Radiological parameters and audiometric findings in otosclerosis: is there any relationship?

OBJECTIVE: The role of high-resolution computed tomography scans in otosclerosis remains uncertain. There is a debate over the relationship between radiological and audiometric findings among patients. METHOD: Pre-operative audiometry and high-resolution computed tomography findings from 40 ears with surgically confirmed otosclerosis were compared. High-resolution computed tomography scan data regarding the characteristics of the disease foci, the endosteal extension and the occurrence of internal auditory canal diverticula were obtained. The influence of each radiological variable on the simple pure tone average, the high-frequency pure tone average and the bone-conduction pure tone average were investigated. RESULTS: Cases with endosteal extension (p = 0.047) and a higher number of affected sites within the otic capsule had a worse bone-conduction pure tone average, although it was only significant for the latter (p = 0.006). Those without concomitant retrofenestral disease (p = 0.019) had better simple pure tone average. CONCLUSION: The number of sites of involvement and concomitant retrofenestral disease seem to significantly impact audiometric findings in otosclerosis.

High-resolution computed tomography and pure-tone audiometry in patients with otosclerosis in the spongiotic phase.

OBJECTIVE: There is no consensus in the literature regarding the relationship between high-resolution computed tomography findings and hearing thresholds in pure-tone audiometry in otosclerosis. This study evaluated the association between high-resolution computed tomography findings and pure-tone audiometry in otosclerosis in the spongiotic phase. METHODS: A cross-sectional study was conducted of 57 ears with surgically confirmed stapes fixation and tomographic findings. Air conduction and bone conduction thresholds on audiometry, and air-bone gap, were analysed. RESULTS: There were no correlations between sites affected by otospongiosis and air conduction threshold, bone conduction threshold or air-bone gap in the analysed tomographic images, but the diameter of the otospongiotic focus was greater in the presence of extension of the otospongiotic foci to the cochlear endosteum. CONCLUSION: There were no relevant associations between high-resolution computed tomography findings and pure-tone audiometric measurements. However, the diameter of the otospongiotic focus was greater in the presence of extension of the otospongiotic foci to the cochlear endosteum.

Local anesthesia for cochlear implant surgery: low risks for the patient and few costs for the hospital, a rational alternative.

OBJECTIVES: The aim of this article is to illustrate the possibility of performing a cochlear implant with local anesthesia and sedation, the anesthesic technique and the advantages of that in comparison to a general anesthesia. MATERIAL AND METHODS: We describe two successful surgeries done with local anesthesia, including the neural telemetry and the conditions the patient presented after the surgery, with a very good recovery and no complications during and after the procedure. RESULTS: The results of these two surgeries are described regarding the fast recovery, no symptoms of dizziness and vomiting after the surgeries, discharging from the hospital on the same day, and the immediate post operative period by meaning of complaints from the patient. CONCLUSION: Local anesthesia with sedation for cochlear implant surgery in adults is a very good alternative for lowering the morbidity of the patient, fewer risks, lower costs for the hospital, with a very good control of the surgery.

Transcanal labyrinthectomy in childhood: report of a case.

Vertigo in children is caused by several factors. One such factor is viruses (e.g., mumps, measles, and rubeola) afflicting the inner ear by various mechanisms. In the majority of cases, affected patients improve with clinical therapy and vestibular rehabilitation. We present the case of a child with vertigo as a sequela of mumps virus infection that did not improve with clinical treatment and vestibular rehabilitation. Consequently, the child was submitted to a transcanal labyrinthectomy followed by vestibular rehabilitation, with significant postprocedure improvement of symptoms. We discuss surgical indications, the technique used in this case, and the importance of vestibular rehabilitation in the postoperative period.