KRONİK OTİTİS MEDİA HASTALARINDA CARHART NOTCH'UNUN TANISAL ÖNEMİ

Year 2021, Volume: 28 Issue: 4, 585 - 590, 30.12.2021

Ergin Bilgin , Aykut Erdem Dinç , Sultan Şevik Eliçora , Duygu Erdem , Semih Alataş

https://doi.org/10.17343/sdutfd.901212

Abstract

Amaç
Stapes fiksasyonuna bağlı otosklerozun neden olduğu
yanlış sensörinöral kayıp, Carhart çentiği olarak bilinir.
Bu çalışmanın amacı, kronik otitis media (KOM)
hastalarında ameliyat öncesi ve sonrası odyometri
sonuçlarını karşılaştırarak hava-kemik aralığı (HKA)
ve kemik yolu (KY) işitme eşiklerinde meydana gelen
değişiklikleri incelemek, hava yolu (HY) iletiminin
KY iletimi üzerindeki etkilerini araştırmak, postoperatif
HY'de iyileşmenin KY iyileşmesi üzerindeki etkilerini
belirlemek, KOM' da Carhart çentiğinin varlığını tespit
etmek ve cerrahinin Carhart çentiği üzerindeki etkilerini
belirlemektir.
Gereç ve Yöntem
Bu retrospektif çalışmaya kliniğimizde Ocak 2012 –
Mart 2017 tarihleri arasında tip 1 timpanoplasti uygulanan
toplam 104 hasta dahil edildi. Preoperatif ve
postoperatif 6. ay yapılan odyometrik değerlendirme
sırasında ölçülen parametreler, 250-8.000 Hz frekanslarda
HY işitme eşiklerini, 500-4.000 Hz'de KY
işitme eşiklerini ve 500-4.000 Hz aralıklarla HKA değerlerini
içermekteydi.
Bulgular
Cerrahi öncesi 104 hastanın 46'sında (% 44,2) Carhart
çentik mevcuttu. Bu hastaların 25'inde (% 54,3)
ameliyat sonrası Carhart çentiğinin düzeldiği görüldü
(p = 0,029).
Sonuç
Timpanoplasti sonrası, sağlam ve hareketli bir kemikçik
zinciri olan KOM olgularında 2.000 Hz'de HKA'daki
belirgin iyileşme KY'de iyileşmeye yol açabilir. Carhart
çentiği ayrıca KOM'da da mevcut olabilir.

Keywords

Carhart notch, saf ses odyometri, kronik otitis media, Timpanoplasti

DIAGNOSTIC IMPORTANCE OF THE CARHART NOTCH IN PATIENTS WITH CHRONIC OTITIS MEDIA

Abstract

Objective
The false sensorineural loss caused by otosclerosis
due to stapes fixation is known as the Carhart notch.
To examine the changes in air-bone gap (ABG)
and bone-conduction (BC) hearing thresholds by
comparing the preoperative and postoperative
audiometry results in patients with chronic otitis media
(COM), to investigate the effects of air conduction
(AC) on BC, to determine the effects of postoperative
improvement in AC on BC, to detect the presence
of the Carhart notch in COM, and to determine the
effects of surgery on the Carhart notch.
Material and Methods
A total of 104 patients who underwent type 1
tympnoplasty between January 2012 - March 2017
in our clinic were included in this retrospective study.
Parameters measured during the preoperative and
postoperative sixth month audiometric evaluation
comprised AC hearing thresholds at the frequencies
of 250-8,000 Hz, BC hearing thresholds at 500-4,000
Hz, and ABG values at 500-4,000 Hz intervals.
Results
Before surgery, the Carhart notch was present in
46 (44.2%) of the 104 patients. Postoperatively, the
Carhart notch was observed to have been corrected
in 25 (54.3%) of these patients (p=0.029).
Conclusion
After tympanoplasty, significant improvement in ABG
may lead to improvement in BC at 2,000 Hz in COM
cases with an intact and mobile ossicular chain. The
Carhart notch may also be present in COM.

Keywords

Carhart notch, pure tone audiometry, chronic otitis media, tympanoplasty

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