Conductive hearing loss after head trauma: review of ossicular pathology, management and outcomes

Basson, O.; Lierop, A C van

doi:10.1017/s0022215108002454

Cited by 20 publications

(14 citation statements)

References 10 publications

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“…Since most of the attention is primarily focused on stabilizing a patient's overall condition after trauma, a time gap between the accident and diagnosis of an ossicular injury often occurs. The mean delay of 5.5 years in our series is comparable to other studies with average intervals ranging from 5.7 to 8.2 years [4,[6][7][8][9] . The higher incidence of indirect traumas to direct traumas also corresponds to previously published data [5,[7][8][9] .…”

Section: Discussionsupporting

confidence: 89%

“…The first cases were treated by restoring the ossicles to their original position or with bone chips, sculpted incus autografts, or allografts [2] . While biocompatible prostheses were initially developed to improve hearing in chronic middle ear disease and otosclerosis, they also proved their usefulness in traumatic disease treatment [2][3][4][5][6][7][8][9] . A recent innovation is the application of hydroxyapatite bone cement, which appears to be a reliable technique to restore the energy transfer in a more physiological way [10,11] .…”

Section: Introductionmentioning

confidence: 99%

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Surgical Management and Hearing Outcome of Traumatic Ossicular Injuries

Delrue¹,

Verhaert²,

Dinther³

et al. 2016

Int Adv Otol

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OBJECTIVE:The purpose of this study was to investigate etiological, clinical, and pathological characteristics of traumatic injuries of the middle ear ossicular chain and to evaluate hearing outcome after surgery. MATERIAL AND METHODS:Thirty consecutive patients (31 ears) with traumatic ossicular injuries operated on between 2004 and 2015 in two tertiary referral otologic centers were retrospectively analyzed. Traumatic events, clinical features, ossicular lesions, treatment procedures, and audiometric results were evaluated. Air conduction (AC), bone conduction (BC), and air-bone gap (ABG) were analyzed preoperatively and postoperatively. Amsterdam Hearing Evaluation Plots (AHEPs) were used to visualize the individual hearing results. RESULTS:The mean age at the moment of trauma was 27.9±17.1 years (range, 2-75 years) and the mean age at surgery was 33.2±16.3 years (range, 5-75 years). In 10 cases (32.3%), the injury occurred by a fall on the head and in 9 (29.0%) by a traffic accident. Isolated luxation of the incus was observed in 8 cases (25.8%). Dislocation of the stapes footplate was seen in 4 cases (12.9%). The postoperative ABG closure to within 10 and 20 dB was 30% and 76.7%, respectively. CONCLUSION:Ossicular chain injury by direct or indirect trauma can provoke hearing loss, tinnitus, and vertigo. As injuries are heterogeneous, they require a tailored surgical approach. In this study, the overall hearing outcome after surgical repair was favorable.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Surgical Management and Hearing Outcome of Traumatic Ossicular Injuries

Delrue¹,

Verhaert²,

Dinther³

et al. 2016

Int Adv Otol

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show abstract

“…The incidence is 30% according to Hollinger et al [1], while a lower incidence (no exact number found) of simultaneous facial nerve paralysis is reported. Incus dislocation is the most common ossicular dislocation, with an incidence up to 63% [1,2,3]. Instances have been reported where the incus was repositioned into either external auditory canal or tympanic antrum, with varying degrees of hearing loss [4,5,6].…”

Section: Discussionmentioning

confidence: 99%

Normal Hearing after Trauma with Completely Ectopic Incus – How Possible?

Zou

Liu²,

Yang³

2012

ORL

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Objectives: To report the rare case of a patient with complete incus dislocation after trauma showing normal hearing. Methodology: Physical examination, audiometry, CT of temporal bone, and detection during operation. Results: The incus had become remotely located in the mastoid cavity, but the patient showed normal hearing because fibrous connections had preserved bony continuity. Conclusion: This case demonstrates that disruption of the ossicular chain does not always require ossicular reconstruction.

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“…5a). Seltener kommt es zu Frakturen, hier sind meist die Stapesschenkel betroffen, teilweise kann es auch zu einer Dislokation desselben in das Vestibulum kommen [2,5]. Mit zeitlicher Latenz können posttraumatische Vernarbungen zu einer Ossikelfixation führen.…”

Section: Verletzungen Der Gehörknöchelchenketteunclassified

Traumatology of the ear and temporal bone

Thomas

Minovi

Dazert

2011

HNO

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In addition to injuries to the pinna otologic traumatology comprises in particular injuries of the tympanic membrane and ossicular chain, temporal bone fractures together with accompanying impairment of the labyrinth and facial nerve as well as acoustic trauma and barotrauma. Depending on the mechanism of injury and typical symptoms, such as hemorrhagic otorrhoea, hearing loss, vertigo, tinnitus, facial nerve palsy, otoliquorrhea or pseudorhinoliquorrhea, further investigations should be planned. The present article provides an overview of the necessary further diagnostic measures as well as the therapeutic options currently available for all forms of injury mentioned here.

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Conductive hearing loss after head trauma: review of ossicular pathology, management and outcomes

Abstract: Cartilage interposition was a very successful method of repairing incudostapedial joint dislocation in this series, at short term follow up.

Cited by 20 publications

References 10 publications

Surgical Management and Hearing Outcome of Traumatic Ossicular Injuries

Surgical Management and Hearing Outcome of Traumatic Ossicular Injuries

Normal Hearing after Trauma with Completely Ectopic Incus – How Possible?

Traumatology of the ear and temporal bone

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