Management of Posttraumatic Vertigo

2005 ◽  
Vol 132 (4) ◽  
pp. 554-558 ◽  
Author(s):  
Arne Ernst ◽  
Dietmar Basta ◽  
Rainer O. Seidl ◽  
Ingo Todt ◽  
Hans Scherer ◽  
...  
Keyword(s):  
Endolymphatic Hydrops ◽  
Medical Center ◽  
Round Window ◽  
Craniocervical Junction ◽  
Treatment Modalities ◽  
Round Window Membrane ◽  
Minor Trauma ◽  
Surgical Measures ◽  
Delayed Endolymphatic Hydrops ◽  
Head Neck

OBJECTIVE: To evaluate patients after blunt trauma of the head, neck, and craniocervical junction (without fractures) with vertigo and to report the results of treatment after extensive diagnostics. STUDY DESIGN: Prospective study of consecutive new cases with vertigo after trauma at different periods of onset. During 2000–2002, 63 patients were examined and treated. SETTING: Regional trauma medical center for the greater Berlin Area, tertiary referral unit. RESULTS: The primary disorders included labyrinthine concussion (18), rupture of the round window membrane (6), and cervicogenic vertigo (12). The secondary disorders included otolith disorders (5), delayed endolymphatic hydrops (12), and canalolithiasis (9). The patients were free of vertigo symptoms (except cervicogenic and otolith disorder) after treatment, which consisted of habituation training, medical and surgical therapy options. The follow-up was 1 year. CONCLUSION: Posttraumatic vertigo can be treated with a high success rate once the underlying disorder has been identified. The extent of the neurotological test battery determines the precision and quality of diagnostics. Surgical measures should be an integral part of treatment modalities if conservative treatment is not effective. SIGNIFICANCE: Minor trauma of the head, neck, and craniocervical junction can have major impact on the vestibular system at different sites. Patients need to be carefully diagnosed, even if the onset of vertigo occurs a few weeks or months after the initial trauma.

Labyrinthitis Ossificans

1977 ◽  
Vol 86 (1) ◽  
pp. 17-29 ◽  
Author(s):  
Fumiro Suga ◽  
J. R. Lindsay
Keyword(s):  
Inner Ear ◽  
Endolymphatic Hydrops ◽  
Round Window ◽  
Round Window Membrane ◽  
Histopathological Changes ◽  
Suppurative Otitis Media ◽  
Labyrinthitis Ossificans ◽  
Contralateral Ear ◽  
Temporal Bones ◽  
Bony Fixation

Three cases with postinflammatory inner ear sequelae are presented to illustrate unusual histopathologic changes. Endolymphatic hydrops without change in the perilymphatic system was present in one ear following “influenza” meningitis and labyrinthitis ossificans in the contralateral ear. The characteristic histopathological changes of the temporal bones with hematogenic bacterial infection were an extensive labyrinthine ossification associated with a generalized sclerotic change of the whole periotic bone. Bony fixation of the stapedial footplate occurred with the generalized inflammatory process of the otic capsule. Severe and diffuse labyrinthitis ossificans occurred in one case due to tympanogenic inflammation spreading through the round window membrane in the course of suppurative otitis media. A general immunosuppression leading to fatal termination was the apparent factor predisposing to the inner ear complication.

Optimal Head Position Following Intratympanic Injections of Steroids, As Determined by Virtual Reality

2019 ◽  
Vol 161 (6) ◽  
pp. 1012-1017
Author(s):  
Omer J. Ungar ◽  
Ophir Handzel ◽  
Limor Haviv ◽  
Solomon Dadia ◽  
Oren Cavel ◽  
...  
Keyword(s):  
Middle Ear ◽  
Medical Center ◽  
Academic Medical Center ◽  
Round Window ◽  
Head Position ◽  
Round Window Membrane ◽  
Drug Bioavailability ◽  
Neck Extension ◽  
Optimal Position ◽  
3 Dimensional

Objectives To study optimal head position after intratympanic steroid injections to enhance drug bioavailability. Study Design Application of virtual and in vitro models of the intratympanic anatomy. Setting The surgical 3-dimensional printing laboratory of a tertiary academic medical center. Subjects and Methods A high-resolution computerized tomographic scan of healthy temporal bone and surrounding soft tissue was segmented and reconstructed to a 3-dimensional model. The tympanic membrane was perforated in the posterior-inferior quadrant. Methylene blue–stained 10-mg/mL dexamethasone was administered to the middle ear cleft, after which a 3-dimensional rotation in space was performed to hypothesize the optimal position in relation to gravity. The same stereolithography file used for the actual model was used for a digital virtual liquid flow simulation. The optimal head position was defined as the one with the maximum vertical distance between the round window membrane and the plane of the aditus ad antrum and eustachian tube orifice. Results The virtual model yielded the following position of the head as optimal: 53º rotation away from the injected ear in the vertical axis (yaw), 27º rotation toward the noninjected ear in the longitudinal axis (roll), and 10º neck extension in the transverse axis (pitch). Conclusions Virtual imaging determined that 53º and 27º yaw and roll, respectively, away and 10º pitch were the optimal position for drug delivery after intratympanic injection to the middle ear and that an erect head position provided optimal passage of steroids from the middle ear to the inner ear.

Clinical features and long-term outcome of ipsilateral delayed endolymphatic hydrops

2019 ◽  
Vol 69 (3) ◽  
Author(s):  
Andrea Albera ◽  
Claudia Cassandro ◽  
Carmine F. Gervasio ◽  
Sergio Lucisano ◽  
Marco Boldreghini ◽  
...  
Keyword(s):  
Clinical Features ◽  
Endolymphatic Hydrops ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Delayed Endolymphatic Hydrops

scholarly journals The Effects of Round Window Membrane Injury and the Use of a Model Electrode Application on Hearing in Rats

2021 ◽  
pp. 014556132199018
Author(s):  
Murat Koc ◽  
Abdullah Dalgic ◽  
Mehmet Ziya Ozuer
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Round Window ◽  
Mechanical Trauma ◽  
Round Window Membrane ◽  
Albino Rats ◽  
Topical Steroids ◽  
Distortion Product ◽  
Significant Difference ◽  
Group 3

Objective: To investigate the effects of the mechanical trauma to the round window, a model electrode inserted into the scala tympani on the cochlear reserve, and the efficacy of topical steroids in preventing hearing loss. Materials and Methods: 21 male Wistar Albino rats were equally categorized into three groups. In all groups an initial mechanical injury to round window was created. Only subsequent dexamethasone injection was administrated into the cochlea in the subjects of group 2 while a multichannel cochlear implant guide inserted into the cochlea prior to dexamethasone administration for group 3. Distortion product otoacoustic emissions (DPOAEs) were obtained prior to and immediately after the surgical injury, eventually on postoperative seventh day (d 7). Mean signal/noise ratios (S/Ns) obtained at 2000, 3000, and 4000 Hz were calculated. Data sets were compared with non-parametric statistical tests. Results: The early intraoperative mean S/Ns were significantly less than preoperative measurements for group 1 and 2; however, preoperative and postoperative d 7 average S/Ns did not differ. There was statistically significant difference between preoperative, intraoperative and postoperative d 7 average S/Ns for group 3. Conclusion: We observed that hearing was restored approximately to the preoperative levels following early postoperative repair. However, an electrode insertion into the cochlea via round window subsequent to mechanical trauma seems to cause a progressive hearing loss. Therefore, a special care must be taken to avoid the injury to the round window membrane in the course of the placement of a cochlear implant electrode and surgery for the chronic otitis media.

scholarly journals Cochlear Implantation Following Explorative Tympanotomy in Patients With Sudden Sensorineural Hearing Loss: Surgical Features and Audiological Outcomes

2021 ◽  
pp. 014556132110091
Author(s):  
Robin Rupp ◽  
Joachim Hornung ◽  
Matthias Balk ◽  
Matti Sievert ◽  
Sarina Müller ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Connective Tissue ◽  
Sensorineural Hearing Loss ◽  
Cochlear Implantation ◽  
Round Window ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Round Window Membrane ◽  
Hearing Results ◽  
Round Window Niche

Objective: To investigate the anatomical status of the round window niche and hearing outcome of cochlear implantation (CI) after explorative tympanotomy (ExT) with sealing of the round window membrane in patients with sudden sensorineural hearing loss at a tertiary referral medical center. Methods: Between January 1, 2007, and July 30, 2020, 1602 patients underwent CI at our department. Out of these, all patients previously treated by ExT with sealing of the round window membrane because of unilateral sudden hearing loss were included in the study. A retrospective chart review was conducted concerning method of round window membrane sealing, intraoperative findings during CI, postoperative imaging, and hearing results. Results: Twenty one patients (9 females; 8 right ears; 54.3 years [± 12.9 years]) underwent ExT with sealing of the round window membrane with subsequent CI after 26.6 months (± 32.9 mo) on average. During CI, in 76% of cases (n = 16), the round window niche was blocked by connective tissue due to the previous intervention but could be removed completely in all cases. The connective tissue itself and its removal had no detrimental effects on the round window membrane. Postoperative computed tomography scan showed no electrode dislocation. Mean postoperative word recognition score after 3 months was 57.4% (± 17.2%) and improved significantly to 73.1% (± 16.4%, P = .005) after 2 years. Conclusion: Performing CI after preceding ExT, connective tissue has to be expected blocking the round window niche. Remaining tissue can be removed safely and does not alter the round window membrane allowing for a proper electrode insertion. Short- and long-term hearing results are satisfactory. Consequently, ExT with sealing of the round window membrane in patients with sudden sensorineural hearing loss does not impede subsequent CI that can still be performed safely.

Effect of round window membrane application of nitric oxide on hearing and nitric oxide concentration in perilymph

2003 ◽  
Vol 67 (6) ◽  
pp. 585-590 ◽  
Author(s):  
Jonathan B. Hanson ◽  
Paul T. Russell ◽  
Andy T.A. Chung ◽  
Claire S. Kaura ◽  
Samantha H. Kaura ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Round Window ◽  
Round Window Membrane ◽  
Oxide Concentration ◽  
Nitric Oxide Concentration

THE ROUND WINDOW MEMBRANE FOLLOWING APPLICATION OF STAPHYLOCOCCAL EXOTOXIN

1981 ◽  
Vol 91 (12) ◽  
pp. 2007???2017 ◽  
Author(s):  
PATRICIA A. SCHACHERN ◽  
MICHAEL M. PAPARELLA ◽  
MARCOS GOYCOOLEA ◽  
BURT GOLDBERG ◽  
PATRICK SCHLIEVERT
Keyword(s):  
Round Window ◽  
Round Window Membrane

Role of the Round Window Membrane in Middle Ear Immune Responses

1988 ◽  
Vol 105 (sup457) ◽  
pp. 139-143 ◽  
Author(s):  
E. M. Keithley ◽  
A. F. Ryan ◽  
J. P. Harris
Keyword(s):  
Immune Responses ◽  
Middle Ear ◽  
Round Window ◽  
Round Window Membrane
Sign in / Sign up

Export Citation Format

Share Document