Audiologic Outcomes After Oval and Round Window Reinforcement Surgery.

Area of Science:

• Otolaryngology
• Audiology
• Neurosurgery

Background:

• Oval window (OW) and round window (RW) reinforcement surgery is used for conditions like perilymphatic fistula and superior semicircular canal dehiscence.
• Concerns exist regarding potential negative audiologic effects due to window stiffening during OW and RW reinforcement procedures.

Purpose of the Study:

• To evaluate the audiologic outcomes following OW and RW reinforcement surgery.
• To assess the impact of OW and RW reinforcement on hearing thresholds, air-bone gap, and speech discrimination.

Main Methods:

• Retrospective review of 71 patients undergoing transcanal OW or RW reinforcement.
• Patients categorized into
• third window
• and
• two-window
• groups based on diagnosis.
• Analysis of pre- and post-operative pure-tone thresholds, PTA, air-bone gap, SRT, and WRS.

Main Results:

• A statistically significant postoperative increase of 2.75 dB in air conduction hearing level at 4000 Hz was observed in the combined cohort.
• This increase was primarily due to a 2.18 dB rise in the air-bone gap at 4000 Hz.
• No significant changes were found in pure-tone average (PTA), speech reception threshold (SRT), or word recognition scores (WRS).

Conclusions:

• OW and RW tissue reinforcement leads to a statistically significant but clinically insignificant decrease in hearing at 4000 Hz.
• The procedure does not negatively impact overall PTA, WRS, or SRT.
• OW and RW reinforcement is a safe procedure with minimal audiologic consequences.