TY - JOUR T1 - DIAGNOSTIC IMPORTANCE OF THE CARHART NOTCH IN PATIENTS WITH CHRONIC OTITIS MEDIA TT - KRONİK OTİTİS MEDİA HASTALARINDA CARHART NOTCH'UNUN TANISAL ÖNEMİ AU - Bilgin, Ergin AU - Dinç, Aykut Erdem AU - Şevik Eliçora, Sultan AU - Erdem, Duygu AU - Alataş, Semih PY - 2021 DA - December Y2 - 2021 DO - 10.17343/sdutfd.901212 JF - Medical Journal of Süleyman Demirel University JO - Med J SDU PB - Süleyman Demirel University WT - DergiPark SN - 1300-7416 SP - 585 EP - 590 VL - 28 IS - 4 LA - en AB - ObjectiveThe false sensorineural loss caused by otosclerosisdue to stapes fixation is known as the Carhart notch.To examine the changes in air-bone gap (ABG)and bone-conduction (BC) hearing thresholds bycomparing the preoperative and postoperativeaudiometry results in patients with chronic otitis media(COM), to investigate the effects of air conduction(AC) on BC, to determine the effects of postoperativeimprovement in AC on BC, to detect the presenceof the Carhart notch in COM, and to determine theeffects of surgery on the Carhart notch.Material and MethodsA total of 104 patients who underwent type 1tympnoplasty between January 2012 - March 2017in our clinic were included in this retrospective study.Parameters measured during the preoperative andpostoperative sixth month audiometric evaluationcomprised AC hearing thresholds at the frequenciesof 250-8,000 Hz, BC hearing thresholds at 500-4,000Hz, and ABG values at 500-4,000 Hz intervals.ResultsBefore surgery, the Carhart notch was present in46 (44.2%) of the 104 patients. Postoperatively, theCarhart notch was observed to have been correctedin 25 (54.3%) of these patients (p=0.029).ConclusionAfter tympanoplasty, significant improvement in ABGmay lead to improvement in BC at 2,000 Hz in COMcases with an intact and mobile ossicular chain. TheCarhart notch may also be present in COM. KW - Carhart notch KW - pure tone audiometry KW - chronic otitis media KW - tympanoplasty N2 - AmaçStapes fiksasyonuna bağlı otosklerozun neden olduğuyanlış sensörinöral kayıp, Carhart çentiği olarak bilinir.Bu çalışmanın amacı, kronik otitis media (KOM)hastalarında ameliyat öncesi ve sonrası odyometrisonuçlarını karşılaştırarak hava-kemik aralığı (HKA)ve kemik yolu (KY) işitme eşiklerinde meydana gelendeğişiklikleri incelemek, hava yolu (HY) iletimininKY iletimi üzerindeki etkilerini araştırmak, postoperatifHY'de iyileşmenin KY iyileşmesi üzerindeki etkilerinibelirlemek, KOM' da Carhart çentiğinin varlığını tespitetmek ve cerrahinin Carhart çentiği üzerindeki etkilerinibelirlemektir.Gereç ve YöntemBu retrospektif çalışmaya kliniğimizde Ocak 2012 –Mart 2017 tarihleri arasında tip 1 timpanoplasti uygulanantoplam 104 hasta dahil edildi. Preoperatif vepostoperatif 6. ay yapılan odyometrik değerlendirmesırasında ölçülen parametreler, 250-8.000 Hz frekanslardaHY işitme eşiklerini, 500-4.000 Hz'de KYişitme eşiklerini ve 500-4.000 Hz aralıklarla HKA değerleriniiçermekteydi.BulgularCerrahi öncesi 104 hastanın 46'sında (% 44,2) Carhartçentik mevcuttu. Bu hastaların 25'inde (% 54,3)ameliyat sonrası Carhart çentiğinin düzeldiği görüldü(p = 0,029).SonuçTimpanoplasti sonrası, sağlam ve hareketli bir kemikçikzinciri olan KOM olgularında 2.000 Hz'de HKA'dakibelirgin iyileşme KY'de iyileşmeye yol açabilir. Carhartçentiği ayrıca KOM'da da mevcut olabilir. CR - 1. Carhart R. The clinical application of bone conduction audiometry. Trans Am Acad Ophthalmol Otolaryngol. 1950;54:699-707. PMID: 15443033 CR - 2. 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. 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Postoperative bone conduction thresholds changes in patients operated on chronic otitis media-analysis. Otolaryngologia Polska, 69(4). https://doi.org/10.5604/00306657.1147030. CR - 12. Wegner A, Bitermann AJN, Hentschel MA, Van der Heijden GJM, Grolman W. Pure-tone Audiometry in Otosclerosis: Insufficient Evidence for the Diagnostic Value of the Carhart Notch 2013;149:528-32. https://doi.org/10.1177/0194599813495661 UR - https://doi.org/10.17343/sdutfd.901212 L1 - https://dergipark.org.tr/en/download/article-file/1654854 ER -