Conductive hearing loss after surgical treatment of otosclerosis—long-term observations

2020 ◽  
Vol 74 (6) ◽  
pp. 1-5
Author(s):  
Witold Szyfter ◽  
Wojciech Gawęcki ◽  
Anna Bartochowska ◽  
Andrzej Balcerowiak ◽  
Marta Pietraszek ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Surgical Treatment ◽  
Medical Records ◽  
Conductive Hearing Loss ◽  
Good Method ◽  
Stapes Footplate ◽  
Conductive Hearing ◽  
Frequent Observation

Introduction: Surgical treatment of otosclerosis has been a commonly accepted method of treatment for many years. The improvement of hearing after surgery is sometimes even spectacular, and good results are obtained in many centres in over 90% of the entire operated population. However, in the years following the procedure, some patients develop permanent or progressive conductive hearing loss. The aim of the study is to present a group of patients with conductive hearing loss that appeared after the first otosclerosis surgery and to analyse the causes of its occurrence. Material and Methods: Retrospective analysis was performed on patients who were first operated on in the years 2000-2009. Their medical records were analysed by the end of 2019, which made it possible to obtain results on at least 10 years of postoperative follow-up. The group consisted of 1118 patients, aged 14-82, including 802 women and 316 men. Results: Reoperations due to conductive hearing loss were performed on 93 patients, who accounted for 8.3% of the originally operated patients. They were much more often performed on patients after stapedectomies (19.7%) than on patients after stapedotomy (5.5%). Intraoperatively, prosthesis displacement was found to be the most frequent observation (44.1%) and was often associated with erosion or necrosis of the long process of incus (28%). Less frequent reasons of hearing loss were: adhesions around the prosthesis (10.8%), too small hole in the stapes footplate (8.6%), too short prosthesis (8.6%), progression of otosclerosis (7.5%), too long prosthesis (6.4%), presence of a granuloma around the prosthesis (5.4 %), and displacement of incus (4.3%). Conclusions: Surgical treatment in otosclerosis is a widely accepted and good method. It allows improvement in hearing in the vast majority of patients treated in this way. Unfortunately, over the years, some patients develop conductive hearing loss again. Reoperation gives a chance to find the cause and improve hearing in most of these cases.

Long-term Compliance and Satisfaction With Percutaneous Bone Conduction Devices in Patients With Congenital Unilateral Conductive Hearing Loss

2015 ◽  
Vol 36 (5) ◽  
pp. 826-833 ◽  
Author(s):  
Rik C. Nelissen ◽  
Emmanuel A. M. Mylanus ◽  
Cor W. R. J. Cremers ◽  
Myrthe K. S. Hol ◽  
Ad F. M. Snik
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Bone Conduction ◽  
Conductive Hearing

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>

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.

Consequences of Early Conductive Hearing Loss on Long-Term Binaural Processing

2017 ◽  
Vol 38 (5) ◽  
pp. 621-627 ◽  
Author(s):  
Kelley Graydon ◽  
Gary Rance ◽  
Richard Dowell ◽  
Bram Van Dun
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Binaural Processing ◽  
Conductive Hearing

scholarly journals Otosclerosis. 2. rész. Diagnózis

2019 ◽  
Vol 160 (51) ◽  
pp. 2007-2011
Author(s):  
Balázs Liktor ◽  
Andor Hirschberg ◽  
Bálint ifj Liktor ◽  
Tamás Karosi
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Preoperative Diagnosis ◽  
Conductive Hearing Loss ◽  
Clinical Suspicion ◽  
Otic Capsule ◽  
Human Temporal Bone ◽  
Stapes Footplate ◽  
Bony Lesions ◽  
Conductive Hearing

Abstract: Otosclerosis is a bone remodeling disorder affecting exclusively the human temporal bone which causes small bony lesions in the otic capsule. The symptoms depend on the location and the extent of the otosclerotic foci. Hence, clinically the most relevant sign is the conductive hearing loss due to the stapedial otosclerosis with fixation of the stapes footplate. In many cases, the specific anamnestic features, the age of presentation and usually the absence of tympanic membrane pathology can provide a strong clinical suspicion for otosclerosis. Although audiometric and imaging examinations and VEMP testing can confirm our preoperative diagnosis, the histolopathologic examination of the removed stapes footplate is the most accurate way to determine the diagnosis. Orv Hetil. 2019; 160(51): 2007–2011.

scholarly journals A Start Codon Variant in NOG Underlies Symphalangism and Ossicular Chain Malformations Affecting Both the Incus and the Stapes

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Nathan R. Lindquist ◽  
Eric N. Appelbaum ◽  
Anushree Acharya ◽  
Jeffrey T. Vrabec ◽  
Suzanne M. Leal ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Start Codon ◽  
Imaging Data ◽  
Hearing Thresholds ◽  
Stapes Footplate ◽  
Multiple Abnormalities ◽  
Protein Variants ◽  
Conductive Hearing

We performed exome sequencing to evaluate the underlying molecular cause of a patient with bilateral conductive hearing loss due to multiple ossicular abnormalities as well as symphalangism of the fifth digits. This leads to the identification of a novel heterozygous start codon variant in the NOG gene (c.2T>C:p.Met1?) that hinders normal translation of the noggin protein. Variants in NOG lead to a spectrum of otologic, digit, and joint abnormalities, a combination suggested to be referred to as NOG‐related‐symphalangism spectrum disorder (NOG‐SSD). Conductive hearing loss from such variants may stem from stapes footplate ankylosis, fixation of the malleoincudal joint, or fixation of the incus short process. In this case, the constellation of both stapes and incus fixation, an exceptionally tall stapes suprastructure, thickened long process of the incus, and enlarged incus body was encountered, leading to distinct challenges during otologic surgery to improve hearing thresholds. This case highlights multiple abnormalities to the ossicular chain in a patient with a start codon variant in NOG. We provide detailed imaging data on these malformations as well as surgical considerations and outcomes.

Congenital stapedial suprastructure fixation with normal footplate mobility: case report

2009 ◽  
Vol 124 (6) ◽  
pp. 680-683 ◽  
Author(s):  
J H Lee ◽  
S H Jung ◽  
H C Kim ◽  
C H Park ◽  
S M Hong
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Rare Case ◽  
Conductive Hearing Loss ◽  
Branchial Arch ◽  
Fallopian Canal ◽  
Stapes Footplate ◽  
The Right ◽  
Conductive Hearing

AbstractObjective:We report a case of bilateral conductive hearing loss caused by stapedial suprastructure fixation with normal footplate mobility.Case report:A 50-year-old woman had suffered hearing loss in both ears since childhood. Exploratory tympanotomy revealed immobility of the stapes due to a bony bridge between the stapedial suprastructure and the fallopian canal. The incus was missing, while the malleus handle was minimally deformed. The mobility of the stapes footplate was normal. Post-operatively, the hearing in the right ear improved both subjectively and audiographically, while that in the left ear did not improve because of footplate subluxation during surgery.Conclusion:This is a rare case of congenital stapedial suprastructure fixation with normal footplate mobility. In this patient, development of the second branchial arch was arrested. When performing exploratory tympanotomy for stapedial fixation, one must keep in mind that normal footplate mobility is possible.

Results, Hearing Rehabilitation, and Follow-up with Magnetic Resonance Imaging after Tympanomastoid Exenteration, Obliteration, and External Canal Overclosure for Severe Chronic Otitis Media

2007 ◽  
Vol 116 (9) ◽  
pp. 705-711 ◽  
Author(s):  
Katrien Ketelslagers ◽  
Thomas Somers ◽  
Bert De Foer ◽  
Andrzej Zarowski ◽  
Erwin Offeciers
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hearing Loss ◽  
Magnetic Resonance ◽  
Otitis Media ◽  
Cochlear Implantation ◽  
Conductive Hearing Loss ◽  
Chronic Otitis Media ◽  
Resonance Imaging ◽  
Conductive Hearing

Objectives: We sought to evaluate the results, auditory rehabilitation, and follow-up with magnetic resonance imaging (MRI) after tympanomastoid exenteration with obliteration of the mastoid cavity and overclosure of the external ear canal in patients with severe chronic otitis media that was resistant to medical therapy and conventional surgery and was associated with a profound sensorineural or severe conductive hearing loss. Methods: Twenty-nine patients were analyzed and underwent this surgical technique. Twelve patients had, during the same or later stage, either cochlear implantation, fixture implantation for a bone-anchored hearing aid, or middle ear implantation. For follow-up control of the obliterated cavity, delayed gadolinium-enhanced, T1-weighted MRI in combination with non-echo planar imaging diffusion weighted sequences were used. Results: No patient had recurrent otorrhea after an average follow-up period of 4.75 years. One patient had a residual cholesteatoma as shown by new MRI techniques, and this was successfully resected. One patient developed complications 6 months after 1-stage tympanomastoid exenteration and cochlear implantation. Conclusions: This technique is very useful in selected patients with severe chronic otitis media that is resistant to medical therapy and surgery and is associated with a profound sensorineural or severe conductive hearing loss. New sequences in MRI are used for postoperative follow-up of these obliterated cavities and seem reliable for the detection of residual or recurrent cholesteatoma. Middle ear implantation and cochlear implantation can be relatively safely performed in these patients in a second stage.

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