Correlation Between Sensorineural Hearing Loss and Chronic Otorrhea.

Many studies have been trying to correlate chronic otorrhea, both in children and in adults, with the sensorineural hearing loss in the affected ear, but have been obtaining contradictory results. This loss might be due to the likely toxicity of the bacteria involved, effects of inflammatory cytokines, or constant use of ototoxic antibiotics. All the studies evaluated up to the present date compared the affected ear with the normal contralateral ear. From the digitized archive of otological surgery files of the Department of Otorhinolaryngology, the ears of patients with chronic otorrhea were evaluated visually and compared with the normal contralateral ears. Ears with otorrhea were also compared to ears with dry tympanic perforation of other patients. Ears with suppuration were evaluated for cholesteatoma. The duration of otorrhea was taken into account. The sensorineural hearing threshold was evaluated for the frequencies of 500, 1000, 2000, and 4000 Hz. A total of 98 patients with chronic otorrhea and 60 with dry tympanic membrane perforation were evaluated. From a statistical study, a correlation between sensorineural hearing loss and the chronic otorrhea was observed, in comparison both with contralateral normal ears and with dry perforated ears of other patients. There was no relationship with the duration of suppuration or with whether this was due to cholesteatoma. Sensorineural hearing loss occurs in ears with chronic otorrhea. The duration of otorrhea and the etiology of suppuration did not influence the hearing loss. The great majority of otorrhea cases begin during childhood.

Correlation between sensorineural hearing loss and chronic otorrhea.

Many studies have attempted to correlate chronic otorrhea in children and in adults with the sensorineural hearing loss in the affected ear, with contradictory results. This loss might be the result of the likely toxicity of the bacteria involved, effects of inflammatory cytokines, or constant use of ototoxic antibiotics. All studies evaluated to date compared the affected ear with the normal contralateral ear. From the digitized archive of otologic surgery files of the Department of Otorhinolaryngology at Santa Casa de São Paulo School of Medical Sciences, the ears of patients with chronic otorrhea were evaluated visually and compared with the normal contralateral ears. Ears with otorrhea were also compared with ears of other patients with dry tympanic perforation. Ears with suppuration were evaluated for cholesteatoma. The duration of otorrhea was considered. The sensorineural hearing threshold was evaluated for the frequencies of 500, 1,000, 2,000, and 4,000 Hz. A total of 98 patients with chronic otorrhea and 60 with dry tympanic membrane perforation were evaluated. A correlation between sensorineural hearing loss and chronic otorrhea was observed when compared with both contralateral normal ears and dry perforated ears of other patients. No relationship between hearing loss and the duration of suppuration or cholesteatoma was found. Sensorineural hearing loss occurs in ears with chronic otorrhea. The duration of otorrhea and the etiology of suppuration did not influence the hearing loss.

Feasibility of ossicular chain reconstruction with resin cement / Viabilidade da reconstrução da cadeia ossicular com cimento resinoso

Abstract Introduction: Disjunction of ossicular chain is a common finding in middle ear chronic disease. In addition to ossicular interposition, various materials have been used for reconstruction, such as ceramic prostheses, polyethylene, and titanium. Objective: Because of the high cost of the available options, the authors propose to reconstruct the ossicular chain with resin cement, a material typically used in dental reconstruction and fixation. Methods: Two anatomical parts of the temporal bones were used, creating a disjunction of the ossicular chain between the incus and staples and then reconstructing with resin cement. These reconstructions were repeated four times by three different surgeons to ensure the feasibility of the method. Results: A total of 12 reconstructions were carried out, four per surgeon. After applying the cement, it could be verified by touch that the space was filled properly by the used material. Proper articulation with motion transfer to the entire ossicular chain was also observed. Conclusion: Resin cement is a suitable material in the reconstruction of ossicular chain injury, and it is inexpensive and technically simple.

Resumo Introdução: É frequente a disjunção da cadeia ossicular nas doenças crônicas da orelha média. Além de interposições ossiculares, vários materiais já foram usados com a finalidade de reconstruí-la, como próteses de cerâmica, polietileno e titânio. Objetivo: Devido ao alto custo das opções existentes, propomos reconstruir a cadeia com cimento resinoso, material usado normalmente na reconstrução e fixação dentária. Método: Serão usadas duas peças anatômicas de ossos temporais, nas quais será criada uma disjunção da cadeia entre a bigorna e o estribo que, a seguir, será reconstruída com o cimento resinoso. Essas reconstruções serão repetidas quatro vezes por três cirurgiões diferentes, para certificação da viabilidade do método. Resultados: Foram feitas 12 reconstruções, quatro por cada cirurgião. Após aplicação do cimento, conseguimos, ao toque, perceber que o espaço foi preenchido adequadamente pelo material empregado. Notamos ainda adequada articulação com transferência de movimento para toda a cadeia ossicular. Conclusão: O cimento resinoso é um material viável na reconstrução de lesões da cadeia ossicular e proporciona um método tecnicamente simples e de baixo custo.

Feasibility of ossicular chain reconstruction with resin cement.

INTRODUCTION: Disjunction of ossicular chain is a common finding in middle ear chronic disease. In addition to ossicular interposition, various materials have been used for reconstruction, such as ceramic prostheses, polyethylene, and titanium. OBJECTIVE: Because of the high cost of the available options, the authors propose to reconstruct the ossicular chain with resin cement, a material typically used in dental reconstruction and fixation. METHODS: Two anatomical parts of the temporal bones were used, creating a disjunction of the ossicular chain between the incus and staples and then reconstructing with resin cement. These reconstructions were repeated four times by three different surgeons to ensure the feasibility of the method. RESULTS: A total of 12 reconstructions were carried out, four per surgeon. After applying the cement, it could be verified by touch that the space was filled properly by the used material. Proper articulation with motion transfer to the entire ossicular chain was also observed. CONCLUSION: Resin cement is a suitable material in the reconstruction of ossicular chain injury, and it is inexpensive and technically simple.