Large vestibular aqueduct syndrome

Large vestibular aqueduct syndrome [LVAS] is a radiologically diagnosed syndrome. Children with delayed speech and hearing loss without any middle ear disorder should arouse the suspicion of inner ear congenital anomaly. A computerized tomography [CT] scan is essential to rule out the possibility of LVAS in these children. Until recently no satisfactory treatment was available either to improve the hearing or to prevent further deterioration of hearing loss in this condition. The hearing loss in these two sisters began in childhood and progressed slowly. One of them also had a history of sudden diminution of hearing at one stage. Neither of them has had any vestibular symptoms. They were fitted with hearing aids and both the sisters are doing well in their education in normal school. Another two cases

Congenital anomalies of stapes and oval window

Ten cases of congenital abnormalies of stapes and oval window are seen between 1984 to 1992 among 1500 patients operated for middle ear pathology. Embryology and possible etiological factors are briefly described. Stapedectomy, vastibulotomy with Shea's fluroplastic cup piston prosthesis and vein grafting was done. In cases with mobile footplate, hearing improvement was not achieved by inserting the prosthesis between footplate and incus. Vestibulotomy certainly improved the hearing. Gelfoam was not used as vein graft acts as a good seal to the opening. None of these ten cases had anacusis and only one suffered from minor degree of sensorineural hearing loss in high frequencies

Tympanoplasty type I: review of 327 cases

This is a review of 327 patients who had tympanoplasty type I procedures in the Riyadh Central Hospital from October 1983 to December 1985. All operations were performed by the author using temporalis fascia grafts and the technique of grafting used was the underlay method. There were no cases of total sensorineural hearing loss. The success rate of this procedure in this series was 89% [i.e. reducing the conductive hearing loss to less than 12 dB]. This success rate is not different from that reported from other otology centres

Stapedectomy: small versus large fenestration technique

The basis of small fenestration Stapedectomy is to increase the efficiency of the mechanical transmission system for sound energy and at the same time reduce the potential threat of cochlear damage to a minimum. Postoperative results were compared in a series of 50 cases, 1 7 having had operations performed by the large fenestration technique [LFT] and 33 by the small fenestration technique [SFT]. Postoperative vertigo was less and no instance of perilymphatic fistula was seen with SFT. The hearing results, when two groups were compared, showed a significant advantage for the SFT patients. No patients from either group had anacusis, and 96% gained optimal hearing in this series

Sensorineural hearing loss in tympanoplasty

A series of 236 consecutive tympanoplasty type one procedures performed from 1983 to 1985 at Riyadh Central Hospital was reviewed. Of these, there were ten cases of sensorineural hearing loss attributable to the surgical procedure. Loss of bone conduction by more than 10 dB in frequencies 0.5 kH[z] was considered significant. The main source of the labyrinthine damage was considered to be hydraulic trauma caused by excessive stapedial movement during removal of the disease process. Immediate postoperative infection of the ear was a second source of damage. The current views on the treatment of post-tympano plasty sensorineural hearing loss will be discussed

Synovial sarcoma of the laryngopharynx

Synovial sarcoma is a rare but a well-documented lesion in the head and neck region. It commonly occurs in the articular sites of hands and feet. The laryngopharynx is one of the extra-articular sites for such a tumour. The diagnosis is histological, characterized by the presence of spindle-cell sarcoma-like and pseudo-epithelial cells. Radical surgical excision followed by radiotherapy is the treatment