"Third Window" and "Single Window" Effects Impede Surgical Success: Analysis of Retrofenestral Otosclerosis Involving the Internal Auditory Canal or Round Window

Journal of Clinical Medicine
Yun Jung BaeJae-Jin Song

Abstract

We aimed to identify prognostic computed tomography (CT) findings in retrofenestral otosclerosis, with particular attention paid to the role of otosclerotic lesion area in predicting post-stapedotomy outcome. We included 17 subjects (23 ears) with retrofenestral otosclerosis who underwent stapedotomy. On preoperative CT, the presence of cavitating lesion and involvement of various subsites (cochlea, round window [RW], vestibule, and semicircular canal) were assessed. Pre- and post-stapedotomy audiometric results were compared according to the CT findings. The surgical outcomes were analyzed using logistic regression with Firth correction. Cavitating lesions were present in 15 of 23 ears (65.2%). Involvement of the RW was the strongest predictor of unsuccessful surgical outcome, followed by involvement of the internal auditory canal (IAC) and the cochlea. RW and IAC involvement in retrofenestral otosclerosis were shown to predict unsuccessful outcomes. While a "third window" effect caused by extension of a cavitating lesion into the IAC may dissipate sound energy and thus serve as a barrier to desirable postoperative audiological outcome, a "single window" effect due to an extension of retrofenestral otosclerosis into the RW may...Continue Reading

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Citations

Dec 14, 2019·AJNR. American Journal of Neuroradiology·J C BensonJ Lane
Jan 11, 2020·Frontiers in Neurology·P Ashley WackymJasdeep S Hundal
Sep 29, 2020·Frontiers in Neurology·Marta M Iversen, Richard D Rabbitt
Nov 17, 2021·Vestnik otorinolaringologii·E V GarovM M Omarova

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