Document Detail


Hearing outcomes after surgical plugging of the superior semicircular canal by a middle cranial fossa approach.
MedLine Citation:
PMID:  22935810     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
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:
Created Date:  2012-09-13     Completed Date:  2013-02-01     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1386-91     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA. bward15@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
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:
T32 DC000027/DC/NIDCD NIH HHS; T32DC000027-22/DC/NIDCD NIH HHS
Comments/Corrections

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