scholarly journals The Effect of Ossicular Chain Disorders on Sound Transmission and Tinnitus Perception using Electrical Model

2021 ◽  
Vol 9 (8) ◽  
pp. 1196-1204
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Sound Transmission ◽  
Ossicular Chain ◽  
Clinical Results ◽  
Electrical Model ◽  
Disorder Effects ◽  
Middle Ear Transfer Function ◽  
Human Middle Ear ◽  
Conductive Hearing

Human middle ear ensures sound transfer due its ossicular chain, any disorder or abnormalities in this structure leads to a conductive hearing loss (CHL). Tinnitus is a health problem, associated with hearing loss, it remains a devastating symptom. In this work, we present an electrical model of the human middle ear including middle ear cavities (ZMEC), tympanic membrane with ossicular chain (ZTOC), and stapes complex with cochlea load (ZSC). This model is modified to represent more closely the related pathologies affecting the middle ear. We will focus our analysis on ossicular chain disorder by studying the effect of increasing ossicular chain (OC) stiffness and mass in both normal middle ear structures and disconnected stapes superstructure. The change in middle ear structures and impedance allows us to simulate ossicular chain disorder effects and analyze their impact on sound transmission. This analysis allowed us to know if this disorder can eventually cause tinnitus. The results showed that the effect of ossicular chain anomalies can be studied based on frequency response of middle ear transfer function by applying only the principle of mass and stiffness, and demonstrate compared to clinical results the efficiency and simplicity of using the electrical model.

scholarly journals Penetrating Middle Ear Trauma: A Report of 2 Cases

2005 ◽  
Vol 84 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Michael C. Neuenschwander ◽  
Ellen S. Deutsch ◽  
Anthony Cornetta ◽  
Thomas O. Willcox
Keyword(s):  
Hearing Loss ◽  
Physical Examination ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Penetrating Trauma ◽  
Ossicular Chain ◽  
The Other ◽  
Ear Injury ◽  
The Right ◽  
Conductive Hearing

Penetrating middle ear injury can result in hearing loss, vertigo, and facial nerve injury. We describe the cases of 2 children with penetrating trauma to the right ear that resulted in ossicular chain disruption; one injury was caused by cotton-tipped swabs and the other by a wooden matchstick. Symptoms in both children included hearing loss and otalgia; in addition, one child experienced ataxia and the other vertigo. Physical examination in both cases revealed a perforation in the posterosuperior quadrant of the tympanic membrane and visible ossicles. Audiometry identified a moderate conductive hearing loss in one child and a mild sensorineural hearing loss in the other. Both children underwent middle ear exploration and reduction of a subluxed stapes. We discuss the diagnosis, causes, and management of penetrating middle ear trauma. To reduce the morbidity associated with these traumas, otologic surgeons should act promptly and be versatile in choosing methods of repairing ossicular chain injuries.

scholarly journals Isolated Incudostapedial Cholesteatomas: Unique Radiologic and Surgical Features

2020 ◽  
pp. 014556132097378
Author(s):  
Bridget MacDonald ◽  
Krishna Bommakanti ◽  
Moises Mallo ◽  
Daniela Carvalho
Keyword(s):  
Hearing Loss ◽  
Soft Tissue ◽  
Ct Scan ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Soft Tissue Mass ◽  
Ossicular Chain ◽  
Ct Scans ◽  
Tissue Mass ◽  
Conductive Hearing

Objectives: Congenital cholesteatomas originate from epithelial tissue present within the middle ear in patients with an intact tympanic membrane, no history of otologic surgery, otorrhea, or tympanic membrane perforation. They are diagnosed by a pearl-like lesion on otoscopy and computed tomography (CT) scan showing an expansile soft-tissue mass. We describe a series of patients with no prior otologic history presenting with progressive unilateral conductive hearing loss and normal otoscopy. The CT scans showed ossicular erosion without obvious soft-tissue mass. Surgery confirmed incudostapedial erosion found to be cholesteatoma. In this study, we characterize the clinical course of patients diagnosed with isolated incudostapedial cholesteatoma (IIC) and review possible pathologic mechanisms. Methods: Retrospective review of IIC cases treated by the Department of Pediatric Otolaryngology, Rady Children’s Hospital, San Diego, 2014 to 2020. Data included patient demographics, clinical features, imaging, surgical findings, and audiologic data. Results: Five patients were diagnosed with IIC (3 [60%] female; mean age at presentation 10.7 years [range 5.5-16.0]). All patients presented with postlingual unilateral conductive hearing loss and normal otoscopy without any past otologic history; delay in diagnosis ranged from 4 months to several years. The CT scans showed ossicular chain erosion with an absent long process of the incus and/or stapes superstructure. All patients underwent middle ear exploration, revealing a thin layer of cholesteatoma in the incudostapedial region, confirmed by histopathology. Mean preoperative speech reception threshold was 55 dB and improved to a mean of 31 dB in the 4 patients who underwent ossicular chain reconstruction. Conclusion: Isolated incudostapedial cholesteatoma should be included as a possible etiology in pediatric patients with insidious onset of unilateral conductive hearing loss with normal otoscopy, unremarkable otologic history, and a CT scan showing ossicular abnormality/disruption without notable middle ear mass. These patients should be counseled preoperatively regarding the possibility of cholesteatoma and should undergo middle ear exploration with possible ossiculoplasty.

Effects of Conductive Hearing Loss on Auditory Brainstem Response

1982 ◽  
Vol 91 (3) ◽  
pp. 304-309 ◽  
Author(s):  
Therese J. McGee ◽  
Jack D. Clemis
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Auditory Brainstem Response ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Auditory Brainstem ◽  
Middle Ear Effusion ◽  
Brainstem Response ◽  
Conductive Hearing ◽  
Ear Effusion

The purpose of this paper is not to propose that auditory brainstem response (ABR) be utilized for the assessment of conductive losses, but to define the effects of conductive hearing loss on the ABR when such a complication occurs. Conductive losses attenuate cochlear stimulation. Since wave V latency is inversely related to stimulus intensity, the magnitude of the conductive loss should be a predictor of the wave V latency delay. In this study, ABR wave V latencies from patients with known conductive losses due to canal occlusion, middle ear effusion, ossicular fixation and chain interruption were compared with latency values calculated from the magnitude of the loss. In those patients with occlusion of the external auditory canal and middle ear effusion, the shift of the wave V latency-intensity function correlated well with the air-bone gap. This correlation was poor for patients with ossicular chain disorders. In mixed hearing losses, the increased wave V latency due to the conductive component may totally mask an increase in latency caused by a retrocochlear component.

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.

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.

Use of hearing AIDS

1976 ◽  
Vol 14 (12) ◽  
pp. 45-46
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
Conductive Hearing Loss ◽  
Auditory Training ◽  
Lip Reading ◽  
Conductive Hearing

Up to 3 million people in Britain might be helped by hearing aids.1 2 Most are over 65 years of age, but some are infants. All should be referred to specialist centres for assessment as soon as possible. Hearing aids generally help most in disorders of the middle ear (conductive hearing loss); they can also help those with sensorineural and other forms of hearing loss. The use of an aid often needs to be supplemented by lip reading and other means of auditory training.1 3

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.

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