Nikkar-Esfahani A, Whelan D, Banerjee A
Department of Otolaryngology, James Cook University Hospital, Middlesbrough, UK.
J Laryngol Otol. 2013 Jul;127(7):705-7. doi: 10.1017/S0022215113001096. Epub 2013 Jun 4.
Conductive hyperacusis in superior semicircular canal dehiscence syndrome occurs due to the presence of a 'third window' created by the dehiscence. Reversible blocking of the round window can, in theory, cause a reduction in the compression-related volume displacement, and thereby minimise symptoms of conductive hyperacusis. This study describes a technique of permeatal blocking of the round window.
The tympanomeatal flap is elevated and the round window niche is identified. The round window membrane is subsequently identified and occluded with bone wax, muscle and fascia, in three separate layers. Finally, the tympanomeatal flap is reflected, and an ear wick is inserted.
Two patients who underwent the procedure reported a reduction in symptoms. Importantly, no Tullio phenomenon was reported post-operation.
Blocking of the round window can be used to control symptoms of superior semicircular canal dehiscence syndrome in patients who present solely with symptoms of conductive hyperacusis. This technique provides an alternative to resurfacing techniques. The procedure is simple to perform, reversible and can be undertaken as day-case surgery.
上半规管裂综合征中的传导性听觉过敏是由于裂孔形成了一个“第三窗”所致。理论上，圆窗的可逆性封闭可减少与压缩相关的容积位移，从而减轻传导性听觉过敏的症状。本研究描述了一种经耳道封闭圆窗的技术。
掀起鼓室鼓膜瓣并识别圆窗龛。随后识别圆窗膜，并用骨蜡、肌肉和筋膜分三层进行封闭。最后，将鼓室鼓膜瓣复位，并插入耳用棉条。
接受该手术的两名患者报告症状减轻。重要的是，术后未报告有图利奥现象。
对于仅表现为传导性听觉过敏症状的上半规管裂综合征患者，圆窗封闭可用于控制症状。该技术为修复技术提供了一种替代方法。该手术操作简单、可逆，可作为日间手术进行。
