ABSTRACT
A 42-year-old construction worker was struck in the head by a ten-foot steel bar that fell 240 feet, entering the left parietal area of the skull and exiting above the left zygoma. The bar was surgically removed and the postoperative course was unremarkable. His residual deficits include mild aphasia and the need of a cane for assistance with walking.
Subject(s)
Skull/injuries , Wounds, Penetrating/surgery , Adult , Aphasia/etiology , Humans , Male , Wounds, Penetrating/etiologySubject(s)
Prostheses and Implants , Stainless Steel , Stapes Surgery , Audiometry , Follow-Up Studies , Humans , Prosthesis DesignABSTRACT
This study sought correlations between sensorineural hearing loss and otosclerotic endosteal involvement in 29 temporal bones examined histologically. The sensorineural hearing loss of the affected parts of the cochlea was determined by the last antemortum bone conduction audiogram available. There were eight temporal bones with only stapes footplate involvement, six with one discrete focus of otosclerotic endosteal involvement, and 15 with two or more foci of endosteal involvement. Analysis of audiometric data showed that the group of bones with two or more foci of endosteal involvement had a similar incidence of 45 dB sensorineural loss (9 of 15 or 60%) as did the group with no endosteal involvement (5 of 8 or 62%). The group with two or more foci had a greater incidence of 60 dB or greater sensorineural loss (46%) compared with the groups with none (12%) or one focus (16%) involved. Correlation between hearing loss and involvement of cochlear endosteum was poor. Correlation existed in only 2 of 15 ears with two or more foci involving the cochlear endosteum. There was no correlation in the other groups. It appears that cochlear endosteal involvement alone may not be sufficient explanation for the sensorineural hearing loss found with otosclerosis, except in the most severely involved ears.
