1/26. Fenestration surgery for otosclerosis: CT findings of an old surgical procedure.Numerous attempts to deal surgically with otosclerosis were made before the current method of stapedectomy with stapes prosthesis was established. We report a case with unique CT findings of a patient who underwent fenestration surgery for otosclerosis in the early 1940s. Recognition of this old surgical procedure on the imaging scans may avoid misdiagnosis of labyrinthine fistulae or middle and inner ear malformations.- - - - - - - - - - ranking = 1keywords = labyrinth, inner ear, inner (Clic here for more details about this article) |
2/26. meningitis following stapedotomy: a rare and early complication.Controversy exists concerning stapedotomy for patients with small unilateral air-bone gaps. Surgical treatment of otosclerosis involves an opening to the labyrinth and accordingly, a risk of complications, usually vertigo and sensorineural hearing loss and infrequently anacusis. In this paper we present a 33-year-old woman with a small unilateral air-bone gap, who developed bacterial labyrinthitis with meningitis and anacusis three days after stapes surgery. The patient had a stapedotomy with the small fenestra piston prosthesis technique. Due to the potential for serious complications, patients with unilateral otosclerosis and mild hearing loss should be given the possibility to choose between a hearing aid and surgery. Although stapedotomy in the vast majority of interventions is a highly successful procedure and the best method of treatment for otosclerosis if successful, there is a high price to pay in the event of failure.- - - - - - - - - - ranking = 1.2489310684136keywords = labyrinth (Clic here for more details about this article) |
3/26. MRI of cochlear otosclerosis.Cochlear otosclerosis is an uncommon cause of mixed and sensorineural hearing loss. This has a characteristic appearance on CT, producing a distinctive pericochlear hypodense double ring. However, its appearance on MRI is not as readily appreciated, producing a ring of intermediate signal in the pericochlear and perilabyrinthine regions on T(1) weighted images, demonstrating mild to moderate enhancement after gadolinium administration. Increased signal on T(2) weighted images may also be seen. Recognition of these MRI features is important as MRI may be the first modality of investigation, especially when patients present with symptoms indicative of sensorineural hearing loss. We review four patients who presented with sensoineural hearing loss, and who were imaged with MRI as the first line of investigation.- - - - - - - - - - ranking = 0.62446553420681keywords = labyrinth (Clic here for more details about this article) |
4/26. magnetic resonance imaging and high-resolution computed tomography in the otospongiotic phase of otosclerosis.otosclerosis very often leads to severe hearing loss in a chronic progressive manner. In the first phase of the disease, otospongiosis causes an inflammatory osteolytic process in the osseous labyrinthine capsule. In the cases reported here, this osteolytic process was pronounced in the osseous capsule of the cochlea. High-resolution CT and MRI showed the precise localization and stage of this inflammatory-osteolytic process in the petrous bone, while scintigraphy confirmed the diagnosis.- - - - - - - - - - ranking = 0.62446553420681keywords = labyrinth (Clic here for more details about this article) |
5/26. Perilymphatic gusher in stapedectomy: demonstration of a fistula of internal auditory canal.Gusher is a very rare phenomenon, generally associated with congenital stapes fixation or otosclerosis in adult age, that may present during stapedectomy. A sudden perilymph flow occurs following platinotomy, due to congenital malformation (abnormally wide cochlear aqueduct or internal auditory canal fistula), that causes an abnormal connection between subarachnoid and perilymphatic spaces. This report deals with a case of bilateral gusher, occurring during stapedectomy, caused by an osseous fistula between bottom of internal auditory canal and the osseous labyrinth later observed at computed tomography scan. The usefulness of a radiologic examination is stressed for a correct therapeutic approach in the even contralateral ear stapedectomy.- - - - - - - - - - ranking = 0.62446553420681keywords = labyrinth (Clic here for more details about this article) |
6/26. The unilateral stapes gusher.A stapes gusher is an alarming situation occurring during stapes surgery for mixed hearing loss. It is characterized by the sudden profuse flow of cerebrospinal fluid in the middle ear and external ear canal after opening the vestibule of the inner ear. An adult patient with unilateral stapes gusher is described; he was operated on both ears with a good hearing result on both sides. The stapes on the side with the cerebrospinal fluid leak was malformed, especially in the posterior crus--a finding which may suggest the possibility of a stapes gusher. The small-hole stapedotomy is a safe technique when dealing with a profuse cerebrospinal fluid leak, and it enables the closure of the leak with additional tamponade of the oval niche and the achievement of a good hearing result.- - - - - - - - - - ranking = 0.37553446579319keywords = inner ear, inner (Clic here for more details about this article) |
7/26. temporal bone histopathology of a patient with a nucleus 22-channel cochlear implant.The temporal bone histopathology of a patient with profound sensorineural hearing loss attributable to cochlear otosclerosis is presented. The patient had a Nucleus 22-channel cochlear prosthesis implanted in the right ear prior to his demise. Unintentional scala media insertion of the electrode array resulted from labyrinthitis ossificans obliteration of the scala tympani. Inadvertent facial nerve stimulation necessitated program exclusion of electrodes 11 to 16 located in proximity to the labyrinthine and geniculate segments of the facial nerve. The patient received significant benefit from use of the device. The histopathologic findings are correlated with psychophysical and speech perception results.- - - - - - - - - - ranking = 1.2489310684136keywords = labyrinth (Clic here for more details about this article) |
8/26. Mondini-like malformation mimicking otosclerosis and superior semicircular canal dehiscence.In 2003, it was reported that superior semicircular canal dehiscence can mimic otosclerosis because of low-frequency bone conduction hearing gain and dissipation of air-conducted acoustic energy through the dehiscence. We report the case of a 17-year-old girl with left-sided combined hearing loss thought to be due to otosclerosis. bone conduction thresholds were -10 dB at 250 and 500 Hz and she had a 40 dB air-bone gap at 250 Hz. When a tuning fork was placed at her ankle she heard it in her left ear. Acoustic reflexes and vestibular evoked myogenic potentials could be elicited bilaterally. Imaging of the temporal bones showed no otosclerosis, superior semicircular canal dehiscence or large vestibular aqueduct, but a left-sided, Mondini-like dysplasia of the cochlea with a modiolar deficiency could be seen. Mondini-like cochlear dysplasia should be added to the causes of inner-ear conductive hearing loss.- - - - - - - - - - ranking = 0.010840785375788keywords = inner (Clic here for more details about this article) |
9/26. Radiographically confirmed cochlear otospongiosis among the Chinese.A high-resolution computed tomography (HRCT) study on 55 patients with surgically confirmed clinical otosclerosis confirms the existence of cochlear otospongiosis among the Chinese. Positive radiographic results of cochlear otospongiosis (13 ears, 12%) were found in patients with mixed-type deafness but in none with conductive hearing loss. Although there is a positive correlation between audiologic and radiographic findings, the HRCT results showed a lower positive rate and less severity than anticipated from the audiologic results. However, compared with the occurrence and extension of radiographic findings in similar studies of white people, it would seem to support our previous contention that the disease is indeed milder in Chinese people. Cochlear otospongiosis with extensive labyrinthine demineralization was found in three young patients with rapidly progressive hearing loss. This is important evidence of the overlooked fact that cochlear otospongiosis may also be one of the causes of sensorineural hearing loss in the Chinese. Thus, a high index of suspicion of the existence of this inner ear disorder is of paramount importance, and in such cases an HRCT study should be performed and sodium fluoride given to prevent further hearing deterioration.- - - - - - - - - - ranking = 1keywords = labyrinth, inner ear, inner (Clic here for more details about this article) |
10/26. KTP laser stapedotomy: is it safe?Recent published concerns about the potential for visible light lasers to injure the inner ear have led to differing conclusions. While one has advised cautious application of a visible light laser, another eschewed visible light lasers in favor of the CO2 laser. Others have anguished over the efficacy of stapes surgeons as numbers of suitable candidates for otosclerosis surgery decline. In three years' experience with the KTP-532 laser, 80 primary and revision stapedotomies have been completed by this author. The author's experience with low morbidity and high air-bone gap closure rates are presented. The absence of apparent cochlear injury suggests that properly used KTP laser systems are safe. Competitive results were obtained with less than prolific numbers of stapes surgeries.- - - - - - - - - - ranking = 0.37553446579319keywords = inner ear, inner (Clic here for more details about this article) |
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