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1.
Annals of the Academy of Medicine, Singapore ; : 346-353, 2020.
Article in English | WPRIM | ID: wpr-827347

ABSTRACT

INTRODUCTION@#Isolated oval window atresia (OWA) is a rare cause of congenital conductive middle ear deafness and may be overlooked owing to the normal appearance of the external ear. This anomaly has been previously described, although the published numbers with both imaging and surgical findings are few. Our aim is to correlate the imaging features of OWA with intraoperative findings.@*MATERIALS AND METHODS@#This is a single-centre retrospective evaluation of patients who were diagnosed with OWA and who received surgery from January 1999 to July 2006. No new case was diagnosed after 2006 to the time of preparation of this manuscript. High resolution computed tomography (HRCT) imaging of the temporal bones of the patients were retrospectively evaluated by 2 head and neck radiologists. Images were evaluated for the absence of the oval window, ossicular chain abnormalities, position of the facial nerve canal, and other malformations. Imaging findings were then correlated with surgical findings.@*RESULTS@#A total of 9 ears in 7 patients (two of whom with bilateral lesions) had surgery for OWA. All patients had concomitant findings of absent stapes footplate with normal, deformed or absent stapes superstructure and an inferiorly displaced facial nerve canal. HRCT was sensitive in identifying OWA and associated ossicular chain and facial nerve abnormalities, which were documented surgically.@*CONCLUSION@#OWA is a rare entity that can be diagnosed with certainty on HRCT, best visualised on coronal plane. Imaging findings of associated middle ear abnormalities, position of the facial nerve canal, which is invariably mal-positioned, and associated deformity of the incus are important for presurgical planning and consent.

2.
Annals of the Academy of Medicine, Singapore ; : 78-82, 2007.
Article in English | WPRIM | ID: wpr-275228

ABSTRACT

<p><b>INTRODUCTION</b>Radiation injury resulting in sudden, late onset sensorineural hearing loss is a recognised complication in patients who have received head and neck irradiation. We describe the magnetic resonance imaging (MRI) of the internal acoustic canal (IAC) of 3 such patients and postulate a cause for these findings.</p><p><b>CLINICAL PICTURE</b>A total of 63 patients were referred for MRI IAC for sudden-onset sensorineural hearing loss. Of these patients, only 5 patients had abnormal MRI finding in the affected ear and the remaining patients had normal studies. Two patients had acoustic neuromas. Three patients demonstrated high T1-weighted signal in the labyrinths of the affected ears and had past histories of head and neck irradiation. The MRI findings and medical records of these 3 patients were reviewed and described in this case series.</p><p><b>OUTCOME</b>High labyrinthine signal on unenhanced T1-weighted images in the symptomatic ear of these patients was observed, suggesting the possibility of haemorrhage. In the patient who had a history of brain tumour, susceptibility artifacts were also seen in the right hemipons on the gradient-echo images, indicating the presence of paramagnetic substances from previous therapy.</p><p><b>CONCLUSION</b>We postulate that labyrinthine haemorrhage is a rare, late complication of head and neck irradiation, resulting in sudden sensorineural hearing loss.</p>


Subject(s)
Female , Humans , Male , Middle Aged , Head and Neck Neoplasms , Radiotherapy , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Hemorrhage , Labyrinth Diseases , Magnetic Resonance Imaging , Radiotherapy , Radiotherapy Dosage , Time Factors
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