correlations between fracture patterns, mortality, and hearing outcomes were analyzed using χ2 tests. Ossicular chain disruption was seen in 11.8% of patients, and otic capsule violation was seen in 5.9%; 22.7% of patients presented for audiologic follow-up. Seventeen patients with conductive hearing loss had air–bone gaps of 26 ± 7.5 dB (500 Hz), 27 ± 6.8 dB (1,000 Hz), 18 ± 6.2 dB (2,000 Hz), and 32 ± 7.7 dB (4,000 Hz). Two cases of profound sensorineural hearing loss were associated with otic capsule violation. No fracture classification scheme was predictive of hearing loss, although longitudinal fractures were statistically associated with ossicular chain disruption ( p < 0.01). Temporal bone fractures in patients older than 60 years carried a relative risk of death of 3.15 compared with those younger than 60 years. The average magnitude of conductive hearing loss resulting from temporal bone fracture ranged from 18 to 32 dB in this cohort. Classification of fracture type was not predictive of hearing loss, despite the statistical association between ossicular chain disruption and longitudinal fractures. This finding may be due to the low follow-up rates of this patient population. Physicians should make a concerted effort to ensure that audiological monitoring is executed to prevent and manage long-term hearing impairment.

scholarly journals P014: Incidental findings in trauma whole-body CT scans: a systematic review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S69-S69
Author(s):  
V. Tsang ◽  
K. Bao ◽  
J. Taylor
Keyword(s):  
Systematic Review ◽  
Incidental Findings ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Subsequent Treatment ◽  
Whole Body ◽  
Trauma Patients ◽  
Patient Demographics ◽  
Study Results

Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.

Successful Placement of a BAHA Implant in a Patient With Epidermolysis Bullosa: A Case Report and Review of the Literature

2017 ◽  
Vol 126 (11) ◽  
pp. 778-780 ◽  
Author(s):  
Jason R. Brown ◽  
D. Micah Milgraum ◽  
Farhaad R. Riyaz ◽  
Marla N. Jahnke ◽  
Prasad John Thottam
Keyword(s):  
Hearing Loss ◽  
Epidermolysis Bullosa ◽  
Hearing Aids ◽  
External Auditory Canal ◽  
Skin Irritation ◽  
Minor Trauma ◽  
Mixed Hearing Loss ◽  
Osseointegrated Implant ◽  
Bone Anchored Hearing Aid ◽  
Conductive Hearing

Introduction: Epidermolysis bullosa (EB) is a spectrum of mechanobullous disorders characterized by blistering following minor trauma or traction to the skin. Hearing loss in this population is poorly described in the otolaryngology literature, and its treatment oftentimes results in external auditory canal skin irritation. Case Presentation: We present the case of a 26-year-old female with EB and mixed hearing loss unable to wear conventional hearing aids due to sequelae of the external auditory canals. An osseointegrated implant was used as other hearing aids were deemed to be too destructive of the external auditory canal skin. Management and Outcome: Our patient underwent placement of a right bone-anchored hearing aid with minimal disruption of the surrounding skin using a minimally invasive punch technique. Over 1 year of follow-up, her course was complicated by 1 simple cellulitic infection at the surgical site treated successfully with oral antibiotics. Discussion: The literature regarding the otolaryngologic manifestations of EB is sparse. The otologic sequelae are particularly overlooked in the workup and management. Based on the results of this case study, it appears that an osseointegrated implant can be safely utilized to treat significant mixed or conductive hearing loss in patients with EB.

scholarly journals Stapedotomy post-operative results and complications

2020 ◽  
Vol 6 (8) ◽  
pp. 1442
Author(s):  
Hanumant S. Giri ◽  
Ram C. Bishnoi ◽  
Pooja D. Nayak ◽  
Ninad S. Gaikwad
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Conductive Hearing Loss ◽  
Major Complication ◽  
Safe Procedure ◽  
Hearing Results ◽  
Post Surgery ◽  
Localized Disease ◽  
Conductive Hearing

<p class="abstract"><strong>Background:</strong> Otosclerosis is a hereditary localized disease of the bone derived from the otic capsule. It is characterized by alternating phases of bone formation and resorption and patient presents with conductive hearing loss. Treatment of otosclerosis can be of two kinds: hearing aids and surgery. Stapedectomy and stapedotomy are the two surgical procedures done for treatment of otosclerosis. Present study was conducted on 30 patients with otosclerosis who underwent stapedotomy to assess the hearing results post-surgery by serial Audiometric studies and to study the complications of stapedotomy surgery.</p><p class="abstract"><strong>Methods:</strong> This prospective observational study conducted on 30 patients of otosclerosis who fulfilled the inclusion and exclusion criteria.  </p><p class="abstract"><strong>Results:</strong> In this study of thirty cases of otosclerosis which were operated for small fenestra stapedotomy, we conclude that Hearing gain post-surgery was remarkable especially for patients with a pure conductive hearing loss. There was no deterioration in hearing after two years of follow-up. In our study on 30 patients we encountered minor complication in 4 patients (13.33%) and 1 major complication of profound sensorineural hearing loss 3.33%.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that stapedotomy is a relatively safe procedure with significant post-surgery hearing benefit.</p>

scholarly journals Assess the hearing of contralateral ear in patients with unilateral chronic squamosal otitis media

2020 ◽  
Vol 6 (5) ◽  
pp. 886
Author(s):  
Raphella Khan ◽  
Anirudh Kasliwal
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Otitis Media ◽  
Conductive Hearing Loss ◽  
Sensorineural Hearing ◽  
Retraction Pocket ◽  
Mixed Hearing Loss ◽  
Contralateral Ear ◽  
The Right ◽  
Conductive Hearing

<p class="abstract"><strong>Background:</strong> Chronic squamosal otitis media can occur due to many conditions affecting the middle ear. Most common sign of developing a chronic squamosal otitis media is formation of a retraction pocket in the tympanic membrane leading to further development of a cholesteatoma and if not treated properly, may lead to development of dangerous complication in the affected ear. These etiological factors may also affect the other ear. It is therefore very necessary to assess and diagnose the contralateral ear, so that the disease can be intervened and treated at the right time, to prevent any deterioration in hearing of the contralateral ear.</p><p class="abstract"><strong>Methods:</strong> The prospective study was done in 100 patients with unilateral chronic squamosal otitis media, where the contra lateral ear was examined and assessed for any hearing loss.  </p><p class="abstract"><strong>Results:</strong> We found hearing loss in the contra lateral ear ranging from mild conductive hearing loss to sensorineural hearing loss with the maximum patients with mild conductive hearing loss (42%) and lowest in sensorineural hearing loss (1%).  </p><p class="abstract"><strong>Conclusions:</strong> In our study, 76 patients were seen with conductive hearing loss. Out of that, 42% patients were seen with mild conductive hearing loss, 30% with moderate conductive hearing loss and 4% with severe conductive hearing loss. 20% patients were seen with normal hearing. 3% patients were seen with mixed hearing loss and only 1% patient was seen with sensorineural hearing loss in contralateral ear.</p>

Results of Surgical Repair of Inapparent Perilymph Fistulas

1986 ◽  
Vol 95 (3_part_1) ◽  
pp. 344-346 ◽  
Author(s):  
G. Joseph Parell ◽  
Gary D. Becker
Keyword(s):  
Hearing Loss ◽  
Surgical Technique ◽  
Surgical Repair ◽  
Conductive Hearing Loss ◽  
Knowing That ◽  
Sensory Neural ◽  
Tissue Grafts ◽  
Conductive Hearing ◽  
Sensory Neural Hearing Loss

In patients who are thought to have a perilymph (PL) fistula, careful inspection of the round and oval windows during exploratory tympanotomy may be normal. The decision must then be made either to terminate the procedure—knowing that the patient's symptoms will probably continue or deteriorate—or to repair both windows as if PL fistulas were present, risking further damage to the inner ear. From a series of 14 patients explored for possible PL fistulas, we report on 6 patients with preoperative diagnoses of PL fistula, based on history, physical examination, and audiometry. Symptoms resulting from trauma were present from 10 days to 23 years before surgery. During exploratory tympanotomy, no fistulas were evident; however, both the oval and round windows were repaired with tissue grafts. Follow up—for 1 to 5 years—revealed that vertigo was relieved in all patients. Postoperatively, one patient had a mild conductive hearing loss; yet no patient sustained a sensory neural hearing loss. We conclude that patch grafting of both the oval and round windows is a safe and effective method of treating suspected, but inapparent fistulas. Patient selection, surgical technique, and results shall be detailed.

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