Idiopathic sudden progressive hearing loss and round window membrane rupture

Kanzaki, Jin

doi:10.1007/bf00470611

Cited by 13 publications

(7 citation statements)

References 10 publications

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“…In the case of profound SSHL without improvement after medical treatment the labyrinthine window rupture and the development of a perilymphatic fistula (PLF) should be considered as one possible etiologic factor [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. According to the literature, exploratory tympanotomy with inspection and sealing of the labyrinthine window may be a therapeutic option in those patients [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Critical Evaluation of Round Window Membrane Sealing in the Treatment of Idiopathic Sudden Unilateral Hearing Loss

Hoch

Vomhof

Teymoortash

2015

Clin Exp Otorhinolaryngol

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ObjectivesRupture of the round window membrane with consecutive development of a perilymphatic fistula (PLF) is still a matter of controversial debate in the pathogenesis of idiopathic sudden sensorineural hearing loss (SSHL). Until now no consensus exists about whether these patients benefit from performing an exploratory tympanotomy with sealing of the round window. The aim of the present study was to analyze critically the effectiveness of sealing the round window membrane in patients with SSHL.MethodsThe clinical data of 51 patients with SSHL and a mean hearing decline of at least 60 dB over 5 frequencies who were treated with tympanotomy and sealing of the round window membrane were retrospectively analyzed. The results have been compared to the current state of the literature.ResultsIntraoperatively a round window membrane rupture or fluid leak was observed in none of the patients. After performing tympanotomy the mean improvement of hearing level was 32.7 dB. Twenty of 51 examined patients (39.2%) showed a mean improvement of the hearing level of more than 30 dB and a complete remission could be detected in 12 patients (23.5%). Reviewing the literature revealed no standard guidelines for definition or treatment of SSHL as well as for evaluation of hearing loss and its recovery.ConclusionThe results of the present study and the literature should be discussed critically. It is unclear whether tympanotomy and sealing of the round window membrane may be a meaningful treatment for SSHL. Therefore this procedure should be discussed as a therapeutic option only in selected patients with sudden deafness or profound hearing loss in which PLF is strongly suspicious or conservative treatment failed.

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Section: Introductionmentioning

confidence: 99%

Critical Evaluation of Round Window Membrane Sealing in the Treatment of Idiopathic Sudden Unilateral Hearing Loss

Hoch

Vomhof

Teymoortash

2015

Clin Exp Otorhinolaryngol

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“…Ten of the 15 markedly recovered ears and 3 of the 10 slightly recovered ears showed an abruptly falling audiometric configuration [7]. Hearing loss did not return to normal where high and middle frequencies in the audiogram obtained just before the surgery were scale out.…”

Section: Resultsmentioning

confidence: 99%

“…They are actual observation of fluid leak [6, 7], direct inspection of the round window membrane rupture [8–11] and no simultaneous pressure transmission from the oval to the round window [11, 12]. The actual fluid leak in the labyrinthine window recesses was found in 71% [6] and 40% [7]. Our result was that a large quantity of leak was seen in 57% and a small quantity of leak was seen in 43%.…”

Section: Discussionmentioning

confidence: 99%

Labyrinthine window rupture as a cause of acute sensorineural hearing loss

Nagai

2011

Eur Arch Otorhinolaryngol

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Labyrinthine window rupture (LWR) is one cause of acute sensorineural hearing loss and need for early exploration is clear for good improved hearing. Acute sensorineural hearing loss of 60 dB or more treated from May 2006 to May 2010 were retrospectively analyzed. There were 21 ears of severe deafness, 18 ears of profound deafness, and 10 ears of total deafness. All patients were examined with temporal bone CT. Space-occupying lesions around the labyrinthine windows were suggestive images of LWR. Thirty-five ears were operated for LWR while 14 ears of SHL received conservative treatments. Fifty-seven percent of LWR improved 30 dB or more after sealing of both labyrinthine windows. Of the 15 markedly recovered ears, 14 ears were operated within 2 weeks from the onset. Of the five cured ears, four ears were operated within a week from the onset. As for the hearing prognosis of SHL, 88% of severe and profound deafness improved 30 dB or more but total deafness did not improve more than 30 dB. Exclusion of LWR from SHL and early surgical intervention in LWR will bring about good hearing prognosis to both LWR and SHL.

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“…B. beim Tauchen, als gesicherter Mechanismus [5,10]. Gleichwohl wird in der Literatur immer wieder die Möglich-keit einer spontanen Rundfensterruptur ohne entsprechende Anamnese diskutiert [2,7,12,15,16,19,23,25].…”

Section: Schlüsselwörterunclassified

“…eine Progredienz des Hörverlustes auftritt, werden oftmals zum Ausschluss eines solchen Ereignisses tympanotomiert. Gemessen an der in der Literatur berichteten Zahl der Eingriffe wurden insbesondere in Studien mit größeren Patientenzahlen relativ selten Perilymphfisteln sicher nachgewiesen [12,15,16].…”

Section: Schlüsselwörterunclassified

Rundfensterruptur - Nachweis mittels Fluoreszenzendoskopie

Kleemann¹,

Nofz²,

Plank³

et al. 2001

HNO

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Rupture of the round window membrane as a special cause of inner ear deafness is widely accepted after changing pressure levels, e.g. in diving. However, even without a barotrauma before, the spontaneous rupture of the round window membrane is suspected occasionally in patients with sudden hearing loss and/or vertigo and tinnitus. To carry through the tympanotomy is decided by ENT surgeons often in cases of progressive hearing loss despite infusion therapy. Perilymph fistulas have been detected relatively seldom, compared to the number of reported operations by several authors. However, covering the round niche with connective tissue leads to the improvement of symptoms sometimes even in cases without microscopical evidence of fistula. Within the last 3 years 14 patients suffering sudden hearing loss of one ear underwent tympanotomy in our department. Of these patients 8 reached restitution of the hearing ability. Especially 2 patients with sudden deafness caused by spontaneous rupture of the round window membrane are reported in the following article. Perilymph fistulas were detected in these cases by IV-application of fluorescein and fluorescence endoscopy of the middle ear. Both patients obtained a normal hearing curve within 1 week after surgical intervention and obliteration of the round niche.

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Idiopathic sudden progressive hearing loss and round window membrane rupture

Cited by 13 publications

References 10 publications

Critical Evaluation of Round Window Membrane Sealing in the Treatment of Idiopathic Sudden Unilateral Hearing Loss

Critical Evaluation of Round Window Membrane Sealing in the Treatment of Idiopathic Sudden Unilateral Hearing Loss

Labyrinthine window rupture as a cause of acute sensorineural hearing loss

Rundfensterruptur - Nachweis mittels Fluoreszenzendoskopie

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