caa a22 4500 60618452X CHVBK 20210128100827.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00405-014-3425-4 doi (NATIONALLICENCE)springer-10.1007/s00405-014-3425-4 Toxic inner ear lesion following otitis media with effusion: a comparative CT-study regarding the morphology of the inner ear [Elektronische Daten] [Thomas Wilhelm, Tim Stelzer, Susanne Wiegand, Christian Güldner, Afshin Teymoortash, Thomas Günzel, Rudolf Hagen] Viral infections of the upper respiratory airways can lead to a delayed viral otitis media (VOM) caused by a diffusion of viruses/virus particles through the round window membrane and resulting in sensorineural hearing loss. The treatment of choice is immediate paracentesis, evacuation of all fluids from the middle ear cavity, and haemorrheological infusions. However, in some cases, persistent symptoms may be an indication for a surgical approach using mastoidectomy. In high-resolution computed tomography, an extended small-sized pneumatisation of the mastoid cells with complete shading was found in these non-responsive cases. Therefore, a direct means of inner ear affliction through weak parts of the labyrinthine bone may be hypothesised. Patients suffering from a toxic inner ear lesion (TIEL) following a common cold, treated over a 10-year period in a Tertiary Care Centre (N=52, 57 ears), were identified and the morphological characteristics of the temporal bones of affected patients were examined by means of high-resolution computed tomography (hrCT). The findings were compared with a matched control group of 64 normal ears (CONT). Measurements included the grade of pneumatisation, distances within the temporal bones and Hounsfield units (HU) at defined anatomical structures. In the TIEL group, we found a small-sized pneumatisation in 79.4% and a medium-sized pneumatisation in 10.9%, thus differing from the CONT group and the literature data. Thickness of the bone wall of the lateral semicircular canal (LSC) and distances within the aditus ad antrum were significantly reduced in the TIEL group. HU's were markedly lower in the TIEL group at the precochlea, the LSC, and dorsolateral to the promentia of the LSC. There was a correlation between the HU's at the prominentia of the LSC and the hearing loss (p=0.002). Persisting interosseous globuli, as described in 1897 by Paul Manasse, form an osseochondral network within the otic capsule and may be responsible for a direct means of toxic inner ear infection. The CT-morphometric results support this thesis. In the group of these patients (TIEL) a CT-scan and in non-responders to conservative treatment a surgical approach by mastoidectomy is recommended. Springer-Verlag Berlin Heidelberg, 2014 Toxic lesion nationallicence Inner ear nationallicence Subacute mastoiditis nationallicence Otitis media with effusion nationallicence Computed tomography nationallicence Sensorineural hearing loss nationallicence Wilhelm Thomas Department of Otolaryngology, Head, Neck and Facial Plastic Surgery, Kliniken Leipziger Land, Klinikum Borna, Rudolf-Virchow-Str. 2, 04552, Borna, Germany aut Stelzer Tim Department of Otolaryngology, Head, Neck and Facial Plastic Surgery, Kliniken Leipziger Land, Klinikum Borna, Rudolf-Virchow-Str. 2, 04552, Borna, Germany aut Wiegand Susanne Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, Germany aut Güldner Christian Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, Germany aut Teymoortash Afshin Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, Germany aut Günzel Thomas Department of Otolaryngology, Head and Neck Surgery, Borromäus Hospital, Leer, Germany aut Hagen Rudolf Department of Otolaryngology and Facial Plastic Surgery, Julius-Maximilians-University, Würzburg, Germany aut European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/12(2015-12-01), 3635-3643 0937-4477 272:12<3635 2015 272 405 https://doi.org/10.1007/s00405-014-3425-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00405-014-3425-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wilhelm Thomas Department of Otolaryngology, Head, Neck and Facial Plastic Surgery, Kliniken Leipziger Land, Klinikum Borna, Rudolf-Virchow-Str. 2, 04552, Borna, Germany aut NATIONALLICENCE 700 1- Stelzer Tim Department of Otolaryngology, Head, Neck and Facial Plastic Surgery, Kliniken Leipziger Land, Klinikum Borna, Rudolf-Virchow-Str. 2, 04552, Borna, Germany aut NATIONALLICENCE 700 1- Wiegand Susanne Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, Germany aut NATIONALLICENCE 700 1- Güldner Christian Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, Germany aut NATIONALLICENCE 700 1- Teymoortash Afshin Department of Otolaryngology, Head and Neck Surgery, Philipps-University, Marburg, Germany aut NATIONALLICENCE 700 1- Günzel Thomas Department of Otolaryngology, Head and Neck Surgery, Borromäus Hospital, Leer, Germany aut NATIONALLICENCE 700 1- Hagen Rudolf Department of Otolaryngology and Facial Plastic Surgery, Julius-Maximilians-University, Würzburg, Germany aut NATIONALLICENCE 773 0- European Archives of Oto-Rhino-Laryngology Springer Berlin Heidelberg 272/12(2015-12-01), 3635-3643 0937-4477 272:12<3635 2015 272 405