Conductive Hearing Loss Due to Trauma

The Journal of Laryngology & Otology, 2008

Introduction:This paper reviews our experience of ossicular chain injuries following head trauma treated at Groote Schuur Hospital, Cape Town, South Africa.Materials and methods:We performed a retrospective chart review of all patients with a history of head trauma and a conductive hearing loss who had undergone exploratory tympanotomy. Sixteen patients were included in the study.Results:Injury was most common at the incudostapedial joint (63 per cent). Disarticulations of the icudostapedial joint were treated with cartilage interposition in all cases. Audiography showed an improvement in 12 of the patients, with an average improvement of 35 dB.Discussion:We discuss the various options available to the otologist to repair ossicular disruptions after trauma. In this series, cartilage autografts were used in most incudostapedial joint injuries, with excellent closure of the air–bone gap.Conclusion:Cartilage interposition was a very successful method of repairing incudostapedial joint ...

International Journal of Pediatric Otorhinolaryngology Extra, 2006

International Journal of Otorhinolaryngology and Head and Neck Surgery

Background: Post traumatic hearing loss is one of the most common problems encountered among trauma victims. It can manifest as conductive, sensorineural or mixed hearing loss. It is against this background that the study evaluated the clinical and audiological outcome of 47 patients of trauma.Methods: A descriptive longitudinal study was conducted over a period January 2017 to March 2018. Follow up was done after 3 months of discharge. Study consisted of 47 patients presenting with features of trauma related injuries. After carrying out systematic clinical, audiometric and radiological evaluation, patients were managed conservatively.Results: Of the 47 patients studied, 89.98% were related to road traffic accidents (RTAs); and 76.60% were under the influence of alcohol at the time of trauma. Among the 32 cases of the RTAs involving two wheelers, 29 patients (90.62%) were not using protective devices like helmet. Nearly 90% of patients had temporal bone fracture. Audiological evalua...

Scholarly Journal of Otolaryngology, 2019

Background: drilling on the intact ossicular chain produce acoustic trauma resulting in inner ear structure damage, these changes occurred in organ of corti with disruption of cytoarchitecture and cellular degeneration. Objective: To evaluate the changes in inner ear structure and function after drill -induced acoustic trauma in guinea pigs by Scanning Electron Microscope (SEM) and Otoacoustic emission (OAE). Methods and Material: An experimental study conducted on healthy pigmented guinea pigs in Otolaryngology-Head and neck Surgery Department at Jazan University, Kingdom of Saudi Arabia. Results: Thirty guinea pigs were divided into a control group (N) to document the baseline Distortion Product Otoacoustic Emissions (DPOAEs) and the normal scanning electron microscopic (SEM) morphology of the inner ear, Drill induced acoustic trauma group (D) to evaluate the effect of induced sensorineural hearing loss using micromotor drill (20,000rpm) maximum speed against the body of incus and 2weeks postoperative group (2W) to evaluate to the effect of spontaneous recovery after 2 weeks from induced sensorineural hearing loss which showed spontaneous although incomplete recovery of the DPOAEs amplitudes and SEM morphology with scar tissue replacing the damaged outer hair cells. Conclusion: Avoid touching ossicular chain when using high speed drill during ear surgery as this may cause structural and functional damage to the inner ear. Spontaneous recovery could be occurs after acoustic trauma but incomplete recovery with permanent scar formation in outer hair cells may occur.

Background: Damage to the peripheral auditory structures has long been recognized as a common component of head injury. It is estimated that a majority of patients with skull trauma have resultant hearing impairment. Damage to the peripheral and/or central auditory pathways can occur as a primary or secondary injury. Considering the high incidence of hearing loss, it was considered worthwhile to conduct an in-depth investigation by administering a comprehensive audiological test battery on head-injured patients. Method: The sample population consisted of 290 subjects with closed head injury (study group) and 50 subjects with otologically normal subjects (control group). The subjects in the study group were further divided into mild (n 150), moderate (n 100), and severe (n 40) category on the basis of Glasgow Coma Scale score. The audiological assessment consisted of pure tone audiometry, speech audiometry, tympanometry, acoustic reflex testing, auditory brain stem response audiometry, and middle latency response audiometry. Results and Conclusions: It is concluded that there is higher prevalence of hearing impairment in the study group compared with control group. Majority of the patients who incur hearing loss after closed head injury have mild degree of hearing impairment. A significant difference between the study and control group observed on majority of the auditory brain stem response and middle latency response parameters studied.

The Journal of the Acoustical Society of America, 1991

This presentation considers important developments and new trends related to acoustic injury in the peripheral auditory system reported during the past 5 years. The discussion begins with the effect overstimulation has on the "active" cochlear process, and the associated loss in receptive field (tuning curve) selectivity. Exposure to intense sound also changes the structure and function of the tectorial membrane, sensory hair bundles, tip links, and intracellular organelles. All of these injuries may change the way in which energy is delivered to the transduction channels of the hair cell. Important new evidence describing the quantitative relation between hair cell loss and permanent hearing loss is reviewed, and the possibility that specific exposure conditions cause unique lesions to the inner or outer hair cells is explored. Finally, the importance of hair cell regeneration in the chick cochlea, changes in the CNS following acoustic injury, and the cochlear vascular system are considered. Ashmore, J. F. (1987). "A fast motile response in guinea-pig outer hair cells: The cellular basis of the cochlear amplifier," J. Physiol. 388, 323-347. Axelsson, A., and Dengernik, H. (1987). "The effects of noise on histological measures of the cochlear vasculature and red blood cells: A review," Hear. Res. 31, 183-192. Billet, T. E., Thorne, P. R., and Gavin, J. B. (1989). "The nature and progression of injury to the organ of Corti during ischemia," Hear. Res. 41, 189-198. Bohne, B. A., Zahn, S. Z., and Bozzay, D. G. (1985). "Damage to the cochlear following interrupted exposure to low frequency noise," Ann. Otol. Rhinol. Laryngol. 94, 122-128. Borg, E., and EngstrSm, B. (1989). "Noise level, inner ear hair cell damage, audiometric features, and equal-energy hypothesis," J. Acoust. Soc. Am. 86, 1776-1782.

American Journal of Otolaryngology, 2010

Purpose: Temporal bone fracture, which involves the otic capsule, can lead to complete loss of auditory and vestibular functions, whereas the patients without fractures may experience profound sensorineural hearing loss due to cochlear concussion. Cochlear implant is indicated in profound sensorineural hearing loss due to cochlear trauma but who still have an intact auditory nerve. Material and methods: This is a retrospective review study. We report 5 cases of postlingually deafened patients caused by cochlear trauma, who underwent cochlear implantation. Preoperative and postoperative hearing performance will be presented. These patients are cochlear implanted after the cochlear trauma in our department between 2001 and 2006. Results: All patients performed very well with their implants, obtained open-set speech understanding. They all became good telephone users after implantation. Their performance in speech understanding was comparable to standard postlingual adult patients implanted. Conclusion: Cochlear implantation is an effective aural rehabilitation in profound sensorineural hearing loss caused by temporal bone trauma. Preoperative temporal bone computed tomography, magnetic resonance imaging, and promontorium stimulation testing are necessary to make decision for the surgery and to determine the side to be implanted. Surgery could be challenging and complicated because of anatomical irregularity. Moreover, fibrosis and partial or total ossification within the cochlea must be expected.

Anales médicos hospital ABC, 2024

Hearing loss (HL) following severe traumatic brain injury has been reported as a frequent complication. In contrast, mild head trauma rarely causes HL. Furthermore, most cases of HL secondary to mild head trauma are mild, and spontaneous full recovery after a few weeks has been reported as the most frequent finding. Objective: The purpose of this paper is to present one case of profound bilateral HL following mild head trauma in a 5-year-old female patient. The patient underwent behavioral pure-tone audiometry, ear immittance measurements, brainstem auditory evoked potentials, magnetic resonance imaging of the head, and head computed tomography scans. A bilateral profound HL was demonstrated. After a 4-week follow-up, mild recovery of hearing thresholds was demonstrated in one ear. Imaging studies were unremarkable. At 8-week post-trauma, there were no significant changes in hearing thresholds. The patient was admitted as a candidate for cochlear implantation. From the findings in this case report, it can be concluded that hearing function should be appropriately assessed following any kind of head trauma regardless of the severity. Even a mild head trauma can result in bilateral profound HL. Early and adequate auditory intervention would prevent long-term communication sequelae.

Malaysian Family Physician, 2013