Title
Simultaneous true stapes fixation and bilateral bony dehiscence between the internal carotid artery and the apex of the cochlea : the ultimate pitfallSimultaneous true stapes fixation and bilateral bony dehiscence between the internal carotid artery and the apex of the cochlea : the ultimate pitfall
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Research group
Faculteit Geneeskunde
Publication type
article
Publication
Philadelphia, Pa.,
Subject
Human medicine
Source (journal)
Otology and neurotology. - Philadelphia, Pa.
Volume/pages
32(2011):6, p. 909-913
ISSN
1531-7129
ISI
000292759500006
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
Background: A dehiscence of a semicircular canal can mimic the audiologic characteristics of otosclerosis. Objective: To present a unique case report of a patient presenting with stapes fixation due to otosclerosis but persisting conductive hearing loss after uneventful laser-assisted stapedotomy with interposition of an àWengen titanium clip stapes prosthesis. Eventually, a bilateral bony dehiscence between the apical turn of the cochlea and the internal carotid artery was eventually identified, which explained the persisting postoperative conductive hearing loss. A dehiscence of the semicircular canals was duly ruled out preoperatively. Patient: Caucasian man aged 63 years. Intervention: Laser-assisted stapedotomy with interposition of an àWengen titanium clip stapes prosthesis. Later on, the patient received a Bone-Anchored Hearing Aid. Results: A 63-year-old man presented with a clinical and audiologic bilateral stapes fixation due to otosclerosis. A possible dehiscence of a semicircular canal was duly ruled out preoperatively by high-resolution computed tomographic scanning. The stapes fixation was treated lege artis by laser-assisted stapedotomy and subsequent interposition of an àWengen titanium clip stapes prosthesis, but the mixed hearing loss persisted. Eventually, a dehiscence between the apical turn of the cochlea and the internal carotid artery was identified. Thereafter, the patient was adequately helped with a Bone-Anchored Hearing Aid. Conclusion: We think that this is the first published case of simultaneous occurrence of radiologically and preoperatively confirmed stapes fixation and bilateral bony dehiscence between the apex of the cochlea and the internal carotid artery. Preoperative imaging studies therefore should look not only for a possible dehiscence of a semicircular canal, mimicking otosclerosis, but also for a dehiscence between the cochlea and the internal carotid artery.
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