Clin Exp Otorhinolaryngol.  2015 Mar;8(1):20-25. 10.3342/ceo.2015.8.1.20.

Critical Evaluation of Round Window Membrane Sealing in the Treatment of Idiopathic Sudden Unilateral Hearing Loss

• Hoch S
• Vomhof T
• Teymoortash A

• KMID: 1973483
• DOI: http://doi.org/10.3342/ceo.2015.8.1.20

Abstract

OBJECTIVES
Rupture of the round window membrane with consecutive development of a perilymphatic fistula (PLF) is still a matter of controversial debate in the pathogenesis of idiopathic sudden sensorineural hearing loss (SSHL). Until now no consensus exists about whether these patients benefit from performing an exploratory tympanotomy with sealing of the round window. The aim of the present study was to analyze critically the effectiveness of sealing the round window membrane in patients with SSHL.
METHODS
The clinical data of 51 patients with SSHL and a mean hearing decline of at least 60 dB over 5 frequencies who were treated with tympanotomy and sealing of the round window membrane were retrospectively analyzed. The results have been compared to the current state of the literature.
RESULTS
Intraoperatively a round window membrane rupture or fluid leak was observed in none of the patients. After performing tympanotomy the mean improvement of hearing level was 32.7 dB. Twenty of 51 examined patients (39.2%) showed a mean improvement of the hearing level of more than 30 dB and a complete remission could be detected in 12 patients (23.5%). Reviewing the literature revealed no standard guidelines for definition or treatment of SSHL as well as for evaluation of hearing loss and its recovery.
CONCLUSION
The results of the present study and the literature should be discussed critically. It is unclear whether tympanotomy and sealing of the round window membrane may be a meaningful treatment for SSHL. Therefore this procedure should be discussed as a therapeutic option only in selected patients with sudden deafness or profound hearing loss in which PLF is strongly suspicious or conservative treatment failed.

Keyword

Hearing Loss; Sudden; Round Window; Ear; Perilymph

MeSH Terms

Consensus
Ear
Fistula
Hearing
Hearing Loss
Hearing Loss, Sensorineural
Hearing Loss, Sudden
Hearing Loss, Unilateral*
Humans
Membranes*
Perilymph
Retrospective Studies
Rupture

Figure

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  Fig. 1 Linear univariate regression analysis of duration before initial presentation and influence on the hearing gain in 51 patients with unilateral sudden sensorineural hearing loss. Hearing gain (dB), duration before initial presentation (day). Pearson correlation R=-0.23; P=0.057.

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