ABSTRACT
The records of 34 children and teenagers with a conductive hearing impairment and an intact and mobile tympanic membrane have been reviewed; 20 patients had a congenital hearing impairment. Stapedectomy was performed on 13 patients with satisfactory results in 12. In 3 cases the operation was terminated because of oval window or facial nerve abnormalities. In 4 cases there was no evidence of an ossicular problem, a so-called inner ear conductive hearing loss. Fourteen patients had otosclerosis, the youngest being 9 years old. Twenty-four stapedectomies were performed on this group with satisfactory results in 22. We conclude that the results of stapedectomy in children appear to be as satisfactory as results in adults.
Subject(s)
Hearing Loss, Conductive/surgery , Hearing Loss/surgery , Stapes Surgery/methods , Adolescent , Child , Child, Preschool , Ear Ossicles/abnormalities , Ear, Inner/physiopathology , Facial Nerve/abnormalities , Female , Hearing Disorders/congenital , Hearing Disorders/surgery , Humans , Male , Otosclerosis/surgerySubject(s)
Computers , Ear, Inner/pathology , Endolymphatic Duct/pathology , Meniere Disease/pathology , Aged , Ear Diseases/pathology , Edema/pathology , Endolymph , Endolymphatic Duct/anatomy & histology , Endolymphatic Sac/anatomy & histology , Endolymphatic Sac/pathology , Female , Humans , Male , Middle Aged , SyndromeABSTRACT
The term 'endolymphatic hydrops' is not a definitive diagnosis since the condition occurs in a variety of otological disorders. Endolymphatic hydrops was found in 57 ears (9 per cent) of the 703 temporal bones in the collection of the Ear Research Institute, Los Angeles. These 57 ears included normal ears of two newborns, post-stapedectomy ears, and ears with the primary diagnosis of Menière's disease. Paget's disease, congenital syphilis, and chronic otitis media. The typical clinical picture of fluctuant hearing loss, pressure, tinnitus, and episodic vertigo occurred in about one-third of the cases with histologically documented hydrops. This symptom complex was common in cases with diffuse, bilateral, cochleo-saccular, or progressive hydrops. A reliable clinical test to determine the presence of endolymphatic hydrops is needed. Complete neurotologic evaluation is indicated in every case suspected of having hydrops to determine specific causes.
Subject(s)
Edema/pathology , Endolymph/physiology , Labyrinth Diseases/pathology , Labyrinthine Fluids/physiology , Adolescent , Adult , Aged , Child , Child, Preschool , Dizziness/etiology , Ear, Inner/pathology , Edema/complications , Female , Hearing Loss/etiology , Humans , Infant , Infant, Newborn , Labyrinth Diseases/complications , Male , Meniere Disease/pathology , Middle Aged , Pressure , Tinnitus/etiologyABSTRACT
The histopathologic findings in the temporal bones of two patients who underwent a cryo-otic-perotic shunt procedure are reported. Morphologic changes in the inner ear were limited to the area of cryoprobe application on the promontory. The hook region of the cochlear duct showed severe atrophy of the spiral ligament, stria vascularis, and sensorineural structures. The ampulla of the posterior semicircular canal showed fibrosis in the perilymphatic space and ruptured membranous walls. No changes were found in the rest of the vestibular labyrinth or in the facial nerve. The long-term improvement in these patients' symptoms, i.e., eight years in one and four years in the other, could only be explained on the basis that endolymph and perilymph mix across intact, nonfunctioning membranes of the cochlear duct or through, presumably antemortem, ruptures of the posterior semicircular canal ampulla.
