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At least 703 records · Page 39Linked to original sources
PubMed1999

Laser stapedotomy.

Thirty-four ears with conductive hearing loss due to otosclerosis were operated upon using the laser stapedotomy technique. Audiological results were compared with the results of 316 non-laser stapedotomies. The post-operative air-bone gap, calculated as the difference between the post-operative air and bone conduction levels, was smaller with the laser stapedotomy group. Also, the bone conduction showed significant improvement with the use of laser. Significant sensorineural hearing loss was not found in any of the laser-treated patients. According to our results, we concluded that laser is of benefit in stapes surgery for improving the hearing results and minimizing the inner ear trauma.

Adult↗
PubMedDate not supplied

Sensorineural impairment in unilateral otosclerosis.

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.

Adult↗
PubMedDate not supplied

Diltiazem for prevention of acoustical trauma during otologic surgery.

100 patients were tested in a prospective, randomized, double-blinded study to assess the perioperative efficacy of a calcium channel blocker (diltiazem) in preventing acoustical trauma during otologic surgery. The patients were randomly divided into a therapy group (diltiazem) and a control group (placebo). Bone conduction hearing thresholds were examined preoperatively and again 1 day and 3 months postoperatively. Frequency-dependent changes in postoperative bone conduction and the number of patients with various degrees of postoperative hearing loss in both groups were statistically analyzed. The results indicated only a small postoperative hearing loss after ear surgery in both groups. There was a tendency for better results in the therapy group, but this was not statistically significant. Despite favorable results in animal trials utilizing different types of noise and the prophylactic application of diltiazem, further studies in humans are needed to determine the role of calcium antagonist drugs in the prophylaxis or treatment of acoustical trauma.

Adult↗
PubMed1996

Reporting operative hearing results in stapes surgery: does choice of outcome measure make a difference?

In a prior study, findings indicated that when reporting results of chronic ear surgery, neither choice of pre-versus postoperative bone-conduction scores nor choice of frequencies to include a averaging makes a substantial difference in reported outcome. In this study, audiologic data from 240 stapes-surgery patients at three different institutions were used to generate a variety of outcome measures. Use of preoperative rather than postoperative bone-conduction values in computing postoperative air-bone gap resulted in an approximately 5-dB smaller mean gap and a 2% higher success rate. Frequencies included in averaging made little difference in mean computed air-bone gap, although success rate (gap < 10 dB) was lower by 6% when 4 kHz was used in a four-frequency average rather than 3 kHz. Results for air conduction were similar to those for air-bone gap regarding choice of frequencies to include in averaging. When using air-conduction pure-tone average (PTA) as the outcome measure, those with normal preoperative sensorineural hearing had a > 20% higher success rate than the general population of stapes-surgery patients. The greatest differences in success rate were based on definition of and criteria for success. Success rate was higher when based on air-bone gap than when based on air-conduction PTA. As in the prior chronic ear study, differences in outcome were more drastically affected by criteria for "success" than by frequencies included. Unlike similar data from chronic ear surgery, however, success rate differed depending on choice of air-bone gap or air-conduction PTA as the definition for success. Further, air and bone scores from the same test interval must be used to accurately reflect air-bone gap in stapes surgery.

Adolescent↗
PubMed1999

Advantages and dangers of erbium laser application in stapedotomy.

Among different types of lasers, the erbium laser exhibits particularly favourable characteristics for ear surgery. Experiments with application of erbium laser pulses to the isolated stapes connected to an inner ear model confirmed that there was virtually no thermal effect to the inner ear liquid and that the border damage zone on the stapes footplate perforation did not exceed 5-10 microm. Erbium laser pulses, however, produce pressure waves due to the explosive ablation of tissue. Pulses of 10 to 17 J/cm2 producing pressure waves between 140 and 160 dB appear to be a limit for clinical application. With these criteria, an in-house built erbium YAG laser with a fiberoptic delivery device was used in 15 patients for stapedotomy. A special microhandpiece, where a zirconium fluoride fiber was connected to a quartz tip, was developed. In addition, three patients had stapedotomy with a commercially available Zeiss (Opmi TwinER) microscope equipped with a micromanipulator-operated erbium laser beam. One year after surgery, the air-bone gap was closed in all patients to within 20 dB between 0.5 and 3 kHz with only minor permanent bone conduction threshold losses (< 20 dB). However, we observed an immediate postoperative middle and high frequency loss of up to 75 dB on bone conduction threshold measurements 2 h after surgery, suggesting an acoustic traumatization by the erbium laser. This threshold shift recovered close to preoperative values within 6 h. These observations prompted us to discontinue the clinical use of erbium laser for stapedotomy until the problem of temporary acoustic traumatization is resolved.

Adult↗
PubMed1983

Cochlear function in chronic otitis media.

Otologic symptoms, audiometric data, and operative findings were reviewed in 200 consecutive patients who had surgically treated unilateral chronic otitis media. Bone conduction thresholds were analyzed in relation to extent of perforation, frequency of otorrhea, duration of disease, and extent of pathologic change. Median bone conduction threshold differences between diseased and uninvolved ears were within 5 dB at all frequencies. The mean speech discrimination score between affected and unaffected ears was equal. Patients with prolonged disease and more extensive pathologic alterations were more likely to experience cochlear changes and hence sensorineural hearing loss, though not to the extent others have described. Our findings indicate that chronic otitis media has little effect on cochlear function in the majority of patients.

Adolescent↗
PubMed1989

[Audiological study for ears with aural stenosis and atresia].

The audiological study for ears with aural stenosis and atresia was performed. The hearing level of ears with three types of ear plugs (with the hole of phi 1mm, with the hole of phi 3mm and without the hole) was tested experimentally by 10 normal hearing subjects in pure tone audiometry, and the audiograms of congenital and acquired aural stenosis and atresia were investigated statistically. And then following results were obtained. 1) The air conduction levels were higher, as the diameter of ear plug's hole got shorter in normal hearing subjects. And the shape of their audiograms was gradual sloping type. 2) The air conduction levels of ears with congenital aural stenosis and atresia were almost from 60 to 70 dB, and the levels were almost same throughout 7 frequencies. But the audiograms of ears with acquired aural stenosis and atresia showed conductive and gradual sloping type. 3) From the results mentioned above, the reason why the hearing loss of ears with aural stenosis and atresia showed conductive hearing loss limited to low and middle frequencies was considered to depend on the abnormality of the middle ear. 4) An average value of hearing threshold level in bone conduction among normal hearing subjects with three types of ear plugs was almost -7.8dB. There was no relation between the size of ear plug's hole and the shift of bone conduction level.

Adult↗
PubMed1996

Reporting operative hearing results in stapes surgery: does choice of outcome measure make a difference?

PURPOSE: Findings of a prior study indicated that neither choice of pre- versus postoperative bone-conduction scores nor choice of frequencies to include in averaging makes a substantial difference in reported outcomes of chronic ear surgery. METHODS: In this study, audiologic data from 240 stapes surgery patients at three different institutions were used to generate a variety of outcome measures. RESULTS: Use of preoperative rather than postoperative bone-conduction values in computing postoperative air-bone gap resulted in an approximately 5-dB smaller mean gap and a 2% higher success rate. Frequencies included in averaging made little difference in mean computed air-bone gap, although success rate (gap < or = 10 dB) was lower by 6% when 4 kHz was used in a four-frequency average rather than 3 kHz. Results for air conduction were similar to those for air-bone gap regarding choice of frequencies to include in averaging. When we used air-conduction pure-tone average (PTA) as the outcome measure, those with normal preoperative sensorineural hearing had a > 20% higher success rate than the general population of patients with stapes surgery. CONCLUSIONS: The greatest differences in success rate were based on definition of and criteria for success. Success rate was higher when based on air-bone gap than when based on air-conduction PTA. As in the prior chronic ear study, differences in outcome were more drastically affected by criteria for "success" than by frequencies included. Unlike similar data from chronic ear surgery, however, success rate differed depending on choice of air-bone gap or air-conduction PTA as the definition for success. Further, air and bone scores from the same test interval must be used accurately to reflect air-bone gap in stapes surgery.

Adolescent↗
PubMed2000

Insert earphone depth and the occlusion effect.

Twenty individuals were tested to determine the occlusion effect caused by supraaural earphones and by insert earphones with shallow and deep insertion of its foam eartip. The bone-conduction oscillator was placed both on the forehead and the mastoid. It was concluded that using deeply inserted earphones is the most practical way in which to carry out clinical bone-conduction measurements.

Adult↗
PubMed1998

Is chronic otitis media with cholesteatoma associated with neurosensory hearing loss?

OBJECTIVE: This study aimed to determine whether chronic otitis media (COM) with cholesteatoma over time is associated with a decrease in neurosensory function. STUDY DESIGN: This study was a review of a database of all patients with cholesteatoma treated surgically. SETTING: The study was conducted at a tertiary care medical center and specialty hospital. PATIENTS: There were children and adults with unilateral COM with acquired, nontraumatic cholesteatoma in this study. INTERVENTIONS: All patients received preoperative pure-tone bone conduction and speech audiometry. MAIN OUTCOME MEASURES: Interaural difference between the cholesteatomatous and normal ears comparing bone conduction pure-tone average (BC-PTA), pure-tone threshold at 4,000 Hz (BC4000), and/or speech discrimination score (SDS) as measured by a repeated measures analysis of covariance, with age as a covariate was examined. RESULTS: A significant difference between ears for SDS and BC4000 that does not vary with age was identified. A significant interaural difference for the BC-PTA that varies with patient age was identified. CONCLUSIONS: Chronic otitis media with cholesteatoma is associated with a decrease in neurosensory function, even in the absence of frank inner ear invasion.

Adolescent↗
PubMed2002

Osteogenic response of hydroxyapatite cement implanted into the femur of rats with experimentally induced osteoporosis.

Hydroxyapatite (HAP) cement was implanted in the femur of rats with experimentally induced osteoporosis, and the osteogenic response was studied histomorphologically. Osteoporosis was induced with ovariectomy with either a normal diet or a low-calcium diet. The rats fed a low-calcium diet after ovariectomy showed a decrease in both cumulative photodensity and the cortical thickness index. There was significant bone conduction in the femur of these rats, but the development of new bone was late, and the affinity index was small. The change in the affinity index with time was similar between the ovariectomy group and the ovariectomy/low calcium-group, suggesting the possibility that estrogen plays a major role in bone conduction.

Animals↗
PubMed1992

The influence of age on the results of stapedectomy.

In a retrospective study, we investigated the results of 384 stapedectomies performed between 1962 and 1989. The purpose was to determine the possible influence of age on the postoperative functional result. The operative technique uniformly consisted of a total stapedectomy, seal of the oval window with perichondrium and replacement of the stapes by a free tragal cartilage graft. The audiometric data at 0.5, 1, 2, and 4 kHz were compared. The patients were divided into five groups based upon chronological age: under 30, 30-40, 41-50, 51-60, over 60 years. Although the preoperative airbone gap (ABG) increased with age at all frequencies, and thus the chance for surgery to improve the ABG, the youngest group showed the best improvement in ABG (P less than 0.05). Using a technique with total removal of the footplate, bone conduction thresholds improved in the frequencies up to 2 kHz. At 4 kHz, they deteriorated in the four oldest groups. The greatest improvement in bone conduction thresholds occurred in the youngest group of patients (P less than 0.05), with a parallel decline in age and postoperative results occurring. The causes of these differences are not yet clear, although spontaneous recovery and greater resistance to operative trauma in the younger age groups might be of influence.

Adult↗
PubMed2006

[Treatment of sensorineural hearing loss in acute viral otitis media with intratympanic dexamethasone and hyaluronic acid in comparison with intravenous therapy].

BACKGROUND: Intratympanic dexamethasone with hyaluronic acid has shown to be an effective treatment of the inner ear damage in sudden hearing loss and Menière's disease. It is not known yet if the same applies to the toxic inner ear damage in acute viral otitis media. PATIENTS: Retrospectively, 26 patients who suffered from acute viral otitis media with sensorineural hearing loss were examined with regard to the improvement of their inner ear hearing loss. Twelve patients were treated with intravenous therapy only, consisting of hydroxyethyl starch, pentoxifylline and prednisolone. Fourteen patients additionally received intratympanic injections, consisting of dexamethasone and hyaluronic acid once acute inflammatory changes subsided. The inner ear hearing loss was evaluated by means of standard bone-conduction audiometry. RESULTS: Neither local nor systemic side effects of the intratympanic injections occurred. During treatment no significant difference in the improvement of bone-conduction thresholds in any frequency was seen between the two groups. CONCLUSIONS: Intratympanic injections of dexamethasone with hyaluronic acid do not result in any additional benefit on the sensorineural hearing loss in acute viral otitis media compared to intravenous therapy alone. A reason might be the post inflammatory changes of the round window membrane or the toxic nature of the acute viral infection affecting the inner ear.

Acute Disease↗
PubMedDate not supplied

Sensorineural hearing loss and acute otitis media in children.

Sensorineural hearing of 359 otoscopically and tympanometrically normal 5-year-old children with known otitis-history was studied under ideal conditions. In the subgroups of children with a different number (0, 1-2, 3-7, greater than or equal to 8) of attacks of acute otitis media (AOM) in their history, the mean bone conduction thresholds unregularly varied from 0.1 dB to 7.4 dB, depending on the frequency and the subgroup studied. The proportion of the ears with a bone conduction threshold greater than 10 dB at 0.5, 1, 2 or kHz ranged, also unregularly, from 10.8% to 0.5%, the greatest percentages being found at 0.5 and 1 kHz in the children without a history of AOM. Thus, neither AOM nor its treatment, even if frequently occurring, seem to cause permanent sensorineural hearing loss in children.

Acute Disease↗
PubMed1996

Audiometric findings in children with chronic suppurative otitis media without cholesteatoma.

Chronic suppurative otitis media without cholesteatoma (CSOMWC) is usually associated with an increase in air conduction thresholds. However, only a few investigations reported on loss of cochlear function in the pediatric population. We undertook a prospective study in order to further delineate air and bone conduction levels in children with CSOMWC and the possible relationship between sensorineural hearing loss (SNHL) and other clinical characteristics that might reflect the extent of disease. Eighty-seven children were enrolled, 40 of which had bilateral disease. Hence, the total number of diseased ears tested was 127. Audiometric studies were performed three days after achieving a 'dry' ear following medical treatment. We found no statistically significant differences between the bone conduction threshold tested in ears with CSOMWC and control ears. This was also the case in 47 children with unilateral disease when cochlear function was investigated in the diseased and uninvolved ear in the same patient. Clinical correlation showed no association between age, sex, duration of otorrhea and presence of granulation or polyps and the degree of cochlear loss. Our study shows that CSOMWC in children has little effect on cochlear function.

Adolescent↗
PubMed1999

Stapedotomy: does prosthesis diameter affect outcome?

Two hundred ears with otosclerosis have been operated upon using a 0.4-mm diameter Teflon platinum piston in 100 ears and a 0.6-mm diameter Teflon piston in the other 100 ears. The postoperative air-bone gap, calculated as the difference between the postoperative air and bone conduction levels, was smaller in the 0.6 mm group for all frequencies except at 2000 Hz, the differences were statistically insignificant except at 4000 Hz. The mean postoperative air-bone gap was 8.6 dB and 7.4 dB for the 0.4 and 0.6 mm groups, respectively, which is statistically insignificant. We found no postoperative loss of bone conduction exceeding 15 dB, there was a deterioration of more than 10 dB in three ears, one in the 0.4 mm group and two in the 0.6 mm group. According to our results, we conclude that the 0.4 mm and the 0.6 mm Teflon prostheses produce the same hearing improvement in stapes surgery for otosclerosis.

Adult↗
PubMed1988

Fluctuating hearing loss in presbyacusis.

Thirty-six patients with bilateral symmetrical presbyacusis who reported a temporary improvement in the hearing of one ear following a Valsalva's manoeuvre were further investigated. Bone conduction and air conduction thresholds, middle ear pressure and middle ear compliance were measured before and after Valsalva's manoeuvre in the ears which had a subjective improvement in hearing following auto-inflation. Bone conduction thresholds remained unaltered in 66 per cent of ears while average air conduction thresholds varied by less than 5 decibels. Middle ear pressure was unchanged in over half the ears tested and in 81 per cent of the ears there was no change in middle ear compliance. There appears to be no simple explanation for the temporary subjective fluctuation in hearing reported by patients with presbyacusis.

Aged↗
PubMed1994

Effects of aging on hearing results in tympanoplasty.

The effects of aging on the preoperative and postoperative hearing results of tympanoplasty were assessed in 642 patients with chronic suppurative otitis media (COM) or cholesteatoma (CHL). Analysis focused on the correlation between hearing results and age for each disease and type of tympanoplasty. Data were evaluated by calculating the regression line, mainly using second order polynomial regression analysis. Averaged air and bone conduction thresholds (PTA) in patients were appreciably poorer in younger patients and increased with age, compared with physiological hearing impairment in old age (presbyacusis). Regression lines for PTA of air and bone conduction in patients and for normal data (air conduction) separated from each other after the age of 30 and hearing impairment gradually accelerated with age. Means of air-borne gap, however, were almost the same in each age group, though hearing thresholds in individual patients were distributed widely. This was more dominant in patients who had undergone type III or IV tympanoplasty than those with type I tympanoplasty, and in patients with COM than with CHL. Labyrinthine function thus appears to be gradually aggravated with age in patients with chronic inflammatory ear disease. Patients with chronic otitis media should be thus recommended to undergo tympanoplasty at an early age.

Adolescent↗