"Value of Tympanoscopy in the Treatment of Sudden Sensorineural Hearing Loss - A Study in Patients of the Department of Otorhinolaryngology, Head and Neck Surgery at the Carl-Thiem Clinics in Cottbus"

Abstract

In 59 patients (40 men; 19 women) who suffered from an acute sudden unilateral deafness caused by a functional lesion of the hair cells in the cochlea and who didn`t show a recovery of hearing by applying a conservative treatment (using corticosteroids and pentoxifyllin) or who reported about signs indicating a perilymph fistula a tympanoscopy and obliteration of the round and oval window with autologous tissue was done. The average age of the patients was 62 years. A significant relative hearing gain (26,4%) in patients having passed the tympanoscopy could be documented. It has been shown that the amount of hearing improvement after tympanoscopy was not related to the hearing disability existing before that therapy. Many factors such as sex, age of the patients, other ear diseases in the past, the attempt of an ambulant therapy of the present hearing impairment before entering the hospital, dizziness and an anamneses indicating a perilymph fistula didn't show any statistical relevant relation to the amount of recovery of hearing measured after having done the operation. Nevertheless the hearing recovery of patients who reported about dizziness was 15% less than that of the patients without any vertigo. Patients in which tympanosplasty has been performed more than 10 days after entering the hospital still had good chances for a recovery of their hearing. The existence of a perilymph fistula proven by tympansocopy could not reliable be predicted by the anamneses of the patients, the simultaneous presence of dizziness besides the hearing loss or a total deafness from the far beginning of the disease. The data of patients who suffered from total or nearly total deafness (>75%) on the one side and those with a much lower degree of hearing impairment (<25%) on the other side have been compared. The same was done with patients with and those without dizziness. In all of these cases there could not be found significant differences concerning the rate of pathological clinical findings or the anemnestic reports of the patients indicating a perilymphatic fistula . A meta - analysis of data from literature collected from patients with a tympanoscopy performed for the same indication as in our study has been done. It included 576 patients published in 10 articles. The rate of recovery or bettering of hearing was 41% in our study compared to 49% in literature. On the other side the rate of complications following the surgical procedure was 3% in our study compared to 13% in literature. Concerning the anamnestic data and pathological findings there could not be found remarkable differences between the population of our study and those published elsewhere. Related to the the same indication tympanoscopy and obliteration of the round and oval windows seems also to be a considerable „salvage therapy“ compared to instillation of corticosteroids into the middle earwhich often are done in hospitals in cases of sudden deafness or unsufficient recovery of hearing following a conservative way of treatment.%%%%Bei 59…