Abstract
Objective: To investigate the changes in bone-conduction and air-bone gap in patients with serous otitis media and to evaluate the presence of Carhart’s notch.
Material and Methods: Patients with unilateral serous otitis media were included in the study. Audiometric evaluation comprised air-conduction and bone-conduction hearing thresholds, and air-bone gap values. The preoperative and postoperative pure tone audiometry results of 45 patients were compared in terms of the air-bone gap and bone-conduction thresholds.
Results: Carhart’s notch was present in 17 (37.8%) patients preoperatively. For pure tone audiometry, there was a statistically significant decrease in air-bone gap at all frequencies postoperatively. The postoperative decrease in the bone-conduction thresholds was statistically significant only at 2 kHz. In the postoperative period, a 4.7 dB improvement was observed in the bone-conduction threshold at 2 kHz for patients with Carhart’s notch.
Conclusion: Carhart’s notch may be present in patients with serous otitis media. It is not specific to otosclerosis.
Keywords
Otitis Media with Effusion Audiometry Hearing Loss Conductive Bone Conduction Carhart’s Notch
References
- 1. Carhart R. The clinical application of bone conduction audiometry. Trans Am Acad Ophthalmol Otolaryngol 1950;54:699-707. google scholar
- 2. Stenfelt S, Goode RL. Bone-conducted sound: physiological and clinical aspects. Otol Neurotol 2005;26(6):1245-61. google scholar
- 3. Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hackell JM, et al. Clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg 2016;154(1_suppl):1-41. google scholar
- 4. Kim J, Koo M. Mass and stiffness impact on the middle ear and the cochlear partition. J Audiol Otol 2015;19(1):1. google scholar
- 5. Sakamoto T, Kakigi A, Kashio A, Kanaya K, Suzuki M, Yamasoba T. Evaluation of the Carhart effect in congenital middle ear malformation with both an intact external ear canal and a mobile stapes footplate. ORL J Otorhinolaryngol Relat Spec 2011;73(2):61-7. google scholar
- 6. Lee HS, Hong SD, Hong SH, Cho YS, Chung WH. Ossicular chain reconstruction improves bone conduction threshold in chronic otitis media. J Laryngol Otol 2008;122(4):351-6. google scholar
- 7. Kumar M, Maheshwar A, Mahendran S, Oluwasamni A, Clayton MI. Could the presence of a Carhart notch predict the presence of glue at myringotomy? Clin Otolaryngol Allied Sci 2003;28(3):183-6. google scholar
- 8. Conijn EA, Van der Drift JF, Brocaar MP, van Zanten GA. Conductive hearing loss assessment in children with otitis media with effusion. A comparison of pure tone and BERA results. Clin Otolaryngol 1989;14(2):115-20. google scholar
- 9. Ahmad I, Pahor AL. Carhart’s notch: a finding in otitis media with effusion. Int J Pediat Otorhinolaryngol 2002;64(2):165-70. google scholar
- 10. Moon CN, Hahn MJ. Primary malleus fixation: diagnosis and treatment. Laryngoscope 1981;91(8):1298-307. google scholar
- 11. Shishegar M, Faramarzi A, Esmaili N, Heydari ST. Is Carhart notch an accurate predictor of otitis media with effusion? Int J Ped Otorhinolaryngol 2009;73(12):1799-802. google scholar
- 12. Telmesani L, Badran OE, Hafiz MI. Diagnostic value of carhart notch in otitis media with effusion. Saudi J Otorhinolaryngol Head Neck Surg 2011;13(1):52. google scholar
- 13. Kashio A, Ito K, Kakigi A. Carhart Notch 2-kHz Bone Conduction Threshold Dip A Nondefinitive Predictor of Stapes Fixation in Conductive Hearing Loss With Normal Tympanic Membrane. Arch Otolaryngol Head Neck Surg 2011;137(3):236-40. google scholar
- 14. Cook JA, Krishnan S, Fagan PA. Quantifying the Carhart Effect in Otosclerosis. Clin Otolaryngol Allied Sci 1995;20(3):258-61. google scholar
- 15. Yasan H. Predictive role of Carhart’s notch in pre-operative assessment for middle-ear surgery. J Laryngol Otol 2007;121(3):219-21. google scholar
Abstract
References
- 1. Carhart R. The clinical application of bone conduction audiometry. Trans Am Acad Ophthalmol Otolaryngol 1950;54:699-707. google scholar
- 2. Stenfelt S, Goode RL. Bone-conducted sound: physiological and clinical aspects. Otol Neurotol 2005;26(6):1245-61. google scholar
- 3. Rosenfeld RM, Shin JJ, Schwartz SR, Coggins R, Gagnon L, Hackell JM, et al. Clinical practice guideline: otitis media with effusion (update). Otolaryngol Head Neck Surg 2016;154(1_suppl):1-41. google scholar
- 4. Kim J, Koo M. Mass and stiffness impact on the middle ear and the cochlear partition. J Audiol Otol 2015;19(1):1. google scholar
- 5. Sakamoto T, Kakigi A, Kashio A, Kanaya K, Suzuki M, Yamasoba T. Evaluation of the Carhart effect in congenital middle ear malformation with both an intact external ear canal and a mobile stapes footplate. ORL J Otorhinolaryngol Relat Spec 2011;73(2):61-7. google scholar
- 6. Lee HS, Hong SD, Hong SH, Cho YS, Chung WH. Ossicular chain reconstruction improves bone conduction threshold in chronic otitis media. J Laryngol Otol 2008;122(4):351-6. google scholar
- 7. Kumar M, Maheshwar A, Mahendran S, Oluwasamni A, Clayton MI. Could the presence of a Carhart notch predict the presence of glue at myringotomy? Clin Otolaryngol Allied Sci 2003;28(3):183-6. google scholar
- 8. Conijn EA, Van der Drift JF, Brocaar MP, van Zanten GA. Conductive hearing loss assessment in children with otitis media with effusion. A comparison of pure tone and BERA results. Clin Otolaryngol 1989;14(2):115-20. google scholar
- 9. Ahmad I, Pahor AL. Carhart’s notch: a finding in otitis media with effusion. Int J Pediat Otorhinolaryngol 2002;64(2):165-70. google scholar
- 10. Moon CN, Hahn MJ. Primary malleus fixation: diagnosis and treatment. Laryngoscope 1981;91(8):1298-307. google scholar
- 11. Shishegar M, Faramarzi A, Esmaili N, Heydari ST. Is Carhart notch an accurate predictor of otitis media with effusion? Int J Ped Otorhinolaryngol 2009;73(12):1799-802. google scholar
- 12. Telmesani L, Badran OE, Hafiz MI. Diagnostic value of carhart notch in otitis media with effusion. Saudi J Otorhinolaryngol Head Neck Surg 2011;13(1):52. google scholar
- 13. Kashio A, Ito K, Kakigi A. Carhart Notch 2-kHz Bone Conduction Threshold Dip A Nondefinitive Predictor of Stapes Fixation in Conductive Hearing Loss With Normal Tympanic Membrane. Arch Otolaryngol Head Neck Surg 2011;137(3):236-40. google scholar
- 14. Cook JA, Krishnan S, Fagan PA. Quantifying the Carhart Effect in Otosclerosis. Clin Otolaryngol Allied Sci 1995;20(3):258-61. google scholar
- 15. Yasan H. Predictive role of Carhart’s notch in pre-operative assessment for middle-ear surgery. J Laryngol Otol 2007;121(3):219-21. google scholar
Details
| Primary Language | English |
|---|---|
| Subjects | Otorhinolaryngology |
| Journal Section | Research Article |
| Authors | |
| Publication Date | March 10, 2022 |
| Submission Date | January 20, 2022 |
| Published in Issue | Year 2022 Volume: 32 Issue: 1 |
