The role of explorative tympanotomy in patients with sudden sensorineural hearing loss with and without perilymphatic fistula

Prenzler, Nils; Schwab, Burkard; Kaplan, Daniel M.; El‐Saied, Sabri

doi:10.1016/j.amjoto.2017.10.006

Cited by 20 publications

(18 citation statements)

References 30 publications

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“…Sudden sensorineural hearing loss (SSHL) or sudden deafness, is typically defined as a hearing loss of at least 30 decibels occurring over at least three consecutive frequencies and lasting at least 3 days [ 1 ]. The estimated incidence varies from approximately 5 to 20 up to 160 per 100000 people per year [ 2 ]. The patient typically first notices symptoms upon awakening and describes an aural fullness/blockage.…”

Section: Introductionmentioning

confidence: 99%

Relationship between platelet parameters and sudden sensorineural hearing loss: a systematic review and meta-analysis

Chen

et al. 2018

Bioscience Reports

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Recent years, the discussion about whether platelets participant in the development of sudden sensorineural hearing loss (SSHL) continues and many studies on the relationship between them have come to our attention. Some studies believe that platelet parameters have significantly changed in patients with SSHL, while some not, controversially. Therefore, to investigate the association between platelet parameters, including mean platelet volume (MPV), platelet distribution width (PDW) and platelet count (PLT), and SSHL, expecting to resolve controversy and provide clinical evidence for diagnosis and monitoring of SSHL. Basic methods: Literature was retrieved searching electronic databases (PubMed, Embase, Cochrane, and Scopus) and searching references of related articles by hand. A total of 18 case–control studies involving 1837/1734 subjects (SSHL/control) were included. Meta-analysis showed there was no difference between the patients who suffered SSHL and healthy controls in MPV level [standard mean difference (SMD) (95% confidence interval (CI)) = 0.16 (−0.07, 0.40), I2 = 80%, P<0.00001] and PLT [SMD (95% CI) = −0.03(−0.18, 0.12), I2 = 73%, P<0.00001]. While PDW exhibited significant difference [SMD (95% CI) = 0.85 (0.20, 1.49), I2 = 93%, P<0.00001]. Subgroup analysis about geographical area suggested PLT have obvious evidence for SSHL in Eastern country [SMD (95% CI) = 0.23 (0.14, 0.33), I2 = 0%, P=0.81]. Our study did not support a correlation between MPV and SSHL, while PLT may have clinical significance for SSHL in Eastern country. With insufficient data to explore the resource of heterogeneity for PDW, there is no decisive conclusion reached.

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Section: Introductionmentioning

confidence: 99%

Relationship between platelet parameters and sudden sensorineural hearing loss: a systematic review and meta-analysis

Chen

et al. 2018

Bioscience Reports

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“…In all studies listed in Table 5, an improved hearing performance was documented post-operatively, although this improvement was not statistically significant. 2,15,18,19,27–30 In addition, there was no correlation between improvement and the presence of a perilymphatic fistula. Klemm and Flach compared surgical with conservative treatment.…”

Section: Resultsmentioning

confidence: 95%

“…The remaining eight publications were included in our paper (Table 5). 2,15,18,19,27–30 All studies had been performed retrospectively, and focused on the identification and sealing of perilymphatic fistula, as well as on the benefit for patients with idiopathic sudden SNHL. A total of 534 patients were included in these 8 studies.…”

Section: Resultsmentioning

confidence: 99%

“…30 The gain of hearing was similar for both treatment modalities, although the gain of hearing after tympanotomy was slightly better than that after conservative treatment. 2,17,18,25–29 In patients with a clinical presentation that was highly suspicious for perilymphatic fistula, only one-third of the cases showed a perilymphatic fistula intra-operatively. 2 Based on the results by Klemm and Flach, 30 tympanotomy showed superior results when compared with purely conservative treatment and should therefore be recommended.…”

Section: Resultsmentioning

confidence: 99%

“…In Germany, the incidence is reported to be as high as 160 per 100 000 persons per year. 1,2 By contrast, other countries such as the USA report incidences as low as 8–15 per 100 000 persons per year. 3…”

Section: Introductionmentioning

confidence: 98%

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

et al. 2020

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AbstractObjectiveThe diagnostic value of exploratory tympanotomy in sudden sensorineural hearing loss remains controversial. This study and review were performed to identify the incidence of perilymphatic fistula in patients with sudden sensorineural hearing loss. The effectiveness of tympanotomy for sealing of the cochlear windows in cases with perilymphatic fistula was evaluated.MethodsA search in common databases was performed. Overall, 5034 studies were retrieved. Further, a retrospective analysis on 90 patients was performed.ResultsEight publications dealing with tympanotomy in patients with sudden sensorineural hearing loss were identified. In 90 patients diagnosed with sudden sensorineural hearing loss and undergoing exploratory tympanotomy, 10 patients (11 per cent) were identified with a perilymphatic fistula, and this corresponds to the results obtained from our review (13.6 per cent).ConclusionThere was no significant improvement after exploratory tympanotomy and sealing of the membranes for patients with a definite perilymphatic fistula.

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Bringt die Abdeckung des ovalen Fensters zusätzlich zum runden Fenster bei der Reservetherapie der akuten idiopathischen Ertaubung einen Vorteil?

Hofmann

Schoenfeld

Jagielski

et al. 2020

HNO

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Hintergrund Bei plötzlich aufgetretener einseitiger hochgradiger sensorineuraler Hörstörung bzw. Ertaubung können Patienten nach frustraner intravenöser Glukokortikoidtherapie einer explorativen Tympanotomie mit Abdeckung des runden und/oder ovalen Fensters (RF und/oder OF) wegen des Verdachts einer Rundfenstermembranruptur mit Perilymphfistel (PLF) oder einer Fissula ante fenestram (FAF) behandelt werden. Die Studie untersucht, ob die zusätzliche Abdeckung des ovalen Fensters im Vergleich zur alleinigen Abdeckung des runden Fensters einen zusätzlichen Hörgewinn bringt. Methodik Die retrospektive Studie untersucht 54 Patienten mit akuter Ertaubung und durchgeführter Tympanoskopie, bei denen Audiogramme von 3 Zeitpunkten (präoperativ, nach Detamponade sowie mindestens 3–6 Monate postoperativ) vorlagen. Bei 28 Patienten erfolgte neben der Rundfensterabdeckung die zusätzliche Abdeckung des ovalen Fensters. Ergebnis Eine intraoperativ sichtbare PFL bzw. FAF wurde in keinem Operationsbericht beschrieben. Die Hörschwellen waren im frühen postoperativen Zeitraum bereits hoch signifikant geringer und verbesserten sich im weiteren Verlauf. Zwischen den Subgruppen RF und RF + OF zeigte sich in beiden postoperativen Zeiträumen kein signifikanter Unterschied. Bei 65 % (Kriterien nach Kanzaki) und 74 % (Kriterien nach Siegel) der Patienten konnte postoperativ eine partielle bzw. komplette Hörverbesserung nachgewiesen werden. Beim Vergleich der Patientengruppen mit bzw. ohne postoperative Hörverbesserung zeigten sich keine statistischen Unterschiede bezüglich Geschlecht, Alter, Nebendiagnosen oder Latenz der Operation bis zum Symptombeginn. Schlussfolgerung In dieser Studie zeigte die zusätzliche Abdeckung des OF keine signifikante Hörverbesserung. Die postoperative Hörverbesserung entspricht den publizierten Spontanremissionsraten. Nur eine prospektive multizentrische Studie mit Kontrollgruppe kann den Stellenwert der Tympanoskopie und mit Rund- bzw. ovaler Fensterabdeckung bei einer akuten hochgradigen sensorineuralen Schwerhörigkeit vor dem Hintergrund der Spontanremissionen klären.

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The role of explorative tympanotomy in patients with sudden sensorineural hearing loss with and without perilymphatic fistula

Cited by 20 publications

References 30 publications

Relationship between platelet parameters and sudden sensorineural hearing loss: a systematic review and meta-analysis

Relationship between platelet parameters and sudden sensorineural hearing loss: a systematic review and meta-analysis

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

Bringt die Abdeckung des ovalen Fensters zusätzlich zum runden Fenster bei der Reservetherapie der akuten idiopathischen Ertaubung einen Vorteil?

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