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Published on: May 23, 2021
Round Window Drill-Out in Advanced Otosclerosis
Kaitlyn E Aragon1, Jeffrey T Vrabec2
1Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine.
Summary
Round window drill-out (RWD) can help patients with severe hearing loss from otosclerosis. This surgical technique may improve hearing aid effectiveness, offering an alternative to cochlear implants.
Area of Science:
- Otolaryngology
- Neurosurgery
- Audiology
Background:
- Otosclerosis can cause mixed hearing loss, sometimes with round window obliteration.
- Advanced otosclerosis may necessitate alternative surgical interventions for hearing restoration.
Purpose of the Study:
- To evaluate the effectiveness of round window drill-out (RWD) in patients with otosclerosis and round window obliteration.
- To assess RWD as a potential alternative to cochlear implantation for severe hearing loss.
Main Methods:
- A retrospective review of 5 ears in 4 adult patients with mixed hearing loss and otosclerosis-induced round window obliteration.
- Round window drill-out (RWD) was performed, opening the cochlea's basal turn and reconstructing with fascia.
- Outcomes measured included feasibility, changes in air conduction thresholds, and air-bone gap (PTA-ABG).
Main Results:
- RWD was performed as primary stapedectomy (3 ears), delayed procedure (1 ear), or standalone surgery (1 ear).
- Median preoperative PTA-ABG was 31.3 dB.
- Significant PTA-ABG improvement (30-45 dB) was observed in 2 ears; minor improvement in 2 ears; and worsening in 1 ear.
Conclusions:
- Formal round window drill-out (RWD) may benefit patients with severe mixed hearing loss due to advanced otosclerosis.
- RWD can facilitate hearing aid use, presenting a viable alternative to cochlear implantation in select cases.
