Inner Ear Conductive Hearing Loss: Current Studies and Controversies

Dear Colleagues,

Conductive hearing loss (CHL) without middle ear abnormalities had generated an otological controversy and mystery for many years, often leading to uneventful surgical procedures. In recent years, it has been adequately evidenced as to how third window pathologies (TWP) could account for the so-called “pseudo-CHL” due to a reduction of bone-conducted threshold and a dissipation of air-conducted sounds for low frequencies in the pure tone audiometry given a low-impedance pathway for the cochlear travelling wave in the labyrinthine partition responsible for the appearance of an air bone gap (ABG). Nevertheless, besides the classical TWP due to a bony labyrinthine structural abnormality (i.e., canal dehiscence), several inner ear disorders affecting both adults and children have shown a similar CHL through different pathomechanisms. For example, early-stage Meniere’s Disease and Intralabyrinthine Schwannoma may result in CHL or mixed HL by interfering with the cochlear traveling wave and a perilymphatic fistula might lead to low-frequency ABG through a similar mechanism to TWP. Additionally, congenital or acquired round window pathologies and other labyrinthine disorders resulting in an abnormal physical or functional communication between inner ear and cerebrospinal fluid might result in similar ABG in audiometry. Examples include dilated vestibular aqueducts, dilated internal auditory meati and X-linked gusher syndrome. Laser-doppler vibrometry, wideband tympanometry and other tests exploring vestibular function (such as the video-head impulse test and vestibular-evoked myogenic potential tests) have led to a robust diagnosis of a third window due to any reason and have gained popularity in the differential diagnosis in CHL with normal middle ear function. It also needs to be borne in mind that TWP in children may present with different and variable phenotypes as compared to adults.  The aim of this Special Issue is to provide new insights in this topic, facing possible clinical presentation, instrumental diagnosis and treatments strategies for inner ear CHL and shading light on controversies on underlying pathomechanisms. Research manuscripts and review on this topic are welcome.

Dr. Andrea Castellucci
Dr. Eduardo Martin Sanz
Prof. Dr. Soumit Dasgupta
Prof. Dr. Issam Saliba
Guest Editors

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• conductive hearing loss
• round window
• third window syndromes
• enlarged vestibular aqueduct
• canal dehiscence
• perilymphatic fistula
• meniere’s disease
• intralabyrinthine schwannoma
• wideband tympanometry
• vestibular-evoked myogenic potentials