sdü tıp fak derg Medical Journal of Süleyman Demirel University 2602-2109 Süleyman Demirel Üniversitesi 10.17343/sdutfd.901212 Clinical Sciences Klinik Tıp Bilimleri KRONİK OTİTİS MEDİA HASTALARINDA CARHART NOTCH'UNUN TANISAL ÖNEMİ DIAGNOSTIC IMPORTANCE OF THE CARHART NOTCH IN PATIENTS WITH CHRONIC OTITIS MEDIA https://orcid.org/0000-0001-7191-6209 Bilgin Ergin BÜLENT ECEVİT ÜNİVERSİTESİ, TIP FAKÜLTESİ https://orcid.org/0000-0001-7006-7479 Dinç Aykut Erdem Ekol Private Hospital https://orcid.org/0000-0002-2915-3727 Şevik Eliçora Sultan ZONGULDAK BÜLENT ECEVİT ÜNİVERSİTESİ https://orcid.org/0000-0002-7973-2719 Erdem Duygu ZONGULDAK BÜLENT ECEVİT ÜNİVERSİTESİ https://orcid.org/0000-0002-5492-8918 Alataş Semih ZONGULDAK BÜLENT ECEVİT ÜNİVERSİTESİ 12 30 2021 28 4 585 590 03 25 2021 08 17 2021 Copyright © 1994, Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 1994 Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

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.

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.

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