Is It Valid to Calculate the 3‐Kilohertz Threshold by Averaging 2 and 4 Kilohertz?

Gurgel, Richard K.; Popelka, Gerald R.; Oghalai, John S.; Blevins, Nikolas H.; Chang, Kay W.; Jackler, Robert K.

doi:10.1177/0194599812437156

Cited by 90 publications

(82 citation statements)

References 5 publications

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“…Air (AC) and bone conduction (BC) thresholds at 0.5, 1, 2, and 3 kHz were recorded and used to calculate four-tone pure-tone averages (PTAs). If the 3-kHz threshold was not recorded, the average of the 2 and 4 kHz thresholds was used, as supported by the current literature (13). Preoperative and postoperative ABG were calculated as AC PTA minus BC PTA.…”

Section: Audiometric Methodsmentioning

confidence: 99%

Ossiculoplasty With Titanium Prostheses in Patients With Intact Stapes

Baker

O’Connell

Nguyen

et al. 2015

Otology &Amp; Neurotology

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TORP reconstruction in patients with an intact stapes is associated with good short and longer-term hearing results. Furthermore, hearing outcomes within TORPs remain stable at follow-up >12 months postoperatively. Results did not differ when compared with traditional PORP reconstruction, suggesting that TORP through an intact stapes arch is an acceptable alternative to PORP reconstruction in patients with challenging anatomy.

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Section: Audiometric Methodsmentioning

confidence: 99%

Ossiculoplasty With Titanium Prostheses in Patients With Intact Stapes

Baker

O’Connell

Nguyen

et al. 2015

Otology &Amp; Neurotology

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“…When the 3-kHz pure tone threshold was not available, the 2-kHz and 4-kHz average was used as a surrogate. 11 Postoperative facial nerve function was appraised using the House-Brackmann grading scale. 13 The distinction of an empty sella turcica was made in cases where the pituitary fossa was largely replaced by CSF, as determined by sagittal T1-or T2-weighted MRI.…”

Section: Data Collectionmentioning

confidence: 99%

Temporal bone encephalocele and cerebrospinal fluid fistula repair utilizing the middle cranial fossa or combined mastoid–middle cranial fossa approach

Carlson¹,

Copeland

Driscoll

et al. 2013

JNS

116

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Object The goals of this study were to report the clinical presentation, radiographic findings, operative strategy, and outcomes among patients with temporal bone encephaloceles and cerebrospinal fluid fistulas (CSFFs) and to identify clinical variables associated with surgical outcome. Methods A retrospective case series including all patients who underwent a middle fossa craniotomy or combined mastoid–middle cranial fossa repair of encephalocele and/or CSFF between 2000 and 2012 was accrued from 2 tertiary academic referral centers. Results Eighty-nine consecutive surgeries (86 patients, 59.3% women) were included. The mean age at time of surgery was 52.3 years, and the left side was affected in 53.9% of cases. The mean delay between symptom onset and diagnosis was 35.4 months, and the most common presenting symptoms were hearing loss (92.1%) and persistent ipsilateral otorrhea (73.0%). Few reported a history of intracranial infection (6.7%) or seizures (2.2%). Thirteen (14.6%) of 89 cases had a history of major head trauma, 23 (25.8%) were associated with chronic ear disease without prior operation, 17 (19.1%) occurred following tympanomastoidectomy, and 1 (1.1%) developed in a patient with a cerebral aqueduct cyst resulting in obstructive hydrocephalus. The remaining 35 cases (39.3%) were considered spontaneous. Among all patients, the mean body mass index (BMI) was 35.3 kg/m2, and 46.4% exhibited empty sella syndrome. Patients with spontaneous lesions were statistically significantly older (p = 0.007) and were more commonly female (p = 0.048) compared with those with nonspontaneous pathology. Additionally, those with spontaneous lesions had a greater BMI than those with nonspontaneous disease (p = 0.102), although this difference did not achieve statistical significance. Thirty-two surgeries (36.0%) involved a middle fossa craniotomy alone, whereas 57 (64.0%) involved a combined mastoid–middle fossa repair. There were 7 recurrences (7.9%); 2 patients with recurrence developed meningitis. The use of artificial titanium mesh was statistically associated with the development of recurrent CSFF (p = 0.004), postoperative wound infection (p = 0.039), and meningitis (p = 0.014). Also notable, 6 of the 7 cases with recurrence had evidence of intracranial hypertension. When the 11 cases that involved using titanium mesh were excluded, 96.2% of patients whose lesions were reconstructed with an autologous multilayer repair had neither recurrent CSFF nor meningitis at the last follow-up. Conclusions Patients with temporal bone encephalocele and CSFF commonly present with persistent otorrhea and conductive hearing loss mimicking chronic middle ear disease, which likely contributes to a delay in diagnosis. There is a high prevalence of obesity among this patient population, which may play a role in the pathogenesis of primary and recurrent disease. A middle fossa craniotomy or a combined mastoid–middle fossa approach incorporating a multilayer autologous tissue technique is a safe and reliable method of repair that may be particularly useful for large or multifocal defects. Defect reconstruction using artificial titanium mesh should generally be avoided given increased risks of recurrence and postoperative meningitis.

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“…Pure tone average was defined as the average of hearing thresholds in decibel hearing level (dB HL) at 0.5, 1, 2, and 3 kHz. If the 3 kHz threshold was unavailable, the average of thresholds at 2 and 4 kHz was substituted . Air–bone gap was defined as the difference between air‐conduction and bone‐conduction thresholds at 0.5, 1, 2, and 3 kHz, with the change in ABG defined as the initial minus final ABG, in accordance with AAO–Head and Neck Surgery reporting guidelines .…”

Section: Methodsmentioning

confidence: 99%