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[Round window membrane pathology in sudden deafness (author's transl)]
Abstract:
Exploration of the middle ear was performed on 15 patients with sudden deafness that had failed to improve after intravenous infusion of Eupaverin and Rheomacrodex. Three patients had abnormalities of the round window membrane, in 2 there was a perilymphatic fistula and in 1 an abnormal bulging of the membrane with no transmission of perilymphatic fluid movement. These 3 patients presented with a history of exertion or stress prior to the onset of symptoms. Surgical closure ofthe 2 fistulae led to improvement of hearing, and perilymphatic decompression in the third patient improved the tinnitus but not the deafness. The possible causes of round window pathology are discussed.
Insights
Sudden deafness may involve round window abnormalities, including perilymphatic fistulas. Surgical intervention for these conditions can improve hearing and tinnitus in some patients.
Area of Science:
- Otolaryngology
- Neurosurgery
- Audiology
Context:
- Sudden deafness is a complex condition often requiring multidisciplinary investigation.
- Previous treatments like Eupaverin and Rheomacrodex were ineffective in these 15 patients.
- Middle ear exploration is a diagnostic tool for refractory sudden deafness.
Purpose:
- To investigate middle ear abnormalities in patients with sudden deafness unresponsive to conventional treatment.
- To identify the role of the round window membrane in sudden deafness.
- To evaluate surgical outcomes for round window pathologies.
Summary:
- Exploration of the middle ear was conducted on 15 patients with sudden deafness.
- Three patients exhibited round window membrane abnormalities: two with perilymphatic fistulas and one with abnormal bulging.
- These three patients reported exertion or stress preceding symptom onset.
- Surgical closure of fistulas improved hearing; decompression improved tinnitus but not deafness.
Impact:
- Highlights potential surgical targets for sudden deafness.
- Suggests a link between physical exertion/stress and round window pathology.
- Informs clinical management of sudden deafness with suspected inner ear involvement.