Lateral semicircular canal fenestration for congenital conductive hearing loss: Solution for a dilemma

Ashtiani, Mohammadtaghi Khorsandi; Yazdani, Nasrin; Dabiri, Sasan; Mokhtari, Zahra; Kouhi, Ali

doi:10.1016/j.otohns.2010.05.023

Cited by 6 publications

(9 citation statements)

References 11 publications

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“…We conducted a rapid systematic literature search, identifying five articles reporting audiometric results after middle ear surgery in children with congenital oval or round window malformations (Table ). Studies were included if at least five cases were analyzed, and if they were written in English, Dutch, French, or German.…”

Section: Discussionmentioning

confidence: 99%

“…Knowing that hearing loss has negative effects on school performance, especially in case of bilateral hearing loss, the patients that are discussed in this article and their families opted for surgery. We conducted a rapid systematic literature search, identifying five articles [6][7][8]18,19 reporting audiometric results after middle ear surgery in children with congenital oval or round window malformations (Table II). Studies were included if at least five cases were analyzed, and if they were written in English, Dutch, French, or German.…”

Section: Discussionmentioning

confidence: 99%

“…At long-term follow-up (mean, 67 months; range, 6-169 months), again no cases achieved ABG closure to 10 dB or less, and the percentage of ABG closure to 20 dB or less declined to 13%. Postoperative mean gain in AC threshold was described by all but one article 18 and varied from 29 dB to 33 dB. [6][7][8]18 Two of these studies 6,8 compared short-and long-term mean gain in AC threshold, showing a deterioration of the AC threshold of 12 dB and 14 dB over time, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative mean gain in AC threshold was described by all but one article 18 and varied from 29 dB to 33 dB. [6][7][8]18 Two of these studies 6,8 compared short-and long-term mean gain in AC threshold, showing a deterioration of the AC threshold of 12 dB and 14 dB over time, respectively. Several authors found bone regrowth in the oval window area during revision surgery, which may explain deterioration of the mean AC threshold over time.…”

Section: Discussionmentioning

confidence: 99%

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Congenital oval or round window malformations in children: Surgical findings and results in 17 cases

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Congenital oval or round window malformations in children: Surgical findings and results in 17 cases

et al. 2016

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“…Overall, the main point we tried to make was regarding the modification of the fenestration site covering with skin graft, and our results show it is a safe and efficacious method for these patients.3© At the risk of sounding like Emmet Eminence, president-elect of the Society for Authority-Based Medcine, 1 the recent "Extracts From The Cochrane Library: Tonsillectomy for Periodic Fever, Apthous Stomatitis, Pharyngitis and Cervical Adenitis Syndrome (PFAPA)," by Kuppersmith et al 2 should not go unchallenged.…”

Section: Doi: 101177/0194599810397588mentioning

confidence: 93%

Lateral Semicircular Canal Fenestration for Congenital Conductive Hearing Loss: Solution for a Dilemma

Ashtiani¹,

Yazdani²,

Dabiri³

et al. 2011

Otolaryngol.--head neck surg.

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In the October issue of Otolaryngology-Head and Neck Surgery, Ashtiani et al 1 published an interesting article on their experience with the classic fenestration of the lateral semicircular canal (LSCC) in cases of congenital conductive hearing loss. The classic fenestration procedure was invented in 1922 by Holmgren (Sweden), introduced in the United States by Sourdille (France) in 1937, and popularized by Lempert (United States) in 1938. In 1948, Holmgren 2 stated, "The improvement in hearing is far from always permanent. In a large number of cases it regresses after a short or long period, and then usually returns to the pre-operative condition." According to Jones, 3 the greatest failure was a bony regrowth that closes the artificial window. No method has been devised that ensures against closure. Any surgeon reporting according to accepted standards who attains a 60% hearing improvement by his surgery may assure himself that he is getting excellent results. 3 The closure of the fenestration fistula was the important issue in the high times of the fenestration era. Lempert invented the Nov-ovalis approach with later the cartilage "stopple" 4 to attack with moderate success the problem of reclosure of the LSCC fenestration.The application of the fenestration of the LSCC for congenital conductive hearing loss is far from new as a solution for the mentioned dilemma. Ombredanne from Paris 5 described in 1947 the fenestration of LSSC for congenital conductive hearing loss, and later in the 1960s, he reported more than 600 cases. In the 1950s, reports appear also on the experience with the fenestration in congenital conducting hearing loss. Unfortunately, the authors were unable to present this information in the recent article.Essential for the Lempert fenestration is the removal of the incus and the malleus head. It is not clear from the present article if this procedure has been followed. The color pictures do not solve this dilemma. It is surprising in this article that in the follow-up, there is no case of chronic otorrhea or at last closure of the fenestration after the surgery. The hearing results are extraordinarily positive when we compare the results with the data described by the masters of the fenestration of LSSC after 25 years of experience with this type of ear surgery in congenital conductive hearing loss. It might be possible that not performing a partial ossiculectomy is the reason for the good results in this study.

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Surgical outcome in class 4 congenital anomalies of the ossicular chain: a systematic review of the literature

Henkemans

Rovers

Thomeer

2023

Eur Arch Otorhinolaryngol

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Objective To review hearing and surgical outcomes after reconstructive middle ear surgery in class 4 congenital middle ear anomalies (CMEA), e.g., patients with oval- or round window atresia of dysplasia. Data sources Pubmed/Medline, Embase and Cochrane library. Review methods Articles containing data on hearing outcomes and complications after reconstructive ear surgery in class 4 anomalies were analyzed and critically appraised. The following data were included and reviewed: patient demographics, audiometric testing, surgical techniques, complications, revision surgeries and their outcomes. Risk of bias was determined, and GRADE certainty of evidence was assessed. Primary outcomes were postoperative air conduction thresholds (AC), change in AC, and success rates (closure of the ABG to within 20 dB), the occurrence of complications (most importantly sensorineural hearing loss) and the long-term stability of hearing results (> 6-month follow-up) and occurrence of recurrence of preoperative hearing loss. Results Success rates varied from 12.5 to 75% at long-term follow-up with larger cohorts reporting success rates around 50%, mean postoperative gain in AC varied from 4.7 to 30 dB and − 8.6 to 23.6 dB at, respectively, short- and long-term follow-up. No postoperative change in hearing occurred in 0–33.3% of ears, and recurrence of hearing loss occurred in 0–66.7% of ears. SNHL occurred in a total of seven ears across all studies of which three experienced complete hearing loss. Conclusion Reconstructive surgery can be an effective treatment option which should be considered in patients with very favorable baseline parameters, while also considering the substantial risk of recurrence of hearing loss, the possibility of unchanged hearing despite surgery and the rare occurrence of SNHL. Level of evidence 2c.

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Lateral semicircular canal fenestration for congenital conductive hearing loss: Solution for a dilemma

Abstract: We demonstrated hearing improvement after lateral semicircular canal fenestration. This technique can be considered as an alternative for patients with middle ear anomalies who are not candidates for ossicular reconstruction.

Cited by 6 publications

References 11 publications

Congenital oval or round window malformations in children: Surgical findings and results in 17 cases

Congenital oval or round window malformations in children: Surgical findings and results in 17 cases

Lateral Semicircular Canal Fenestration for Congenital Conductive Hearing Loss: Solution for a Dilemma

Surgical outcome in class 4 congenital anomalies of the ossicular chain: a systematic review of the literature

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