Document Detail


Treatment of traumatic stapediovestibular luxation: case report with the introduction of a new technique and review of literature.
MedLine Citation:
PMID:  24622014     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: Stapediovestibular luxations are rare lesions that are most commonly caused by direct, penetrating trauma to the external ear canal. In this type of ossicular dislocation, disruption of the annular ligament or footplate fracture may lead to a perilymphatic fistula (PLF) presenting with cochleovestibular symptoms including (progressive) sensorineural hearing loss, tinnitus, and vestibular symptoms. The objective of this article is to define the optimal treatment of stapediovestibular luxations and review the literature on this topic.
PATIENT: We present a case of internal stapediovestibular dislocation and pneumolabyrinth after penetrating trauma with predominantly conductive hearing loss and incapacitating vertigo.
INTERVENTION: Middle ear inspection with removal of the luxated incus, repositioning of the stapes with a "stapedial strut" and closure of the tympanic membrane.
MAIN OUTCOME MEASURES: Hearing outcome and vestibular symptoms of this patient are presented, and all comparable cases in the literature are reviewed.
RESULTS: Complete resolution of the vestibular symptoms and stabilization of the bone conduction thresholds.
CONCLUSION: In patients with pneumolabyrinth after middle ear trauma with mild symptoms, we recommend initial conservative treatment with close monitoring of hearing. In patients with severe, persisting, or progressive vestibulocochlear symptoms, exploratory tympanotomy should be performed to check for and treat PLF. Oval window fistula repair is reported to have variable hearing outcomes but offers complete resolution of vestibular symptoms in most cases. The stapedial strut is one of the possible surgical techniques in case of an internally luxated stapes.
Authors:
Marie Bogaerts; Jérôme Waterval; Joost van Dinther; Thomas Somers; Andrzej Zarowski; Frans Erwin Offeciers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  35     ISSN:  1537-4505     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-03-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  582-8     Citation Subset:  IM    
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