PMID- 30502003
OWN - NLM
STAT- MEDLINE
DCOM- 20190621
LR  - 20190621
IS  - 1532-818X (Electronic)
IS  - 0196-0709 (Linking)
VI  - 40
IP  - 2
DP  - 2019 Mar-Apr
TI  - Stapes hypermobility as a possible cause of hyperacusis.
PG  - 247-252
LID - S0196-0709(18)30980-3 [pii]
LID - 10.1016/j.amjoto.2018.10.018 [doi]
AB  - OBJECTIVE: Hyperacusis is a reduction of normal tolerances for everyday sounds. 
      Although several publications have been produced demonstrating that minimally 
      invasive surgical procedures may improve patient symptoms, the precise etiology 
      of hyperacusis often remains elusive. This study describes 21 patients, 7 of whom 
      stapes hypermobility is believed to be a mechanical genesis of their hyperacusis 
      symptoms. STUDY DESIGN: A prospective, repeated-measure single-arm design was 
      used for this study. SETTING: All patients were evaluated and treated at a 
      tertiary level otologic referral center. SUBJECTS AND METHODS: 21 patients 
      (Cohort A) with severe hyperacusis underwent oval and round window reinforcement. 
      Seven patients (Cohort B) intraoperatively appeared to have subjective 
      hypermobility of the stapes. Additional reinforcement of the stapes 
      superstructure was performed in these patients. RESULTS: In Cohort A, loudness 
      discomfort level (LDL) values improved on average from 72.7 dB to 81.9 dB. 
      Hyperacusis questionnaire (HQ) scores improved from 30.1 to 14.7. Numeric Rating 
      Scale scores (0-10) decreased from 8.5 to 4.0. In Cohort B, values similarly 
      improved from an average of 72.4 dB to 88.2 dB. HQ scores improved from 35.8 to 
      18.9. Numeric Rating Scale scores fell from 10.0 to 3.7. Postoperatively there 
      were no complaints of hearing loss. Sixteen out of 21(76%) reported improved 
      quality of life and diminished symptoms of hyperacusis. CONCLUSION: It is 
      possible that patients suffering from hyperacusis may have a mechanical cause for 
      their symptoms. Further research is necessary to clarify stapes mobility in 
      patients with these symptoms. Excess temporalis tissue reinforcement of the 
      stapes along with round window reinforcement shows promise as a minimally 
      invasive surgical option for patients suffering from hyperacusis.
CI  - Copyright (c) 2018 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Silverstein, Herbert
AU  - Silverstein H
AD  - Ear Research Foundation, 1901 Floyd Street, Sarasota, FL 34239, United States of 
      America. Electronic address: Info@earsinus.com.
FAU - Smith, Joshua
AU  - Smith J
AD  - Ear Research Foundation, 1901 Floyd Street, Sarasota, FL 34239, United States of 
      America.
FAU - Kellermeyer, Brian
AU  - Kellermeyer B
AD  - Ear Research Foundation, 1901 Floyd Street, Sarasota, FL 34239, United States of 
      America.
LA  - eng
PT  - Journal Article
DEP - 20181031
PL  - United States
TA  - Am J Otolaryngol
JT  - American journal of otolaryngology
JID - 8000029
SB  - IM
MH  - Female
MH  - Humans
MH  - Hyperacusis/*etiology/physiopathology/surgery
MH  - Male
MH  - Middle Aged
MH  - Minimally Invasive Surgical Procedures/methods
MH  - *Movement
MH  - Otologic Surgical Procedures/methods
MH  - Prospective Studies
MH  - Quality of Life
MH  - Round Window, Ear/surgery
MH  - Stapes/*physiopathology
MH  - Stapes Surgery
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Hyperacusis
OT  - Labyrinthine fistula
OT  - Minimally invasive
OT  - Stapes
EDAT- 2018/12/07 06:00
MHDA- 2019/06/22 06:00
CRDT- 2018/12/04 06:00
PHST- 2018/10/24 00:00 [received]
PHST- 2018/10/30 00:00 [accepted]
PHST- 2018/12/07 06:00 [pubmed]
PHST- 2019/06/22 06:00 [medline]
PHST- 2018/12/04 06:00 [entrez]
AID - S0196-0709(18)30980-3 [pii]
AID - 10.1016/j.amjoto.2018.10.018 [doi]
PST - ppublish
SO  - Am J Otolaryngol. 2019 Mar-Apr;40(2):247-252. doi: 10.1016/j.amjoto.2018.10.018. 
      Epub 2018 Oct 31.