title: Mixed hearing loss in iatrogenic tympanic membrane perforations over the round window niche and the immediate effect of paper patch myringoplasty.
abstract: OBJECTIVE
  Report the immediate audiologic effect of paper patch myringoplasty to repair iatrogenic tympanic membrane perforations directly over the round window.
  
  
  METHODS
  Retrospective case-control study of 15 patients treated for inner ear disease with a MicroWick and dexamethasone for 1 month, resulting in 2-mm perforations over the round window. Paper patch myringoplasties were performed to repair the perforations. Audiograms were performed before and immediately after the paper patch myringoplasty.
  
  
  RESULTS
  After paper patch placement, there was a significant improvement in air-bone gap at 250 (p < 0.001), 500 (p = 0.003), and 1000 Hz (p = 0.004) and a significant improvement in bone conduction (BC) threshold at 250 (p = 0.002), 500 (p < 0.001), 1000 (p = 0.002), 2000 (p = 0.003), and 3000 Hz (p = 0.02).
  
  
  CONCLUSIONS
  Paper patch myringoplasty improves both air conduction and BC hearing from small perforations over the round window. The decrease in BC hearing is a result of middle ear mechanics and is not a true sensorineural hearing loss.
authors: Ear Research Foundation, Sarasota, FL 34239, USA. hsilverste@aol.com
authors: Herbert
authors: H
authors: Silverstein
authors: Benjamin J
authors: BJ
authors: Wycherly
authors: D Spencer
authors: DS
authors: Darley
authors: Yadiel A
authors: YA
authors: Alameda
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007759:Labyrinth Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009225:Myringoplasty / Q000379:methods*; D012189:Retrospective Studies; D012405:Round Window, Ear / Q000601:surgery*; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000139:chemically induced / Q000150:complications* / Q000601:surgery
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone