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Hearing Preservation With Labyrinthine Ablation in Otitis Media
Author(s) -
Antonelli Patrick J.,
Briggs Russell D.,
Gerhardt Kenneth J.
Publication year - 2000
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200005000-00008
Subject(s) - medicine , middle ear , streptococcus pneumoniae , haemophilus influenzae , otitis , fenestration , inner ear , hearing loss , sensorineural hearing loss , audiology , surgery , anatomy , biology , microbiology and biotechnology , antibiotics
Objectives Iatrogenic fenestration of the inner ear in the presence of otitis media is commonly associated with permanent hearing loss. Hearing can generally be preserved when the vestibular labyrinth is ablated in a controlled manner in noninflamed ears. The purpose of this study was to examine the feasibility of hearing preservation with violation of the inner ear in the presence of middle ear inflammation. Study Design Prospective and controlled animal model. Methods Otitis media was induced bilaterally in pigmented guinea pigs with transtympanic injection of Streptococcus pneumoniae , nontypeable Haemophilus influenzae , or formalin‐killed nontypeable H influenzae . Two to 4 days after injection, the horizontal canal of one ear was transected and sealed. Hearing was tested before and after labyrinthine ablation. Results Otitis media was induced in all ears. Bacterial cultures were positive in 19 of 20 S pneumoniae –injected ears, and in 10 of 16 nontypeable H influenzae –injected ears. One week after surgery, elevation of click thresholds (> 15 dB) was encountered in none of the fenestrated or unfenestrated S pneumoniae –infected ears, in two of six unfenestrated and three of six fenestrated nontypeable H influenzae –infected ears, and in one of five killed‐nontypeable H influenzae– injected ears both with and without fenestration. Conclusions These data suggest that ablation of a semicircular canal in the presence of middle ear inflammation or infection does not necessarily lead to profound sensorineural hearing loss. Hearing loss associated with iatrogenic violation of the semicircular canals may be more dependent on factors other than the presence of nonspecific middle ear inflammation.