Idiopathic sudden progressive hearing loss and round window membrane rupture

Area of Science:

• Otolaryngology
• Audiology
• Neurosurgery

Background:

• Idiopathic sudden progressive deafness (ISPD) is characterized by sensorineural hearing loss.
• Progressive hearing loss requires investigation into effective treatment strategies.

Purpose of the Study:

• To evaluate the efficacy of exploratory tympanotomy in treating idiopathic sudden progressive deafness (ISPD).
• To compare hearing outcomes and associated symptoms between surgical and conservative management of ISPD.

Main Methods:

• Audiometric evaluation of 24 patients with confirmed worsening sensorineural hearing loss.
• Exploratory tympanotomy performed in 10 patients, with assessment for perilymphatic leak.
• Comparison of hearing improvement, vertigo, and imbalance between operated and non-operated groups.

Main Results:

• Perilymphatic leak identified in 4 of 10 surgically treated patients.
• No significant difference in hearing improvement between surgical and conservative groups.
• Higher incidence and severity of vertigo and imbalance observed in the surgically treated group.

Conclusions:

• Exploratory tympanotomy for ISPD did not demonstrate superior hearing outcomes compared to conservative management.
• Surgical intervention in ISPD may be associated with increased risk of vestibular symptoms.
• Findings suggest a potential common cochlear lesion, possibly at the basal turn, in ISPD patients.