Exploratory tympanotomy in sudden sensorineural hearing loss

Exploratory tympanotomy in sudden sensorineural hearing loss; a
preliminary report from northeast Iran
Rajati M, Ghalehnavi M A

Background: The pathogenesis of sudden sensorineural hearing loss (SSNHL)is unclear and round window (RW) rupture may be one possible mechanism.

Objectives: This study was performed to detect RW fistula and evaluate the effectiveness of its sealing in patients with SSNHL and vertigo.

Methods: Seven patients with severe to profound SSNHL associated with vertigo who were admitted within the first 10 days, underwent explorative tympanotomy under local anesthesia; RW membrane was scrutinized for perilymph leakage and it was sealed with free fat and gel foam. Audiometric evaluation was done before and 2 weeks after surgery.

Result: The average hearing loss (3 pure tone average) of all patients was 102.1 dB before and 73.5 dB after surgery, which is an average improvement of 28.6 dB. Vertigo was improved in all patients. Only in one case (14%)RW fistula could be confirmed.

Conclusions: This study suggests that Exploratory tympanotomy and sealing of the RWM may be effective in selected cases of SSNHL and vertigo.