Objective: This case series aims to describe the diagnosis and management of otosclerosis in a series of Filipino patients encountered in a private, subspecialty otologic clinical practice. In particular, it elucidates the demographics, clinical presentation, diagnostic exam findings, clinical intervention and hearing outcomes. Methods: Study Design : Retrospective review of medical records of a case series. Setting : Subspecialty otologic / neurotologic clinical practice. Participants : Medical records of all patients diagnosed to have otosclerosis based on radiologic evidence of fenestral or retrofenestral otosclerosis and/or confirmed during surgical exploration of the middle ear, during the period 2004-2017. Results: Nine patients with otosclerosis were identified. Most patients presented with bilateral, primarily conductive hearing loss in middle age. However, an adolescent patient was also identified. Most patients were from the component cities of the National Capital Region. However, patients from the Cordillera region and south-central Mindanao were also identified. Radiologic evidence of fenestral or retrofenestral otosclerosis was identified in the majority of patients. However, readings of normal temporal bone CT findings were also seen. Obliterative otosclerosis was identified in one patient. Both objective and subjective evidence of hearing improvement was documented after stapedectomy in patients undergoing surgery. Conclusions This study documents the presence of clinical otosclerosis in a Filipino population. As in other populations, it typically presents in middle age as a bilateral, primarily conductive hearing loss. However, a younger age does not preclude its diagnosis, as juvenile otosclerosis has been identified. The presence of patients in regions of the Philippines other than the National Capital Region implies that it has to be considered even in regional populations without a racial predilection for otosclerosis. The identification of radiologic evidence of fenestral and retrofenestral otosclerosis on CT imaging of the temporal bone makes this is an essential part of the work-up of Filipino patients with conductive hearing loss and normal otologic examinations. Surgical treatment via stapes surgery is an effective and viable option in the management of Filipino patients with otosclerosis. The identification of less common variants such as obliterative otosclerosis indicates the need for specialized surgical equipment and appropriate surgical training in order to successfully deal with these situations.
Otosclerosis ; Hearing Loss, Conductive

No abstract available.
Hearing Loss, Conductive ; Sound Localization

A 29-year-old Filipina of Chinese descent presented with progressive bilateral conductive hearing loss of several years’ duration. While working overseas, she consulted with an otolaryngologist and underwent computerized tomographic (CT) imaging of the temporal bone as part of her evaluation. She was informed that no abnormalities were identified in the imaging exam, and she was offered exploratory middle ear surgery with possible stapes surgery. She then sought a second opinion, with the intention of obtaining a more definitive diagnosis prior to any invasive medical intervention. A review of the CT imaging study, with particular emphasis on looking for radiologic evidence of otosclerosis, revealed the presence of a focal region of bone demineralization in the region of the fissula ante fenestram. (Figure 1) This finding is consistent with a diagnosis of fenestral otosclerosis.
Otosclerosis ; Hearing Loss, Conductive ; Filipino

BACKGROUND AND OBJECTIVES: In clinical masking, the plateau is a state in which the non-test ear (NTE) is completely masked by the noise and tone is heard only by the test ear (TE). At least 15 to 20 dB of plateau width is needed to obtain valid threshold. In the study, a part of plateau after initial masking level known as the minimum plateau width (mPW) was determined and compared by a new formula and the plateau searching method. SUBJECTS AND METHODS: Minimum plateau widths of air conduction were obtained in 29 participants with unilateral and 30 participants with bilateral conductive hearing loss (CHL) aged 20 to 45 years old by using step by step plateau method and mPW estimation by the formula between two points of masking diagram [mPW=(N2-N1)-(T2-T1)] and then the mPW of two methods was compared for each frequency. RESULTS: There was no significant difference between the minimum plateau width obtained by the plateau and formula methods for two given point of masking diagram in people with unilateral and bilateral CHL at octave frequencies from 500 Hz to 4,000 Hz. CONCLUSIONS: Threshold obtaining of TE by two tones for two noise levels delivered to the NTE is enough to estimate the mPW between these two noise points and it is not necessary that for clinicians to know the actual values of masking diagram components.
Ear ; Hearing Loss, Conductive ; Masks ; Methods ; Noise

A high jugular bulb is often discovered as an incidental finding that is asymptomatic. The incidence of high jugular bulb protruding into the level of oval window is rare. Conductive hearing loss in association with this anomaly may occur, but has been reported infrequently in the literature. We report one case of high jugular bulb and the associated conductive hearing loss. Mechanisms to explain the conductive hearing loss include contact of the jugular bulb with tympanic membrane, interference with the ossicular chain, and obstruction of the round and oval window niche. The operative findings, radiographic and audiometric data that support these mechanisms of couductive hearing loss are presented.
Hearing Loss ; Hearing Loss, Conductive* ; Incidence ; Incidental Findings ; Tympanic Membrane

Audiant bone conductor(ABC) can be beneficial to patients with conductive hearing loss and sensorineural hearing loss. We have implanted ABC for 3 patients with bilateral conductive hearing loss and 2 patients with unilateral profound sensorineural hearing loss. And we evaluated the hearing gain in these patients except 1 case who did not return for follow up. The preoperative average air conduction threshoulds at the three speech frequencies 500, 1000 and 2000Hz, SRT, SD scores were 48.3dB HL, 47.5dB HL, 95% respectively and 19.1dB HL, 20dB HL, 95% postoperatively in 2 patients with bilateral conductive hearing loss. The preoperative average air conduction threshoulds at the three speech frequencies 500, 1000 and 2000Hz, SRT, SD scores were no response, no response, 0% respectively and 42.5dB HL, 51.3dB HL, 60% postoperatively in 2 patients with sensorineural hearing loss.
Follow-Up Studies ; Hearing ; Hearing Loss, Conductive ; Hearing Loss, Sensorineural ; Humans

BACKGROUND AND OBJECTIVES: A nonprogressive and conductive hearing loss in the range of 40 to 60 dB with normal tympanic membrane is highly suggestive of a congenital ossicular malformation. Among the ossicular anomalies, congenital stapedial anomaly is most common, and it is clinically important because hearing loss can be corrected by appropriate procedure. In this study, we attempted to describe patterns of stapes anomalies encountered in patients who have a normal ear drum. We also analysed the surgical result with special reference to the patterns of stapes anomaly. MATERIALS AND METHODS: We experienced 17 cases (20 ears) of congenital stapedial anomalies which were confirmed through the explo-tympanotomy at Ajou University Hospital between June 1994 and March 1997. The preoperative and postoperative audiologic findings, operative findings and CT findings were analysed. RESULT: There were 5 types of stapes anomalies with 7 anomalous patterns among which stapes footplate fixation was the most common anomaly. We could get 78.9% of hearing improvement after ossiculoplasty with several prosthesis. CONCLUSION: Stapes footplate fixation was usually bilateral, while partial stapes anomalies or anomalies associated with incus anomaly was usually unilateral. The surgical result of stapes anomaly was good.
Ear ; Hearing ; Hearing Loss ; Hearing Loss, Conductive ; Humans ; Incus ; Prostheses and Implants ; Stapes ; Tympanic Membrane

The ossification of stapedial tendon is a rare disorder of middle ear that results in conductive hearing loss. It might be easily misdiagnosed as otosclerosis, and only exploratory tympanotomy can indicate cases where the mobility of stapes is not fixed or has increased. Cutting of the tendon results in nearly normal ossicular mobility and hearing improvement. A 41-year-old patient visited our clinic with slowly progressive hearing loss. Hearing evaluation revealed that he had a conductive hearing loss with intact tympanic membrane. The mobility of stapes was enhanced by cutting of the tendon through exploratory tympanotomy ; hearing was improved thereafter.
Adult ; Ear, Middle ; Hearing ; Hearing Loss ; Hearing Loss, Conductive ; Humans ; Otosclerosis ; Stapes ; Tendons ; Tenotomy ; Tympanic Membrane

Herniation of the temporomandibular joint (TMJ) into the external auditory canal (EAC) is known to be associated with a defect of the anterior wall of the EAC. Spontaneous herniation of TMJ into EAC is very rare and can induce clicking tinnitus, conductive hearing loss, otalgia, otorrhea and even no symptom. Here we report a very interesting case of spontaneous TMJ herniation, which resulted in severe and annoying clicky tinnitus and otalgia. There was no response to the initial conservative management, so surgical correction of TMJ herniation using titanium mesh was performed. After the surgery, the annoying clicky tinnitus completely disappeared. This study suggests that tinnitus caused by TMJ herniation be considered as another type of surgically curable objective tinnitus.
Ear Canal ; Earache ; Hearing Loss, Conductive ; Temporomandibular Joint* ; Tinnitus* ; Titanium*

BACKGROUND AND OBJECTIVES: Otosclerosis is known to be rare in orientals, but there have been a few reports of the clinically suspicious otosclerosis cases in Korea. Confirmation of otosclerosis, in theory, should be done by histopathology. However, for LASER stapedotomy, it is very hard to obtain the tissue to conduct such histopathological study. In this research, we had surgical specimens available for a review of otosclerosis case. We aimed to confirm the pathologic findings of otosclerosis in Koreans, and review their clinical information. SUBJECTS AND METHOD: Among 126 otosclerosis patients who were operated in the Seoul National University Hospital from January 1981 to December 2001, three cases were selected for pathologic evaluation. We used the H & E method for staining. RESULTS: There were positive histologic findings in all three cases. Two typical phases (early spongiotic and late sclerotic of otosclerosis) could be observed in specimen. CONCLUSION: In the pathologic specimen from the patients showing progressive conductive hearing loss, we could confirm otosclerosis. Both early and late phase of otsclerotic foci coexisted in the same specimen.
Hearing Loss, Conductive ; Humans ; Korea* ; Otosclerosis* ; Pathology ; Seoul