XVI The Slipped Strut Problem

Steffen, Ted N.; House, Howard P.; Sheehy, James L.

doi:10.1177/000348946307200116

Cited by 33 publications

(3 citation statements)

References 9 publications

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“…PLFs can broadly be divided into two categories: those with an identifiable cause and those without. At first, PLFs were observed in post-stapedectomy patients where perilymph would leak around a prosthesis placed into the oval window due to a failure of the seal around or under the prosthesis (7)(8)(9). Though techniques for stapes surgery have advanced, PLFs still occur as a complication in ∼1% of stapedotomy procedures (10) and may be present in up to one-third of individuals requiring revision stapedectomies (11).…”

Section: Etiologymentioning

confidence: 99%

Perilymphatic Fistula: A Review of Classification, Etiology, Diagnosis, and Treatment

et al. 2020

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A perilymphatic fistula (PLF) is an abnormal communication between the perilymph-filled inner ear and the middle ear cavity, mastoid, or intracranial cavity. A PLF most commonly forms when the integrity of the oval or round window is compromised, and it may be trauma-induced or may occur with no known cause (idiopathic). Controversy regarding the diagnosis of idiopathic PLF has persisted for decades, and the presenting symptoms may be vague. However, potential exists for this condition to be one of the few etiologies of dizziness, tinnitus, and hearing loss that can be treated surgically. The aim of this review is to provide an update on classification, diagnosis, and treatment of PLF. Particular attention will be paid to idiopathic PLF and conditions that may have a similar presentation, with subsequent information on how best to distinguish them. Novel diagnostic criteria for PLF and management strategy for PLF and PLF-like symptoms is presented.

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Section: Etiologymentioning

confidence: 99%

Perilymphatic Fistula: A Review of Classification, Etiology, Diagnosis, and Treatment

et al. 2020

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“…Some controversy exists concerning the symptoms that occur with a rupture of the round or oval window without concurrent rupture of the inner ear membranes. Steffen et al 2 found that fistulas that occur in the oval window, after stapedectomy with a polyethylene strut placed on Gelfoam, do not produce symptoms of inner ear malfunction in about 25% of the cases; in those cases with symptoms, the strut had slipped into the vestibule.…”

Section: Discussionmentioning

confidence: 99%

Inner Ear Membrane Ruptures Demonstrated with Keratin Immunohistochemistry

Shi

Linthicum

1997

Otolaryngol.--head neck surg.

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The extent of inner ear membrane distention and rupture in the ears of a patient with otosclerosis, who had an oval window fistula 6 years after stapedectomy, was demonstrated by immunohistochemical staining of the keratin in the celIoidinembedded temporal bone sections according to an antigenretrieval technique. 1 The ability to demonstrate clearly the position of, and define the edges of, inner ear membranes derived from ectoderm, with a keratin ectoderm-specific stain, was instrumental in developing a hypothesis to explain the symptoms resulting from inner ear membrane raptures in this patient. CASE REPORTThe temporal bones reported in this study were from a man first examined in 1957, at the age of 54 years. He had a progressiwe bilateral hearing loss with an average of 88 dB for speech frequencies in the right ear and 71 dB in the left ear. Physical examination of the ears revealed thin and intact tympanic membranes. Audiometric tests, with masking, elicited bilateral mixed hearing losses (Fig. 1A). Bone conduction was better than air conduction with the tuning fork test at t024 Hz, bilaterally.A diagnosis of otosclerosis was made and the patient underwent a right stapes mobilization and subsequent revision stapedectomies with a polyethelene strut and then a vein plug. At the last surgery it was found that the round window was closed by otosclerosis, so the prognosis was guarded. However, there was an improvement to a level of 60 DB (converted from the American Standards Association) in the speech frequencies recorded in 1960. There was a gradual decline in air and bone conduction until the last test in 1977, 7 years before the patient's death (Fig. 1B).In spite of the expected poor result from surgery on the right ear because of the sensorineural component of the loss, it became the better-hearing ear after surgery, so the left ear underwent a stapedectomy with a polyethelene strut over Gelfoam with a resultant improvement in hearing to 40 dB.Six years after the last surgery, during an upper respirato-From the

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“…At the same time, some authors consider such re-operations admissible, though more difficult than the primary operation (Dawes and Jackson, 1962;Sheehy and House, 1962;Steffen et al, 1963).…”

mentioning

confidence: 99%

Probability of perceptive deafness in obliterative otosclerosis undergoing re-operation

Gukovich¹

1969

J. Laryngol. Otol.

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XVI The Slipped Strut Problem

Cited by 33 publications

References 9 publications

Perilymphatic Fistula: A Review of Classification, Etiology, Diagnosis, and Treatment

Perilymphatic Fistula: A Review of Classification, Etiology, Diagnosis, and Treatment

Inner Ear Membrane Ruptures Demonstrated with Keratin Immunohistochemistry

Probability of perceptive deafness in obliterative otosclerosis undergoing re-operation

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