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round window reinforcement

Herbert Silverstein, Rosemary Ojo, Julie Daugherty, Ronen Nazarian, Jack Wazen
OBJECTIVE: To evaluate the efficacy of a minimally invasive surgical procedure in patients with severe hyperacusis. STUDY DESIGN: Prospective, longitudinal design. SETTING: Tertiary referral center. PATIENTS: Adult patients with history of severe hyperacusis. INTERVENTION: Using a transcanal approach, the round and oval window was reinforced with temporalis fascia or tragal perichondrium in six subjects (nine ears) and was subdivided into two groups (unilateral or bilateral reinforcement procedure)...
September 23, 2016: Otology & Neurotology
Annekatrin Coordes, Linda Jahreiss, Uwe Sch├Ânfeld, Minoo Lenarz
After stapes surgery, patients with mixed or moderate hearing loss have limited possibilities for hearing improvement. We are reporting on a patient who underwent stapedotomy bilaterally 20 years ago and had sensorineural and mixed hearing loss. Recurrent otitis externa prevented the use of hearing aids. This patient was treated bilaterally with the Vibrant Soundbridge (Med-El, Innsbruck, Austria) successively. The Schuknecht piston stapes prostheses remained in situ. The Floating Mass Transducer (FMT; Med-El) was coupled to the round window (RW) and provided good acoustic reinforcement bilaterally...
June 27, 2016: Laryngoscope
Inge Wegner, Mostafa M A S Eldaebes, Thomas G Landry, Robert B Adamson, Wilko Grolman, Manohar L Bance
HYPOTHESIS: Round window reinforcement leads to conductive hearing loss. BACKGROUND: The round window is stiffened surgically as therapy for various conditions, including perilymphatic fistula and superior semicircular canal dehiscence. Round window reinforcement reduces symptoms in these patients. However, it also reduces fluid displacement in the cochlea and might therefore increase conductive hearing loss. METHODS: Perichondrium was applied to the round window membrane in nine fresh-frozen, nonpathologic temporal bones...
June 2016: Otology & Neurotology
P Ashley Wackym, Carey D Balaban, Heather T Mackay, Scott J Wood, Christopher J Lundell, Dale M Carter, David A Siker
OBJECTIVE: Patients with peripheral vestibular dysfunction because of gravitational receptor asymmetries display signs of cognitive dysfunction and are assumed to have neurobehavioral sequelae. This was tested with pre- and postoperatively quantitative measurements in three cohort groups with superior semicircular canal dehiscence syndrome (SSCDS) symptoms with: 1) superior canal dehiscence (SCD) repaired via a middle cranial fossa craniotomy and canal plugging only; 2) otic capsule defects not visualized with imaging (no-iOCD) repaired with round window reinforcement (RWR) only; or 3) both SCD plugging and subsequent development of no-iOCD followed by RWR...
January 2016: Otology & Neurotology
P Ashley Wackym, Scott J Wood, David A Siker, Dale M Carter
We conducted a prospective longitudinal study of two cohorts of patients who had superior semicircular canal dehiscence syndrome (SSCDS); one group had radiographically confirmed superior canal dehiscence (SCD), and the other exhibited no identified otic capsule dehiscence on imaging (no-iOCD). We compiled data obtained from prospective structured symptomatology interviews; diagnostic studies; three-dimensional, high-resolution, temporal bone computed tomography; and a retrospective case review from our tertiary care referral center...
August 2015: Ear, Nose, & Throat Journal
Herbert Silverstein, Yi-Hsuan Emmy Wu, Suzannah Hagan
PURPOSE: To present the outcomes of two patients (three ears) with hyperacusis treated with round and oval window reinforcement. MATERIALS AND METHODS: Transcanal placement of temporalis fascia on the round window membrane and stapes footplate was performed. Loudness discomfort level testing was performed. Results of pre and post-operative hyperacusis questionnaires and audiometric testing were reviewed. RESULTS: Two patients (three ears) underwent surgery...
March 2015: American Journal of Otolaryngology
Robert Mlynski, Ernst Dalhoff, Andreas Heyd, Daniela Wildenstein, Rudolf Hagen, Anthony W Gummer, Sebastian P Schraven
OBJECTIVES: The active middle ear implant Vibrant Soundbridge® was originally designed to treat mild-to-severe sensorineural hearing losses. The floating mass transducer (FMT) is crimped onto the long incus process. The procedure is termed incus vibroplasty to distinguish from other attachment sites or stimulus modi for treating conductive and mixed hearing losses. Rare but possible complications are difficult incus anatomy, necrosis of the long incus process, secondary detachment, and loosening of the FMT with concomitant amplification loss...
January 2015: Ear and Hearing
Herbert Silverstein, Jack M Kartush, Lorne S Parnes, Dennis S Poe, Seilesh C Babu, Mark J Levenson, Jack Wazen, Ryan W Ridley
PURPOSE: To evaluate the outcome of round window (RW) tissue reinforcement in the management of superior semicircular canal dehiscence (SSCD). MATERIALS AND METHODS: Twenty-two patients with confirmed diagnosis of SSCD by clinical presentation, imaging, and/or testing were included in the study. Six surgeons at four institutions conducted a multicenter chart review of patients treated for symptomatic superior canal dehiscence using RW tissue reinforcement or complete RW occlusion...
May 2014: American Journal of Otolaryngology
Bor-Rong Huang, Chih-Hung Wang, Yi-Ho Young
OBJECTIVE: The aim of this study was to present our experience on facing the dehiscent high jugular bulb (HJB) during middle ear surgery in the past 2 decades. STUDY DESIGN: Retrospective review. SETTING: Secondary referral hospital. PATIENTS: From January 1982 to June 2002, consecutive 1,657 patients underwent surgical intervention for middle ear cleft diseases, a total of 1,857 operations. Of them, 10 ears (0.5%) in nine patients were proven to have dehiscent HJB during operation for adhesive otitis media in four ears and for chronic otitis media with cholesteatoma in six ears...
October 2006: Otology & Neurotology
Kelly Carney Harris, Eric Bielefeld, Bo Hua Hu, Donald Henderson
Conditioning is the phenomenon where exposure to moderate-level acoustic stimuli can increase the ear's resistance to subsequent more intense sound exposures. In recent years, research has shown that conditioning increases the availability of antioxidant enzymes which presumably protects the ear from oxidative stress induced by a traumatic noise exposure [Jacono, A.A., Hu, B., Kopke, R.D., Henderson, D., Van De Water, T.R., Steinman, H.M., 1998. Changes in cochlear antioxidant enzyme activity after sound conditioning and noise exposure in the chinchilla...
March 2006: Hearing Research
M Sone
Pathology of a round window membrane rupture was demonstrated in a human temporal bone from a case in which labyrinthotomy had been performed through the round window membrane. Proliferation of mesothelial cells was seen in the inner layer of the membrane, and it appeared to be reinforced from the inside by these reactive cells. The middle layer of the membrane was thickened by increased collagen and elastin. The pathologic changes which take place during healing of the ruptured round window membrane are discussed...
January 1998: ORL; Journal for Oto-rhino-laryngology and its related Specialties
S N Merchant, M E Ravicz, J J Rosowski
In a type IV tympanoplasty, the stapes footplate is directly exposed to incoming sound while the round window is "shielded," usually with a fascia graft. Postoperative hearing results are quite variable, with air-bone gaps ranging from 10 to 60 dB. A cadaveric human temporal bone preparation was developed to investigate the middle ear mechanics of this operation to identify causes of variable results and to test predictions of a recently described theoretic model of type IV tympanoplasty. The ear canal, tympanic membrane, malleus, and incus were removed so as to expose the stapes and round window to the sound stimulus...
January 1997: Annals of Otology, Rhinology, and Laryngology
S N Merchant, J J Rosowski, M E Ravicz
Type IV and type V tympanoplasty operations are simple, robust, and well-established techniques to reconstruct middle ears that have been severely altered by chronic otitis media. In a previous paper, the authors developed a simple four-block physiologic model to describe hearing results after these procedures. This paper presents a comparison of model predictions to hearing results obtained from a detailed retrospective clinical review of 30 type IV and type V procedures. Audiograms predicted by the model and those observed clinically show good agreement over a wide frequency range (500-4000 Hz) and for many different clinical conditions...
September 1995: American Journal of Otology
M Zrunek, K Burian
Insertion of intracochlear electrodes may damage the basilar membrane, the stria vascularis and adjacent structures. When electrodes were placed in human temporal bone specimens, perforations were shown to be independent of the type of implant used, the depth of insertion or the use of a lubricating agent. Helical electrode reinforcements and failure to enlarge the round window frame increase the risk of damage. Perforations are invariably localized at a distance of about 7-14 mm from the round window and occur at the site where the curvature of the basal turn is greatest...
1985: Archives of Oto-rhino-laryngology
B W Anderson, L C Oatman
Four cats, classically conditioned to a flashing light paired with food reinforcement, were tested for amplitude changes of click-evoked potentials during increasing hours of deprivation. Signal averaged evoked potentials from the auditory cortex, cochlear nucleus, and round window electrodes showed no significant changes in amplitude, but significant changes were found in the variance as food deprivation increased. Such changes are more consistent with expected changes in the CNS than the amplitude changes of the auditory cortex found by Saunders and Chabora...
November 1976: Journal of Psychology
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