Explorative Tympanoskopy and Sudden Sensorineural Hearing Loss – A Retrospective Study and Metaanalysis

Introduction:

The diagnostic value of explorative tympanoscopy with a coverage of round window in sudden sensorineural hearing loss (SSNHL) remains controversial. To this end we studied the incidence of a perilymphatic fistula (PLF) in patients with SSNHL and performed a meta-analysis.

Methods:

Ninety patients with SSNHL treated at our institution by explorative tympanoscopy and coverage of the oval and round window were included in the present study. Demografic and audiological data, caloric testing, split-image procedure and intraoperative findings were evaluated retrospectively. A meta-analysis covered the search in “Pubmed”, “Cochrane Library”, “Web of Sciences” and “Clinical Trials”.

Results:

By tympanoscopy, 11% of patients were identified with PLF. Patients with a threshold of 61 – 80 dB in pure tone audiometry were most likely to benefit from surgical sealing of the membranes. Correlation analyses of patients with and without a PLF in terms of vertigo and tinnitus did not show any significant finding. A preoperative split-image procedure did not reveal any presence of a PLF. Out of 3898 studies regarding our exclusion criteria were 8 papers further analyzed. The overall incidence of PLF in our meta-analysis was about 24.5%. Thus, no predictive factors for the success of surgical sealing of the membranes for treating ISSNHL can be identified based on the presented results.

Discussion:

The PLF is well documented in the literature. The diversity of etiologies underlying SSNHL make it difficult to perform validated studies. However, tympanoscopy with sealing of round window may be helpful in certain cases.

Publication History

Publication Date:
23 April 2019 (online)