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Hertel V, Schick B. [Diagnosis and treatment of frontobasal cerebrospinal fluid fistulas]. Laryngorhinootologie 2012; 91:585-97. [PMID: 22907624 DOI: 10.1055/s-0032-1316382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Independent of its origin a frontobasal cerebrospinal fluid (CSF) fistula is characterized by an open connection between the intracranial space with the outside world (usually the nose and paranasal sinuses). It leads to loss of CSF and is associated with a significant risk of developing meningitis for the patient during further life. Precise knowledge of possible aetiologies, clinical symptoms, current diagnostic options and surgical strategies are essential for the detection and successful management of frontobasal CSF fi fistulas. This article summarizes aetiology and clinical signs of frontobasal CSF fistulas. Further, laboratory tests to analyse fluid samples for cerebrospinal fluid as well as radiological and endoscopic investigation methods aiming to localize a CSF-fistula are presented. Finally, surgical techniques to close a frontobasal CSF fistula are explained.
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Al Kadah B, Bumm K, Charalampaki P, Schick B. [First experience in endonasal surgery using a new 3D-Chipendoscope]. Laryngorhinootologie 2012; 91:428-33. [PMID: 22581663 DOI: 10.1055/s-0032-1309051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Endoscopic surgery for treatment of nasal, paranasal and anterior skull base pathologies is an established treatment modality. Available rigid endoscopes with angled views provide a 2-dimensional view with restriction of depth perception. In this study we report about our first experience with a new 3D-Chipendoscope in surgery at the nose, paranasal sinuses und anterior skull base. MATERIAL AND METHODS 30 patients were enrolled in this study with chronic rhinosinusitis, inverted papilloma, frontal sinus mucocele, frontal sinus osteoma, chronic dacryocystitis and pituitary adenoma. All patients were subjected to standard endonasal endoscopic surgery using 3D-endoscopes. RESULTS Surgery was performed by the use of the 3D-endoscope in all patients. The operative handling of the 3D-endoscopes was user friendly in regard to design and weight of the endoscopes. The problem of fogging during endoscopic surgery diminishing the quality of view was not observed. Blood crusts on the endoscope tip however was able to changed the 3D-view to a 2D-view. To close positioning of the 3D-endoscopes to the surgical field reduced image quality. The visualisation of the frontal sinus was limited. CONCLUSION 3D-endoscopic surgery is an interesting development in endonasal surgery of pathologies at the nose, paranasal sinuses and anterior skull base.
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Al Kadah B, Bumm K, Schick B. [Endoscopic frontal sinus revision following transcutaneous endoscopic puncture and diaphanoscopy]. Laryngorhinootologie 2012; 91:301-5. [PMID: 22402999 DOI: 10.1055/s-0031-1301296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Endoscopic revision sinus surgery in case of frontal sinus pyocele may poses a great surgical challenge for various reasons. Due to the often troublesome anatomical changes caused by prior resection and findings of scaring with new bone formation, the identification of the frontal sinus in revision surgery is frequently a challenge for the surgeon. An easy endoscopic technique for a safe endonasal identification of the frontal sinus in revision surgery is therefore of major importance. MATERIAL AND METHODS 4 patients (3 men, 1 female) were enrolled with an acute frontal pyocele following prior open frontal sinus surgery over an external access. All patients were subjected to standard endonasal endoscopic frontal sinus surgery. The frontal sinus was endonasally approached after endoscopic transcutaneous frontal sinus puncture through the pre-existing bone defect achieving a diaphanoscopy with endonasal identification of the frontal sinus floor. RESULTS The external endoscopic puncture and illumination of the frontal sinus was performed in all 4 patients with a modular endoscopic system (Sinus View). A visual exploration of the frontal sinus was easily carried out after irrigation. A clear endonasal identification of the frontal sinus floor by diaphanoscopy was achieved in all patients and guided a direct opening of the frontal sinus. A stable frontal sinus drainage type IIb according to Draf was reached in all cases. CONCLUSION Transcutaneous frontal sinus puncture with an modular endoscope allows not only to verify frontal sinus pyocele diagnosis, but also provides the option to open the frontal sinus directly guided by the diaphanoscopy at the frontal sinus floor even in situations of complex anatomy.
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Schick B, Kronsbein H, Kahle G, Prescher A, Draf W. Papillary tumor of the temporal bone. Skull Base 2011; 11:25-33. [PMID: 17167601 PMCID: PMC1656843 DOI: 10.1055/s-2001-12783] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Papillary tumors of the middle and inner ear have been interpreted histogenetically in many ways. In 1989 Heffner proposed the endolymphatic sac epithelium as a possible origin. These rare tumors are clinically aggressive and can cause extensive temporal bone destruction. Because of this behavior, endolymphatic sac tumors (ELST) were classified as low-grade adenocarcinomas, although metastasis has not yet been documented. Two papillary neoplasms of the temporal bone are presented, which we believe are examples of adenomatous tumors arising from the epithelium of the endolymphatic sac. One was associated with a pituitary adenoma. A third case of a papillary middle ear neoplasm is described that shows histologic features similar to the other two, but it was located in the tympanum and had no connection to the endolymphatic sac. This report focuses on clinical, radiologic, and histologic findings of papillary tumors of the temporal bone with additional emphasis on modern concepts of histogenesis and aspects of differential diagnosis.
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Schick B, Weber R, Kahle G, Draf W, Lackmann GM. Late manifestations of traumatic lesions of the anterior skull base. Skull Base Surg 2011; 7:77-83. [PMID: 17170993 PMCID: PMC1656597 DOI: 10.1055/s-2008-1058612] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The authors review their experience in detecting occult traumatic dural lesions. In a retrospective study covering the period from January 1, 1984 to December 31, 1996, 23 patients were evaluated for occult traumatic dural lesions. Clinical presentation, diagnostic work-up, and management of the dural lesions were analyzed.The clinical presentations of the previously undetected dural lesions of the anterior skull base were meningitis in eight cases, cerebrospinal fluid (CSF) rhinorrhea in eight cases, both meningitis and CSF rhinorrhea in five cases, and a pulsating swelling in the region of the right upper eyelid in one case. In another case a fracture of the posterior frontal wall was detected incidentally on the preoperative CT scan performed prior to surgery for chronic sinusitis. One patient had a CSF fistula of the lateral skull base in addition to the frontobasal fistula. The interval between trauma and diagnosis varied from 1 to 48 years. Dural lesions were localized by high-resolution CT, fluorescein nasal endoscopy, CT cisternography, and MRI. Intraoperative exposure of the dural lesions and duraplasty were possible in all cases. During the first attempt successful repair of the dural lesions was accomplished in 22 (95.7%) of the 23 patiants. Two interventions were necessary to close a CSF leak of the cribriform plate.Modern clinical and radiologic diagnostic methods should be employed to search for an occult dural lesion in patients with recurrent meningitis, meningitis caused by upper airway pathogens, or CSF rhinorrhea. The patient will remain at risk of potentially fatal meningitis until the lesion is appropriately repaired by duraplasty.
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Abstract
Reconstruction of the anterior skull base must be secure and watertight. Failure to achieve this places the patient at risk of the development of cerebral sepsis. We have developed the technique of endonasal duraplasty and have achieved a 90% long-term success rate. In this article we described the key elements of our technique starting with radiographic and fluorescein localization of a skull base defect. The main steps in reconstruction and materials used are detailed, together with modifications of our technique for certain difficult situations and tips for success. Attention is drawn to potential pitfalls that have been identified over 25 years of clinical practice.
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Bader CA, Bohle RM, Schick B, Naumann A. [Mechanically disturbed phonation - a case report]. Laryngorhinootologie 2011; 90:619-20. [PMID: 21547868 DOI: 10.1055/s-0031-1275280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Naumann A, Ehrmantraut S, Willnecker V, Menger M, Schick B, Laschke M. Ohrrekonstruktionen mit Hilfe poröser Polyethylenimplantate. HNO 2011; 59:268-73. [DOI: 10.1007/s00106-010-2226-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kushalnagar P, Topolski TD, Schick B, Edwards TC, Skalicky AM, Patrick DL. Mode of communication, perceived level of understanding, and perceived quality of life in youth who are deaf or hard of hearing. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2011; 16:512-23. [PMID: 21536686 PMCID: PMC3202327 DOI: 10.1093/deafed/enr015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Given the important role of parent-youth communication in adolescent well-being and quality of life, we sought to examine the relationship between specific communication variables and youth perceived quality of life in general and as a deaf or hard-of-hearing (DHH) individual. A convenience sample of 230 youth (mean age = 14.1, standard deviation = 2.2; 24% used sign only, 40% speech only, and 36% sign + speech) was surveyed on communication-related issues, generic and DHH-specific quality of life, and depression symptoms. Higher youth perception of their ability to understand parents' communication was significantly correlated with perceived quality of life as well as lower reported depressive symptoms and lower perceived stigma. Youth who use speech as their single mode of communication were more likely to report greater stigma associated with being DHH than youth who used both speech and sign. These findings demonstrate the importance of youths' perceptions of communication with their parents on generic and DHH-specific youth quality of life.
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Al Kadah B, Wolf G, Schick B. [Lacrimal systems endoscopy with a new endoscope system]. Laryngorhinootologie 2010; 89:730-6. [PMID: 20859845 DOI: 10.1055/s-0030-1262824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Successful therapy of postsaccal stenosis in the lacrimal system can be done by an ENT Surgeon by endonasal dacryocystorhinostomy. It is desirable to have a good diagnostic method of the lacrimal system before undertaking surgery. This study describes the first experiences of endoscopic diagnostics of the lacrimal system with a new endoscope. MATERIAL AND METHODS 24 patients (10 male and 14 female, between 3 and 65 years old) with epiphora and chronic lacrimal system infections were examined in the ENT Department Homburg/Saar with a 0.53 mm modular endoscope, between 11/2008 and 12/2009. The result were evaluated and analysed. RESULTS The endoscopic lacrimal system examination was done in all 24 patients. 8 patients with high stenosis postsaccal and purulent epiphora had an endonasal dacryocystorhinostomie. 13 patients with prasaccal stenosis or stenosis in the ductus nasolacrimalis with clear epiphora were treated with irrigation, dilatation and U-intubation. The removal of the Endoscopic dilatation was undertaken in 3 children without using bicanicular intubation. CONCLUSION Lacrimal system endoscopy with a modular endoscope with the possibility of interventional procedures is an efficient option in the widening diagnosis and therapy of the lacrimalm system disease. With this technique is it possible with selected patients to do interventional therapy. On the basis of the endoscopic findings an interventional therapy or an endonasal dacryocystorhinostomie can be done.
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Heindl LM, Schick B, Kämpgen E, Kruse FE, Holbach LM. [Malignant melanoma of the lacrimal sac]. Ophthalmologe 2009; 105:1146-9. [PMID: 18438631 DOI: 10.1007/s00347-008-1740-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A 68-year-old woman presented with a 10-month history of right-sided epiphora, bloody tears, and medial canthal mass. Computed tomography revealed a soft tissue mass of the right lacrimal sac with widening of the bony nasolacrimal canal. External dacryocystorhinostomy with incisional biopsy confirmed the diagnosis of malignant melanoma. After staging, further therapy included orbital exenteration, lateral rhinotomy with en bloc resection of the lacrimal drainage apparatus, and adjuvant radioimmunotherapy. One year after surgery, no evidence of local recurrence or metastatic disease could be detected.
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Schick B, Habermann F, Sinowatz F. Histochemical Detection of Glycoconjugates in the Canine Epididymis. Anat Histol Embryol 2009; 38:122-7. [DOI: 10.1111/j.1439-0264.2008.00908.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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De Souza EJ, Kamperman M, Castellanos G, Kroner E, Armbruester V, Romann MS, Schick B, Arzt E. In vitro adhesion measurements between skin and micropatterned poly(dimethylsiloxane) surfaces. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2009; 2009:6018-6021. [PMID: 19964886 DOI: 10.1109/iembs.2009.5334532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Micropatterned adhesive surfaces may have potential in reconstructive surgery. The adhesion performance of mice ear skin to micropatterned poly(dimethylsiloxane) (PDMS) was investigated, under in vitro conditions, and compared to flat substrates. No significant difference in separation force F was observed between flat substrates and micropatterned surfaces with pillar arrays. However, the energy necessary for separation of the substrate from the skin was sensitive to the topography. Furthermore, our results show that the force-displacement curves depended on the wetness of the skin: Highest force values were obtained for fresh skin while the forces decreased as the skin dried out. The results are encouraging for further studies on the potential of patterned PDMS in biomedical applications.
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Gramann M, Wendler O, Haeberle L, Schick B. Expression of Collagen Types I, II and III in Juvenile Angiofibromas. Cells Tissues Organs 2008; 189:403-9. [DOI: 10.1159/000158754] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2008] [Indexed: 11/19/2022] Open
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Dlugaiczyk J, Gottwald F, Amann K, Schick B. Liposarkom. HNO 2008; 56:916-9. [PMID: 17464491 DOI: 10.1007/s00106-007-1567-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
With less than 100 cases described in the literature, the incidence of liposarcoma in the head and neck is very low. We report on a 54-year-old patient with a liposarcoma of the right cervical soft tissue. After complete tumor extirpation the patient underwent radiotherapy. Diagnostics, histopathological classification, therapy and prognosis of liposarcoma are discussed in this case report and review of the literature.
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Behnecke A, Mayr S, Schick B, Iro H, Raithel M. Evaluation of ECP release from intact tissue biopsies from patients with nasal polyps. Inflamm Res 2008; 57 Suppl 1:S65-6. [PMID: 18345486 DOI: 10.1007/s00011-007-0632-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Behnecke A, Aigner T, Rösler W, Schick B. [Septal perforation and palatal defect]. HNO 2008; 56:623-6. [PMID: 18340423 DOI: 10.1007/s00106-008-1668-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Psychogios G, Alexiou C, Schick B, Papadopoulos T, Iro H. [Salivary gland tumor of the hard palate]. Laryngorhinootologie 2008; 87:579-82. [PMID: 18461513 DOI: 10.1055/s-2007-995620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Pleomorphic adenomas of the small salivary glands are very rare and usually arise from the hard palate. CASE REPORT We present a female patient who was referred to our Department because of a bleeding enoral tumor, which persisted for 35 years. Histopathological examination after complete tumor excision showed a pleomorphic adenoma. CONCLUSION Pleomorphic adenomas are an important differential diagnosis for tumors of the hard palatine. The therapy of choice is surgical excision.
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Schick B. Buchbesprechung/Book Review. Anat Histol Embryol 2007. [DOI: 10.1111/j.1439-0264.2007.00818.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hornung J, Zenk J, Schick B, Wurm J, Iro H. [First experiences with a new nickel-titanium piston with a shape memory feature]. HNO 2007; 55:104-8. [PMID: 16767427 DOI: 10.1007/s00106-006-1432-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The aim of this study was to describe a new stapes prosthesis with memory characteristics for wire crimping (SMart-Piston). PATIENTS AND METHODS This technique was used in 15 patients (mean age 43.4 years; range 28-71) undergoing routine stapes surgery. SMart-Piston prostheses with a shaft diameter of 0.5 mm and length ranging from 4.25-4.5 mm were used. Heat induced wire crimping was performed by CO2 laser in five patients, and by bipolar diathermy forceps in ten patients. In 15 patients, postoperative audiological testing was performed at an average 21.9 days and in another 10 again after 435 days following surgery. RESULTS The median observed air-bone-gap (ABG) postoperatively was 8.7 dB+/-7.7 dB. A total of 73% of all patients had an ABG of 10 dB or less, and all patients had less than 20 dB. In the ten patients controlled after 435 days, the ABG was 4.4 dB+/-2.4 dB. It was lower than 10 dB in all individuals. DISCUSSION A critical point in every stapes surgery, the prosthesis fixation to the incus, is greatly facilitated by this novel technique. Long-term results in a larger group of patients are pending.
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Schick B, Weidenbecher M, Miller R, Iro H. [Experience with laryngotracheal reconstruction in subglottic stenosis in a 30 years time period]. Laryngorhinootologie 2007; 86:358-64. [PMID: 17226434 DOI: 10.1055/s-2006-945002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Severe subglottic stenosis is a difficult condition to manage. It can be treated by laryngotracheal reconstruction or cricotracheal resection. PATIENTS AND METHODS In this retrospective study the experiences for treatment of isolated subglottic stenosis in 37 patients (age: 3-78 years; stenosis grading: 20 x grade II, 13 x grade III, and 4 x grade IV) by laryngotracheal reconstruction in a 30-years experience are presented. RESULTS In 33 out of 37 patients (89.2 %) a sufficient subglottic patency (postoperative endoscopic finding: stenosis less than 30 %) was achieved by laryngotracheal reconstruction. However, 5 patients of this series had required revision of laryngotracheal recontruction and in 22 patients endoscopic removal of granulation tissue had been performed. Sufficient widening of the subglottic space had been possible in all grade II stenosis (20/20), in 11 out of 13 patients with grade III stenosis, and in 3 out of 4 patients with grade IV stenosis. In one child an accidental decannulation occurred and due to asphyxia an apallic syndrome developed. CONCLUSIONS Even through laryngotracheal reconstruction is a demanding surgical technique requiring great experience it is an effective option for treatment of subglottic stenosis less than 90 %. For severe subglottic stenosis (> 90 %) treatment by laryngotracheal reconstruction is possible and should be considered if mobilisation of the trachea by scar tissue is suited to be worse or to extended cricotracheal stenosis is present, both being not good candidates for cricotracheal resection.
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Schick B, Schick BT, Kochannek S, Starlinger V, Iro H. [Temporary sensory hearing deficits after ear surgery--a retrospective analysis]. Laryngorhinootologie 2006; 86:200-5. [PMID: 17131257 DOI: 10.1055/s-2006-944750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Temporary and persistent threshold shifts can occur after ear surgery. So far, only few studies deal with temporary sensory hearing deficits after ear surgery. PATIENTS AND METHODS In a retrospective study, thresholds at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz were analysed in 393 patients (125 x mesotympanal chronic otitis media, 164 x cholesteatoma, 44 x tympanosclerosis, 60 x otosclerosis) before, the first 4 days and 3 weeks after ear surgery to evaluate possible temporary threshold shifts. RESULTS Analysis of all patients in total proved statistically significant slight temporary threshold shifts of up to 7 dB at 2000 Hz (postoperative day 1 to 3) and at 4000 Hz (postoperative day 1 and 2). Use of a drill caused a statistically slight temporary threshold shift only at 2000 Hz at the first postoperative day (4.2 dB). In cholesteatoma surgery with preparations at the ossicular chain a statistically significant slightly higher threshold level was found in all postsurgical evaluations at 500 Hz. Removal of scars or granulation tissue attached to the ossicular chain was not associated with an elevation of threshold levels. CONCLUSION Slight temporary threshold shifts can be observed at 2000 Hz and 4000 Hz after ear surgery. Use of the drill and preparation at the ossicular chain usually results in no significant sensory hearing deficit.
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