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Third windows as a cause of failure in hearing gain after exploratory tympanotomy.

 Sang Cheol Kim  ;  Won-Sang Lee  ;  Minbum Kim  ;  Ju Hyun Jeon  ;  Jinna Kim  ;  Jae Young Choi 
 OTOLARYNGOLOGY-HEAD AND NECK SURGERY, Vol.145(2) : 303-308, 2011 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Audiometry, Pure-Tone ; Cochlea/abnormalities* ; Cochlea/diagnostic imaging ; Cochlear Diseases/complications* ; Cochlear Diseases/diagnosis ; Female ; Follow-Up Studies ; Hearing/physiology* ; Hearing Loss, Conductive/etiology ; Hearing Loss, Conductive/physiopathology ; Hearing Loss, Conductive/surgery* ; Humans ; Male ; Middle Aged ; Middle Ear Ventilation* ; Prognosis ; Retrospective Studies ; Temporal Bone/diagnostic imaging ; Tomography, X-Ray Computed ; Treatment Failure ; Young Adult
third window, exploratory tympanotomy, inner ear, air-bone gap
OBJECTIVE: Exploratory tympanotomy (ET) can be performed selectively on patients who have air-bone gaps (ABGs) without any apparent external or middle ear abnormalities for diagnosis and treatment of their conductive hearing loss. However, surgeons cannot always find middle ear problems. It has recently been reported that pathologic third windows in inner ears can cause ABGs. Therefore, the authors conducted this study to evaluate the inner ear anatomical problems of patients who had undergone ET. STUDY DESIGN: Case series with chart review. SETTING: Tertiary center. SUBJECTS AND METHODS: The authors included 51 consecutive patients with ABGs ≥20 dB who had undergone ET at Yonsei University Severance Hospital between 2005 and 2009. In the preoperative evaluations, all 51 patients showed normal drums on otoscopy, and no abnormal middle ear problems that could cause ABGs were detected on temporal bone computed tomography (TBCT). The authors retrospectively reevaluated the hearing results and the causes of their conductive hearing loss, including the inner ear problems, through a review of their TBCT. RESULTS: Six of the 51 patients were found to have inner ear abnormalities with possible pathologic third windows. Four had enlarged vestibular aqueducts (EVAs), and 2 had superior semicircular canal dehiscence (SSCD). All patients with pathologic third windows failed to improve their hearing. CONCLUSION: About 12% of the patients had inner ear anomalies, which could possibly cause ABGs. Inner ear conductive components might lead to frustrating results. Therefore, surgeons must take inner ear conductive components into account before attempting ET in patients with inner ear anomalies.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Bum(김민범)
Kim, Sang Cheol(김상철)
Kim, Jinna(김진아) ORCID logo https://orcid.org/0000-0002-9978-4356
Lee, Won Sang(이원상)
Jeon, Ju Hyun(전주현)
Choi, Jae Young(최재영) ORCID logo https://orcid.org/0000-0001-9493-3458
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