Genesis of the round window rupture syndrome; some experimental observations.

Clinical and experimental evidence has revealed that rupture of the round window membrane, by itself, is not a major cause of sensorineural hearing loss. Eighteen guinea pigs underwent removal of the round window. The status of cochlear function was determined by recording the cochlear microphonic. An average loss of only about 6 db was observed after surgery. It is felt that there must commonly be more cochlear damage concurrent with window rupture to explain the significant and often relatively immediate hearing losses seen in clinical practice. The site(s) of this primary trauma has not yet been discovered, but it would seen reasonable in the light of recent reports that the perilymphatic vessels, the vas spirale, the stria vascularis and/or the intergrity of the cochlear duct might be involved in the genesis of this hearing loss. We propose that the term "round window rupture syndrome" be used as a more accurate description of this entity. The round window damage provides evidence of more devastating trauma within the cochlea. Thus, the clinician, being alerted, should not stop his therapeutic efforts with surgical closure of the RW. Better prognosis for the patient, as well as leading into new avenues for the investigation of cochlear function, would be the result.