Labyrinthine window rupture as a cause of acute sensorineural hearing loss

Abstract

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.

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

“…However, according to the literature a fluid leak in the labyrinthine window recesses could be found in 40%-71% of patients with a PLF [ 7 , 8 ]. There is also a report that a large quantity of fluid leak could be found more often in patients, who were treated within the first week after the beginning of the symptoms [ 24 ]. In the same study patients with large quantity of fluid leak had a tendency toward a poor hearing recovery.…”

Exploratory tympanotomy in sudden sensorineural hearing loss for the identification of a perilymphatic fistula – retrospective analysis and review of the literature

“…Nagai and Nagai described the benefit of sealing of the membrane during tympanotomy. 23 However, only patients who were suspicious for having a perilymphatic fistula based on their CT scans were subjected to tympanotomy. As expected, the incidence of perilymphatic fistula in their patient cohort was 100 per cent, indicating the predictive value of high-resolution CT and not the overall incidence of perilymphatic fistula.…”

“…As expected, the incidence of perilymphatic fistula in their patient cohort was 100 per cent, indicating the predictive value of high-resolution CT and not the overall incidence of perilymphatic fistula. 23…”

“…This is in contrast to the report of Nagai and Nagai, which identified leaks in every operated ear. 23 They describe that, in the presence of a perilymphatic fistula, fluid was identified at the sinus tympani or at the round window recess on CT scans. Thus, pre-operative CT can be helpful to indicate the need for surgical exploration and sealing.…”

Μελέτη Ανοσολογικών Παραμέτρων Στο Περιφερικό Αίμα Ασθενών Με Οξεία Πτώση Ακοής

“…Το αποτέλεσμα του απεικονιστικού ελέγχου, υπό αυτό το πρίσμα, συνιστά ένα ακόμη κριτήριο επιλογής των ασθενών εκείνων με οξεία πτώση ακοής στους οποίους ενδείκνυται η διενέργεια ερευνητικής τυμπανοανάσπασης και απόφραξης της στρογγύλης θυρίδας. 68 Τέλος αξίζει να σημειωθεί ότι ακόμη και η ανεύρεση ενός συριγγίου στα πλαίσια της χειρουργικής διερεύνησης του μέσου ωτός δεν λύνει το διαγνωστικό δίλημμα της οξείας πτώσης ακοής καθώς αξιολογεί μόνο την ακεραιότητα της ωοειδούς και της στρογγύλης θυρίδας χωρίς να παρέχει πληροφορίες για την κατάσταση των ενδολαβυρινθικών μεμβρανών. Είναι γνωστό εξ άλλου ότι ένα μικρό συρίγγιο των θυρίδων είναι υπεύθυνο μόνο για μία μικρού βαθμού απώλεια ακοής, με ελάχιστη ή και καθόλου βλάβη του κοχλία, και διατήρηση σε μεγάλο βαθμό της ικανότητας διάκρισης του λόγου.…”