| Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach. | |
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MedLine Citation:
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PMID: 22935810 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine postoperative hearing outcomes after surgical plugging via middle cranial fossa approach for superior semicircular canal dehiscence syndrome (SCDS). STUDY DESIGN: Clinical review. SETTING: Tertiary care medical center. PATIENTS: Forty-three cases of SCDS based on history, physical examination, vestibular function testing, and computed tomography imaging confirming the presence of a dehiscence. All patients underwent surgical plugging of the superior semicircular canal via middle cranial fossa approach. INTERVENTION: Pure tone audiometry was performed preoperatively and at 7 days and at least 1 month postoperatively. MAIN OUTCOME MEASURES: Change in air-bone gap (ABG) and pure tone average (PTA). RESULTS: Preoperative average ABG across 0.25, 0.5, 1, and 2 kHz was 16.0 dB (standard deviation [SD], 7.5 dB). At 7 days postoperatively, average ABG was 16.5 dB (SD, 11.1; p = 0.42), and at greater than 1 month was 8.1 dB (SD, 8.4; p < 0.001). 53% (95% confidence interval, 33-69) of affected ears had greater than 10 dB increase in their 4-frequency (0.5, 1, 2, and 4 kHz) PTA measured by bone-conduction (BC) threshold 7 days postoperatively and 25% (95% confidence interval, 8-39) at greater than 1 month postoperatively. Mean BC PTA of affected ears was 8.4 dB hearing loss (HL) (SD, 10.4) preoperatively. Compared with baseline, this declined to 19.2 dB HL (SD, 12.6; p < 0.001) at 7 days postoperatively and 16.4 dB HL (SD, 18.8; p = 0.01) at greater than 1 month. No significant differences in speech discrimination score were noted (F = 0.17). CONCLUSION: Low-frequency air-bone gap decreases after surgical plugging and seems to be due to both increased BC thresholds and decreased AC thresholds. Surgical plugging via a middle cranial fossa approach in SCDS is associated with mild high-frequency sensorineural hearing loss that persists in 25% but no change in speech discrimination. |
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Authors:
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Bryan K Ward; Yuri Agrawal; Elena Nguyen; Charles C Della Santina; Charles J Limb; Howard W Francis; Lloyd B Minor; John P Carey |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology Volume: 33 ISSN: 1537-4505 ISO Abbreviation: Otol. Neurotol. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-09-13 Completed Date: 2013-02-01 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 100961504 Medline TA: Otol Neurotol Country: United States |
Other Details:
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Languages: eng Pagination: 1386-91 Citation Subset: IM |
Affiliation:
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Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA. bward15@jhmi.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Audiometry, Pure-Tone Auditory Threshold / physiology Bone Conduction / physiology Cranial Fossa, Middle / surgery* Data Interpretation, Statistical Ear Diseases / surgery Female Follow-Up Studies Hearing / physiology* Hearing Loss, Sensorineural / surgery Humans Male Middle Aged Otologic Surgical Procedures / methods* Semicircular Canals / surgery* Speech Perception Surgery, Computer-Assisted Surgical Instruments Tomography, X-Ray Computed Treatment Outcome Vestibular Function Tests |
| Grant Support | |
ID/Acronym/Agency:
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T32 DC000027/DC/NIDCD NIH HHS; T32DC000027-22/DC/NIDCD NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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