Following sudden unilateral deafness or high-grade sensorineural hearing loss, patients
with unsuccessful improvement of hearing after first- or second-line therapy with
steroids, can be treated with an explorative tympanotomy, covering the cochlear and/or
oval window niche.
Goal of the study was to evaluate the validity of this method as additional therapeutic
option. In particular it was investigated if an improvement in hearing was accomplished
by covering the round and depending on the group additionally of the oval window niche
with dexamethasone soaked connective tissue or Gelitta® respectively.
Patients and methods:
133 patients with acute high-grade hearing impairment underwent surgery. As reference
served a loss of > 80 dB 5-PTA (“pure tone average” over five frequencies). 64 patients
could be followed-up with control hearing-tests between 3 and 6 months postoperatively.
Results:
30 out of 64 patients had a postoperative hearing improvement by the criteria of Siegel.
The additional covering of the oval window niche resulted in no further significant
improvement in hearing.
Also a stratification for gender, age, time of occurrence to operation, co-symptoms
(Vertigo, tinnitus) or comorbidities (diabetes mellitus, cardiovascular disease) did
not reveal any differences.
A visible rupture of the cochlear window was not reported for any surgery.
An ongoing study will elucidate the hearing gain in comparison to a non-operated study
group.