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To demonstrate the need for computed tomography imaging of the temporal bone before considering revision stapes surgery in patients with recurrent or residual conductive hearing loss.
We report the case of a high-riding jugular bulb with an associated jugular bulb diverticulum, which was dehiscent towards the vestibular aqueduct, in a patient with confirmed otosclerosis who did not experience hearing improvement after stapedotomy.
This case demonstrates the usefulness of temporal bone computed tomography in the evaluation of patients with otosclerosis in whom stapedotomy has not improved hearing. In such patients, revision surgery to address residual hearing loss would eventually prove unnecessary and avoidable.
To demonstrate the need for computed tomography imaging of the temporal bone in patients clinically suspected of otosclerosis who present with atypical symptoms or audiological findings.
We present two patients with bilateral conductive hearing loss and suspected otosclerosis in whom third mobile window lesions were revealed. The first patient had bilateral large vestibular aqueducts and bilateral fenestral otosclerotic foci. Computed tomography imaging of the second case revealed bilateral superior semicircular canal dehiscence and bilateral cochlear clefts, mimicking an otosclerotic focus in the fissula ante fenestram.
Differentiating third mobile window lesions from otosclerosis as the cause of a conductive hearing loss is essential before considering stapes surgery, as such treatment would be unnecessary and potentially harmful.
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