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At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

Simultaneous round and oval window fistulae in a child.

Sudden hearing loss from simultaneous rupture of both oval and round windows, occurring in the only hearing ear of a child, is described. The condition was surgically managed with recovery of hearing. Of particular note was the presence of air aspirated into the labyrinth at the time of membrane rupture, which has not previously been described. The possible mechanisms and some clinical correlates associated with anatomic predisposition to such rupture are discussed.

Child, Preschool↗
PubMed1985

Conservative management of inner ear barotrauma resulting from scuba diving.

Fourteen patients who experienced inner ear barotrauma (IEBT) while scuba diving were examined shortly after the episode and were followed up until symptoms resolved or stabilized. On the basis of these observations and a review of the literature, three types of IEBT are hypothesized that usually result from forceful autoinflation of the middle ear: (1) hemorrhage within the inner ear, (2) labyrinthine membrane tear, and (3) perilymph fistula through the round or oval window. Presenting symptoms, treatment regimens, and final results are detailed.

Adolescent↗
PubMed1980

A syndrome with mixed deafness, Mozart ear, middle and inner ear dysplasias.

A 10-year-old boy presenting a disorder of multiple malformations with an otologic component consisting of mixed deafness, Mozart ear, thin stapes, small oval window and agenesis of the semicircular canals, was studied. A comparative analysis of similar malformation-entities has permitted the delineation of a previously undescribed syndrome.

Abnormalities, Multiple↗
PubMed1983

[Acoustic inner ear trauma by impedance measurement. Acute acoustic trauma?].

We report on two patients with sudden hearing loss occurring immediately after registration of an acoustically elicited acoustic reflex with pure tones of 500, 1000, 2000, and 4000 cps and 125 dB HL. Aetiology and patho-physiology of this form of acute acoustic trauma are discussed. An obvious destruction of middle ear structures or the membrane of the round and oval window can be excluded. Assuming pre-existing disposition, e.g. distortion of microcirculation in the cochlea, the acoustic stimulus is merely the trigger for the imminent sudden hearing loss. Therefore, we suggest to limit the stimulus power to 105 dB HL. In every case one should keep in mind the possible danger of this examination and perform a benefit-risk calculation in every patient.

Acoustic Impedance Tests↗
PubMed1989

Gentamicin and other ototoxic antibiotics for the transtympanic treatment of Menière's disease.

Severe unilateral cases of Menière's disease can be successfully treated with ototoxic antibiotics. Among them gentamicin sulfate gives the safest results. With the aid of a small syringe this antibiotic is introduced into the external auditory canal 5 times/day. From there it reaches the middle ear through a ventilating tube by using a Politzer bag. Gentamicin then penetrates the round and oval windows, where it influences inner ear function. Of 92 patients treated during the past 20 years, more than 90% have had no further attacks after therapy.

Auditory Threshold↗
PubMed2001

Cerebrospinal fluid otorrhea in a patient with congenital inner ear dysplasia.

A case of a 10-month-old boy with a cerebrospinal fluid (CSF) fistula in his right ear is reported. In the same ear, the patient also showed congenital inner ear dysplasia. The CSF fistula was obstructed surgically. Surgical exploration showed a fistula superior to the oval window and a normally shaped stapes. The stapes was removed and the fistula was closed by obliteration of the vestibulum with the temporal fascia and fat tissue. The location of the fistula was very rare; to our knowledge, this is the first reported case of CSF fistula superior to the oval window. The relationship between perilymphatic fistula and the microfissure revealed by temporal bone study is discussed.

Cerebrospinal Fluid Otorrhea↗
PubMed1995

Transtympanic gentamycin in the treatment of Ménière's disease.

Severe cases of Ménière's disease are successfully treated with ototoxic antibiotics. Gentamycin sulphate gives the best results. With the aid of a small syringe the drug is introduced into the external auditory canal 3-5 times per day. From there it is transported into the middle ear through a ventilating tube (Grommet) under slight pressure (Politzer bag). The liquid then penetrates the round and oval windows and influences inner-ear function. More than 90% of our patients in 25 years after therapy had no further attacks.

Ear, Middle↗
PubMed1991

The fate of bone grafts in deep oval windows.

The use of bone grafts for total ossicular chain reconstructions in patients with deep oval windows may result in varying degrees of absorption of the segment of the bone graft in the fossula fenestra vestibuli. The mechanism of bone absorption is described--a condition not described before.

Adolescent↗
PubMedDate not supplied

Distribution of HRP in the inner ear after injection into the middle ear cavity.

The distribution patterns of horseradish peroxidase (HRP) reaction products in the inner ears of guinea pigs were studied after injections into the middle ear cavities and perilymphatic and subarachnoid spaces. The normal round window membrane resisted HRP penetration from the middle ear side, but when it became pathological after repeated applications, its permeability increased. HRP deposits were found in the cochlear and vestibular sensory cells and in the lumen of the endolymphatic sac. HRP reaction products were minimal at the cochlear apex even after long survival times, suggesting that perilymph flow, if it exists, is rather weak toward this direction. Whereas the stria vascularis is impermeable to HRP, the vestibular dark cells were accessible; thus, the metabolic activity of the dark cells can be more readily controlled by drug applications through the middle ear cavity. The finding of HRP deposits on the scala vestibuli surface of Reissner's membrane and the absence of HRP in the upper portion of the spiral ligament at the basal turn suggests that the oval window is a secondary route of passage for these particles from the middle ear cavity to the inner ear. In order to determine the route of HRP into the endolymphatic sac from the middle ear cavity or scala tympani, the cochlear and/or vestibular aqueducts were obliterated singly or together. The route of HRP was determined to be the vestibular aqueduct. HRP is believed to enter the sac lumen through Reissner's and saccular membranes and the sac epithelium. Drugs and other large molecular substances instilled in or gaining access to the middle ear cavity may reach the endolymphatic sac causing its functional alteration.

Animals↗
PubMed2005

Bone-conduction hearing and the occlusion effect in otosclerosis and normal controls.

OBJECTIVE: The goal of this study was to better understand bone-conduction hearing in subjects with normal hearing and in those with otosclerosis through the occlusion effect. With this study, the authors hope to lend credence to commonly accepted theories of bone-conduction hearing and the effect of lateralization during the Weber tuning fork test. BACKGROUND: There are three accepted theories defining bone-conduction hearing: compressional bone conduction describes an auditory percept produced by the compression and expansion of the cochlea leading to basilar membrane vibration; inertial bone conduction describes the inertia of the ossicular chain as a result of skull vibration during bone conduction testing; whereas skull vibration may also be transmitted to the external auditory canal, surrounding soft tissues, and para-auditory structures to illicit tympanic membrane vibration known as osseotympanic bone conduction. METHODS: Twenty normal volunteers and 17 unilateral otosclerosis patients underwent external canal sound pressure level measurement during bone-conduction testing using a standardized bone oscillator placement and stimulation paradigm. Sound was detected with a probe microphone placed in the external auditory canal in nonoccluded and occluded conditions after a 50-dB hearing level bone-conduction stimulus. RESULTS: There was no significant difference in sound pressure level between otosclerosis and normal subjects when the external auditory canals were nonoccluded. With occlusion, sound pressure level increased in both groups, but at a statistically significantly higher level for the otosclerosis group. CONCLUSION: Sound measured in the external canal likely represents energy lost to the environment transmitted through the middle and external ear systems, aided by the effect of both inertial and osseotympanic bone conduction. Occluding the ear leads to sound trapping and amplification. Also, the pressure exerted against the tympanic membrane reduces middle ear compliance and increases the impedance mismatch between air and the middle ear system, reflecting sound back into the external canal. This effect is further enhanced by stapes fixation to explain our data in both groups of subjects. The final common pathway in "lateralization" is probably a product of higher than normal impedance mismatch at the oval window.

Auditory Threshold↗
PubMed1999

Factors affecting hearing results after stapes surgery.

Factors affecting auditory improvement after stapes surgery were investigated retrospectively on a study group of 106 otosclerotic ears (86 subjects). While the closure of the air-bone (A-B) gap after surgery was good at 2 kHz and 4 kHz, it was poor at 8 kHz and at frequencies lower than 1 kHz. Under 1 kHz, the lower the frequency, the worse the A-B gap after surgery. Stapedotomy and partial stapedectomy showed better post-operative hearing gain at 4 kHz than total stapedectomy. Total stapedectomy scored significantly better at 250 Hz and 500 Hz than stapedotomy. There was a close relationship between the pre-operative and post-operative A-B gap at frequencies under 1 kHz. The smaller the pre-operative A-B gap, the better the closure of the post-operative A-B gap at these frequencies. It was speculated that otosclerotic ears with a larger pre-operative airbone gap might have another lesion in the middle ear other than the oval window.

Adult↗