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Endoscopic middle ear exploration in pediatric patients with conductive hearing loss.

Abstract To describe our indications, findings, and outcomes for transcanal endoscopic middle ear exploration in pediatric patients with conductive hearing loss of unknown etiology, without effusions.
PMID
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Authors

Mayor MeshTerms
Keywords

Ear

Endoscopic

Exploration

Middle

Surgery

Journal Title international journal of pediatric otorhinolaryngology
Publication Year Start




PMID- 28390607
OWN - NLM
STAT- MEDLINE
DA  - 20170409
DCOM- 20170517
LR  - 20170517
IS  - 1872-8464 (Electronic)
IS  - 0165-5876 (Linking)
VI  - 96
DP  - 2017 May
TI  - Endoscopic middle ear exploration in pediatric patients with conductive hearing
      loss.
PG  - 21-24
LID - S0165-5876(17)30077-0 [pii]
LID - 10.1016/j.ijporl.2017.02.017 [doi]
AB  - OBJECTIVE: To describe our indications, findings, and outcomes for transcanal
      endoscopic middle ear exploration in pediatric patients with conductive hearing
      loss of unknown etiology, without effusions. METHODS: Prospective case series for
      all pediatric patients undergoing totally endoscopic transcanal middle ear
      exploration between April 2012 and October 2015 at a pediatric tertiary care
      referral hospital. Demographic data, operative findings, and hearing results were
      reviewed. RESULTS: 21 cases were performed in 20 ears (1 revision). Average age
      at surgery was 7.98 years and average follow up was 2.1 years. Middle ear
      pathology identified on CT imaging was confirmed in 55% of cases while identified
      in 45% of cases where pre-operative imaging was non-diagnostic. 6/20 patients
      (30%) had an ossicular deformity. 8/20(40%) had bony ossicular fixation.
      5/20(25%) had ossicular discontinuity. 2/20(10%) had facial nerve dehiscence
      impinging on the stapes. 15% had adhesive myringosclerosis or severe granulation 
      causing hearing loss. Prosthetic ossiculoplasty was done in 7/21 (33.3%) of the
      cases, with 1 TORP, 3 PORPs, and 3 IS joint replacements. Imaging was predictive 
      of intra-operative findings in 13/20 cases (55%). Trainees assisted in 16/21(76%)
      of cases. The average improvement of PTA was 11.65 dB (range -10 to 36.25), and
      the average ABG improved 10.19 (range -11.25 to 28.75). There were no
      perioperative complications or adverse events. CONCLUSIONS: The endoscopic
      transcanal approach for middle ear exploration offers excellent visualization and
      is one of the best applications for the endoscopes in pediatric otology cases.
      This is particularly helpful for "unexplained" conductive hearing loss where
      ossicular deformity/fixation/discontinuity is suspected. The etiology of the
      conductive hearing loss was definitively found in 100% of cases, and can be
      repaired in the same sitting when applicable.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Carter, John M
AU  - Carter JM
AD  - Ochsner Medical Center, 1514 Jefferson Hwy, New Orleans, LA, 70121, United
      States. Electronic address: [email protected]
FAU - Hoff, Stephen R
AU  - Hoff SR
AD  - Anne & Robert H. Lurie Children's Hospital of Chicago, 225 Chicago Ave, Chicago, 
      IL, 60611, United States; McGaw Medical Center of Northwestern University, 240
      East Huron Street, Chicago, IL, 60611, United States. Electronic address:
      [email protected]
LA  - eng
PT  - Journal Article
DEP - 20170228
PL  - Ireland
TA  - Int J Pediatr Otorhinolaryngol
JT  - International journal of pediatric otorhinolaryngology
JID - 8003603
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Ear, Middle/pathology/*surgery
MH  - Endoscopy/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Hearing
MH  - Hearing Loss, Conductive/*diagnosis
MH  - Hearing Tests
MH  - Humans
MH  - Male
MH  - Prospective Studies
OTO - NOTNLM
OT  - Ear
OT  - Endoscopic
OT  - Exploration
OT  - Middle
OT  - Surgery
EDAT- 2017/04/10 06:00
MHDA- 2017/05/18 06:00
CRDT- 2017/04/10 06:00
PHST- 2016/10/24 [received]
PHST- 2017/02/13 [revised]
PHST- 2017/02/15 [accepted]
AID - S0165-5876(17)30077-0 [pii]
AID - 10.1016/j.ijporl.2017.02.017 [doi]
PST - ppublish
SO  - Int J Pediatr Otorhinolaryngol. 2017 May;96:21-24. doi:
      10.1016/j.ijporl.2017.02.017. Epub 2017 Feb 28.

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