High-Tone Sensorineural Losses Following Chronic Ear Surgery

Palva, Tauno; Kärjä, Juhani; Palva, A.

doi:10.1001/archotol.1973.00780020184008

Cited by 86 publications

(51 citation statements)

References 2 publications

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“…The reluctance to deal with both the sides has been primarily due to a theoretical risk of iatrogenic sensori-neural hearing loss, need of bilateral ear canal gauze packing and chances of graft intake failure. The risk of iatrogenic hearing loss engaged with chronic ear surgery has been found to be variable (1.2-4.5 %), depending upon the pre-morbid conditions like congenital malformations, cholesteatoma or granulating otitis or if concurrent ossiculoplasty was performed [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Outcome of Single-Sitting Bilateral Type 1 Tympanoplasty in Indian Patients

Raghuwanshi¹,

Asati

2013

Indian J Otolaryngol Head Neck Surg

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Tympanoplasty is the standard and well established procedure for closure of tympanic membrane perforations. Traditionally each ear drum is taken up for grafting sequentially in two different sittings, which leads to huge increase in operation cost, time and discomfort to the patient. Since, simultaneous bilateral tympanic membrane grafting could be quite safe and helpful to the patients, we performed the same in 32 patients with bilateral (64) ear drum perforations due to chronic suppurative otitis media. All patients had a conductive hearing loss corresponding to the size and site of the perforation, without evidence of ossicular chain defect or any other middle or inner ear pathology. The post-aural route was approached for the grafting in 27 ears, endaural in 22 perforations and the remaining 15 small perforations were done via endomeatal approach. All the ears were operated using the Underlay technique. The majority of the grafts were harvested from temporalis fascia (59 grafts), remaining five were obtained from tragal perichondrium. All the patients were subjected to regular follow-up evaluation and audiometry for up to 1 year after the surgery. Six ears showed incomplete recovery with residual perforation, although in two of them the tissue regeneration over next few weeks led to entire shutting down of the defect. Thus, the graft take rate was 93.75 % without any retraction pockets or displaced grafts. We did not encounter any iatrogenic sensorineural hearing loss. Thus the results from our study reinforce the safety of the single-step procedure and question the traditional apprehension regarding theoretical risk of iatrogenic sensorineural hearing loss making the ENT surgeon reluctant to perform this readily acceptable minor surgery in one sitting.

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Section: Introductionmentioning

confidence: 99%

Outcome of Single-Sitting Bilateral Type 1 Tympanoplasty in Indian Patients

Raghuwanshi¹,

Asati

2013

Indian J Otolaryngol Head Neck Surg

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“…This has primarily been because of a theoretical risk of iatrogenic sensorineural hearing loss (HL) in one ear, which, in cases of conventional, two-stage procedures, would change the indication for operation or the nature of the procedure to be performed on the second ear. The risk of iatrogenic HL in surgery for ear disease has been reported to be 1.2-4.5% [1][2][3]. It is, however, essential to note that these incidents with HL occurred in patients with congenital malformations, cholesteatoma, or granulating otitis or in cases in which ossiculoplasty was performed.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Type 1 Tympanoplasty in Chronic Otitis Media

Mane

Patil

Mohite

et al. 2011

Indian J Otolaryngol Head Neck Surg

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A theoretical risk of iatrogenic sensorineural hearing loss during surgery has induced a reluctance to perform bilateral tympanoplasty type I among some otosurgeons. This paper presents results of bilateral surgery in 14 patients (28 ears). Fourteen patients with bilateral, dry tympanic membrane perforations caused by chronic otitis media were selected prospectively for bilateral tympanoplasty type I (28 ears) at a tertiary referral center. All patients had a HL corresponding to the size and localization of the perforation (no suspicion of ossicular chain defect or other pathology). Mean age was 37.5 years. There were seven males and seven females in our study. All but five ears were operated through an endaural or endomeatal approach, and five ears operated by postaural approach. The Underlay technique was used in all cases. Total ten cases operated using Fascia Lata and four cases operated using Temporalis fascia as graft material. Follow-up examination and hearing tests (pure tone audiometry) were performed up to 20 months after surgery. The graft take rate was 96%, with no retraction pockets or displaced grafts observed during follow-up. One patient had small residual perforation which healed at the end of 3 months. Hearing improved significantly, and the air-bone gap was significantly reduced. The air-bone gap was closed to within 10 dB in 92% and within 20 dB in 100% of the ears. Surprisingly good hearing was found during postoperative, bilateral ear canal gauze packing. Iatrogenic sensorineural HL did not occur. We conclude that bilateral myringoplasty is safe, with good results, reduces costs, and leaves the patient satisfied. The hearing impairment during postoperative ear canal packing is surprisingly modest and readily acceptable by the patients.

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“…There are some studies specifying that the incidence of sensorineural hearing loss varies between 1.2% and 4.5% in the ears applied drilling (10,15). Besides these studies, another study revealed that although minimal changes associated with drilling were seen in the operated ear, no statistically significant change was observed in the hearing level of the contralateral ear (16).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Inner Ear Damage by Using Otoacoustic Emissions in Patients Who Underwent Mastoidectomy and Tympanoplasty Operations in Early Period

Özdamar

Koçak

Aydın

et al. 2015

Turk Arch Otorhinolaryngol

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Objective: We aim to demonstrate inner ear damage caused by drilling in the early period. Healthy contralateral ears of patients who underwent mastoidectomy using drill or tympanoplasty without using drill were compared. Methods:A total of 38 patients (mastoidectomy: 22, tympanoplasty: 16) who were diagnosed as chronic otitis media and were scheduled for surgery were included. Distortion product (dp) otoacoustic emissions measurements were performed on healthy contralateral ears of patients on pre-and post-operative 1. hour, 1. day, 2. day, 3. day, and 4. day. Results:In mastoidectomy group, dp otoacoustic emission values on post-operative 1. hour, 1. day, 2. day, 3. day, and 4. day at a frequency of 4000 Hz were significantly lower than in tympanoplasty group (p<0.05). In mastoidectomy group, dp values on post-operative 1. hour, 1. day, 2. day, 3. day, and 4. day at 4000 Hz significantly decreased in comparison with pre-operative period (p<0.05). In comparison with pre-operative period, decrease in dp values on post-operative 1. hour, 1. day, and 2. day at 4000 Hz in mastoidectomy group is significantly higher than those in tympanoplasty group (p<0.05). In tympanoplasty group, dp values on post-operative 1. hour at 4000 Hz significantly decreased in comparison with pre-operative period (p<0.05). Conclusion:Drilling used in mastoidectomy operation damage healthy contralateral ears by causing acoustic trauma. This damage can be determined by otoacoustic emissions in the early period. According to our study, hearing loss is temporary and more distinct at higher frequencies. Keywords

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High-Tone Sensorineural Losses Following Chronic Ear Surgery

Cited by 86 publications

References 2 publications

Outcome of Single-Sitting Bilateral Type 1 Tympanoplasty in Indian Patients

Outcome of Single-Sitting Bilateral Type 1 Tympanoplasty in Indian Patients

Bilateral Type 1 Tympanoplasty in Chronic Otitis Media

Evaluation of Inner Ear Damage by Using Otoacoustic Emissions in Patients Who Underwent Mastoidectomy and Tympanoplasty Operations in Early Period

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