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At least 19 recordsLinked to original sources
PubMed1989

Perilymphatic fistulas in children: rationale for therapy.

We report 26 consecutive patients (32 ears) who were identified in a 2 year period (July 1, 1985-June 30, 1987) with unexplained sudden, fluctuating, or progressive sensorineural hearing loss (SNHL). All patients underwent an exploratory tympanotomy and a perilymphatic fistula was identified in 13 patients (14 ears). The mean change of 14 +/- 27 dB in speech reception threshold before and after surgery was significant at p = 0.08 among children with fistula and ranged from -30 to 80 dB. In children with sudden, progressive or fluctuating SNHL and multiple sensory deficits, including blindness or contralateral SNHL, or prior head trauma, prompt surgical exploration is mandatory. Additionally, the aggressive management of otitis media with effusion is essential in such patients to minimize fluctuations in hearing caused by superimposed conductive hearing loss. Caution must be exercised to separate fluctuating hearing loss from fluctuations in audiologic testing.

Adolescent↗
PubMed1978

Spontaneous labyrinthine window rupture.

Spontaneous labyrinthine window rupture has been increasingly recognized in recent years. Seven such case histories and details of subsequent management by tympanotomy and fat graft plugging of the fistulae are reported. The importance of a history of physical stress preceding onset of symptoms is emphasized in the case of certain patients who presented with sudden hearing loss accompanied, in some cases, by tinnitus or vertigo. The first 5 patients were reported in a paper presented in October 1977 at the First South African National Otorhinological Congress in Cape Town.

Adult↗
PubMed1986

The effect of butyl 2-cyanoacrylate on the middle and inner ear of the chinchilla.

Butyl 2-cyanoacrylate was placed on the oval and round window of the ear of the chinchilla and was also used as an adhesive for myringoplasty with autogenous muscle fascia. Butyl 2-cyanoacrylate was found to be difficult to manipulate and moderately toxic to the middle ear; there were occasional significant reactions in the inner ear.

Animals↗
PubMed1979

The double-membrane break syndrome in sudden hearing loss.

Some patients with sudden hearing loss actually have two membrane breaks, one at the oval or round window and one further inside the cochlea. One may heal spontaneously and the other not, or both, or neither. It is very likely impossible to detect this early from the threshold audiogram, because the intracochlear breaks allows endolymph and perilymph mixing which spreads over much of the anatomically normal clchlea causing diffuse loss of function. This theory is illustrated by three case histories.

Adult↗
PubMed1992

Perilymphatic fistula induced by barotrauma.

The association between diving, barotrauma, and the production of perilymphatic fistula has been known for almost 20 years. Forty-eight cases of round and oval window fistulas following diving have been reviewed and essentially corroborate previous findings. Any patient with a history of diving and subsequent sensorineural hearing loss within 72 hours should be suspected of having a round or oval window perilymphatic fistula and surgical exploration and closure of the fistula should be undertaken. Patients who have a loss of hearing, vertigo, nausea, or vomiting following a decompression dive should be re-compressed and if symptoms do not clear, exploration should be performed. Surgical treatment should be executed as soon as possible after the diagnosis is suspected for the best possible results.

Acute Disease↗
PubMed1988

The effect of fibrin tissue adhesive on the middle and inner ears of chinchillas.

The purpose of this study was to examine potential toxic effects of fibrin tissue adhesive to the middle and inner ears. Using the chinchilla as our experimental model, we placed fibrin sealant on either the footplate or the round window membrane in one ear, and placed similar amounts of normal saline in the same area of the opposite ear. In addition, the fibrin adhesive was used to anchor a fascia lata graft for myringoplasty. Both fibrin adhesive and normal saline produced mild reactions in the middle and inner ears when they were placed on the round window membrane; little reaction occurred when fibrin adhesive was placed on the oval window or when it was used for myringoplasty.

Animals↗
PubMed1978

[About rupture and lesion of the labyrinthine windows (author's transl)].

After the extensive discussion of the last published literature on the different possibilities of a lesion of the labyrinthine windows, four own cases are discussed. In case of a typical anamnesis of single patients with sudden deafness after sudden exertion or trauma prior to onset the surgical exploration is recommended. It is concluded that spontaneous labyrinthine window ruptures must be added to the etiologic factors in sudden hearing loss.

Adult↗
PubMed1991

[Bifenestration--a hearing-improving operation in severe ear malformations].

Bifenestration as an operation for hearing improvement is described in a case of congenital absence of the oval and round window. Besides the classical fenestration of the horizontal semicircular duct, an artificial round window was performed in the middle ear. Due to the acoustic resonance of the mastoid cavity, the resulting conductive loss in the higher frequencies was only 20-30 dB.

Adult↗
PubMed1990

Inner ear decompression sickness combined with a fistula of the round window. Case report.

Inner ear barotrauma with rupture of the round or oval window secondary to diving and decompression sickness (DCS) of the inner ear can be a difficult diagnosis to differentiate. The dive profile or associated elements of DCS will often confirm the diagnosis. Occasionally, diagnosis is made during recompression or during operation. The differential diagnosis is important, since immediate recompression is indicated for inner ear DCS, while it is contraindicated in cases of inner ear barotrauma. We have found no cases reported in the world literature in which both diseases have been diagnosed and proven simultaneously. We present a case of a diver who developed DCS with inner ear manifestations complicated by a round window fistula. Treatment and clinical outcome are discussed along with a brief review of the suspected cause.

Audiometry↗
PubMed1992

Treatment and management of perilymphatic fistula: a New Hampshire experience.

From August of 1975 to June of 1990 the author managed 45 cases of spontaneously occurring perilymphatic fistula. Twenty-nine of the 45 cases were reported in 1988. In the series there were eight patients with bilateral involvement, seven with involvement of both oval and round window in the same ear, and seven with fistulas believed to be of congenital origin. Seventeen patients (38%) required revision surgery. Occasionally adjunct modalities (endolymphatic shunt, labyrinthectomy, blocking a cochlear aqueduct, and streptomycin ablation) were used for symptom control. Diagnosis, treatment, and management of these patients is discussed.

Adolescent↗
PubMed1989

Tolerance of membranous inner ear structures to pressure.

Pressure tolerance of round and oval labyrinthine windows and a cochlear segment represented by a part of the cochlear duct were investigated in experiments on cadaveric human temporal bones. The cochlear segment is less resistant than both the windows. Inner ear spaces are protected from pressure changes in the surroundings of the temporal bone by a system of narrow and comparatively long connections and some of them include also other structures strengthening the protective function (the valve described near the place where the cochlear aqueduct leads to scala tympani). Experiments with guinea pigs showed significance of inner ear integrity in protection from pressure changes. Tolerance of both windows was significantly higher in live animals than in cadaveric guinea pig bullae. Pressure tolerance of the windows was in turn higher in bullae than in isolated inner ear labyrinth. Conclusions were arrived at on the basis of the above facts that the inner ear is considerably resistant to pressure changes around it under normal circumstances. Ruptures in its parts appear only under special conditions and a number of factors participate in them. Window ruptures accompany most frequently injuries in other inner ear structures to which different degrees of hearing loss correspond. An isolated injury of windows is, from this viewpoint, rare even though it can be found and treated surgically best.

Animals↗
PubMed1989

Round window reflex and oval window fistulae.

The round window reflex is normally absent in stapedial fixation. In this study, six cases of oval window fistula are described in which the round window reflex was absent. This is probably because there is insufficient pressure transmitted to the round window membrane through the perilymph because of leakage from the oval window. This is considered as an important diagnostic sign of oval window/stapes footplate ligament disruption.

Cochlea↗
PubMed1992

T cell subsets in round window membrane after middle ear immunostimulation.

In secondary middle ear immune response, kinetics of immunocytes, especially T cell subsets, was examined in the round window membrane (RWM) using immunohistochemical methods. Healthy BALB/c mice and keyhole limpet hemocyanin (KLH) antigen were employed in this study. The inflammatory responses of the RWM and middle ear were investigated after antigen challenge into the middle ear bulla. We used antibodies against murine macrophages and granulocytes (anti-Mac-1), murine helper/inducer T cells (anti-Lyt-1 and -L3T4), murine suppressor/cytotoxic T cells (anti-Lyt-2), murine interleukin-2 receptor (7D4), murine immunoglobulins (anti-IgG, -IgM and -IgA) and KLH. In the RWM and middle ear mucosa, inflammatory cells were observed at 6 hours, peaking on days 3-7, whereas these cells were rarely seen in the scala tympani of the basal turn. Luminal effusion with an enormous infiltration of inflammatory cells, which consisted mainly of Mac-1 cells, IgG cells and IgM cells, was observed in the middle ear cavity on days 1-7 post antigen challenge. In the inflamed RWM, Mac-1 cells were the predominant cell type followed by helper T cells, interleukin 2 receptor positive cells and IgG positive cells, though IgM, IgA and Lyt-2 positive cells were rarely observed after antigen challenge. Our results suggest that RWM has the ability to protect inner ear by cellular immune response through activated helper T cells and Mac-1 cells.

Animals↗
PubMed1989

Spontaneous perilymphatic fistula in children.

Treatment of fistulae in children should be targeted at four different problem areas. The surgical intervention of these fistulae is most efficacious in controlling recurrent meningitis, which has not been discussed in this paper, and in the controlling of vestibular symptoms. Whether or not it will stop the progression of hearing loss or restore hearing is not known in a group of patients. It has been documented in this and other reports that the closure of the fistula will in specific cases appear to be associated in time with a stopping of the progression of the hearing loss and is associated also in time with the restoration of hearing function. Various factors must be considered in developing criteria for intervention. A decision to explore the ear should be based on history, audiometric change, vestibular testing including a fistula test, and malformation of bony labyrinth.

Adolescent↗
PubMed1989

Effects of round window membrane rupture on cochlear blood flow and inner ear pressures.

Effects of round window membrane rupture on cochlear blood flow and inner ear pressures were investigated using non-radioactive microspheres and a servo-micropipet system in guinea pigs. When perilymphatic pressure was raised through a glass capillary tube inserted into the perilymphatic space, both endolymph pressure and perilymph pressure rose. When these inner ear pressures were raised to relatively high levels, cochlear blood vessels could be compressed and endocochlear potential decreased to a negative value due to the interruption of cochlear blood flow. However, in the case when the round window membrane was ruptured by further increase in perilymph pressure, the inner ear pressures decreased and restoration of cochlear blood flow and endocochlear potential was observed. When the round window membrane was ruptured with a fine needle under ordinary inner ear pressures, cochlear blood flow did not change significantly.

Animals↗