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We conducted a retrospective study of 29 patients who had undergone stapedectomy for otosclerosis to determine how well their subjective perceptions of hearing improvement correlated with objective audiometric measurements. Patients expressed their assessments of hearing function by completing two versions of the Hearing Disability and Handicap Scale (HDHS). One version of the HDHS was based on patients' retrospective recollections of their hearing impairment prior to surgery, and the other reflected their assessment of their current function. We evaluated these HDHS data both separately and in conjunction with pre- and postoperative audiometric findings. Following surgery, the group's mean pure-tone average improved significantly, from 58 to 27 dB--that is, the average patient had a moderately severe hearing loss preoperatively and only a mild hearing loss postoperatively. Significant improvement was also reflected in the difference between the mean pre- and postoperative HDHS scores, although some patients indicated that they experienced almost no improvement. Overall, our findings indicated that there was a relationship between objective and subjective assessments of hearing improvement following surgery, but that it was weak. Although most patients perceived significant improvement, the degree of that perceived improvement cannot be predicted from the pure-tone audiogram. We conclude, therefore, that a significant difference between audiometric findings and HDHS self-assessments is useful in identifying patients who might benefit from additional counseling and/or aural rehabilitation.

Spondyloepiphyseal dysplasia is a disorder characterized by abnormalities of growth. Previous studies of this disorder have identified a significant incidence of associated hearing loss. Hearing loss has been reported to occur in 25 to 30% of affected patients. To date, all reports of associated hearing loss have indicated the presence of a sensorineural component. In this article, we report the case of a child who was diagnosed with spondyloepiphyseal dysplasia congenita and who was found to have a significant conductive hearing loss with a Carhart's notch, indicating the likely presence of stapes footplate fixation. We also review the diagnosis of this condition and the literature associated with hearing loss as it occurs with this disorder.

During the years 1980 through 1990, 247 patients underwent parotidectomy at our institution for the removal of primary parotid lesions. Charts were reviewed in an effort to document the distribution of pathology in patients undergoing parotidectomy and the histopathology from each case was organized and tallied by virtue of the final specific diagnoses. An additional goal of this study was to evaluate the efficacy of pre-operative fine-needle aspiration biopsy (FNAB) and frozen section pathology in accurately predicting final histopathology. In our series, 86.7% of lesions were found to be benign and 13.3% were malignant in nature. When compared to final pathologic findings, FNAB yielded a diagnostic accuracy rate of 89.3% with a 2.1% false negative rate with regards to pre-operative detection of malignancy. Frozen section biopsy was found to have a diagnostic accuracy of 94.1% and also demonstrated a 2.1% false-negative rate. We believe these studies are indeed complementary to each other, as reflected in the 96.2% diagnostic accuracy achieved with a combination of FNAB and frozen section biopsy information. This report will review the patterns of misdiagnosis for each modality of diagnostic testing and present the parotid histopathology found over a 10-year period.