Clin Exp Otorhinolaryngol.  2018 Mar;11(1):35-39. 10.21053/ceo.2017.00458.

The Effect of Endoscopic Tympanoplasty on Cochlear Function

• Kaya I
• Turhal G
• Ozturk A
• Gode S
• Bilgen C
• Kirazli T

• KMID: 2407790
• DOI: http://doi.org/10.21053/ceo.2017.00458

Abstract

OBJECTIVES
The aim of this prospective clinical study was to measure the audiologic outcomes of the patients that underwent endoscopic transcanal cartilage tympanoplasty, and to investigate the effects on cochlear function.
METHODS
Thirty-three patients (33 ears) who were diagnosed with noncomplicated chronic otitis media and underwent endoscopic transcanal cartilage tympanoplasty technique were included. Pre- and postoperative first month distortion product otoacoustic emission (DPOAE) signal-to-noise ratio (SNR), bone conduction hearing levels and air bone gap (ABG) values were measured and total endoscope usage time was noted.
RESULTS
Preoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (1-11; interquartile range [IQR], 1), 6 dB (4-20; IQR, 1), 7 dB (3-26; IQR, 5) and 5.50 dB (0-9; IQR, 3), respectively. Postoperative median SNR measurements at 0.5, 1, 2, and 4 kHz were 6 dB (3-9; IQR, 1), 6 dB (2-21; IQR, 3), 7 dB (2-20; IQR, 3), and 6 dB (0-10; IQR, 7), respectively. Regarding the DPOAE measurements, there was no statistically significant difference between the SNR values of all given frequencies (P>0.05). Regarding the pure tone audiometry (PTA) measurements, bone conduction was significantly better at 0.5 and 1 kHz, postoperatively (P < 0.05) and there was statistically significant difference at 2 and 4 kHz (P>0.05). Additionally, no statistically significant correlation was found between the SNR and PTA measurements and the endoscope usage time (P>0.05).
CONCLUSION
We suggested that cochlear functions and sensorineural hearing remained stable after endoscopic transcanal cartilage tympanoplasty and cold light source doesn't cause significant adverse effects cochlear functions.

Keyword

Endoscopic Ear Surgery; Endoscopic Tympanoplasty; Cold Light Source; Otoacoustic Emission

MeSH Terms

Audiometry
Bone Conduction
Cartilage
Clinical Study
Endoscopes
Hearing
Humans
Otitis Media
Prospective Studies
Signal-To-Noise Ratio
Tympanoplasty*

Figure

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  Fig. 1. (A) Central tympanic membrane perforation, (B) tympanomeatal flap incision and anteriorly based tympanomeatal flap elevation, (C) cartilage graft placing, (D) closure of tympanic membrane perforation.

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  Fig. 2. Pre- and postoperative signal-to-noise ratio measurements.

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  Fig. 3. Pre- and postoperative pure tone bone conduction audiometry levels (dB hearing level).

Reference

1. Ayache S. Cartilaginous myringoplasty: the endoscopic transcanal procedure. Eur Arch Otorhinolaryngol. 2013; Mar. 270(3):853–60.

2. Dundar R, Bulut H, Yukkaldiran A, Guler OK, Demirtas Y, Iynen I, et al. Temperature rises in the round window caused by various light sources during insertion of rigid endoscopes: an experimental animal study. Clin Otolaryngol. 2016; Feb. 41(1):44–50.

3. MacKeith SA, Frampton S, Pothier DD. Thermal properties of operative endoscopes used in otorhinolaryngology. J Laryngol Otol. 2008; Jul. 122(7):711–4.

4. Bottrill I, Perrault DF Jr, Poe D. In vitro and in vivo determination of the thermal effect of middle ear endoscopy. Laryngoscope. 1996; Feb. 106(2 Pt 1):213–6.

5. Lonsbury-Martin BL, Martin GK. Noise-induced hearing loss. In : Flint PW, Haughey BH, Lund VJ, Niparko JK, Robbins KT, Thomas JR, editors. Cummings otolaryngology: head and neck surgery. 6th ed. Philadelphia (PA): Saunders Elsevier;2014. p. 2345–58.

6. Lonsbury-Martin BL, Martin GK. The clinical utility of distortion-product otoacoustic emissions. Ear Hear. 1990; Apr. 11(2):144–54.

7. Aksoy F, Dogan R, Ozturan O, Eren SB, Veyseller B, Gedik O. Thermal effects of cold light sources used in otologic surgery. Eur Arch Otorhinolaryngol. 2015; Oct. 272(10):2679–87.

8. Badr-El-Dine M, James AL, Panetti G, Marchioni D, Presutti L, Nogueira JF. Instrumentation and technologies in endoscopic ear surgery. Otolaryngol Clin North Am. 2013; Apr. 46(2):211–25.

9. Kozin ED, Lehmann A, Carter M, Hight E, Cohen M, Nakajima HH, et al. Thermal effects of endoscopy in a human temporal bone model: implications for endoscopic ear surgery. Laryngoscope. 2014; Aug. 124(8):E332–9.

10. Khan MM, Parab SR. Endoscopic cartilage tympanoplasty: a two-handed technique using an endoscope holder. Laryngoscope. 2016; Aug. 126(8):1893–8.