The incidence of blast injury has increased recently. As the ear is the organ most sensitive to blast overpressure, the most frequent injuries seen after blast exposure are those affecting the ear. Blast overpressure affecting the ear results in sensorineural hearing loss, which is untreatable and often associated with a decline in the quality of life. Here, we review recent cases of blast-induced hearing dysfunction. The tympanic membrane is particularly sensitive to blast pressure waves, since such waves exert forces mainly at air-tissue interfaces within the body. However, treatment of tympanic membrane perforation caused by blast exposure is more difficult than that caused by other etiologies. Sensorineural hearing dysfunction after blast exposure is caused mainly by stereociliary bundle disruption on the outer hair cells. Also, a reduction in the numbers of synaptic ribbons in the inner hair cells and spiral ganglion cells is associated with hidden hearing loss, which is strongly associated with tinnitus or hyperacusis.
Blast Injuries/complications* ; Ear/injuries* ; Hearing Loss, Conductive/etiology* ; Hearing Loss, Sensorineural/etiology* ; Humans ; Tympanic Membrane Perforation/complications*

OBJECTIVETo investigate the clinical and imaging characteristics of chronic otitis media with intact tympanic membrane.

METHODTen patients were retrospective studied in the department of otorhinolaryngology of Guangdong general hospital from December 2006 to January 2015. The clinical characteristics of their manifestations, audiology and imaging examinations were analyzed.

RESULTSAll the cases could be divided into two groups: the intracranial complication group who was primarily diagnosed as intracranial complications, and the hearing loss group who primarily complained of hearing loss. Five cases belonged to the first group, which include 1 cerebellar abscess, 3 meningitis and 1 meningoencephalitis, 2 of them were profound hearing loss, 2 were mixed hearing loss, and 1 was normal hearing. The other 5 cases belonged to the hearing loss group, 3 were mixed deafness, 2 were conductive deafness. All the case showed positive high-resolution computed tomography (HRCT) features. In the first group, four cases showed the soft tissue shadow in tympanic antrum/superior tympanic pouch and 1 case showed a wide damage of skull base, in addition to intracranial complications. In the second group, five cases showed soft tissue imaging in tympanic antrum/superior tympanic pouch. Pathology showed that 2 cases were cholesterol granuloma(one was in the first group and the other was in the second group), 4 were intracranial inflammatory(the first group) and 4 were cholesteatoma(the seond group).

CONCLUSIONSIn chronic otitis media with intact tympanic membrane, intracranial complications may be the primarily diagnosis, which should be paid much attention by multidisciplinary team. HRCT and audiology were valuable for early diagnosis.

Brain Abscess ; etiology ; Cerebellar Diseases ; etiology ; Cholesteatoma ; pathology ; Chronic Disease ; Granuloma ; pathology ; Hearing Loss ; Hearing Loss, Conductive ; Humans ; Meningitis ; etiology ; Otitis Media ; complications ; pathology ; Retrospective Studies ; Tympanic Membrane

Tympanosclerosis is the middle ear tissue hyalinization and calcification caused by chronic middle ear inflammation, which mainly results in conductive deafness with unobvious clinical symptom. Etiology is unclear. The treatment is given priority to surgical treatment at present, while long-term effect reported mostly poor. This article analyzed etiology and treatment of the tympanic cavity sclerosis.
Calcinosis ; Chronic Disease ; Ear, Middle ; Hearing Loss, Conductive ; etiology ; Humans ; Myringosclerosis ; complications ; etiology ; therapy ; Otitis Media ; Sclerosis

In this paper, patients with the left ear hearing loss, aural fullness. CT: the left wing palatine nest sites. MRI: on the left wing palatine timid benign lesions; Electric listening: conductive deafness. Acoustic immittance: B type curve. Clinical diagnosis: the left wing palatine fossa cyst, left ear secretory otitis media.
Acoustic Impedance Tests ; Auditory Perception ; Cysts ; diagnosis ; Deafness ; diagnosis ; etiology ; Hearing Loss, Conductive ; etiology ; Humans ; Magnetic Resonance Imaging ; Otitis Media with Effusion ; diagnosis

OBJECTIVE: To investigate and analyze the characteristic of destructive ossicular chain and it's impact on air-bone gap (ABG) among patients with cholesteatoma. METHOD: Data from 204 cases (213 ears) undergoing an initial surgery for cholesteatoma were retrospectively reviewed to evaluate the relationships between preoperative pure tone audiometry data and intraoperative assessment of individual ossicular destruction. RESULT: Incus was the most significantly affected ossicle. Furthermore, the destruction of malleus and stapes was often accompanied by the destruction of incus. A partially eroded incus caused significantly increase in ABG from that of an intact incus with cholesteatoma abutting (P < 0.05). A partially eroded incus and a partially eroded stapes caused significantly increase in ABG compared to a partially eroded incus (P < 0.05). A completely eroded incus caused significantly increase in ABG compared to a partially eroded incus (P < 0.05). False fibre-connected would significantly influence on ABG in some ossicular chain erosion patterns (P < 0.05). Cholesteatoma abutting an intact ossicle significantly altered average ABG compared to a normal ossicle (P < 0 01). CONCLUSION Different ossicular chain erosion pattern caused different degrees of ABG.
Adolescent ; Adult ; Aged ; Bone Conduction ; Child ; Cholesteatoma, Middle Ear ; complications ; pathology ; Female ; Hearing Loss, Conductive ; etiology ; pathology ; Humans ; Incus ; pathology ; Male ; Malleus ; pathology ; Middle Aged ; Retrospective Studies ; Stapes ; pathology ; Young Adult

OBJECTIVE: To investigate the diagnose therapy and the postoperative curative effect of traumatic ossicular chain disruption and dislocation. METHOD: Eight cases (8 ears) with traumatic ossicular chain disruption. Six cases of unilateral conductivity deafness, 2 of mixed deafness still with conductive primarily. Eight ears all were performed tympanic exploration and ossicular replacement prosthesis, 1 ear with TORP (total ossicular replacement prosthesis). 4 ears with PORP (partial ossicular replacement prosthesis), 2 with ossicular chain reset, 1 with artificial incus reconstruction. The treatment effect was compared by the preoperative and postoperative ABG (air bone gap). RESULT: Preoperative average ABG was 42. 9 dB, the average ABG 3 weeks after operation was 22.3 dB, which reduced 20.6 dB compared to the preoperative, having a statistically significant difference (t = 22.10, P < 0.01). The average ABG was 18.6 dB 6-8 months after operation, which reduced 24.3 dB compared to the preoperative, having a statistically significant difference (t = 12.813, P < 0.01). CONCLUSION The conductivity hearing loss after traumatic ossicular chain disruption or dislocation is preferred operation treatment, and replacement should use different ways according to the operation in case, and the hearing improvement was obvious.
Adolescent ; Adult ; Bone Conduction ; Ear Ossicles ; injuries ; Female ; Hearing Loss, Mixed Conductive-Sensorineural ; diagnosis ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Ossicular Prosthesis ; Ossicular Replacement ; Young Adult

OBJECTIVETo study the incidence of tympanosclerosis (TS) and the major risk factors of hearing loss.

METHODSA total of 118 TS patients (137 ears) were compared with 265 patients with chronic otitis media (COM) (311 ears) for gender, age and course of disease. The disease regions and hearing loss of the TS patients were analyzed.

RESULTSTS showed higher prevalence in women of older ages. Sclerosis was seen most frequently in the tympanic membrane, followed by the malleus, incus, incudomalleolar joint, other regions, ariticulus incudostapedius and stapes. The patients with sclerosis or deterioration in the ossicular chain had worse hearing loss than the other patients. Carhart notch occurred in 45 ears (32.85%), an incidence similar to that of inverted "V"-shaped curve of air-conduction audiometry near 2 kHz (47 ears, 34.31%). The factors contributing to the hearing loss, listed in the order of their importance, included pathologies in the incus, malleus, incudomalleolar joint, ariticulus incudostapedius, stapes, other regions, tympanic membrane, and gender.

CONCLUSIONSFemale patients may had increased risk of TS. The presence of Carhart notch and inverted "V"-shaped curve in air-conduction audiograph may indicate myringosclerosis or ossicular chain sclerosis. Abnormal ossicular chain is the leading factor contributing to hearing loss.

Adolescent ; Adult ; Aged ; Child ; Ear Ossicles ; pathology ; Female ; Hearing Loss, Conductive ; etiology ; physiopathology ; Humans ; Male ; Middle Aged ; Otitis Media, Suppurative ; complications ; Otosclerosis ; etiology ; pathology ; physiopathology ; Retrospective Studies ; Risk Factors ; Tympanic Membrane ; pathology ; Young Adult

OBJECTIVE: To investigate the location, clinical symptom, image features, treatment and prognosis of the congenital middle ear cholesteatoma. METHOD: Retrospective review of 9 patients treated at Department of Otolaryngology Head and Neck Surgery, the affiliated Hospital of the first Strasbourg University, France. RESULT: The mean age was 6.1 years. Including 7 boys and 2 girls with hearing loss, and 7 of them suffered conductive hearing loss. Typical cholesteatomas were found behind posterior tympanic membrane according the otoscopic examinations in 6 cases. CT were completed in 8 of 9 cases, spheroid or ovoid masses were found in the tympanic cavities, most of them located in the posterior region. All of the patients underwent the surgical treatment, 5 of 9 cases had the ossicular erosion. Four of 9 cases had the residual diseases. All of the cases were followed-up at the mean period of 5.3 years, the preoperative hearing threshold is 28 dB compared with 26 dB of postoperative hearing threshold. CONCLUSION Congenital middle ear cholesteatoma is a rare and hiding lesion. The symptoms are more typical in children than that in adults, which is unilateral conductive hearing loss. Likewise,the preoperative CT scanning is important. The rate of residual lesions and prognosis of congenital cholesteatoma is mainly depended on the extension and the methods of the surgery, revision surgery as well.
Auditory Threshold ; Child ; Child, Preschool ; Cholesteatoma, Middle Ear ; congenital ; diagnosis ; Female ; Hearing Loss, Conductive ; etiology ; Humans ; Male ; Prognosis ; Retrospective Studies

OBJECTIVE: To study the bone conductive hearing loss in adults of otitis media with effusion (OME). METHOD: Fifty adults of OME treated in our hospital, from Mar. 2009 to Feb. 2010, were enrolled for analyzing bone conduction hearing loss (BCHL) before auripuncture and after auripuncture, the difference between which were compared in 51 ears. BCT of pre auripuncture 24 subjects, BCT of post-auripuncture 22 subjects, and BCT recovered from OME 9 subjects compared with the contralateral ear respectively. High and extend high frequency (8, 10, 12, 16 kHz) air conduction threshold (ACT) after recover from OME was compared to the normal contralateral ear in 4 adults. RESULT: BCT improved significantly after auripuncture at the frequencies (0.5-4.0 kHz), and the improvements in 4.0 kHz are more than that in 0.5 kHz significantly (P<0.05). In the unilateral OME subjects, BCT, of post auripuncture and recovered from OME, nearly recovered to the same level as the contralateral ear in most cases. While high and extend-high frequency (8, 10, 12, 16 kHz) ACT elevated in 3 of 4 patients recovered from OME. CONCLUSION Both effusion in middle ear and injury in inner ear could result in the elevation of BCT. Elevation of BCT at regular frequencies (0.5-4.0 kHz) is frequently associated with the effusion in middle ear, while these frequencies were insensitive in the early inner ear injury. The high and extend high frequency ACT elevation may be sensitive for the early sensorineural hearing loss. As the disease prolonged, sensorineural hearing loss of the lower frequencies (0.5-4.0 kHz) could be detected of OME patient.
Adult ; Aged ; Aged, 80 and over ; Bone Conduction ; Female ; Hearing Loss, Conductive ; etiology ; physiopathology ; Humans ; Male ; Middle Aged ; Otitis Media with Effusion ; complications ; physiopathology

OBJECTIVETo analyze the clinical data of the hearing in otosclerosis patients and explore their association with the clinical manifestations.

METHODA retrospective analysis of 88 otosclerosis cases (162 ears) was performed. Pure tone audiometry was performed in all the cases 1 to 3 days before the operation for speech analysis at the frequencies of 500, 1 k, 2 kHz and to determined the average pure-tone hearing threshold (PTA) and gas Bone gap (ABG). The incidence of carhart notch was observed in patients with simple conductive hearing loss and mixed hearing loss, and in the early, middle and late stage of otosclerosis.

RESULTSCarhart notch occurred at significant higher incidence in patients with simple conductive hearing loss and in early otosclerosis (P<0.05).

CONCLUSIONFor common otosclerosis, the lesion invades initially the vestibular window, round ligament and stapes floor, followed by the base of the cochlea, and therefore observation of the carhart notch may help determine the disease course.

Adult ; Audiometry, Pure-Tone ; Auditory Threshold ; physiology ; Female ; Hearing Loss, Conductive ; etiology ; physiopathology ; Humans ; Male ; Middle Aged ; Otosclerosis ; complications ; physiopathology ; Retrospective Studies