1.Safety and Efficacy of Mastoidoplasty With Demineralized Bone Matrix in Canal Wall Down Mastoidectomy: A Pilot Study
Jae Hong HAN ; Yeonji KIM ; Jae Sang HAN ; Celeste Ann CHUA ; Jae-Hyun SEO ; So Yong PARK ; Shi Nae PARK
Korean Journal of Otolaryngology - Head and Neck Surgery 2023;66(2):92-98
Background and Objectives:
The canal wall down mastoidectomy brings changes in the anatomy of the external auditory canal (EAC), causing potential problems, such as accumulated crust, vertigo attacks, and difficulties in wearing hearing aids (HAs). The objective of this study is to evaluate the safety and efficacy of mastoidoplasty using the demineralized bone matrix (DBM) to obliterate the mastoidectomized cavity and reconstruct EAC.Subjects and Method Medical records of patients with chronic otitis media with or without cholesteatoma who received mastoidoplasty using DBM by a single surgeon at Seoul St. Mary’s hospital between 2014 and 2021 were reviewed retrospectively.
Results:
A total of 27 patients were included in this study. None of the patients showed any recurrence of cavity problem, wound infection, or any other complications during their followup period of 13.07±37 months. The average air and bone conduction hearing level of pure tone audiometry showed no significant change after surgery (p=0.50, p=0.54, respectively). Five patients indicated for hearing rehabilitation could adopt canal type HAs after surgery; six patients used completely-in-the canal type HAs, and one patient used in-the-canal type HAs. None of the patients using HAs complained of acoustic feedback or any other problem in wearing HAs.
Conclusion
Mastoidoplasty using DBM seems to be a very safe and effective surgical procedure that shows functionally acceptable EAC for hearing rehabilitation with canal type HAs and demonstrates no specific complication.
2.Effect of Bonebridge Implantation on Tinnitus in Patients With Asymmetric Hearing Loss or Single-Sided Deafness
Yeonji KIM ; Jae Sang HAN ; Celeste Ann CHUA ; Jae-Hyun SEO ; So Young PARK ; Shi Nae PARK
Korean Journal of Otolaryngology - Head and Neck Surgery 2022;65(10):580-586
Background and Objectives:
The objective of this study was to investigate the effect of an active transcutaneous bone conduction implant (BCI) of Bonebridge (MED-EL) on tinnitus patients with asymmetric hearing loss (AHL) or single-sided deafness (SSD).Subjects and Method Medical records and tinnitus questionnaires were reviewed retrospectively of patients with AHL or SSD, who received Bonebridge by a single surgeon at Seoul St. Mary’s Hospital from 2017 to 2021. Audiologic evaluation and tinnitus questionnaires were conducted before and after surgery.
Results:
Of the 17 patients, 8 patients had SSD and 9 patients had AHL, and 13 patients (76.47%) had tinnitus before surgery while 4 patients did not. No patient showed newly developed tinnitus after surgery. After implantation, three patients (23.08%) showed a complete resolution of tinnitus. All patients showed significant improvement in hearing level after surgery. The mean tinnitus handicap inventory (THI) score and visual analogue scale (VAS) score for effect on life showed a significant decrease after surgery, from 43.1±28.2 to 29.7±25.7 (p<0.05), and 4.7±2.9 to 3.2±3.3 (p<0.05), respectively. The mean THI scores of seven AHL patients and seven patients with tinnitus on the implanted ear were significantly decreased after implantation from 50.9±24.7 to 34.6±27.5 (p<0.05) and from 53.1±23.4 to 37.4±15.0 (p<0.05), respectively.
Conclusion
BCI seems to be effective in suppressing tinnitus in the patients with AHL but not with SSD. Along with directive counseling, sound therapy with Bonebridge can decrease tinnitus in some patients with AHL.