title: Preoperative computed tomography scan may fail to predict perilymphatic gusher.
abstract: OBJECTIVE
  A stapes gusher is a very rare event in ear surgery, but the consequences for hearing can be dramatic. It can usually be predicted by characteristic radiologic abnormalities. We report 2 cases of gusher without any abnormalities seen on the preoperative computed tomography scans.
  
  
  METHODS
  The first case was in a 30-year-old man with a bilateral mixed hearing loss. The gusher occurred after a stapedotomy performed with a microdrill. The oval window was plugged with a vein graft, and a fluoroplastic piston was inserted. The second case was in a 39-year-old woman with a family history of hearing loss who presented with a bilateral mixed hearing loss. The footplate was fractured during the stapedotomy drilling and was covered with a temporalis fascia graft that was fixed with a fluoroplastic piston.
  
  
  RESULTS
  The first patient had no cerebrospinal fluid leakage and no vertigo or tinnitus. He did have a sensorineural hearing loss. The second patient had dizziness and tinnitus. Postoperative magnetic resonance imaging scans were performed, but again no features were identified that might have predicted these cases.
  
  
  CONCLUSIONS
  Surgeons should be reminded that a preoperative computed tomography scan may fail to detect the risk of a perilymphatic gusher.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rouen University Hospital-Charles Nicolle, France.
authors.forename: Lydia
authors.initials: L
authors.lastname: Krouchi
authors.forename: Françoise
authors.initials: F
authors.lastname: Callonnec
authors.forename: Pierre
authors.initials: P
authors.lastname: Bouchetemblé
authors.forename: Eleonore
authors.initials: E
authors.lastname: Tollard
authors.forename: Danièle
authors.initials: D
authors.lastname: Dehesdin
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Marie
mesh_terms: D000328:Adult; D001299:Audiometry; D005260:Female; D040181:Genetic Diseases, X-Linked / Q000000981:diagnostic imaging*; D006314:Hearing Loss, Conductive / Q000000981:diagnostic imaging*; D006319:Hearing Loss, Sensorineural / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011859:Radiography; D013201:Stapes Surgery / Q000009:adverse effects*