Outcomes for Conservative Management of Traumatic Conductive Hearing Loss
Autor: | David R. Friedland, Jonathan R. Grant, Jill Arganbright |
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Rok vydání: | 2008 |
Předmět: |
medicine.medical_specialty
Hearing loss medicine.medical_treatment Hearing Loss Conductive Perforation (oil well) Hemorrhage Audiology Severity of Illness Index Tympanoplasty Bone conduction otorhinolaryngologic diseases Craniocerebral Trauma Humans Medicine Retrospective Studies Tympanic Membrane Perforation medicine.diagnostic_test business.industry Hemotympanum Temporal Bone Auditory Threshold Retrospective cohort study Prognosis medicine.disease Sensory Systems Conductive hearing loss Treatment Outcome Otorhinolaryngology Audiometry Pure-Tone Neurology (clinical) medicine.symptom Audiometry business Bone Conduction |
Zdroj: | Otology & Neurotology. 29:344-349 |
ISSN: | 1531-7129 |
Popis: | Objectives To evaluate the natural history of traumatic conductive hearing loss. Study design Retrospective chart review. Methods Otologic and audiometric evaluations of patients in the early posttraumatic phase were compared with evaluations at follow-up. Assessment included etiologies of trauma, classification of hearing loss, factors causing conductive loss, and analyses of changes in air-bone gaps, pure-tone averages and hearing loss class. Results There were 45 patients, representing 47 ears, with sufficient initial and follow-up documentation to analyze the natural history of traumatic conductive hearing loss. Overall, 77% of ears showed an improvement in pure-tone averages without surgical intervention. Air-bone gaps closed from an average of 24.8 +/- 12.1 to 13.2 +/- 11.1 dB. Only 11% of ears demonstrated a decrease in pure-tone averages, and 12% showed no change in thresholds. All forms of injury contributing to the conductive hearing loss had good outcomes. Specifically, tympanic membrane perforations showed final air-bone gaps of 14.9 +/- 11.2 dB; cases of hemotympanum had final air-bone gaps of 10.0 +/- 8.1 dB; and suspected ossicular chain disruptions had final air-bone gaps of 13.9 +/- 12.3 dB. Only 5 of 47 ears ultimately required surgical intervention for persistent pathology. Conclusion Patients with all forms of traumatic conductive hearing loss can be initially managed conservatively. Even suspected ossicular chain disruptions have a high rate of spontaneous reparation. Surgical intervention for perforation or conductive hearing loss should be undertaken in the rare cases when these conditions persist greater than 6 months. |
Databáze: | OpenAIRE |
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