The Effect of Endoscopic Endonasal Transsphenoidal Skull Base Surgery on Cochlear Function

Abstract

Endoscopic transsphenoidal skull base surgery (ETSS) has become a standard approach in the treatment of sellar and clival lesions, such as pituitary adenoma and chordoma. Due to the close proximity of the clivus and the sella turcica to the inner ear, it is thought that bone drilling in the surgery may have effects on hearing. The aim of this study was to assess the effect of bone drilling in ETSS procedure on cochlear function. This study was performed on 18 patients who underwent ETSS procedure between December 2016 and May 2017. The study was designed as a prospective study. All of the data were prospectively collected. These included demographic data, date of surgery, type of surgery, preoperative pure-tone audiometry, and preoperative and postoperative distortion product otoacoustic emission (DPOAE) measurements. Of the DPOAE measurements of the patients who were operated for pituitary adenoma, there was a statistically significant difference between the signal-to-noise ratio (SNR) measurements at 0.5, 1, 2 and 4 kHz (p < 0.05). Additionally, there were no significant differences in preoperative and postoperative SNR measurements of six patients who were selected for clivus chordoma. When the preoperative and postoperative tonal audiometric tests of the patients were compared, no statistically significant difference was found (p > 0.05). In conclusion, it is found that bone drilling in ETSS procedure has a negative effect on cochlear function in the early period. This is the first study to evaluate the degree of noise-induced cochlear damage in patients who were gone under ETSS procedure.

Keywords

pituitary - clivus - endoscopic - chordoma - cochlear function

• References

• 1 Farzanegan G, Ghasemi M, Panahi F, Raza M, Alghasi M. Does drill-induced noise have an impact on sensorineural hearing during craniotomy procedure?. Br J Neurosurg 2010; 24 (01) 40-45
• 2 Kylén P, Arlinger S. Drill-generated noise levels in ear surgery. Acta Otolaryngol 1976; 82 (5–6): 402-409
• 3 Michaelides EM, Kartush JM. Implications of sound levels generated by otologic devices. Otolaryngol Head Neck Surg 2001; 125 (04) 361-363
• 4 Baradaranfar MH, Shahbazian H, Behniafard N. , et al. The effect of drill-generated noise in the contralateral healthy ear following mastoid surgery: the emphasis on hearing threshold recovery time. Noise Health 2015; 17 (77) 209-215
• 5 Dalchow CV, Hagemeier KC, Muenscher A, Knecht R, Kameier F. Investigation of noise levels generated by otologic drills. Eur Arch Otorhinolaryngol 2013; 270 (02) 505-510
• 6 Clark WW, Bohne BA. Effects of noise on hearing. JAMA 1999; 281 (17) 1658-1659
• 7 Atchariyasathian V, Chayarpham S, Saekhow S. Evaluation of noise-induced hearing loss with audiometer and distortion product otoacoustic emissions. J Med Assoc Thai 2008; 91 (07) 1066-1071
• 8 Furst M, Reshef I, Attias J. Manifestations of intense noise stimulation on spontaneous otoacoustic emission and threshold microstructure: experiment and model. J Acoust Soc Am 1992; 91 (02) 1003-1014
• 9 Attias J, Horovitz G, El-Hatib N, Nageris B. Detection and clinical diagnosis of noise-induced hearing loss by otoacoustic emissions. Noise Health 2001; 3 (12) 19-31
• 10 Migirov L, Wolf M. Influence of drilling on the distortion product otoacoustic emissions in the non-operated ear. ORL J Otorhinolaryngol Relat Spec 2009; 71 (03) 153-156
• 11 Kazikdas KC, Onal K, Yildirim N. Sensorineural hearing loss after ossicular manipulation and drill-generated acoustic trauma in type I tympanoplasty with and without mastoidectomy: a series of 51 cases. Ear Nose Throat J 2015; 94 (09) 378-398
• 12 Gode S, Kaya I, Turhal G. , et al. The effect of mandibulectomy and mandibulotomy on cochlear function. J Craniofac Surg 2016; 27 (08) 1926-1928
• 13 Kanai R, Kaneko K. Negative middle ear pressure and otitis media with effusion after surgery under general anesthesia. Acta Otolaryngol 2012; 132 (10) 1049-1053