Surgical Management For Dysplastic Or Congenitally Absent Oval Window

Keywords

Conductive hearing loss; Congenitally absent oval window; Facial nerve anomaly; Oval window drill out

Abstract

Objective: To evaluate surgical findings and hearing results for patient’s undergoing the described surgical approach for congenitally absent or dysplastic oval window (OW). Study Design: The Institutional Review Board approved retrospective review of patients with conductive hearing loss (CHL) operated on from 1992 to 2016. Setting: Academic tertiary center. Patients: Patients with CHL, an intact tympanic membrane (TM), and without history of chronic infection underwent middle ear exploration. Eleven patients and 13 ears underwent an oval window drill-out (OWD) procedure. Intervention: Eleven patients presented, all with dysplastic or congenitally absent oval window (CAOW). CHL was identified using audiometry and tuning forks, many patients also had preoperative computed tomography temporal bones. A transcanal approach was used and an OWD was performed with a variety of prostheses placed. Main Outcome Measure: Audiometric studies before and after intervention were compared with 12 month and long-term follow-up (1–22 yr). Results: Preoperative air-bone gaps ranged from 40 to 60dB and averaged 55.1dB. Postoperative air-bone gaps ranged from 0 to 60dB and averaged 24.1dB. The preoperative pure-tone average (PTA) ranged from 55 to 99dB and averaged 71.3dB. Postoperative PTA ranged from 21 to 108dB and averaged 49.6dB. Conclusion: Dysplastic and CAOW are uncommon congenital major ear anomalies. OWD is a viable treatment option, though careful counseling is critical, as significant complications are possible, especially with facial nerve (FN) abnormalities. This series demonstrates successful closure of the air-bone gap for many patients with this technique.

Publication Date

1-1-2018

Publication Title

Otology and Neurotology

Volume

39

Issue

10

Number of Pages

e1039-e1046

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1097/MAO.0000000000002001

Socpus ID

85056564935 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/85056564935

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