PubMed · 6851209
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A Wright. 1983. The normal cochlea; how does it work?. https://doi.org/10.1111/j.1365-2273.1983.tb01409.x
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OBJECTIVE: This study was undertaken to investigate how hormone therapy affects hearing in postmenopausal women. STUDY DESIGN: This prospective study involved 109 postmenopausal women. Twenty of the women were using estrogen therapy (ET group), 30 women were using hormone therapy (HT group), and 59 had not received hormone therapy of any kind (control group). Otoscopic examination revealed normal tympanic membranes in all 109 subjects. Each individual was tested with low- (250-2000 Hz) and high-frequency audiometry (4000-16000 Hz). Duration of hormone therapy was recorded, and patient characteristics (age, type of menopause, time since onset of menopause), body mass index (BMI), and hearing test results in the ET, HT, and control groups were compared. RESULTS: There were no statistically significant differences between the treatment (ET and HT group) and control groups with respect to age, BMI, or time since onset of menopause. The mean time on HT and ET was 4.13+/-2.41 years and 3.35+/-2.20 years, respectively. The mean air conduction results at low frequencies (250, 500, 1000, and 2000 Hz) in the ET group were significantly higher than the corresponding findings in the control group (P<.001) and than the HT group (P<.001). When the same comparisons were made between the HT group and the control group, none of the differences was statistically significant (P>.05). The mean air-conduction results at high frequencies (4, 6, 8, 10, 12, 14, and 16 kHz) in the ET group were significantly higher than the corresponding results in the HT group (P<.008). ET versus controls and HT versus controls at high frequencies revealed no significant differences (P>.05). The mean bone conduction results in the ET group were significantly higher than the corresponding findings in the control group (P<.016). Analysis of the same comparisons between the HT-ET and HT-control groups revealed no significant differences (P>.05). CONCLUSION: Estrogen therapy may slow down hearing loss in aging postmenopausal women; however, further studies of larger series are needed to confirm this, and the sites of hormonal action must also be explored.
OBJECTIVE: We reviewed the results and management of cases in which total ossiculoplasty requires footplate removal. STUDY DESIGN AND SETTING: We conducted a retrospective review of 10 patients who underwent total ossiculoplasty with footplate removal between 1999 and 2002. These 10 patients represented 5.4% of those undergoing stapedectomy (n = 91) and ossiculoplasty (n = 93) during these years at a tertiary otologic referral center. RESULTS: A total of 10 patients were evaluated, with a mean 17-month follow-up. Closure of air-bone gap (ABG) to within 20 dB was achieved in 6 of 10 patients (60%). Mean postoperative ABG was 21.7 dB (500 to 4000 Hz) with an average 4-frequency pure tone improvement of 20.7 dB. Operative findings included extensive tympanosclerosis, partial obstruction of oval window by facial nerve, and changes from prior surgery. There were no patients with postoperative sensorineural hearing loss. CONCLUSIONS: The need to open the footplate in cases of total ossiculoplasty is uncommon. This may be accomplished with good improvement in hearing with minimal risk.
Heterotopic brain tissue usually involves extracranial midline structures of the head and neck such as nose, nasopharynx, and oral cavity. Its occurrence in the non-midline structures, including middle ear, is rare. We described a 50-yr-old-man with heterotopic glial tissue in the middle ear and mastoid bone. The patient presented with progressive hearing loss for 8 yr. There was no history of congenital anomalies, trauma, or ear surgery. Computed tomography revealed a mass-like lesion with soft tissue density occupying the middle ear cavity and mastoid antrum. At the operation, a gray-white fibrotic mass was detected in the epitympanic area. Mesotympanum and ossicles were intact. The patient underwent left simple mastoidectomy with type I tympanoplasty. During operation, definite cranial bone defect or cerebrospinal fluid leakage was not found. Histologically, the lesion was composed of exclusively mature, disorganized glial tissue with fibrovascular elements in a rather loose fibrillary background. Glial tissue showed diffuse positive reaction for glial fibrillar acidic protein and S100 protein on immunohistochemical study.