Cases reported "Hearing Loss, Sudden"

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1/11. Sensorineural hearing loss as the result of cliff jumping.

    A case of unilateral, sudden sensorineural hearing loss and possible perilymphatic fistula as the result of cliff jumping into water is presented. The physiological mechanisms contributing to such a barotraumatic auditory injury are described. A conservative treatment protocol is reviewed as well as documented hearing recovery.
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keywords = perilymphatic
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2/11. Sudden hearing loss due to large vestibular aqueduct syndrome in a child: should exploratory tympanotomy be performed?

    A 16-year-old girl applied to our ENT clinic with a 3-day history of right hearing loss, tinnitus, and pressure in the right ear. She had had surgery for right perilymph fistula two times, one at the age of 7 and the second at the age of 9. She had recovered after both of these surgeries. This time she had exploratory tympanotomy and perylymh fistula was detected. Computerized tomography investigation obtained after 5 days postoperatively showed bilateral large vestibular aqueducts and otherwise normal inner ear structures. thyroid function tests and neck palpation were normal. It was an unusual case with both large vestibular aqueduct syndrome (LVAS) and simultaneous spontaneous perilymph fistula.
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keywords = aqueduct
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3/11. pathology and pathophysiology of idiopathic sudden sensorineural hearing loss.

    BACKGROUND: The cause and pathogenesis of idiopathic sudden sensorineural hearing loss remain unknown. Proposed theories include vascular occlusion, membrane breaks, and viral cochleitis. AIMS: To describe the temporal bone histopathology in 17 ears (aged 45-94 yr) with idiopathic sudden sensorineural hearing loss in our temporal bone collection and to discuss the implications of the histopathologic findings with respect to the pathophysiology of idiopathic sudden sensorineural hearing loss. methods: Standard light microscopy using hematoxylin and eosin-stained sections was used to assess the otologic abnormalities. RESULTS: Hearing had recovered in two ears and no histologic correlates were found for the hearing loss in both ears. In the remaining 15 ears, the predominant abnormalities were as follows: 1) loss of hair cells and supporting cells of the organ of corti (with or without atrophy of the tectorial membrane, stria vascularis, spiral limbus, and cochlear neurons) (13 ears); 2) loss of the tectorial membrane, supporting cells, and stria vascularis (1 ear); and 3) loss of cochlear neurons only (1 ear). Evidence of a possible vascular cause for the idiopathic sudden sensorineural hearing loss was observed in only one ear. No membrane breaks were observed in any ear. Only 1 of the 17 temporal bones was acquired acutely during idiopathic sudden sensorineural hearing loss, and this ear did not demonstrate any leukocytic invasion, hypervascularity, or hemorrhage within the labyrinth, as might be expected with a viral cochleitis. DISCUSSION: The temporal bone findings do not support the concept of membrane breaks, perilymphatic fistulae, or vascular occlusion as common causes for idiopathic sudden sensorineural hearing loss. The finding in our one case acquired acutely during idiopathic sudden sensorineural hearing loss as well as other clinical and experimental observations do not strongly support the theory of viral cochleitis. CONCLUSION: We put forth the hypothesis that idiopathic sudden sensorineural hearing loss may be the result of pathologic activation of cellular stress pathways involving nuclear factor-kappaB within the cochlea.
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keywords = perilymphatic
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4/11. Considerations for cochlear implantation of children with sudden, fluctuating hearing loss.

    The histories of two pediatric patients who received cochlear implants with subsequent partial recovery of hearing in the nonimplanted ear are reviewed. One child had a sudden bilateral hearing loss, presumably secondary to autoimmune ear disease. The other child had a bilateral progressive hearing loss diagnosed as large vestibular aqueduct syndrome (LVAS). The rationale for the timing of the surgical implantation is discussed. Retrospectively, recovery of hearing in the nonimplanted ear suggests the possibility that the implant could have been delayed or eliminated as a treatment option, and that wearable hearing aids may have been appropriate. A number of factors, however, suggest the decision to implant was appropriate. Issues involved in the decision-making process of when to implant are presented and discussed.
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ranking = 0.057201495910848
keywords = aqueduct
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5/11. Perilymphatic hypertension.

    A syndrome termed perilymphatic hypertension is described as being seen in a small subset of patients with sudden sensorineural hearing loss. A patent or semipatent cochlear aqueduct or modiolus are considered precursors to this condition. Perilymphatic hypertension is believed to predispose to perilymphatic fistula, which may be part of the process of resolution. The pathogenesis for perilymphatic hypertension and fistula are hypothesized and discussed. Treatment for this subset of patients consisted of paracentesis of the round window membrane followed by grafting, with improvement of hearing in certain patients. In no instance did hearing subsequently decrease.
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ranking = 3.0572014959108
keywords = perilymphatic, aqueduct
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6/11. temporal bone findings in a case of sudden deafness and relapsing polychondritis.

    light microscopic examination was made of the right temporal bone from a 57-year-old female who developed sudden total hearing loss in both ears 1 year before death. The patient had suffered from relapsing polychondritis for 1 1/2 years prior to death. Pathological changes were compatible with known viral endolymphatic labyrinthritis. Slight ossification and fibrous tissue proliferation in the perilymphatic space seem to have been caused by a spread of infection from the middle ear. Susceptibility to viral infection in the labyrinth in patients with a long-devastating illness is discussed.
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keywords = perilymphatic
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7/11. Sudden deafness and vertigo due to inner ear hemorrhage--a temporal bone case report.

    A case of sudden deafness with vertigo shortly before death is reported in a patient with disseminated adenocarcinoma of the breast. Examination of the temporal bones revealed extensive perilymphatic hemorrhage as the probable cause of the deafness. The pathophysiology of deafness due to inner ear hemorrhage is discussed.
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ranking = 1
keywords = perilymphatic
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8/11. The progression of hearing loss in the early stages of sudden deafness.

    The pathogenesis of sudden deafness is still not known. Therefore, to clarify its pathophysiology, it is important to know whether the progression of hearing loss occurs in the early stage of sudden deafness. The subjects were 11 patients with sudden deafness showing the progression of hearing loss by pure tone audiometry after the onset of the initial attack of hearing loss. The progression of hearing loss was mostly observed within 4-7 days after the onset of the initial attack. Average hearing loss in initial audiometry was severe and the recovery was poor in the majority of cases. An exploratory tympanotomy was performed in five cases and revealed one case of perilymphatic leak from the round window and another case of suspected round-window membrane rupture. As far as the causes of the progression of hearing loss in the early stage of sudden deafness are concerned, the following could be considered (1) aggravation of viral labyrinthitis, (2) aggravation of the vascular lesion of the inner ear, and (3) rupture of the membranous labyrinth of window(s).
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ranking = 1
keywords = perilymphatic
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9/11. The round window in acute hearing loss.

    Sensorineural hearing loss has various etiologies. One of them is perilymphatic fistula, which is observed in (1) congenital malformation of the internal ear in children: (2) after operations on the oval window (stapedectomy, interposition); (3) in cases of head trauma, and (4) in acute hearing loss of unknown origin. The authors report 5 of 19 cases of acute hearing loss observed at the ORL Clinic in Krakow and operated on by exploratory tympanotomy. In 4 of them, rupture of the round window membrane (secondary tympanic membrane) was found. A hypothesis for the rupture mechanism is presented.
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ranking = 1
keywords = perilymphatic
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10/11. Endoscopic diagnosis of idiopathic perilymphatic fistula.

    The usefulness of endoscopic examination for the diagnosis of idiopathic perilymphatic fistula (IPLF) was investigated. Eight patients presenting with unilateral sensorineural hearing loss and vertigo underwent endoscopic examination by the transtubal or transtympanic approach. In 5 out of the 8 patients, transtubal endoscopy was carried out using a superfine flexible endoscope. With this approach, no abnormal findings were visualized. A perilymphatic leak from the round window was observed in 2 patients by means of transtympanic examination using a needle scope. These findings were confirmed in both patients by microscopic observation during tympanotomy. In one patient who was finally diagnosed with IPLF, the transtympanic endoscopy failed to detect perilymphatic leakage. Although incision of the tympanic membrane is necessary for the examination, transtympanic endoscopy is useful for the diagnosis of IPLF. Further improvement of the superfine flexible fiberscope is necessary before transtubal observation of the tympanic cavity can be effectively conducted.
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ranking = 7
keywords = perilymphatic
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