Conductive hearing loss following retrolabyrinthine surgery

A. A. Parikh and G. B. Brookes
Royal National Throat, Nose and Ear Hospital, London, England.

BACKGROUND: Conductive hearing loss can occur following neuro-otological procedures due to bony ossicular fixation resulting from viable bone dust remains. OBJECTIVE: To highlight the frequency and features of the complication of conductive hearing loss following retrolabyrinthine surgery. DESIGN: In a review of 77 retrolabyrinthine neuro-otological procedures, 3 cases (3.9%) of postoperative conductive hearing loss were encountered. RESULTS: Bone dust can cause a postoperative conductive hearing deficit that becomes apparent 6 months following surgery, and progressive deterioration can occur up to 18 months. The anatomical areas of ossicular fixation are the incudomalleal joint in the attic and around the stapes in the oval window niche. Excision of these bony accumulation particles does not revert the conductive hearing loss. CONCLUSIONS: We advocate the use of occlusive material in the aditus during temporal bone surgery to prevent bone dust accumulation in the attic and middle ear. In the event of such a complication, an incus transposition ossiculoplasty is recommended.