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Author: admin | 26.06.2015 | Category: One Ear Ringing

The new MED-EL Sports Headband provides comfort and security for sports and many other physical activities. TriformanceExperience the fullest, richest range of sounds and perceive speech and music more naturally. RehabilitationCochlear implant users of all ages can practice speaking and listening skills with interactive and downloadable (re)habilitation activities. Any problem in the outer or middle ear that prevents sound from being conducted properly is known as a conductive hearing loss. Sensorineural hearing loss results from missing or damaged sensory cells (hair cells) in the cochlea and is usually permanent. Mild to severe sensorineural hearing loss can often be helped with hearing aids or a middle ear implant. A problem that results from the absence of or damage to the auditory nerve can cause a neural hearing loss. Hearing aids and cochlear implants cannot help because the nerve is not able to pass on sound information to the brain. Diagnosis of hearing loss into one of the above categories is achieved by otological examination including comprehensive audiometric testing that is performed with masking where needed. Conductive Hearing Loss is a mechanical interference of sound conduction from the environment to the inner ear. The more complex causes of CHL can be treated surgically with very good to excellent outcomes. CHL that persists despite aggressive medical and surgical care is usually amenable to hearing aid use. Sensorineural Hearing Loss is nerve-related hearing loss and reflects dysfunction of the cochlea (inner ear), hearing (cochlear) nerve, or auditory brainstem. Treatment of SNHL is medical in disorders of fluctuating hearing loss, use of hearing aids in the majority of cases, and surgical implantation of cochlear implant or baha™ implant where indicated.
If you have any questions about treatment, billing, or insurance, please feel free to call for an appointment.
Email address must have at least 0 and no more than 256 characters.The value of the Email address field is not valid. Two surgical approaches have been used - superior canal resurfacing and superior canal plugging. Middle fossa craniotomy is a safe surgical procedure and is the most common approach used to repair SCD. If the skull base or tegmen is very low it can be difficult to safely reach the superior canal safely with a transmastoid approach to create two labyrinthotomies (as the SCD is not directly repaired) and then plug these two holes to indirectly repair the defect.
Ideally, the transmastoid approach may be useful for a patient that has SCD and a skull base or tegmen that is NOT low-lying and has no other associated holes or brain herniating into the ear.
This patient complained of chronic dysequilibrium and episodic dizziness, worsened with straining and loud noises.


Serial audiograms before surgery showed a progressive severe sensorineural hearing loss on the left ear with a mild to moderate conductive component in the low frequencies, and present stapedial, or acoustic reflexes. Vestibular Evoked Myogenic Potential Testing (VEMP) revealed markedly decreased thresholds in the left ear (50 to 60dB using tone burst testing), compared with the right (80 to 90 dB). ABOVE: Temporal bone CT scans of the right (A,C) and left (B,D) superior semicircular canals. This patient was followed conservatively for several months with vestibular suppressants but her symptoms worsened. A 4-5mm widely dehiscent SSC was encountered intraoperatively and was plugged with bone wax. Within about one month following her surgery, she noticed a complete resolution of her dizziness with improvement in her conductive hearing loss.
Audiogram, right: Postop hearing test showing closure of her air-bone gap following SCD plugging.
Below: 3-D reconstruction, lateral skull CT, showing the approximate size and shape of the middle fossa craniotomy needed to expose and repair a left-sided SCD. Photo 1: middle fossa craniotomy performed, centered over the external auditory meatus, approximately 4 x 5cm. Photo 3: bone paste, harvested while turning the middle fossa craniotomy bone flap, is used to resurface the plugged superior semicircular canal. Photo 5: split calverial bone graft followed by a second piece of fascia is used to resurface the remaining skull base floor. Not shown: once the skull base reconstruction is complete, a mini-titanium plate cranioplasty is performed, followed by multiple layer tissue and skin closure. The multi-disciplinary team of pediatric specialists and caregivers stands ready to help achieve the best outcome possible. In the normal ear, sound vibrations are funneled by the outer ear into the ear canal where they hit the ear drum. Obstructing cerumen or foreign body is cleared from the ear canal under the office microscope.
In these cases, the ear canal, ear drum and middle ear are working, but the sound is not transmitted or received properly from the cochlea inwards. Certainly, where the cause is a surgical one such as cholesteatoma, surgery is indicated to eradicate the underlying disease, but surgery will not correct the SNHL.
Although theoretically less traumatic to the membraneous labyrinth, resurfacing techniques have led to recurrent symptoms secondary to shifting or resorption of the bone and fascia reconstruction.
In some cases, the SCD may be located along the SIDE of the canal (Case #4) and not on the TOP, as seen in most classic cases of SCDS. These were high resolution CT scans reformatted to the planes of Stenver (A,B) and Poschel (C,D). A big concern was that she was deaf in the right ear since birth, and so there was great reluctance to offer a left sided SCD repair.


Because the surrounding tegmen (skull base) is often very thin or also dehiscence, a bone graft was used to reconstruct the floor around and on top of the plugged canal. The tegmen represents the floor of the middle fossa, which is exposed using an extradural dissection to reveal the dehiscent left superior semicircular canal. This process ensures that without your approval, data will not be transferred to the social networks. These vibrations cause movement of the ear drum that transfers to the three small bones of the middle ear, the malleus (hammer), incus (anvil), and stapes (stirrup). In young children, general anesthesia may be required to remove a foreign body from the ear canal if the child is not cooperative.
Plugging with bone wax, bone paste, or fascia has been more commonly used to create a stable seal of the dehiscent superior semicircular canal. The craniotomy approach is ideal to 1) visual the SCD directly and 2) repair the tegmen defect(s) directly using bone and fascia. If the defect is located on the side of the canal away from the surgeon (posterior-medial), the SCD may be more difficult to visualize using a craniotomy approach. She notes an extremely violent episode of vertigo, in the vertical plane, during child birth. A very thin, but intact bony covering is see over the right superior semicircular canal (A,C) compared with a dehiscent left superior semicircular canal (B,D). However she could no longer care for her young children and was unable to function normally, and so after careful counseling, she elected to proceed with a surgical repair of her left SCD via a middle fossa craniotomy approach.
When the stapes bone moves, it sets the inner ear fluids in motion, which, in turn, start the process to stimulate the auditory (hearing) nerve. Fluid in the middle ear space (otitis media with effusion) is the primary reason for non-well-child visits to the pediatrician in the U.S. SNHL can also occur as a result of exuberant middle ear disease, specifically untreated cholesteatoma or aggressive otitis media.
She has since had hearing loss, autophony, and sensitivity to loud noises and pressure on this left ear. The fluid will either drain on its own or respond to antibiotic therapy in the vast majority of cases. If the fluid persists despite adequate antibiotic therapy, a small hole can be made in the ear drum (myringotomy) and, if needed, a tube can be placed.



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