Cases Of Conductive Hearing Loss Research Articles

Sudden Hearing Loss before, during, and after the Pandemic: Investigating COVID-19 Illness and Vaccine-Related Symptoms.

Accumulating reports suggest an increase in sudden sensorineural hearing loss during the COVID-19 pandemic and vaccination periods. However, clear evidence is lacking. The goal of this study was to determine if sudden sensorineural hearing loss is associated with COVID-19 illness or its vaccine. Retrospective chart review of 50 randomly selected patients from three, 6-month time periods: "pre-pandemic," "early pandemic," and "late pandemic." Group comparisons were performed for demographics, comorbid conditions, audiologic history, audiometric data, speech reception thresholds, and word recognition. One hundred 50 patients were included in this study. A mean difference was observed in that the relative percentage of sensorineural hearing loss (SNHL) cases increased over time, corresponding to a relative decrease in conductive hearing loss cases. However, this change was not explained by proportional changes in sudden SNHL. Patients in the early pandemic time period were more likely to report tinnitus. Otherwise, the patient groups did not differ on demographic variables, hearing health history, hearing loss presentation, pure tone averages, speech reception thresholds, or word recognition performance. Proportion of patients with sudden sensorineural hearing loss did not change over time from the pre-pandemic period to the early or late pandemic phases. Despite a randomized sample, these findings do not support the hypothesis that COVID-19 illness or vaccine is associated with sudden sensorineural hearing loss.

Adhear for hearing rehabilitation for a rare case of conductive hearing loss

Adhear for hearing rehabilitation for a rare case of conductive hearing loss

A Large Vestibular Aqueduct With Conductive Hearing Loss as the Only Manifestation.

Conductive hearing loss is a common clinical condition caused by disorders of the middle and external ear. Here, we report a case of conductive hearing loss with complete tympanic membranes. Clinical examinations revealed no external and middle ear lesions, but high-resolution temporal bone computed tomography revealed enlarged vestibular aqueducts. Detailed audiological tests and follow-up results indicate that the exclusive air-bone gap is the outcome of inner ear malformation but not middle ear lesions, preventing the need for tympanic assessment.

Análise de um programa de identificação e intervenção da perda auditiva nos primeiros anos de vida na atenção primária

ABSTRACT Purpose: to analyze the implementation and effectiveness of a hearing loss identification and intervention program in the first years of life in primary care. Methods: an experimental study carried out in two Basic Health Units. Twenty-three Community Health Workers participated, trained through an online self-instructional course from the Ministry of Health. Subsequently, they followed the hearing and language of children from zero to two years old, referring them, if necessary, to audiological evaluation. For the analysis of pre and post online course knowledge, the Wilcoxon test was applied, and to compare the performance between the participants of the two Basic Health Units, the Mann Whitney test was used, adopting p<0.05. Additionally, the qualitative perception of participating community workers, the referrals, and the result of the audiological evaluation were analyzed. Results: the online course was effective in improving the knowledge of the participants. A total of 102 children were monitored, 15 of them were referred for evaluation. From these, four underwent hearing screening and 11 underwent a complete hearing assessment, a case of conductive hearing loss being identified. Conclusion: the implementation of a program for the identification and intervention of hearing loss, in the first years of life, in primary care, permeated by community health workers, is feasible.

The Accuracy of Sensorineural Acuity Level Test in Predicting Bone Conduction Thresholds in Unilateral Hearing Loss Cases

The sensorineural acuity level (SAL) test is useful to determine the type of hearing loss if overmasking occurs in pure-tone audiometry (PTA) testing. In this article, we report two unilateral hearing loss cases to highlight the accuracy of the SAL test in predicting bone conduction (BC) thresholds in unilateral hearing loss cases, as well as the importance of using the appropriate SAL normative data. As found, the estimated BC thresholds (provided by the SAL test) were in good agreement with the actual BC thresholds (from the PTA) (i.e. within ± 5 dB) for both sensorineural hearing loss and conductive hearing loss cases. The accuracy of the SAL test is adequate to support the PTA results. Implementing inappropriate normative data may result in the misdiagnosis of the type of hearing loss.

The Absence of Permanent Sensorineural Hearing Loss in a Cohort of Children with SARS-CoV-2 Infection and the Importance of Performing the Audiological "Work-Up".

Currently, the novel coronavirus (SARS-CoV-2) causes an acute respiratory illness named COVID-19 and is a controversial risk factor for hearing loss (HL). Herein, we aim to describe the associated symptoms and to evaluate hearing function in the COVID-19 pediatric population. A retrospective cross-sectional observational study was carried out on 37 children who contracted COVID-19 infection with no previous audio-vestibular disorders. Clinical data on the infections were collected, and an audiological assessment of all affected children was performed by using different diagnostic protocols according to their age. Fever, upper respiratory and gastrointestinal manifestations were common presentations of infection. Audiological function was normal in 30 (81.08%) children, while 7 children showed an increased hearing threshold: 6 (16.21%) had transient conductive hearing loss (CHL) due to middle ear effusion and normalized at the follow-up and 1 had sensorineural hearing loss (SNHL). A single child was affected by bilateral SNHL (2.7%); however, he underwent a complete audiological work-up leading to a diagnosis of genetic HL due to a MYO6 gene mutation which is causative of progressive or late onset SNHL. HL needs to be considered among the manifestations of COVID-19 in children, nevertheless, we found cases of transient CHL. The onset of HL during or following COVID-19 infection does not eliminate the indication for maintaining audiological surveillance and audiological work-ups, including genetic diagnosis, to avoid the risk of mistaking other causes of HL.

Unfavourable prognostic factors in patients treated surgically for otosclerosis

Backgrounds: Otosclerosis is the cause of between 5% and 9% of all deafness cases and between 18% and 22% of conductive hearing loss cases. Neurosensory deafness develops in 30% of patients with otosclerosis.Aims/Objectives: The aim was to seek a correlation that would reflect the dependence of the results of middle ear surgery on the type of abnormalities atypical of otosclerosis but found during the stapedotomy surgery.Materials and Methods: The analysis included 140 patients who underwent surgery for otosclerosis. The hearing of all patients was assessed using an audiometric test.Results: In the assessment of changes in the mean bone conduction values, statistically significant differences between the reference group and the subgroup of patients on whom a myringoplasty was performed, as well as in patients with adhesions present in the middle ear spaces, were found only for the 500 Hz frequency.Conclusion and Significance: The removal of abnormalities, such as the loss of the eardrum (iatrogenic), changes to the lining and adhesions other than those typical of otosclerosis, restores middle ear mechanics after a stapedotomy on the inner ear and leads to a measurable improvement in mean bone conduction values.

A multi-center retrospective study of ossiculoplasty surgery under oto-endoscope in 45 cases of conductive hearing loss with intact tympanic membrane

Objective: To explore the efficacy of ossiculoplasty surgery under oto-endoscope in patients of conductive hearing loss with intact tympanic membrane. Methods: A retrospective study was conducted. The clinical data of 45 patients with conductive hearing loss who had undergone simple ossiculoplasty surgery between October 2015 and December 2017 from five hospitals in China (West China Hospital of Sichuan University, General Hospital of the People's Liberation Army, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Xijing Hospital, Fourth Military Medical University and Shenzhen Sixth People's Hospital) were collected. There were 28 males and 17 females, with the age ranging from 12 to 69 years old. The tympanic membranes of those patients were intact before surgery. The lesion only occurred in the ossicular chain from CT and intraoperative exploration. The cases of otosclerosis, tympanosclerosis, cholesteatoma of middle ear, chronic suppurative otitis media, and tumor of middle ear were excluded. The postoperative complications, hearing improvements and operation time were observed. SPSS 23.0 software was used for statistic analysis. Results: There was neither sensorineural hearing loss nor facial paralysis after surgery in this group. Seven patients had transient mild tinnitus after surgery and gradually relieved during the follow-up period. Nine patients developed dysgeusia after surgery. Two patients developed dizziness after surgery, and the symptoms were mild and relieved during 1 week without special intervention. The air-bone gap (ABG) range of pre-operation was 22.5-45.7 dB, and the average ABG was (25.3±8.6) dB. The ABG range in the third month after surgery was 5.7-26.8 dB, and the average ABG was (9.3±8.6) dB. The mean value of ABG was significantly lower in the third month after surgery compared with that of pre-operation (t=2.31, P<0.05). The operation time of the surgeons in each research center was similar. The overall average of operation time was (43.56±18.25) min. There was no significant difference in the duration of operation between the centers (F=3.26, P>0.05). Conclusion: The ossiculoplasty surgery under oto-endoscope has good efficacy.

Conductive hearing loss in chronic inflammatory demyelinating polyneuropathy (CIDP): A case report

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a progressive autoimmune disorder that targets peripheral nerves. It commonly presents with motor-predominant dysfunction and enlargement of cranial nerves. With regards to hearing loss, a few cases of sensorineural loss have been described. We present a novel case of conductive hearing loss caused by a mass on the tympanic segment of the facial nerve in the setting of CIDP.

Study the Effect of Tubotympanic Disease on Bone Conduction Threshold.

Tubo-tympanic disease of middle ear cleft can temporarily detoriate the bone conduction threshold specially in higher frequency in long standing cases. It mainly affects the inertial ossicular component of the bone conduction mechanism. (1) Study the effect of tubotympanic disease on bone conduction threshold (SN loss). (2) Study the duration of the disease on bone conduction threshold. 84 cases of tubotympanic disease were taken for the study. There pre-operative PTA was done and effect of the disease on the bone conduction threshold was noted. Results were analyzed by using analysis of variance. The significance level α was taken 0.05 as at marginally significant, 0.01 significant and 0.001 as highly significant. The bone conduction at all frequencies increased significantly P < 0.05 with duration of ear discharge. The differences in the bone conduction at all frequencies amongst normal ears were significantly lower as compared to the diseased ear. Duration of ear discharge and type of hearing loss reveals that in patients with ear discharge less than 11years there were 24 (77.41%) subjects with conductive hearing loss, 1 (3.22%) subject with mixed hearing loss. As the duration increased 11-20years, the cases of conductive hearing loss decreased 13 (56.52%) and cases of mixed hearing loss increased to 3 (13.04%). In patients with ear discharge of > 21years conductive subjects were 19 (63.33%) and subjects with mixed hearing loss increased to 5 (33.33%) cases. The average hearing loss and the average bone conduction threshold increases as the duration of disease increases. In patients of safe CSOM who have poor BCT, it is the higher frequencies which are more affected.

Hearing loss in pediatric temporal bone fractures: Evaluating two radiographic classification systems as prognosticators

IntroductionTemporal bone fractures (TBF) are traditionally classified by their angle of fracture relative to the petrous ridge, and more recently by whether or not they violate the otic-capsule. This study compared rates of hearing loss (HL) and signs of otologic dysfunction among fracture types of both classification systems, within the pediatric population. MethodsPediatric patients were retrospectively characterized from a previously identified cohort of TBF patients, diagnosed from 2000 to 2014. CT scans were reviewed and TBFs were classified first as longitudinal (L), transverse (T) or mixed (M), and then as otic-capsule sparing (OCS) or otic-capsule violating (OCV). Medical records were reviewed, and rates of HL and presenting signs were compared among L, T and M fractures, and OCS and OCV fractures. ResultsForty-three patients with 47 TBFs met the inclusion criteria. Eighteen, 4 and 25 TBFs were classified as L, T and M fractures, respectively. Thirty-three and 9 were classified as OCS, and OCV, respectively. Among 24 cases of HL: 20, 3, and 1 were conductive HL (CHL), sensorineural HL (SNHL) and mixed HL, respectively. Two cases of SNHL were found among OCV fractures, with none in OCS fractures (estimated difference 0.22; 95% confidence interval 0.01–0.60). Similar rates of CHL were found across L, T and M fractures (range 36–50%), and across OCV and OCS fractures (range 42–44%). Hemotympanum was the most common presenting sign, found in 68% of TBFs and 80% of CHL cases. There were no significant differences in the incidence of signs or symptoms between fracture types. ConclusionsIn our cohort, both the traditional and otic-capsule radiographic classification systems failed to predict the incidence of CHL and other otologic signs in the pediatric population. Though OCV fractures conferred an increased risk for developing SNHL, we found a lower incidence than anticipated given violation to the bony labyrinth.

The study of hearing loss after microvascular decompression for hemifacial spasm

Objective: To compare the difference of hearing loss after microvascular decompression for hemifacial spasm between control and experimental groups, and to explore the possible causes. Methods: A retrospective analysis including 443 patients was performed, including 203 cases of group A (before the operation was improved) and 240 cases of group B (after the operation was improved). Chi-square test was used to compare the rate of hearing loss. Results: There were 18(8.9%) cases with postoperative hearing loss in group A, including 9 cases of conductive hearing loss and 9 cases of sensorineural hearing loss.While 2 cases of conductive hearing loss and 3 cases of sensorineural hearing loss occurred in group B. Conductive hearing loss and sensorineural hearing loss of two groups had the significant deference (P=0.015 and P=0.04). Conclusion: The type of hearing loss after microvascular decompression for hemifacial spasm included conductive and sensorineural hearing loss.It could be reduced by early closing of the mastoid air chamber, avoiding continuous traction of the cerebellum, avoiding excessive irrigation and exhaust, and intraoperative auditory brainstem evoked potential monitoring.

Preliminary Model for the Design of a Custom Middle Ear Prosthesis.

Custom prostheses could be used to recreate the ossicular chain and improve hearing. Ossicular discontinuity or fixation occurs in 55% of cases of conductive hearing loss, with most cases involving the incus. Reconstruction has been achieved by a variety of methods; however, there has been little improvement in hearing outcomes in decades. Precise measurements of anatomic dimensions, weight, and center of gravity were taken from 19 cadaveric incudes. These measurements were combined with measurements from the medical literature and micro-computed tomography (micro-CT) of cadaveric temporal bones to generate a rasterizable incus model. As a proof of concept, incudal replacements including possible anatomic variations were then three-dimensionally (3-D) printed and inserted into a cadaveric temporal bone. Our measurements of cadaveric incudes corresponded well with those from the medical literature. These measurements were combined with anatomical information from micro-CT allowing identification of critical features of the incus, which remained constant. Other model features were modified to increase stability and facilitate synthesis, including broadening and thickening of the lenticular process and the incudomalleolar articulation. 3-D printed incudal replacements based on this model readily fit into a cadaveric temporal bone and successfully bridged the gap between malleus and incus. We have generated a model for custom 3-D synthesis of incudal prostheses. While current 3-D printing in biocompatible materials at the size required is limited, the technology is rapidly advancing, and 3-D printing of incudal replacements with polylactic acid (PLA) is of the correct size and shape.

Now you see the drum, now you don’t: a rare case of conductive hearing loss in a child

Introduction : Fibrous dysplasia is a benign disease of the bones, which affects the differentiation and maturation of osteoblasts. Fibrous dysplasia can affect the craniofacial bones, which can be asymptomatic or present with symptoms commonly found in an ENT outpatient clinic. Method : We present an unusual case of temporal bone fibrous dysplasia. This is used as a platform to discuss craniofacial fibrous dysplasia further and the investigations and management. Results: Other cases have been reported on temporal bone fibrous dysplasia, but our case is unique in the presentation. Gold-standard diagnosis for craniofacial fibrous dysplasia is by histopathological sampling, although computerised-tomography imaging can be used to diagnose fibrous dysplasia if a biopsy cannot be sought. Conclusion : Fibrous dysplasia of the temporal bones is uncommon. Many cases from other series are found incidentally from radiology reports.

Rapid Maxillary Expansion and Conductive Hearing loss- Review

In recent years, great emphasis has been given to the Stomatognathic system. Constricted maxillary arch is not only a dental issue, but it has other systemic concerns. This maxillary constriction is one of the causes of nasal stenosis, which may be associated with mouth breathing, that can affect the Eustachian tubes and the middle ear, and resulting in hearing loss. Rapid maxillary expansion is an orthodontic procedure for the correction of transverse maxillary problems. Rapid maxillary expansion produces changes in the oral and nasopharyngeal region thus improve the hearing. The purpose of this article is to make the clinician aware of some cases of conductive hearing loss, a relationship may exist with constricted maxillary arch and review the literature and to evaluate the effect of maxillary expansion on conductive hearing loss.

Otosclerosis Surgery: Contribution of Imaging in Surgical Failures and Labyrinthine Complications Diagnosis

Objective: The purpose of this study was to review the role of post-operative imaging and to illustrate with a rich iconography the main causes of surgical failures and post-operative complications of otosclerosis. Subjects and methods: This a retrospective study of 49 ears having otosclerosis and undergoing middle ear surgery. CT scan was performed in the postoperative assessment when post-operative complication or unsatisfactory surgical results were suggested. Results: Surgical failures were noticed in 28 ears (57%): Hearing loss was the most frequent symptom (89%).Tinnitus was found in 21 cases and vertigo in three cases. Audiometric exploration found 21 cases of conductive hearing loss, six cases of mixed type and one case was a sensorineural type. The causes of surgical failure were erosion of the long process of the incus in four cases, uncudo-mallear dislocation in one case, displacement of the prosthesis in five cases and fibrosis of the oval window in one case. Progression of otosclerosis was noticed in 13 cases. Labyrinthine complication was retained in 21 ears of our study. The causes of labyrinthine complication were intravestibular protrusion of the prosthesis (15 cases), intravestibular footplate dislocation (1 case), perilymphatic fistula (1 case), ossificans labyrinthitis (1 case), infectious labyrinthitis (1 case) and intravestibular granulation tissue (1 case). In one case, no abnormities was retained in CT and MRI Conclusion: After this study, to ensure maximum efficiency in the postoperative monitoring and the management of complications and post-operative failures, the clinician is required to take into account both the functional findings, results audiometric and radiological data.

Inner Ear Conductive Hearing Loss and Unilateral Pulsatile Tinnitus Associated with a Dural Arteriovenous Fistula: Case Based Review and Analysis of Relationship between Intracranial Vascular Abnormalities and Inner Ear Fluids.

While pulsatile tinnitus (PT) and dural arteriovenous fistula (DAVF) are not rarely associated, the finding of a conductive hearing loss (CHL) in this clinical picture is unusual. Starting from a case of CHL and PT, diagnosed to be due to a DAVF, we analyzed relationship between intracranial vascular abnormalities and inner ear fluids. DAVF was treated with endovascular embolization. Following this, there was a dramatic recovery of PT and of CHL, confirming their cause-effect link with DAVF. We critically evaluated the papers reporting this association. This is the first case of CHL associated with PT and DAVF. We describe the most significant experiences and theories reported in literature, with a personal analysis about the possible relationship between vascular intracranial system and labyrinthine fluids. In conclusion, we believe that this association may be a challenge for otolaryngologists. So we suggest to consider the possibility of a DAVF or other AVMs when PT is associated with CHL, without alterations of tympanic membrane and middle ear tests.

Conductive Hearing Loss with Present Acoustic Reflex: A Case Report

Acoustic reflex is a sensitive indicator of middle ear lesions when the tympanic membrane is in-tact and tympanometry is normal. Acoustic reflex is not usually observed in conductive hearing loss caused by disruption of the ossicular chain including ossicular discontinuity and fixation. Ossicular disruption can show at least partially intact acoustic reflex under a certain condition. Moreover, ossicular discontinuity with a nearly intact acoustic reflex is quite rare and there have been few reports published to date. We here present a rare case of conductive hearing loss with a nearly intact acoustic reflex, and the patient was surgically confirmed to have ossicular discontinuity.

Does microtia predict severity of temporal bone CT abnormalities in children with persistent conductive hearing loss?

This study aimed to determine the spectrum of temporal bone computed tomography (CT) abnormalities in children with conductive hearing loss (CHL) with and without microtia. From 1993 to 2008, a total of 3396 pediatric records including CHL were reviewed at our institution and revealed 180 cases of persistent CHL, 46 of whom had diagnostic temporal bone CT examinations. All of these examinations were systematically reviewed by two pediatric neuroradiologists, working in consensus, who had 5 and 18 years, respectively, of dedicated pediatric neuroradiology experience. Of the 46 children, 16 were boys and 30 were girls (age: 0.2-16 years; mean: 5 years). Also, 21 (46%) children had microtia and 25 (54%) children did not, as determined by clinical evaluation. External auditory canal atresia/stenosis (EAC-A/S) was the most common anomaly in both microtia and non-microtia groups. Two or more anomalies were observed in 18/21 children with microtia. The frequency of EAC-A/S was greater in children with microtia versus those without it (86% versus 32%, respectively; P = 0.0003). Syndromic diagnoses were also significantly more frequently made in children with microtia versus those without microtia (76% versus 20%, respectively; P = 0.0001). Temporal bone CT scans were normal in 10 children (22%) with persistent CHL. Microtia is an important finding in children with CHL. EAC and middle ear/ossicle anomalies were significantly more frequently seen in children with microtia, and multiple anomalies and bilateral microtia were more common in children with syndromic associations. These findings highlight the importance of understanding the embryological development of the temporal bone. The presence of one anomaly should raise suspicion of the possibility of other anomalies, especially in the setting of microtia. Bilateral microtia and multiple anomalies should also raise suspicion of genetic syndromes.

A rare case of conductive hearing loss due to partially ossified chorda tympani

A rare case of conductive hearing loss due to partially ossified chorda tympani