Postoperative bone conduction thresholds changes in patients operated on chronic otitis media – analysis

Abstract

Unchanged mucous lining middle ear spaces and intact ossicular chain are crucial for bone conduction improvement after otosurgery. Scars, especially in round window, are poor prognostic factor for hearing improvement. Cleaning of the middle ear from granulation has an positive influence for bone conduction threasholds changes.

One-Stage Complete Resection of Cholesteatoma With Labyrinthine Fistula: Hearing Changes and Clinical Outcomes

“…Possible mechanisms include elimination of the toxic influence of inflammatory mediators from middle ear inflammation or serous labyrinthitis or restoration of the middle ear cavity and auditory ossicular chain. 26,27 Overall SDS was minimally changed without statistical significance over time with a slight improvement immediate postoperatively, as was in accordance with previous reports. 6 A total of 4 cases had >15% improvement of SDS postoperatively, whereas only 2 cases experienced >15% decrease.…”

“…Possible mechanisms include elimination of the toxic influence of inflammatory mediators from middle ear inflammation or serous labyrinthitis or restoration of the middle ear cavity and auditory ossicular chain. 26,27…”

Middle Ear Packing and External Ear Packing With Fibrin Glue Enhance the Success of Fat Myringoplasty Without Hyaluronic Acid Disc

“…That is, depressed BC threshold does not always represent the cochlear injury. Recently by Wiatr et al (33), reported that significant improvement of bone conduction after myringoplasty was observed in the patients with dry perforation with intact ossicular chain. They explained that normalization of the preoperative granular mucosa and discharge is a positive impact on improvement of bone conduction after myringoplasty.…”

The Relationship between Bone Conduction Hearing Threshold Shifts after Surgery for Chronic Otitis Media with Cholesteatoma According to STAM, EAONO/JOS, and SAMEO-ATO Classifications

“…Improvement is explained variously by closure of the perilymphatic fistula, unblocking of the membrane of the round window, or removal of cholesteatoma and limitation of action of its toxins. An important positive factor is removal of granulations from the tympanic cavity, and precise preservation of the mucosa in the middle-ear cavity, whereas a negative factor for the threshold of bone conduction proved to be the scars in the round window [ 9 ]. Our observations overall logically infer that pre-surgically deteriorated bone conduction shows a greater tendency towards improvement than pre-surgically unchanged bone conduction.…”

“…Significant differences were found in the sensorineural hearing loss frequencies at the different cholesteatoma locations [ 8 ]. Nevertheless, improvement of the hearing threshold of bone conduction may sporadically even occur [ 9 ].…”