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Thedinger WB, Dornhoffer JR, Merlino DJ, Lane JI, Carlson ML, Kircher ML. Cochlear Implantation in Patients With Osteolytic Labyrinthitis: A Case Series. Otol Neurotol 2024; 45:e406-e410. [PMID: 38728556 DOI: 10.1097/mao.0000000000004193] [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: 05/12/2024]
Abstract
OBJECTIVE To describe the rare process of osteolytic labyrinthitis, previously referred to as labyrinthine sequestrum, which involves progressive obliteration of the bony and membranous labyrinth with eventual supplantation with soft tissue and, in some cases, bony sequestrum. PATIENTS Three patients with diverse presentations of osteolytic labyrinthitis from two tertiary care academic medical centers. INTERVENTIONS Case series report analyzing the relevant clinical, radiologic, pathologic, and surgical data on our patients with osteolytic labyrinthitis and comparing these index cases to the existing literature. MAIN OUTCOME MEASURES We describe the varying image findings seen in osteolytic labyrinthitis on computed tomography and magnetic resonance imaging. Also, we report successful surgical intervention and hearing rehabilitation with cochlear implantation in patients with osteolytic labyrinthitis. RESULTS Our three patients presented with profound sudden sensorineural hearing loss and vertigo consistent with labyrinthitis. None of the three patients had a history of chronic otitis media. Imaging workup revealed varying degrees of erosion to the otic capsule bone demonstrating the spectrum of disease seen in osteolytic labyrinthitis. Although two cases showed osteolytic changes to the semicircular canals and vestibule, the first case revealed frank bony sequestrum within the obliterated labyrinth. The three cases were taken for surgical debridement and cochlear implantation. CONCLUSIONS We propose the new term, osteolytic labyrinthitis-previously referred to as labyrinthine sequestrum-to describe the rare spectrum of disease characterized by destruction of the osseous and membranous labyrinth and potential supplantation with bony sequestrum. Cochlear implantation is a viable option in selected patients with osteolytic labyrinthitis.
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Affiliation(s)
- William B Thedinger
- Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois
| | - James R Dornhoffer
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Dante J Merlino
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - John I Lane
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | | | - Matthew L Kircher
- Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois
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Zeng X, Lin Z, Han X, Li J, Zhang P, Gou L, Xu J. Bilateral Hearing Loss and Unilateral Cochlear Ossification in a Patient With Chronic Myelogenous Leukemia. EAR, NOSE & THROAT JOURNAL 2020; 100:301S-303S. [PMID: 32970497 DOI: 10.1177/0145561320961073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Bilateral sensorineural deafness and unilateral cochlear ossification have rarely been described in patients with chronic myeloid leukemia (CML). A 21-year-old man presented to a hospital with right-sided sudden hearing loss and tinnitus. He was diagnosed with CML. Five days later, sudden hearing loss appeared in the other ear. Abnormality of the right-sided inner ear structure was revealed by preoperative magnetic resonance imaging; honeycomb-like cochlear ossification was observed during cochlear implant surgery in the right ear. The patient's auditory performance exhibited significant improvement after bilateral cochlear implantation in our hospital. Hematological disorders must be considered in patients with sensorineural hearing loss. Cochlear implantation is feasible in patients with CML who exhibit sensorineural deafness, but cochlear ossification should be carefully evaluated by means of preoperative imaging examinations.
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Affiliation(s)
- Xianhai Zeng
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China.,Shenzhen Key Laboratory of E.N.T., Institute of E.N.T., Longgang, Shenzhen, Guangdong, China
| | - Zengping Lin
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China
| | - Xiaodong Han
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China
| | - Juanjuan Li
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China
| | - Peng Zhang
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China.,Shenzhen Key Laboratory of E.N.T., Institute of E.N.T., Longgang, Shenzhen, Guangdong, China
| | - Lingshan Gou
- 557766Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, China
| | - Jian Xu
- Department of Otolaryngology, Longgang E.N.T. Hospital, Longgang, Shenzhen, Guangdong, China.,Shenzhen Key Laboratory of E.N.T., Institute of E.N.T., Longgang, Shenzhen, Guangdong, China.,Shenzhen Longgang Institute of Stomatology, Longgang, Shenzhen, Guangdong, China
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Yilmazer R, Karatay E, Akbulut S, Alkan Z, Sarikaya B. Anatomical landmarks for cochlear implantatıon in ossifıed cochleas. Eur Arch Otorhinolaryngol 2020; 277:3301-3306. [PMID: 32440899 DOI: 10.1007/s00405-020-06044-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/08/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE In this study, we aimed to introduce the facial nerve as a new anatomical landmark which can be used in ossified cochleas during cochlear implantation. We also set out to define a safe line to preserve the internal auditory canal (IAC) while drilling the basal turn of the cochlea. METHODS Thirty patients who had temporal computed tomography (CT) were studied. The distances from the facial nerve and the round window to the IAC, carotid artery, and jugular bulb were measured in the reformatted CT images. We have created a line in the direction of the stapedial tendon from the round window to the IAC and called it ROWIAC (Round window-IAC) line. We have investigated whether this line intersects the IAC and measured the distances from this line to the IAC. RESULTS Fifty-four temporal CT scans were included to the study. The mean distances from the facial nerve to the IAC, carotid artery, and jugular bulb were 8.8 ± 0.9, 15.0 ± 2.0, and 12.2 ± 2.9 mm, respectively. The mean distances from the round window to these structures were 3.8 ± 0.7, 9.4 ± 2.2, and 8.3 ± 2.9 mm, respectively. ROWIAC line did not intersect the IAC in any of the patients. The mean distance between this line and the IAC was 0.8 ± 0.4 mm. CONCLUSION We propose that facial nerve and ROWIAC line can be used as potential landmarks during cochlear implantation in ossified cochleas to protect the adjacent neurovascular structures.
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Affiliation(s)
- Rasim Yilmazer
- Department of Otolaryngology, Demiroglu Bilim University Hospital, Istanbul, Turkey.
- Florence Nightingale Atasehir Hastanesi, Kulak Burun Bogaz Anabilim Dali, Kuçukbakkalkoy Mahallesi, Isiklar Cd. 35/A, 34750, Atasehir/Istanbul, Turkey.
| | - Emrah Karatay
- Department of Radiology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey
| | - Sevtap Akbulut
- Department of Otolaryngology, Yeditepe University Hospital, Istanbul, Turkey
| | - Zeynep Alkan
- Department of Otolaryngology, Yeditepe University Hospital, Istanbul, Turkey
| | - Basar Sarikaya
- Department of Radiology, University of Washington, Seattle, WA, USA
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Benson JC, Diehn F, Passe T, Guerin J, Silvera VM, Carlson ML, Lane J. The Forgotten Second Window: A Pictorial Review of Round Window Pathologies. AJNR Am J Neuroradiol 2019; 41:192-199. [PMID: 31831467 DOI: 10.3174/ajnr.a6356] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/02/2019] [Indexed: 12/26/2022]
Abstract
The round window serves to decompress acoustic energy that enters the cochlea via stapes movement against the oval window. Any inward motion of the oval window via stapes vibration leads to outward motion of the round window. Occlusion of the round window is a cause of conductive hearing loss because it increases the resistance to sound energy and consequently dampens energy propagation. Because the round window niche is not adequately evaluated by otoscopy and may be incompletely exposed during an operation, otologic surgeons may not always correctly identify associated pathology. Thus, radiologists play an essential role in the identification and classification of diseases affecting the round window. The purpose of this review is to highlight the developmental, acquired, neoplastic, and iatrogenic range of pathologies that can be encountered in round window dysfunction.
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Affiliation(s)
- J C Benson
- From the Departments of Neuroradiology (J.C.B., F.D., T.P., J.G., V.M.S., J.L.)
| | - F Diehn
- From the Departments of Neuroradiology (J.C.B., F.D., T.P., J.G., V.M.S., J.L.)
| | - T Passe
- From the Departments of Neuroradiology (J.C.B., F.D., T.P., J.G., V.M.S., J.L.)
| | - J Guerin
- From the Departments of Neuroradiology (J.C.B., F.D., T.P., J.G., V.M.S., J.L.)
| | - V M Silvera
- From the Departments of Neuroradiology (J.C.B., F.D., T.P., J.G., V.M.S., J.L.)
| | - M L Carlson
- Otolaryngology-Head and Neck Surgery (M.L.C.), Mayo Clinic, Rochester, Minnesota
| | - J Lane
- From the Departments of Neuroradiology (J.C.B., F.D., T.P., J.G., V.M.S., J.L.)
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Buch K, Baylosis B, Fujita A, Qureshi MM, Takumi K, Weber PC, Sakai O. Etiology-Specific Mineralization Patterns in Patients with Labyrinthitis Ossificans. AJNR Am J Neuroradiol 2019; 40:551-557. [PMID: 30792250 DOI: 10.3174/ajnr.a5985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/05/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Our aim was to identify whether specific patterns of ossification in labyrinthitis ossificans are associated with the known risk factors. Labyrinthitis ossificans has been described as sequela of prior temporal bone trauma, prior infection, and other disorders including sickle cell disease. Specific patterns of mineralization in the membranous labyrinth associated with these risk factors has not been previously described. MATERIALS AND METHODS This was a retrospective study evaluating temporal bone CT scans at our institution from November 2005 to May 2018 in patients with labyrinthitis ossificans. Membranous labyrinthine structures evaluated for ossification included the following: basal, middle, and apical cochlear turns; lateral, posterior, and superior semicircular canals; and the vestibule for both ears in all patients. These structures were assigned a severity score, 0-4, based on degree of mineralization. Clinical records were reviewed for potential labyrinthitis ossificans risk factors. Basic descriptive statistics and a mixed model were used to correlate the degree and patterns of ossification with clinical history. RESULTS Forty-four patients (58 ears) with labyrinthitis ossificans were identified and evaluated. The most common risk factors were chronic otomastoiditis (n = 18), temporal bone surgery (n = 9), temporal bone trauma (n = 6), sickle cell disease (n = 5), and meningitis (n = 4). For all etiologies, the semicircular canals were most severely affected, and the vestibule was the least. In patients with prior temporal bone surgery, significantly greater mineralization was seen in the basal turn of the cochlea (P = .027), the vestibule (P = .001), and semicircular canals (P < .001-.008). No significant pattern was identified in patients with meningitis, sickle cell disease, or trauma. CONCLUSIONS Significant patterns of mineralization in labyrinthitis ossificans were observed in patients with prior temporal bone surgery. For all etiologies, the semicircular canals were most severely affected. No significant mineralization pattern was observed in patients with chronic otomastoiditis, meningitis, sickle cell disease, or prior temporal bone trauma.
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Affiliation(s)
- K Buch
- From the Departments of Radiology (K.B., B.B., A.F., M.M.Q., K.T., O.S.)
| | - B Baylosis
- From the Departments of Radiology (K.B., B.B., A.F., M.M.Q., K.T., O.S.)
| | - A Fujita
- From the Departments of Radiology (K.B., B.B., A.F., M.M.Q., K.T., O.S.)
- Department of Radiology (A.F.), Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - M M Qureshi
- From the Departments of Radiology (K.B., B.B., A.F., M.M.Q., K.T., O.S.)
- Radiation Oncology (M.M.Q., P.C.W., O.S.)
| | - K Takumi
- From the Departments of Radiology (K.B., B.B., A.F., M.M.Q., K.T., O.S.)
| | - P C Weber
- Radiation Oncology (M.M.Q., P.C.W., O.S.)
| | - O Sakai
- From the Departments of Radiology (K.B., B.B., A.F., M.M.Q., K.T., O.S.)
- Radiation Oncology (M.M.Q., P.C.W., O.S.)
- Otolaryngology-Head and Neck Surgery (O.S.), Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
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Bunch PM, Kelly HR. Labyrinthitis. Neuroradiology 2019. [DOI: 10.1016/b978-0-323-44549-8.00043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mancini P, Atturo F, Di Mario A, Portanova G, Ralli M, De Virgilio A, de Vincentiis M, Greco A. Hearing loss in autoimmune disorders: Prevalence and therapeutic options. Autoimmun Rev 2018; 17:644-652. [PMID: 29729446 DOI: 10.1016/j.autrev.2018.01.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 01/02/2018] [Indexed: 12/20/2022]
Abstract
The objective of this study was to review our current knowledge relative to the correlation between sensorineural hearing loss (SNHL) and autoimmune diseases, focusing on the prevalence of hearing loss in different pathologies and possible therapeutic approaches. A review of the literature on hearing loss in different forms of autoimmune disease has been carried out, with emphasis on incidence and prevalence of SNHL. Therapeutic protocols have been assessed including both conservative medical and rehabilitative methods. Cochlear implant outcomes have been investigated. The prevalence of hearing loss in autoimmune and immune-mediated inner ear diseases, as referred by case reports or single-center statistics, is widely variable. More difficult is the evaluation of severe/profound SNHL, usually reported in relation to cochlear implantation. Though these patients represent ideal candidates for cochlear implantation, as they become deaf after years of hearing; the associated systemic disease, the specific damage on inner ear structures and the medication taken may influence the result of cochlear implantation. The main problem is the cochlear fibrosis or ossification that has been found to affect 50% of implanted ears in patients suffering from autoimmune and immune-mediated SNHL. Hence, in the presence of severe/profound SNHL earlier implantation may be indicated before post-inflammatory obliterative changes to the cochlea.
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Affiliation(s)
- Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Francesca Atturo
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Alessia Di Mario
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy
| | - Ginevra Portanova
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy
| | - Massimo Ralli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Armando De Virgilio
- Otorhinolaryngology Unit, Humanitas Clinical and Research Center, Viale Manzoni 56, 20089, Rozzano (MI)
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
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Kaya S, Paparella MM, Cureoglu S. Pathologic Findings of the Cochlea in Labyrinthitis Ossificans Associated with the Round Window Membrane. Otolaryngol Head Neck Surg 2016; 155:635-40. [PMID: 27221575 DOI: 10.1177/0194599816651245] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 05/03/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To quantitatively demonstrate and classify the histopathologic changes in the cochlea of the human temporal bones with labyrinthitis ossificans (LO). STUDY DESIGN Comparative human temporal bone study. SETTING Tertiary academic medical center. SUBJECTS AND METHODS We compared 23 temporal bone specimens from 19 deceased donors with LO associated with the round window membrane (RWM) and 27 age-matched specimens from 20 deceased donors without any otologic diseases. We focused on the location of LO in the inner ear, the intensity of endolymphatic hydrops, the number of spiral ganglion cells and cochlear hair cells, and the areas of the stria vascularis and spiral ligament. In addition, we created a new pathologic grading system for temporal bone specimens from deceased donors with LO associated with the RWM. RESULTS We most often observed LO in the scala tympani of the basal cochlear turn. In the LO group (as compared with the control group), the intensity of endolymphatic hydrops was significantly increased; the number of spiral ganglion cells was significantly decreased in all segments; the loss of outer and inner hair cells was significantly increased in all turns of the cochlea; the atrophy of the stria vascularis was significantly greater in all turns of the cochlea; and atrophy of the spiral ligament was significantly greater in the basal and middle cochlear turn. CONCLUSION LO was associated with significant cochlear damage (to the spiral ganglion cells, cochlear hair cells, stria vascularis, and spiral ligament) and with increased intensity of endolymphatic hydrops.
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Affiliation(s)
- Serdar Kaya
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA Department of Otolaryngology-Head and Neck Surgery, Gebze Fatih State Hospital, Gebze, Turkey
| | | | - Sebahattin Cureoglu
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
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The incidence of tympanogenic labyrinthitis ossificans. The Journal of Laryngology & Otology 2014; 128:618-20. [DOI: 10.1017/s002221511400111x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To estimate the incidence of tympanogenic labyrinthitis ossificans.Methods:The records of patients treated with mastoidectomy for various tympanogenic aetiologies from January 2007 to December 2011 were retrospectively reviewed. Patients whose high-resolution computed tomography scans showed evidence of labyrinthine calcification of the temporal bone were enrolled. Patients with a history of head and neck cancer, meningitis, and otosclerosis, and patients with cochlear implants, were excluded from this study.Results:A total of 195 patients were enrolled in this study; 4 of the patients presented with calcification in the inner ear. Therefore, the incidence of tympanogenic labyrinthitis ossification was 2 per cent. The computed tomography findings revealed: (1) cochlear calcifications of the basal and middle turn in two patients; and (2) vestibular, superior semicircular canal, posterior semicircular canal and lateral semicircular canal calcification in one, four, three and two patients, respectively.Conclusion:The incidence of tympanogenic labyrinthitis ossification in patients who had undergone a mastoidectomy was 2 per cent.
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High-resolution 3-D T2-weighted imaging in the diagnosis of labyrinthitis ossificans: emphasis on subtle cochlear involvement. Pediatr Radiol 2013; 43:1584-90. [PMID: 23843131 DOI: 10.1007/s00247-013-2747-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/22/2013] [Accepted: 06/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Meningitis is the most common cause of acquired sensorineural hearing loss (SNHL) in children. Labyrinthitis ossificans develops in a significant number of patients with meningitis-related SNHL. Reduced T2 signal on MRI within the membranous labyrinth is often noted in the fibrous and ossifying stages of labyrinthitis ossificans. OBJECTIVE The purpose of this study is to demonstrate the distribution and extent of involvement of the cochlea in children being evaluated for labyrinthitis ossificans; using high-resolution 3-D T2-weighted imaging, and to evaluate for subtle involvement of the scala tympani within the basal turn of the cochlea. MATERIALS AND METHODS A retrospective review from 2002 to 2012 was performed using a cochlear implant database and PACS search function. Twenty-four patients were found to have MR findings consistent with labyrinthitis ossificans, 13 previously reported. Axial 3-D T2-weighted sequences were obtained in all patients. The presence of abnormal decreased T2 signal within the scala tympani and vestibuli of the cochlea was noted and graded according to the extent. The electronic medical record was reviewed for audiometry and risk factors as well as correlative operative findings. RESULTS The average age at imaging was 4.2 years. M:F ratio = 5:1. Eighty-eight percent (21/24) of patients had bilateral SNHL. The most common risk factor for labyrinthitis ossificans was meningitis (19/24 or 79%). Eighteen (75%) patients had a history of bacterial meningitis. The mean age for the onset of labyrinthitis was 1.2 years with an average of 2.2-year interval to imaging. Nineteen patients (79%) underwent placement of a cochlear implant. Cochlear obstruction was documented in 83% (40/48) of the ears. Lower grade (1) cochlear obstruction was present in 14 ears and limited to the scala tympani. Statistical analysis was performed correlating MRI imaging and surgical findings. CONCLUSION Subtle, isolated involvement of the scala tympani within the proximal basal turn is a common finding in labyrinthitis ossificans and history typical for meningitis is not uniformly present. The extent of cochlear obstruction is important and has surgical implications.
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Suzuki M, Goto T, Kashio A, Yasui T, Sakamoto T, Ito K, Yamasoba T. Preservation of vestibular function after scala vestibuli cochlear implantation. Auris Nasus Larynx 2011; 38:638-42. [PMID: 21330072 DOI: 10.1016/j.anl.2011.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2010] [Revised: 01/03/2011] [Accepted: 01/13/2011] [Indexed: 10/18/2022]
Abstract
A 58-year-old man, in whom the cochlear implant (CI) had been inserted into the left ear, had right middle-ear cancer. The CI was removed immediately before receiving subtotal removal of right temporal bone. Four months later, the CI was again inserted in his left cochlea. Because of obliterated scala tympani, the 22 active electrodes of the CI were placed into the scala vestibuli. After the surgery, the patient complained that he experienced rotary vertigo and "jumbling of vertical direction" of objects on walking. Using rotation test, we evaluated vestibular function of remaining left ear. Numerous horizontal nystagmus beats were induced during earth-vertical axis rotation, whereas vertical downbeat nystagmus was scarcely induced during off-vertical axis rotation. The horizontal vestibulo-ocular reflex (VOR) was almost normally induced by sinusoidal stimulation at 0.8Hz. These data suggest that the scala vestibuli insertion of CI would be not so invasive against the lateral semicircular canal.
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Affiliation(s)
- Mitsuya Suzuki
- Department of Otolaryngology, Sakura Medical Center, University of Toho, Chiba, Japan.
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Hohman MH, Backous DD. Techniques for cochlear implant electrode placement in the ossified cochlea. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.otot.2010.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Benson AG. Labyrinthitis ossificans secondary to autoimmune inner ear disease: a previously unreported condition. Otolaryngol Head Neck Surg 2010; 142:772-3. [PMID: 20416474 DOI: 10.1016/j.otohns.2009.10.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Accepted: 10/28/2009] [Indexed: 10/19/2022]
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15
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Cureoglu S, Schachern PA, Rinaldo A, Tsuprun V, Ferlito A, Paparella MM. Round window membrane and labyrinthine pathological changes: an overview. Acta Otolaryngol 2005; 125:9-15. [PMID: 15799567 DOI: 10.1080/00016480410022534] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The round window membrane is considered the most likely pathway from the middle to the inner ear. Various substances placed in the middle ear have been seen to pass through the round window membrane. Once toxic substances or inflammatory mediators such as cytokines and nitric oxide enter the inner ear, various inner ear sequelae such as labyrinthitis, endolymphatic hydrops, sensorineural hearing loss or more insidious diseases can occur.
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Affiliation(s)
- Mark Aferzon
- Department of Otolaryngology–Head and Neck Surgery, Geisinger Medical Center, Danville, Pa
| | - Carl L. Reams
- Department of Otolaryngology–Head and Neck Surgery, Geisinger Medical Center, Danville, Pa
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van Cauwenberge P, Watelet JB, Dhooge I. Uncommon and unusual complications of otitis media with effusion. Int J Pediatr Otorhinolaryngol 1999; 49 Suppl 1:S119-25. [PMID: 10577789 DOI: 10.1016/s0165-5876(99)00214-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Some complications of otitis media with effusion (OME) are not obvious and not always associated with otitis media by physicians and patients; the authors propose to call them 'unusual complications', although they may be quite frequent. Complications such as dizziness, clumsiness and behavioural disorders are classified in this group. Other complications are rare and uncommon such as sensorineural hearing loss and cholesteatoma. Some of these sequelae are structural, others more functional. The impact of OME on complex functions such as language, learning or behaviour is still controversial but seems to have been underestimated until now. Not only withholding treatment in children with OME may cause complications but also the treatment of OME may lead to sequelae, although serious side effects caused by the treatment of OME are rare. In this literature review, the epidemiology, importance and diagnosis of the uncommon and unusual complications of OME will be discussed.
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Affiliation(s)
- P van Cauwenberge
- Department of Otorhinolaryngology, University Hospital of Ghent, Belgium
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Spoor F, Stringer C, Zonneveld F. Rare temporal bone pathology of the Singa calvaria from Sudan. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1998; 107:41-50. [PMID: 9740300 DOI: 10.1002/(sici)1096-8644(199809)107:1<41::aid-ajpa4>3.0.co;2-g] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Evidence has recently accumulated that the Singa calvaria from Sudan probably dates from Oxygen Isotope Stage 6 (>130 ka). Morphological studies have indicated a mixture of archaic and more modern human traits, but such analyses are complicated by the possibility that the vault is pathologically deformed, although the exact etiology has not been established. Now computed tomography (CT) has revealed that the right temporal bone lacks the structures of the bony labyrinth. The most likely cause of this rare pathological condition appears to be labyrinthine ossification, in which newly deposited bone obliterates the inner ear spaces following an infectious disease or occlusion of the labyrinthine blood supply. A possible cause of vascular compromise could have been the presence of an expanding acoustic neuroma in the internal acoustic meatus, which is suggested by a significantly wider right meatus compared with the left side. Interestingly, labyrinthine ossification is also consistent with the controversial diagnosis that an anemia caused the characteristic diploic widening at the parietal bosses, because prime etiological factors of ossification are among the common complications of some of these blood diseases. CT examination of the vault and a review of the literature suggest that a blood disorder may well have caused the unusual parietal morphology. Given the nature of these pathological conditions, the Singa individual must have experienced a period of considerable disability. The morphological evidence from the normal bony labyrinth on the left side and from the CT evaluation of the vault is consistent with the interpretation of Singa as a late archaic hominid or an early representative of Homo sapiens drawn from a population which might be directly ancestral to modern humans.
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Affiliation(s)
- F Spoor
- Department of Anatomy and Developmental Biology, University College London, United Kingdom.
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Affiliation(s)
- J L Weissman
- Department of Radiology, Eye and Ear Hospital, Pittsburgh, PA
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