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Exploratory tympanotomy in sudden sensorineural hearing loss for the identification of a perilymphatic fistula – retrospective analysis and review of the literature

Published online by Cambridge University Press:  19 June 2020

S Heilen ,
C P Lang ,
A Warnecke ,
T Lenarz  and
M Durisin
S Heilen
Affiliation:
Department of Otolaryngology, Hannover Medical School, Hannover, Germany
C P Lang
Affiliation:
Department of Otolaryngology, Hannover Medical School, Hannover, Germany
A Warnecke
Affiliation:
Department of Otolaryngology, Hannover Medical School, Hannover, Germany Cluster of Excellence of the German Research Foundation (Deutsche Forschungsgemeinschaft; ‘DFG’), Hearing4all, Hannover, Germany
T Lenarz
Affiliation:
Department of Otolaryngology, Hannover Medical School, Hannover, Germany Cluster of Excellence of the German Research Foundation (Deutsche Forschungsgemeinschaft; ‘DFG’), Hearing4all, Hannover, Germany
M Durisin*
Affiliation:
Department of Otolaryngology, Hannover Medical School, Hannover, Germany
*
Author for correspondence: Dr Martin Durisin, Carl-Neuberg-Str. 1, 30625 Hannover, Germany E-mail: Durisin.martin@mh-hannover.de Fax: +49 511 532 5558
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Abstract

Objective

The diagnostic value of exploratory tympanotomy in sudden sensorineural hearing loss remains controversial. This study and review were performed to identify the incidence of perilymphatic fistula in patients with sudden sensorineural hearing loss. The effectiveness of tympanotomy for sealing of the cochlear windows in cases with perilymphatic fistula was evaluated.

Methods

A search in common databases was performed. Overall, 5034 studies were retrieved. Further, a retrospective analysis on 90 patients was performed.

Results

Eight publications dealing with tympanotomy in patients with sudden sensorineural hearing loss were identified. In 90 patients diagnosed with sudden sensorineural hearing loss and undergoing exploratory tympanotomy, 10 patients (11 per cent) were identified with a perilymphatic fistula, and this corresponds to the results obtained from our review (13.6 per cent).

Conclusion

There was no significant improvement after exploratory tympanotomy and sealing of the membranes for patients with a definite perilymphatic fistula.

Keywords

Hearing LossSensorineural Hearing LossSudden Hearing LossCochlear AqueductFistula

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 6 , June 2020 , pp. 501 - 508
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr M Durisin takes responsibility for the integrity of the content of the paper

References

Klemm, E, Deutscher, A, Mösges, R. Current sample of idiopathic hearing loss and its epidemiology [in German]. Laryngorhinootologie 2009;88:524–7CrossRefGoogle Scholar
Prenzler, NK, Schwab, B, Kaplan, DM, El-Saied, S. The role of explorative tympanotomy in patients with sudden sensorineural hearing loss with and without perilymphatic fistula. Am J Otolaryngol 2018;39:46–9CrossRefGoogle ScholarPubMed
Alexander, TH, Harris, JP. Incidence of sudden sensorineural hearing loss. Otol Neurotol 2013;34:1586–9CrossRefGoogle ScholarPubMed
Plontke, SK, Meisner, C, Caye-Thomasen, P, Parnes, L, Agrawal, S, Mikulec, T. Intratympanic glucocorticoids for sudden sensorineural hearing loss. Cochrane Database Syst Rev 2009;(4):CD008080Google Scholar
Hughes, GB, Freedman, MA, Haberkamp, TJ, Guay, MB. Sudden sensorineural hearing loss. Otolaryngol Clin North Am 1996;29:393–40510.1016/S0030-6665(20)30362-5CrossRefGoogle ScholarPubMed
Stachler, RJ, Chandrasekhar, SS, Archer, SM, Rosenfeld, RM, Schwartz, SR, Barrs, DM et al. . Clinical practice guideline: sudden hearing loss. Otolaryngol Head Neck Surg 2012;146(3 suppl):S1–S35CrossRefGoogle ScholarPubMed
Hara, JH, Zhang, JA, Gandhi, KR, Flaherty, A, Barber, W, Leung, MA et al. Oral and intratympanic steroid therapy for idiopathic sudden sensorineural hearing loss: steroid therapy for sudden hearing loss. Laryngoscope 2018;3:73–7Google Scholar
Ahmadzai, N, Kilty, S, Wolfe, D, Bonaparte, J, Schramm, D, Fitzpatrick, E et al. A protocol for a network meta-analysis of interventions to treat patients with sudden sensorineural hearing loss. Syst Rev 2018;7:74CrossRefGoogle ScholarPubMed
Conlin, A, Parnes, LS. Treatment of sudden sensorineural hearing loss. I. A systematic review. Arch Otolaryngol Head Neck Surg 2007;133:573–81CrossRefGoogle ScholarPubMed
Marx, M, Younes, E, Chandrasekhar, SS, Ito, J, Plontke, S, O'Leary, S et al. International consensus (ICON) on treatment of sudden sensorineural hearing loss. Eur Ann Otorhinolaryngol Head Neck Dis 2018;135:23–8CrossRefGoogle ScholarPubMed
Samim, E, Kilic, R, Ozdek, A, Gocmen, H, Eryilmaz, A, Unlu, I. Combined treatment of sudden sensorineural hearing loss with steroid, dextran and piracetam: experience with 68 cases. Eur Arch Otorhinolaryngol 2004;261:187–90CrossRefGoogle ScholarPubMed
Rivero V, Pino, Ruíz G, Trinidad, García M, Marcos, García C, Montero, Palomino A, González, Hernández CG, Pantoja et al. Statistical study and clinical results by comparison of two different protocols in the treatment of sudden hearing loss [in Spanish]. Acta Otorrinolaringol Esp 2005;56:63–7Google Scholar
Labus, J, Breil, J, Stützer, H, Michel, O. Meta-analysis for the effect of medical therapy vs. placebo on recovery of idiopathic sudden hearing loss. Laryngoscope 2010;120:1863–71CrossRefGoogle ScholarPubMed
AWMF online. Hearing loss guideline [in German]. In: https://www.awmf.org/uploads/tx_szleitlinien/017-010l_S1_Hoersturz_2014-02-verlaengert.pdf [30 March 2020]Google Scholar
Haubner, F, Rohrmeier, C, Koch, C, Vielsmeier, V, Strutz, J, Kleinjung, T. Occurence of a round window membrane rupture in patients with sudden sensorineural hearing loss. BMC Ear Nose Throat Disord 2012;12:14CrossRefGoogle ScholarPubMed
Bailey, BJ, Vrabec, JT. Victor Goodhill, MD and perilymph fistula: reflecting on the man and the controversy. Laryngoscope 1997;107:580–4CrossRefGoogle Scholar
Freeman, P. Rupture of the round window membrane. Otolaryngol Clin North Am 1978;11:81–93CrossRefGoogle ScholarPubMed
Gedlicka, C, Formanek, M, Ehrenberger, K. Analysis of 60 patients after tympanotomy and sealing of the round window membrane after acute unilateral sensorineural hearing loss. Am J Otolaryngol 2009;30:157–61CrossRefGoogle ScholarPubMed
Reineke, U, Hühnerschulte, M, Ebmeyer, J, Sudhoff, H. Tympanotomy and sealing of the round window membrane in sudden sensorineural hearing loss: a retrospective analysis [in German]. HNO 2013;61:314–20CrossRefGoogle Scholar
Gehrking, E, Wisst, F, Remmert, S, Sommer, K. Intraoperative assessment of perilymphatic fistulas with intrathecal administration of fluorescein. Laryngoscope 2002;112:1614–18CrossRefGoogle ScholarPubMed
Poe, D, Gadre, A, Rebeiz, EE, Pankratov, MM. Intravenous fluorescein for detection of perilymphatic fistulas. Am J Otol 1993;14:51–5Google ScholarPubMed
Durmuş, K, Terzi, H, Karataş, TD, Doğan, M, Uysal, IÖ, Şencan, M et al. Assessment of hematological factors involved in development and prognosis of idiopathic sudden sensorineural hearing loss. J Craniofac Surg 2016;27:85–91CrossRefGoogle ScholarPubMed
Nagai, T, Nagai, M. Labyrinthine window rupture as a cause of acute sensorineural hearing loss. Eur Arch Otorhinolaryngol 2012;269:67–71CrossRefGoogle ScholarPubMed
Selmani, Z, Pyykkö, I, Ishizaki, H, Marttila, TI. Role of transtympanic endoscopy of the middle ear in the diagnosis of perilymphatic fistula in patients with sensorineural hearing loss or vertigo. ORL J Otorhinolaryngol Relat Spec 2002;64:301–6CrossRefGoogle ScholarPubMed
Loader, B, Seemann, R, Atteneder, C, Sterrer, E, Franz, P, Lill, C. Sealing of the round and oval window niches with triamcinolone-soaked fascia as salvage surgical therapy in sudden sensorineural hearing loss. Acta Otolaryngol (Stockh) 2017;137:923–7CrossRefGoogle ScholarPubMed
Tigges, G, Stoll, W, Schmael, F. Assessment of prognostic factors regarding hearing improvement after acute one-sided deafness [in German]. HNO 2003;51:305–9CrossRefGoogle Scholar
Maier, W, Fradis, M, Kimpel, S, Schipper, J, Laszig, R. Results of exploratory tympanotomy following sudden unilateral deafness and its effects in hearing restoration. Ear Nose Throat J 2008;87:438–51CrossRefGoogle ScholarPubMed
Hoch, S, Vomhof, T, Teymoortash, A. Critical evaluation of round window membrane sealing in the treatment of idiopathic sudden unilateral hearing loss. Clin Exp Otorhinolaryngol 2015;8:20–5CrossRefGoogle ScholarPubMed
Kampfner, D, Anagiotos, A, Luers, JC, Hüttenbrink, KB, Preuss, SF. Analysis of 101 patients with severe to profound sudden unilateral hearing loss treated with explorative tympanotomy and sealing of the round window membrane. Eur Arch Otorhinolaryngol 2014;271:2145–52CrossRefGoogle ScholarPubMed
Klemm, E, Flach, M. Sudden deafness. A clinical analysis with special reference to tympanoscopy [in German]. Laryngorhinootologie 1991;70:646–910.1055/s-2007-998115CrossRefGoogle Scholar