[Lesions of round window membrane]

Area of Science:

• Otolaryngology
• Neurosurgery
• Auditory Medicine

Context:

• Rupture of the round window membrane (RWM) is a rare but significant cause of sensorineural hearing loss.
• Clinical presentation can be subtle, making diagnosis challenging without surgical exploration.
• Blunt head trauma is a potential cause of RWM rupture.

Purpose:

• To investigate the clinical presentation and outcomes of round window membrane rupture.
• To evaluate the efficacy of surgical repair in restoring hearing and alleviating symptoms.
• To study the healing process and pathological changes of the RWM in animal models and post-mortem human temporal bones.

Summary:

• Exploratory tympanotomy identified round window membrane rupture in 15 cases, primarily presenting with inner ear deafness, and less frequently vertigo and tinnitus.
• Early surgical repair of the resulting fistula offers a high chance of hearing restoration, with diminishing prospects over time.
• Delayed operations were effective in resolving vertigo and tinnitus, irrespective of the time interval since injury.

Impact:

• Highlights the necessity of exploratory tympanotomy in suspected cases of round window membrane injury.
• Emphasizes the time-sensitive nature of surgical intervention for optimal hearing preservation.
• Provides insights into the pathophysiology of RWM rupture and healing, informing future clinical management and research.