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Hu R, Wu F, Zheng YQ. Ivacaftor attenuates gentamicin-induced ototoxicity through the CFTR-Nrf2-HO1/NQO1 pathway. Redox Rep 2024; 29:2332038. [PMID: 38563333 PMCID: PMC10993751 DOI: 10.1080/13510002.2024.2332038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVES Gentamicin is one of the most common ototoxic drugs that can lower patients' quality of life. Oxidative stress is a key factors inducing sensory hair cell death during gentamicin administration. So far, there are no effective drugs to prevent or treat gentamicin- induced hearing loss. A recent study found cystic fibrosis transmembrane conductance regulator (CFTR) as a new target to modulate cellular oxidative balance. The objective of this study was to estimate the effect of the CFTR activator ivacaftor on gentamicin-induced ototoxicity and determine its mechanism. METHODS The hair cell count was analyzed by Myosin 7a staining. Apoptosis was analyzed by TUNEL Apoptosis Kit. Cellular reactive oxygen species (ROS) level was detected by DCFH-DA probes. The Nrf2 related proteins expression levels were analyzed by western blot. RESULTS An in vitro cochlear explant model showed that gentamicin caused ROS accumulation in sensory hair cells and induced apoptosis, and this effect was alleviated by pretreatment with ivacaftor. Western blotting showed that ivacaftor administration markedly increased the protein expression of nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO1), and NAD(P)H:quinone oxidoreductase 1 (NQO1). The protective effect of ivacaftor was abolished by the Nrf2 inhibitor ML385. DISCUSSION Our results indicate the protective role of the CFTR-Nrf2-HO1/NQO1 pathway in gentamicin-induced ototoxicity. Ivacaftor may be repositioned or repurposed towards aminoglycosides-induced hearing loss.
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Affiliation(s)
- Rui Hu
- Shenshan Medical Center, Memorial Hospital of Sun Yat-Sen University, Shanwei, People’s Republic of China
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Fan Wu
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC, USA
| | - Yi-Qing Zheng
- Shenshan Medical Center, Memorial Hospital of Sun Yat-Sen University, Shanwei, People’s Republic of China
- Department of Otolaryngology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China
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Hu Y, Ye Y, Ji X, Wu J. The role of hyperbaric oxygen in idiopathic sudden sensorineural hearing loss. Med Gas Res 2024; 14:180-185. [PMID: 39073325 DOI: 10.4103/2045-9912.385943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/10/2023] [Indexed: 07/30/2024] Open
Abstract
Idiopathic sudden sensorineural hearing loss is an unexplained sudden loss of sensorineural hearing, with no specific pathogenesis, and is difficult to treat. The most common therapeutic strategy for idiopathic sudden sensorineural hearing loss is the use of steroids combined with neurotrophic drugs, as other treatments have shown limited efficacy. However, in recent years, hyperbaric oxygen therapy has emerged as a promising treatment option. Studies have shown that hyperbaric oxygen therapy, in combination with conventional treatments, can effectively alleviate inner ear edema, improve blood circulation, and suppress inflammation. Therefore, hyperbaric oxygen therapy plays an important role in the treatment of idiopathic sudden sensorineural hearing loss. In this review, we aim to assess existing studies and summarize the clinical effects and mechanisms of hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss, providing a basis for further research on the clinical treatment of this disorder.
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Affiliation(s)
- Yukun Hu
- Department of Neurosurgery, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
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Shi W, Zhao Q, Gao H, Yang Y, Tan Z, Li N, Wang H, Ji Y, Zhou Y. Exploring the bioactive ingredients of three traditional Chinese medicine formulas against age-related hearing loss through network pharmacology and experimental validation. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024:10.1007/s00210-024-03464-2. [PMID: 39356317 DOI: 10.1007/s00210-024-03464-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 09/16/2024] [Indexed: 10/03/2024]
Abstract
Traditional Chinese medicine (TCM) formulas, including the Er-Long-Zuo-Ci pill, Tong-Qiao-Er-Long pill, and Er-Long pill, have long been utilized in China for managing age-related hearing loss (ARHL). However, the specific bioactive compounds, pharmacological targets, and underlying mechanisms remain elusive. This study aims to find the shared bioactive ingredients among these three formulas, uncover the molecular pathways they regulate, and identify potential therapeutic targets for ARHL. Furthermore, it seeks to validate the efficacy of these major components through both in vivo and in vitro experiments. Common bioactive ingredients were extracted from the TCMSP database, and their putative target proteins were predicted using the Swiss Target Prediction database. ARHL-related target proteins were collected from GeneCards and OMIM databases. Our approach involved constructing drug-target networks and drug-disease-specific protein-protein interaction networks and conducting clustering, topological property analyses, and functional annotation through GO and KEGG enrichment analysis. Molecular docking analysis was utilized to delineate interaction mechanisms between major bioactive ingredients and key target proteins. Finally, in vivo and in vitro experiments involving ABR recording, immunofluorescent staining, HE staining, and quantitative PCR were conducted to validate the treatment effects of flavonoids on the declining auditory function in DBA/2 J mice. We identified 11 common chemical compounds across the three formulas and their associated 276 putative targets. Additionally, 3350 ARHL-related targets were compiled. As an intersection of the putative targets of the common compounds and ARHL-related proteins, 145 shared targets were determined. Functional enrichment analysis indicated that these compounds may modulate various biological processes, including cell proliferation, apoptosis, inflammatory response, and synaptic connections. Notably, potential targets such as TNFα, MAPK1, SRC, AKT, EGFR, ESR1, and AR were implicated. Flavonoids emerged as major bioactive components against ARHL based on target numbers, with molecular docking demonstrating diverse interaction models between these flavonoids and protein targets. Furthermore, baicalin could mitigate the age-related cochlear damage and hearing loss of DBA/2 J mice through its multi-target and multi-pathway mechanism, involving anti-inflammation, modulation of sex hormone-related pathways, and activation of potassium channels. This study offers an integrated network pharmacology approach, validated by in vivo and in vitro experiments, shedding light on the potential mechanisms, major active components, and therapeutic targets of TCM formulas for treating ARHL.
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Affiliation(s)
- Wenying Shi
- School of Basic Medical Sciences, Hebei University, Baoding, 071030, China
| | - Qi Zhao
- School of Basic Medical Sciences, Hebei University, Baoding, 071030, China
| | - Hongwei Gao
- School of Basic Medical Sciences, Hebei University, Baoding, 071030, China
| | - Yaxin Yang
- School of Basic Medical Sciences, Hebei University, Baoding, 071030, China
| | - Zhiyong Tan
- School of Basic Medical Sciences, Hebei University, Baoding, 071030, China
| | - Na Li
- School of Basic Medical Sciences, Hebei University, Baoding, 071030, China
| | - Hongjie Wang
- School of Basic Medical Sciences, Hebei University, Baoding, 071030, China
| | - Yonghua Ji
- School of Basic Medical Sciences, Hebei University, Baoding, 071030, China
| | - You Zhou
- School of Basic Medical Sciences, Hebei University, Baoding, 071030, China.
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Mammen L, Zlatopolsky A, Tu N. Cochlear implantation in children with single-sided deafness under the age of 5 years: a review of current literature. Curr Opin Otolaryngol Head Neck Surg 2024; 32:324-328. [PMID: 39146020 DOI: 10.1097/moo.0000000000000992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
PURPOSE OF REVIEW Here we explore the current literature on cochlear implantation of pediatric patients under the age of 5 years with single-sided deafness (SSD). RECENT FINDINGS Single-sided deafness has been noted to cause developmental delays in speech, language, and cognition because of loss of binaural hearing. Currently, cochlear implantation is the only intervention capable of restoring binaural hearing for pediatric patients with SSD. Young children have been shown to have the greatest neuroplasticity of the auditory cortex before 4 years of age. Currently, only children over the age of 5 years are approved by the United States Food and Drug Administration (FDA) to undergo cochlear implantation for SSD. Cochlear implantation for SSD in patients under the age of 5 years has been performed on a limited basis and has been shown to have excellent results. SUMMARY Cochlear implantation is a well tolerated and effective treatment for pediatric patients under the age of 5 years with SSD. Receiving cochlear implantation under the age of 5 years is critical for child development as neuroplasticity decreases after this age.
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Affiliation(s)
- Luke Mammen
- Department of Otolaryngology - Head and Neck Surgery, Albany Medical Center, New York, USA
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Spinos D, Martinos A, Petsiou DP, Mistry N, Garas G. Artificial Intelligence in Temporal Bone Imaging: A Systematic Review. Laryngoscope 2024. [PMID: 39352072 DOI: 10.1002/lary.31809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/03/2024] [Accepted: 09/17/2024] [Indexed: 10/03/2024]
Abstract
OBJECTIVE The human temporal bone comprises more than 30 identifiable anatomical components. With the demand for precise image interpretation in this complex region, the utilization of artificial intelligence (AI) applications is steadily increasing. This systematic review aims to highlight the current role of AI in temporal bone imaging. DATA SOURCES A Systematic Review of English Publications searching MEDLINE (PubMed), COCHRANE Library, and EMBASE. REVIEW METHODS The search algorithm employed consisted of key items such as 'artificial intelligence,' 'machine learning,' 'deep learning,' 'neural network,' 'temporal bone,' and 'vestibular schwannoma.' Additionally, manual retrieval was conducted to capture any studies potentially missed in our initial search. All abstracts and full texts were screened based on our inclusion and exclusion criteria. RESULTS A total of 72 studies were included. 95.8% were retrospective and 88.9% were based on internal databases. Approximately two-thirds involved an AI-to-human comparison. Computed tomography (CT) was the imaging modality in 54.2% of the studies, with vestibular schwannoma (VS) being the most frequent study item (37.5%). Fifty-eight out of 72 articles employed neural networks, with 72.2% using various types of convolutional neural network models. Quality assessment of the included publications yielded a mean score of 13.6 ± 2.5 on a 20-point scale based on the CONSORT-AI extension. CONCLUSION Current research data highlight AI's potential in enhancing diagnostic accuracy with faster results and decreased performance errors compared to those of clinicians, thus improving patient care. However, the shortcomings of the existing research, often marked by heterogeneity and variable quality, underscore the need for more standardized methodological approaches to ensure the consistency and reliability of future data. LEVEL OF EVIDENCE NA Laryngoscope, 2024.
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Affiliation(s)
- Dimitrios Spinos
- South Warwickshire NHS Foundation Trust, Warwick, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Anastasios Martinos
- National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | | | - Nina Mistry
- Gloucestershire Hospitals NHS Foundation Trust, ENT, Head and Neck Surgery, Gloucester, UK
| | - George Garas
- Surgical Innovation Centre, Department of Surgery and Cancer, Imperial College London, St. Mary's Hospital, London, UK
- Athens Medical Center, Marousi & Psychiko Clinic, Athens, Greece
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Houmøller SS, Tsai LT, Wolff A, Kaithali Narayanan S, Hougaard DD, Gaihede M, Hammershøi D, Neher T, Godballe C, Schmidt JH. A history of occupational noise exposure is associated with steep-slope audiograms and poorer self-reported hearing-aid outcomes. Int J Audiol 2024; 63:772-784. [PMID: 37909290 DOI: 10.1080/14992027.2023.2272558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 09/25/2023] [Accepted: 10/11/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To investigate the effects of previous occupational noise exposure in older adults with hearing loss on (1) audiometric configuration and acoustic reflex (AR) thresholds and (2) self-reported hearing abilities and hearing aid (HA) effectiveness. DESIGN A prospective observational study. STUDY SAMPLE The study included 1176 adults (≥60 years) with bilateral sensorineural hearing loss. Pure-tone audiometry, AR thresholds, and responses to the abbreviated version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ12) and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire were obtained, along with information about previous occupational noise exposure. RESULTS Greater occupational noise exposure was associated with a higher prevalence of steeply sloping audiograms in men and women and a 0.32 (95% CI: -0.57; -0.06) scale points lower mean SSQ12 total score among noise-exposed men. AR thresholds did not show a significant relation to noise-exposure status, but hearing thresholds at a given frequency were related to elevated AR thresholds at the same frequency. CONCLUSIONS A noise exposure history is linked to steeper audiograms in older adults with hearing loss as well as to poorer self-reported hearing abilities in noise-exposed men. More attention to older adults with previous noise exposure is warranted in hearing rehabilitation.
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MESH Headings
- Humans
- Male
- Female
- Aged
- Hearing Aids/statistics & numerical data
- Audiometry, Pure-Tone
- Prospective Studies
- Middle Aged
- Noise, Occupational/adverse effects
- Self Report
- Auditory Threshold
- Hearing Loss, Noise-Induced/etiology
- Hearing Loss, Noise-Induced/diagnosis
- Hearing Loss, Noise-Induced/physiopathology
- Occupational Exposure/adverse effects
- Hearing Loss, Sensorineural/rehabilitation
- Hearing Loss, Sensorineural/diagnosis
- Hearing Loss, Sensorineural/physiopathology
- Hearing Loss, Sensorineural/psychology
- Reflex, Acoustic
- Hearing
- Risk Factors
- Speech Perception
- Treatment Outcome
- Correction of Hearing Impairment/instrumentation
- Aged, 80 and over
- Hearing Loss, Bilateral/rehabilitation
- Hearing Loss, Bilateral/physiopathology
- Hearing Loss, Bilateral/diagnosis
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Affiliation(s)
- Sabina Storbjerg Houmøller
- Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Li-Tang Tsai
- Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Anne Wolff
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | | | - Dan Dupont Hougaard
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Michael Gaihede
- Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Dorte Hammershøi
- Section for AI and Sound, Department of Electronic Systems, Aalborg University, Aalborg, Denmark
| | - Tobias Neher
- Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
| | - Christian Godballe
- Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Jesper Hvass Schmidt
- Research Unit for ORL - Head & Neck Surgery and Audiology, Odense University Hospital & University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
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Yamazaki H, Moroto S, Yamazaki T, Tamaya R, Fujii N, Fujiwara K, Yamamoto N, Naito Y. Significant influence of prelingual deafness but less impact of elderly age at implantation on long-term psychoacoustic CI programming parameters. Auris Nasus Larynx 2024; 51:846-852. [PMID: 39084004 DOI: 10.1016/j.anl.2024.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/08/2024] [Accepted: 07/25/2024] [Indexed: 08/02/2024]
Abstract
OBJECTIVE This study aimed to elucidate the long-term impact of prelingual deafness and elderly age at cochlear implantation on cochlear implant (CI) programming parameters and CI thresholds METHODS: We retrospectively reviewed patients who underwent cochlear implantation less than 5 years (Prelingual group) and equal and more than 18 years in our institute. The latter group was further divided into Adult and Elderly groups according to whether the patient was younger or older than 65 at implantation. From 152, 69, and 55 patients in the Prelingual, Adult, and Elderly groups, 242, 92, and 58 ears were included. We compared CI thresholds and CI programming parameters, including impedances, T/C levels, and dynamic ranges for 8 years after implantation between the Prelingual, Adult, and Elderly groups. RESULTS The Prelingual group showed consistently lower CI thresholds than the Adult and Elderly groups during the postoperative 2-8 years, but no difference was detected between the Elderly and Adult groups, except at the postoperative 4 years. The elderly group's CI thresholds did not deteriorate until postoperative 8 years. The Prelingual group showed consistently larger T/C levels (minimum/maximum current strength from CI), especially C levels, than the other two groups. At the same time, there was no significant difference between the Elderly and Adult groups except for smaller dynamic ranges in the Elderly group until postoperative 2 years. These results in the CI programming parameters might explain the lower CI thresholds in the Prelingual group than in the other groups. Focusing on CI maps 1 and 3 years after implantation, the strength of the T/C levels was similar for all channels in the Prelingual group, but the Adult and Elderly groups showed larger electrical stimuli in channels responsible for the middle frequencies than those for the lower or higher frequencies. CONCLUSIONS Our results suggest a significant influence of prelingual deafness but less impact of elderly age at implantation on long-term CI programming parameters and CI thresholds. The larger C levels and lower CI thresholds in the Prelingual group than in the Adult and Elderly groups implied that CI children with prelingual deafness tolerate and prefer larger CI stimuli, which may reflect the CI-dependent development of their auditory system before the critical period. No age-related reduction in hearing thresholds was observed in the Elderly group, probably because the CI compensates for age-related dysfunction of the peripheral auditory system.
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Affiliation(s)
- Hiroshi Yamazaki
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; Hearing Research Division, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan; Foundation for Biomedical Research and Innovation at Kobe, Kobe City, Japan; Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Saburo Moroto
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; Comprehensive Ear and Hearing Center, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tomoko Yamazaki
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; Comprehensive Ear and Hearing Center, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Rinko Tamaya
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; Comprehensive Ear and Hearing Center, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Naoko Fujii
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; Comprehensive Ear and Hearing Center, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keizo Fujiwara
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Norio Yamamoto
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; Comprehensive Ear and Hearing Center, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasushi Naito
- Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; Comprehensive Ear and Hearing Center, Kobe City Medical Center General Hospital, Kobe, Japan
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Göksu MR, Gümrükçü Z, Balaban E, Mercantepe T, Gökçe FM. Electrophysiological and histopathological evaluation of the effectiveness of melatonin and glatiramer acetate for traumatic facial nerve injuries. Injury 2024; 55:111719. [PMID: 39003883 DOI: 10.1016/j.injury.2024.111719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/20/2024] [Accepted: 07/04/2024] [Indexed: 07/16/2024]
Abstract
AIM This study aimed to evaluate the effect of systemic/local use of melatonin and glatiramer acetate on regeneration in traumatic nerve injury models. MATERIALS AND METHODS A total of 42 male Wistar albino rats were randomly divided into 6 groups: healthy control (Group 1), injured control (Group 2), local melatonin (Group 3), systemic melatonin (Group 4), local glatiramer acetate (Group 5), and systemic glatiramer acetate (Group 6). In all groups, electromyography recordings of the facial nerve were obtained after surgery and before sacrifice, and the damaged nerve region was histopathologically examined after sacrifice. RESULTS In the electrophysiological evaluation, the control group had the greatest decrease in amplitude and extension in latency time following surgery than the treatment groups. Furthermore, a significant decrease in the degenerative axon count, edematous areas, and fibrotic areas as well as a significant increase in axonal surface areas was observed in all the treatment groups compared with the damage control group. CONCLUSIONS Although both glatiramer acetate and melatonin are beneficial in regeneration in traumatic facial nerve injuries, it can be concluded that systemic use of melatonin can yield more positive results than glatiramer acetate and local use of both two drugs.
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Affiliation(s)
| | - Zeynep Gümrükçü
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Recep Tayyip Erdoğan University, Rize, Turkey.
| | - Emre Balaban
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry Recep Tayyip Erdoğan University, Rize, Turkey
| | - Tolga Mercantepe
- Department of Histology Embryology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Fatih Mehmet Gökçe
- Department of Physiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
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Natour A, Doyle E, DeDio R, Samy RN. Temporal bone fracture related facial palsy: efficacy of decompression with and without grafting. Curr Opin Otolaryngol Head Neck Surg 2024; 32:294-300. [PMID: 39234847 DOI: 10.1097/moo.0000000000001007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
PURPOSE OF REVIEW This systematic review investigates the recent literature and aims to determine the approach, efficacy, and timing of facial nerve decompression with or without grafting in temporal bone fractures with facial palsy. RECENT FINDINGS The surgical management of facial palsy is reserved for a small population of cases in which electrophysiologic tests indicate a poor likelihood of spontaneous recovery. The transmastoid (TM), middle cranial fossa (MCF), and translabyrinthine (TL) approaches to the facial nerve provide access to the entire intracranial and intratemporal segments of the facial nerve. In temporal bone (TB) related facial palsy, the peri-geniculate and labyrinthine portions of the facial nerve are most commonly affected by either direct trauma and/or subsequent edema. When hearing is still serviceable, the combined TM/MCF approach provides the best access to these regions. In the presence of severe sensorineural hearing loss (SNHL), the TL approach is the most appropriate for total facial nerve exploration (this can be done in conjunction with simultaneous cochlear implantation if the cochlear nerve has not been avulsed). Grade I to III House-Brackmann (HB) results can be anticipated in timely decompression of facial nerve injury caused by edema or intraneuronal hemorrhage. Grade III outcomes, with slight weakness and synkinesis, is the outcome to be expected from the use of interpositional grafts or primary neurorrhaphy. In addition to good eye care and the use of systemic steroids (if not contraindicated in the acute trauma setting), surgical decompression with or without grafting/neurorrhaphy may be offered to patients with appropriate electrophysiologic testing, physical examination findings, and radiologic localization of injury. SUMMARY Surgery of the facial nerve remains an option for select patients. Here, we discuss the indications and results of treatment as well as the best surgical approach to facial nerve determined based on patient's hearing status and radiologic data. Controversy remains about whether timing of surgery (e.g., immediate vs. delayed intervention) impacts outcomes. However, no one with facial palsy due to a temporal bone fracture should be left with a complete facial paralysis.
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Affiliation(s)
- Amed Natour
- Lehigh Valley Health Network-LVHN, Institute for Surgical Excellence, Otolaryngology Head & Neck Surgery, Allentown, Pennsylvania
| | - Edward Doyle
- Cleveland Clinic Foundation, Department of Otolaryngology Head & Neck Surgery Cleveland, Ohio, USA
| | - Robert DeDio
- Lehigh Valley Health Network-LVHN, Institute for Surgical Excellence, Otolaryngology Head & Neck Surgery, Allentown, Pennsylvania
| | - Ravi N Samy
- Lehigh Valley Health Network-LVHN, Institute for Surgical Excellence, Otolaryngology Head & Neck Surgery, Allentown, Pennsylvania
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Skare TL, de Carvalho JF. Ear Complaints in Fibromyalgia: A Narrative Review. Rheumatol Ther 2024; 11:1085-1099. [PMID: 39096417 PMCID: PMC11422319 DOI: 10.1007/s40744-024-00701-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/10/2024] [Indexed: 08/05/2024] Open
Abstract
INTRODUCTION Patients with fibromyalgia (FM) have innumerable complaints due to the central amplification of somatic stimuli. The aim of this paper was to review the ear complaints in patients with FM. METHODS A review of articles published in PubMed/MEDLINE, Embase, Web of Science, and Scopus from 1966 to June 2023 was performed. RESULTS Seventeen papers were included in the review. They showed that patients with FM have a higher hearing loss rate, mostly at high frequencies, and hyperacusis. The prevalence of vestibular symptoms (tinnitus, dizziness) and hyperacusis was higher than in the general population, reaching 87.0% of the sample. Subjective findings did not always correspond to objective results. In some studies, the degree of FM severity was associated with ear symptoms; in others, it was not. CONCLUSIONS Ear complaints in patients with FM are linked to subjacent disease and may be related to stimuli central amplification.
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Affiliation(s)
| | - Jozélio Freire de Carvalho
- Núcleo de Pesquisa Em Doenças Crônicas Não Transmissíveis (NUPEN), School of Nutrition, Federal University of Bahia, Rua das Violetas, 42, Ap. 502, Pituba, Salvador, Bahia, Brazil.
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Malouf WT, Bachmann MP, Meegalla NT, Kirse DJ, Kiell EP, Gandolfi MM, Sioshansi PC, Hiatt KD, Bunch PM. Evaluation of Hearing Loss: Understanding Audiologic Testing to Refine Image Interpretation. Radiographics 2024; 44:e240018. [PMID: 39264839 DOI: 10.1148/rg.240018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
The standard of reference for diagnosing and characterizing hearing loss is audiologic testing. The results of audiologic testing inform the imaging algorithm and the differential diagnosis for the underlying cause. Pure-tone audiometry tests the ability to hear tones across different frequencies, and the results are displayed as an audiogram. Tympanometry measures tympanic membrane compliance as a function of pressure to generate a tympanogram. Acoustic reflex testing helps differentiate third window lesions from other causes of conductive hearing loss. Clinical and audiologic assessment of sensorineural hearing loss helps in differentiating cochlear from retrocochlear causes. Symmetrical sensorineural hearing loss is typical of cochlear disease. Asymmetry increases the likelihood of a retrocochlear lesion, the most common of which among adults is vestibular schwannoma. Unlike patients with sensorineural hearing loss, who commonly have normal imaging studies, patients with conductive hearing loss are expected to have abnormal temporal bone CT studies. By incorporating the results of audiologic testing into their evaluation, radiologists can perform a more informed and more intentional search for the structural cause of hearing loss. The authors describe several audiogram configurations that suggest specific underlying mechanisms of conductive hearing loss. By providing a practical and accessible summary of the basics of audiologic testing, the authors empower the radiologist to leverage relevant clinical information and audiologic test results to interpret temporal bone imaging more confidently and more accurately, particularly temporal bone CT in the setting of conductive hearing loss. ©RSNA, 2024.
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Affiliation(s)
- William T Malouf
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Meagan P Bachmann
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Nuwan T Meegalla
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Daniel J Kirse
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Eleanor P Kiell
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Michele M Gandolfi
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Pedrom C Sioshansi
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Kevin D Hiatt
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Paul M Bunch
- From the Departments of Radiology (W.T.M., K.D.H., P.M.B.), Audiology (M.P.B.), and Otolaryngology (N.T.M., D.J.K., E.P.K., M.M.G., P.C.S.), Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
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12
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Eichorn FC, Kameda-Smith M, Fong C, Graham AK, Main C, Lu JQ. Polymicrobial brain abscesses: A complex condition with diagnostic and therapeutic challenges. J Neuropathol Exp Neurol 2024; 83:798-807. [PMID: 38874452 DOI: 10.1093/jnen/nlae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
Brain abscesses (BA) are focal parenchymal infections that remain life-threatening conditions. Polymicrobial BAs (PBAs) are complex coinfections of bacteria or bacterial and nonbacterial pathogens such as fungi or parasites, with diagnostic and therapeutic challenges. In this article, we comprehensively review the prevalence, pathogenesis, clinical manifestations, and microbiological, histopathological, and radiological features of PBAs, as well as treatment and prognosis. While PBAs and monomicrobial BAs have some similarities such as nonspecific clinical presentations, PBAs are more complex in their pathogenesis, pathological, and imaging presentations. The diagnostic challenges of PBAs include nonspecific imaging features at early stages and difficulties in identification of some pathogens by routine techniques without the use of molecular analysis. Imaging of late-stage PBAs demonstrates increased heterogeneity within lesions, which corresponds to variable histopathological features depending on the dominant pathogen-induced changes in different areas. This heterogeneity is particularly marked in cases of coinfections with nonbacterial pathogens such as Toxoplasma gondii. Therapeutic challenges in the management of PBAs include initial medical therapy for possibly underrecognized coinfections prior to identification of multiple pathogens and subsequent broad-spectrum antimicrobial therapy to eradicate identified pathogens. PBAs deserve more awareness to facilitate prompt and appropriate treatment.
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Affiliation(s)
- Frances-Claire Eichorn
- Department of Pathology and Molecular Medicine/Diagnostic and Molecular Pathology, McMaster University, Hamilton, Canada
| | | | - Crystal Fong
- Department of Radiology/Neuroradiology, McMaster University, Hamilton, Canada
| | - Alice K Graham
- Department of Pathology and Molecular Medicine/Diagnostic and Molecular Pathology, McMaster University, Hamilton, Canada
| | - Cheryl Main
- Department of Pathology and Molecular Medicine/Microbiology, McMaster University, Hamilton, Canada
| | - Jian-Qiang Lu
- Department of Pathology and Molecular Medicine/Diagnostic and Molecular Pathology, McMaster University, Hamilton, Canada
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Rapoport N, Pavelchek C, Michelson AP, Shew MA. Artificial Intelligence in Otology and Neurotology. Otolaryngol Clin North Am 2024; 57:791-802. [PMID: 38871535 DOI: 10.1016/j.otc.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Clinical applications of artificial intelligence (AI) have grown exponentially with increasing computational power and Big Data. Data rich fields such as Otology and Neurotology are still in the infancy of harnessing the power of AI but are increasingly involved in training and developing ways to incorporate AI into patient care. Current studies involving AI are focused on accessible datasets; health care wearables, tabular data from electronic medical records, electrophysiologic measurements, imaging, and "omics" provide huge amounts of data to utilize. Health care wearables, such as hearing aids and cochlear implants, are a ripe environment for AI implementation.
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Affiliation(s)
- Nicholas Rapoport
- Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, PO Box 8115, St Louis, MO 63110, USA
| | - Cole Pavelchek
- Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA
| | - Andrew P Michelson
- Department of Pulmonary Critical Care, Washington University School of Medicine, 660 South Euclid Avenue, PO Box 8052-43-14, St Louis, MO 63110, USA; Institute for Informatics, Washington University School of Medicine, St Louis, MO, USA
| | - Matthew A Shew
- Otology & Neurotology, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, PO Box 8115, St Louis, MO 63110, USA.
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Xie Y, Ma C, Zhu Q, Fu T, Bai L, Lan X, Liu L, Xiao J. Facial nerve regeneration via body-brain crosstalk: The role of stem cells and biomaterials. Neurobiol Dis 2024; 200:106650. [PMID: 39197536 DOI: 10.1016/j.nbd.2024.106650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 08/24/2024] [Accepted: 08/25/2024] [Indexed: 09/01/2024] Open
Abstract
The human body is a complex, integral whole, and disruptions in one organ can lead to dysfunctions in other parts of the organ network. The facial nerve, as the seventh cranial nerve, arises from the brainstem, controls facial expression muscles and plays a crucial role in brain-body communication. This vulnerable nerve can be damaged by trauma, inflammation, tumors, and congenital diseases, often impairing facial expression. Stem cells have gained significant attention for repairing peripheral nerve injuries due to their multidirectional differentiation potential. Additionally, various biomaterials have been used in tissue engineering for regeneration and repair. However, the therapeutic potential of stem cells and biomaterials in treating facial nerve injuries requires further exploration. In this review, we summarize the roles of stem cells and biomaterials in the regeneration and repair of damaged facial nerves, providing a theoretical basis for the recovery and reconstruction of body-brain crosstalk between the brain and facial expression muscles.
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Affiliation(s)
- Yuping Xie
- Department of Oral Implantology, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China; Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China
| | - Chuan Ma
- Department of Oral Implantology, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China
| | - Qiang Zhu
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China; Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China
| | - Ting Fu
- Department of Oral Implantology, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China
| | - Long Bai
- Department of Oral Implantology, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China; Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China
| | - Xiaorong Lan
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China
| | - Lin Liu
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China; Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China.
| | - Jingang Xiao
- Department of Oral Implantology, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China; Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China; Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou 646000, China.
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Tan D, Fujiwara RJT, Tan C, Isaacson B, Hunter JB. Endolymphatic Sac Tumors Associated With von Hippel-Lindau: A Case Report Highlighting Opportunity for Novel Orphan Drug Therapy. Otol Neurotol 2024; 45:e644-e646. [PMID: 39165133 DOI: 10.1097/mao.0000000000004307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
OBJECTIVE To discuss the potential benefit of belzutifan therapy in a patient with von Hippel-Lindau (VHL) disease-associated endolymphatic sac tumor (ELST). PATIENTS Case report. INTERVENTIONS Clinical details of a patient with residual ELST after hearing preservation surgery who initiated belzutifan therapy postoperatively for concurrent renal cell carcinoma, as well as literature review of belzutifan and ELST. MAIN OUTCOME MEASURES The patient remained without radiologic evidence of growth of her residual tumor at 17 months post-initiation of belzutifan. It is unknown whether this represents therapeutic drug effect, nonviability of residual tumor, or slow tumor growth not captured radiographically within the duration of follow-up. CONCLUSIONS Belzutifan could have direct therapeutic benefit in patients with VHL-associated ELST.
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Affiliation(s)
- Donald Tan
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Texas
| | - Rance J T Fujiwara
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Texas
| | - Christopher Tan
- University of California Irvine School of Engineering, Irvine, California
| | - Brandon Isaacson
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Texas
| | - Jacob B Hunter
- Department of Otolaryngology-Head and Neck Surgery, Jefferson Health, Philadelphia, Pennsylvania
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Fröhlich L, Plontke SK, Löffler LB, Manthey A, Rahne T. Stimulation conditions leading to electrical vestibular co-stimulation in cochlear implant users. Laryngoscope Investig Otolaryngol 2024; 9:e70011. [PMID: 39257730 PMCID: PMC11382355 DOI: 10.1002/lio2.70011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 08/18/2024] [Indexed: 09/12/2024] Open
Abstract
Objectives The study objective was to investigate the influence of electrical stimulus properties on cervical and ocular vestibular-evoked myogenic potentials to electrical stimulation by cochlear implants (e-cVEMPs, e-oVEMPs). Methods E-VEMPs were recorded in adult Nucleus cochlear implant (CI) patients using electric pulse trains (4 biphasic pulses at 1000 Hz burst rate). Ground path and stimulation electrodes were varied between monopolar stimulation at basal electrode contact E3 (MP1 + 2 E3), monopolar stimulation at apical electrode contact E20 (MP1 + 2 E20), and bipolar transmodiolar stimulation between E3 and E14 (BP E3-E14). The electric pulse train was further varied to 2 pulses at 1000 Hz, 2 pulses at 500 Hz, and a single pulse, in patients with present e-VEMP responses. VEMPs to bone-conducted vibration (BCV) were recorded as reference in all participants. Results Measurements were conducted in 30 ears of 27 participants (mean age 49.3 years, SD 12.7 years). E-VEMPs were present in 13 ears (43%). 5 of the 13 cases showed e-VEMPs but no BCV evoked VEMPs. Response numbers increased with increasing stimulation levels. The highest response rate of 40% was obtained for MP1 + 2 E3 stimulation. Stimulus variation did not affect response numbers. E-VEMP amplitudes were comparable to BCV-stimulated VEMPs. Latencies were up to 3.1 ms shorter for electric stimulation. Some patients showed e-VEMP thresholds close to or below the electric hearing threshold level. Conclusion The occurrence of e-VEMPs is dependent on current path and stimulation level. Vestibular co-stimulation by the CI is more likely in patients with high stimulation levels and for monopolar stimulation of basal electrode contacts. Level of Evidence 4.
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Affiliation(s)
- Laura Fröhlich
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg University Medicine Halle (Saale) Halle (Saale) Germany
- Present address: Department of Otolaryngology, Head and Neck Surgery University Medical Center Bonn Bonn Germany
| | - Stefan K Plontke
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg University Medicine Halle (Saale) Halle (Saale) Germany
| | - Lea B Löffler
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg University Medicine Halle (Saale) Halle (Saale) Germany
| | - Antonia Manthey
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg University Medicine Halle (Saale) Halle (Saale) Germany
| | - Torsten Rahne
- Department of Otorhinolaryngology, Head & Neck Surgery, Martin Luther University Halle-Wittenberg University Medicine Halle (Saale) Halle (Saale) Germany
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Maturi JR, Noij KS, Babu V, Creighton FX, Galaiya D, Jenks CM. A Systematic Review and Meta-analysis Examining Outcomes of Cochlear Implantation in Children With Bilateral Cochlear Nerve Deficiency. Otol Neurotol 2024; 45:971-984. [PMID: 39264916 DOI: 10.1097/mao.0000000000004274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
OBJECTIVE To assess hearing and speech outcomes in pediatric patients with bilateral cochlear nerve deficiency (CND) who underwent cochlear implantation (CI) and to identify factors associated with improved outcomes. DATABASES REVIEWED PubMed, Embase, Web of Science, and Cochran databases were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS Studies that reported hearing and speech outcomes of pediatric patients with bilateral CND who underwent CI were included. Demographics, comorbidities, inner ear abnormalities, CND classification (aplasia or hypoplasia), details of diagnostic workup, and outcomes data were extracted. Outcomes were assessed using the four-level auditory performance level (APL) scale. Meta-analysis, using Cochran-Armitage tests, was performed on patients with individual data to assess factors associated with performance. RESULTS A total of 314 papers were screened, and 40 papers with 378 total patients met inclusion criteria. A total of 339 patients had patient-level data and were included in the meta-analysis. Of the 339 patients, 19% (n = 63) of patients had no measurable stimulation, 28% (n = 95) had improved detection, 22% (n = 76) achieved closed-set speech perception, and 31% (n = 105) achieved open-set speech perception. Patients with cochlear nerve aplasia (p = 0.016) and syndromes (p < 0.001) had significantly worse APL scores relative to patients with cochlear nerve hypoplasia and patients without syndromes, respectively. CONCLUSIONS While most patients with bilateral CND benefit from CI and almost one-third of patients achieved open-set speech perception, outcomes were heterogenous and one-fifth of patients did not experience measurable benefit from CI.
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Affiliation(s)
- Jay R Maturi
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Urdang ZD, Jain A, Li M, Haupt TL, Wilcox TO, Chiffer RC, Gurgel RK. Conductive Hearing Loss Associates With Dementia, and Middle Ear Reconstruction Mitigates This Association: A Multinational Database Study. Otol Neurotol 2024; 45:1078-1086. [PMID: 39167564 PMCID: PMC11392634 DOI: 10.1097/mao.0000000000004308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
OBJECTIVE To test the hypothesis that conductive hearing loss (CHL) is associated with dementia, and that middle ear reconstruction (MER) associates with improved outcomes for these measures in a multinational electronic health records database. STUDY DESIGN Retrospective cohort study with propensity-score matching (PSM). SETTING TriNetX is a research database representing about 110 million patients from the United States, Taiwan, Brazil, and India. PATIENTS Subjects older than 50 years with no HL and any CHL (ICD-10: H90.0-2). Subjects of any age with and without any MER (CPT: 1010174). MAIN OUTCOME MEASURES Odds ratios (ORs) and hazard ratios with 95% confidence intervals (95% CIs) for incident dementia (ICD-10: F01, F03, G30). RESULTS Of 103,609 patients older than 50 years experiencing any CHL, 2.74% developed dementia compared with 1.22% of 38,216,019 patients with no HL (OR, 95% CI: 2.29, 2.20-2.37). Of patients experiencing CHL, there were 39,850 who received MER. The average age was 31.3 years, with 51% female patients. A total of 343,876 control patients with CHL were identified; 39,900 patients remained in each cohort after 1:1 PSM for HL- and dementia-related risk factors. Matched risk for developing dementia among MER recipients was 0.33% compared with 0.58% in controls (OR: 0.58, 0.46-0.72). CONCLUSIONS CHL increases the odds for dementia, and MER improves the odds for incident dementia. This study represents the first population study on the topic of CHL, MER, and dementia.
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Affiliation(s)
| | - Amiti Jain
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Marwin Li
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | | | | | - Richard K Gurgel
- Department of Otolaryngology, University of Utah, Salt Lake City, Utah
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Tavanai E, Rahimi V, Bandad M, Khalili ME, Fallahnezhad T. Efficacy of tailor-made notched music training (TMNMT) in the treatment of tinnitus: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:5033-5049. [PMID: 38847844 DOI: 10.1007/s00405-024-08732-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/12/2024] [Indexed: 09/25/2024]
Abstract
INTRODUCTION Numerous treatment modalities have been suggested for managing tinnitus. Tailor-Made Notched Music Training (TMNMT) is a viable strategy in music therapy for tinnitus management. Many research studies have examined the effectiveness and potential benefits of this intervention. This study aims to assess the effectiveness of TMNMT in treating chronic tinnitus. METHODS This systematic review and meta-analysis study used a research methodology that covered up until February 2023. The search was conducted across academic databases including Google Scholar, PubMed, Scopus, and Web of Science. A total of 234 papers were evaluated, and seven relevant clinical trials were included. RESULTS The meta-analysis, which included five studies using the tinnitus handicap inventory (THI), showed no statistically significant effect of TMNMT on tinnitus handicap after 3 and 6 months of intervention (dppc2: - 0.99, 95%CI - 2.94 to 0.96; I2 = 79.96%, p = 0.00), (dppc2 - 1.81, 95%CI - 5.63 to 2.01; I2 = 79.96%, p = 0.00). However, four out of five studies using the total Visual Analogue Scale (VAS) or its subscale showed positive effects of TMNMT on chronic tinnitus. Unfortunately, there were not enough articles to conduct a meta-analysis on this outcome. CONCLUSION Although the meta-analysis did not show a statistically significant effect of TMNMT on tinnitus handicap, the large effect size observed after at least 3 months of intervention suggests that this method may potentially decrease tinnitus handicap if more studies are conducted. Due to the limited number of studies, subgroup analysis could not be performed to analyze potential causes of heterogeneity. Therefore, further high-quality clinical trials are necessary to draw a definitive conclusion and evaluate the impact of different variables, techniques, and outcomes.
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Affiliation(s)
- Elham Tavanai
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Street, Pich-E-Shemiran, Tehran, Iran
| | - Vida Rahimi
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Street, Pich-E-Shemiran, Tehran, Iran.
| | - Mina Bandad
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Street, Pich-E-Shemiran, Tehran, Iran
| | | | - Tayyebe Fallahnezhad
- Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Street, Pich-E-Shemiran, Tehran, Iran
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Uğurlu BN, Aktar Uğurlu G. Exploring trends and developments in cholesteatoma research: a bibliometric analysis. Eur Arch Otorhinolaryngol 2024; 281:5199-5210. [PMID: 38809268 DOI: 10.1007/s00405-024-08749-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/22/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE Examination of the scientific literature on cholesteatoma from past to present using bibliometric methods. METHODS A total of 2353 articles on cholesteatoma between 1980 and 2023 were obtained from the Web of Science database and statistically analysed using bibliometric techniques. RESULTS The journals with the highest number of contributions to the literature were Otology & Neurotology (n = 192), Acta Oto-Laryngologica (156) and Laryngoscope (149). The most impactful journals based on h-index and total citation (TC) counts were Laryngoscope (h:36, TC: 4241), Otology & Neurotology (29, 3141), and American Journal of Otology (26, 2071) respectively. The most prolific author was Kojima H. (n = 49). According to the findings of the Reference Publication Year Spectroscopy (RPYS) analysis, there has been a significant increase in academic interest in Cholesteatoma since its first description in 1959, particularly following the expansion of its definition in 1977. Subsequently, the trend of increased interest has risen rapidly in later years, with notable peaks in research intensity observed in 1989, 2006, and 2011. The highest academic trend occurred in 2006. In recent years, trending topics have included innovative approaches such as diagnostic and imaging methods particularly alongside technological developments, endoscopic surgery, recurrence and complications, prognosis and quality of life, artificial intelligence, and obliteration. CONCLUSION In conclusion, the evolution of cholesteatoma and its research priorities reveal temporal shifts and emerging areas of interest over time. Primarily, diagnosis, treatment, and surgical approaches remain central. Additionally, research has expanded to encompass developments in surgical techniques, imaging modalities, cellular biology, pathology, and molecular mechanisms.
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Affiliation(s)
- Burak Numan Uğurlu
- Private Practitioner, Otolaryngology, Çorum, Turkey.
- Department of Otorhinolaryngology, Faculty of Medicine , Hitit University, Çorum, Turkey.
| | - Gülay Aktar Uğurlu
- Department of Otorhinolaryngology, Faculty of Medicine , Hitit University, Çorum, Turkey
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Müller-Graff FT, Spahn B, Herrmann DP, Kurz A, Voelker J, Hagen R, Rak K. [Comprehensive literature review on the application of the otological-surgical planning software OTOPLAN® for cochlear implantation. German version]. HNO 2024; 72:687-701. [PMID: 38587661 PMCID: PMC11422278 DOI: 10.1007/s00106-024-01461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 04/09/2024]
Abstract
BACKGROUND The size of the human cochlear, measured by the diameter of the basal turn, varies between 7 and 11 mm. For hearing rehabilitation with cochlear implants (CI), the size of the cochlear influences the individual frequency map and the choice of electrode length. OTOPLAN® (CAScination AG [Bern, Switzerland] in cooperation with MED-EL [Innsbruck, Austria]) is a software tool with CE marking for clinical applications in CI treatment which allows for precise pre-planning based on cochlear size. This literature review aims to analyze all published data on the application of OTOPLAN®. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were applied to identify relevant studies published in the PubMed search engine between January 2015 and February 2023 using the search terms "otoplan" [title/abstract] OR "anatomy-based fitting" [title/abstract] OR "otological software tool" [title/abstract] OR "computed tomography-based software AND cochlear" [title/abstract]. RESULTS The systematic review of the literature identified 32 studies on clinical use of OTOPLAN® in CI treatment. Most studies were reported from Germany (7 out of 32), followed by Italy (5), Saudi Arabia (4), the USA (4), and Belgium (3); 2 studies each were from Austria and China, and 1 study from France, India, Norway, South Korea, and Switzerland. In the majority of studies (22), OTOPLAN® was used to assess cochlear size, followed by visualizing the electrode position using postoperative images (5), three-dimensional segmentation of temporal bone structures (4), planning the electrode insertion trajectory (3), creating a patient-specific frequency map (3), planning of a safe drilling path through the facial recess (3), and measuring of temporal bone structures (1). CONCLUSION To date, OTOPLAN® is the only DICOM viewer with CE marking in the CI field that can process pre-, intra-, and postoperative images in the abovementioned applications.
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Affiliation(s)
- Franz-Tassilo Müller-Graff
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.
| | - Björn Spahn
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - David P Herrmann
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Anja Kurz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Johannes Voelker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Rudolf Hagen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
| | - Kristen Rak
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland
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22
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Zheng L. Clinical and electrophysiological prognostic factors in predicting poor outcomes in patients with idiopathic facial nerve paralysis. J Clin Neurosci 2024; 128:110776. [PMID: 39137715 DOI: 10.1016/j.jocn.2024.110776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/26/2024] [Accepted: 08/07/2024] [Indexed: 08/15/2024]
Abstract
OBJECTIVE This study was designed to verify whether one or more clinical and neurophysiological parameters could predict a poor prognosis in idiopathic facial paralysis. METHODS Seventy-three outpatients with unilateral idiopathic facial nerve paralysis who visited our hospital within 7 days of onset. All patients received treatment according to a standard therapy protocol and ocular care. Patients' baseline characteristics were assessed before initiating treatment, including demographic characteristics, facial nerve function assessment and previous medical history. House-Brackmann (H-B) grading system was performed at baseline and six months after the onset. Electroneurography (ENoG) and blink reflex tests were conducted 7-10 days after the onset of paralysis. Sunnybrook Facial Grading System (SFGS) was conducted at baseline, days 7-10 post-onset when the electrophysiological tests were performed, and one month after the onset. RESULTS According to the H-B grade at 6 months following the onset, 58 patients (79.5 %) had a good prognosis, while 15 patients (20.5 %) had a poor prognosis. The CMAP amplitudes in three facial muscles (frontalis, orbicularis oculi, and orbicularis oris) were decreased, and ENoG values were increased in the poor prognosis group compared with the good prognosis group (all p < 0.01). The results of the blink reflex study showed that the group with a poor prognosis had a longer R1 latency compared to the group with a good prognosis. Additionally, the group with a poor prognosis exhibited a higher rate of R1 absence on the affected side (both p < 0.01). The findings of conditional logistic regression indicated that the absence of R1 on the affected side, frontalis ENoG, orbicularis oculi ENoG, and orbicularis oris ENoG were predictive factors of a poor prognosis for facial nerve palsy. The receiver operating characteristic (ROC) curves showed that the SFGS at 1 month after onset of 55 is considered a critical cutoff value for poor prognosis, with a sensitivity of 86.7 % and specificity of 91.4 %. CONCLUSION Electroneurography (ENoG) and blink reflex tests acquired within 7-10 days after the onset of paralysis are significant and highly valuable for predicting the prognosis of idiopathic facial nerve paralysis. Higher ENoG values of the muscles innervated by the facial nerve and the absence of R1 on the affected side of the blink reflex are predictive factors for a poor prognosis. The SFGS is a clinical tool that plays an important role in evaluating the prognosis of idiopathic facial paralysis, particularly one month after onset.
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Affiliation(s)
- Lina Zheng
- Department of Neurology, Tianjin Hospital, Tianjin, China.
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23
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Patel TR, Welch CM. The Science of Cholesteatoma. Otolaryngol Clin North Am 2024:S0030-6665(24)00119-1. [PMID: 39353746 DOI: 10.1016/j.otc.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
Cholesteatoma is a potential end-stage outcome of chronic ear infections that can result in the destruction of temporal bone structures with potential resultant hearing loss, vertigo, and intracranial infectious complications. There is currently no treatment apart from surgery for this condition, and despite years of study, the histopathogenesis of this disease remains poorly understood. This review is intended to summarize our accumulated knowledge of the mechanisms of cholesteatoma development and the underlying molecular biology. Attention will be directed particularly to recent developments, covering many potential pharmacologic targets that could be used to treat this disease in the future.
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Affiliation(s)
- Tirth R Patel
- Division of Otology/Neurotology-Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1500 Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Christopher M Welch
- Division of Otology/Neurotology-Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1500 Medical Center Drive, Ann Arbor, MI 48109, USA.
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24
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Alahmadi RA, Lajdam GB, Aghashami A, Hamdan D, Almalki AH, Altalhi AA, Amoodi HA. Platelet Concentrates Impact on Myringoplasty Outcomes in Chronic Otitis Media Patients: Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2024. [PMID: 39342500 DOI: 10.1002/ohn.988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 07/19/2024] [Accepted: 08/10/2024] [Indexed: 10/01/2024]
Abstract
OBJECTIVE We aimed to perform a systematic review and meta-analysis of myringoplasty outcomes following platelet concentrates application in patients with chronic otitis media (COM). DATA SOURCES We searched MEDLINE, Embase, and Cochrane Central register of Controlled Clinical Trials (CENTRAL). We also performed a manual search in Google Scholar and reference lists. REVIEW METHODS Eligible for inclusion were randomized controlled trials on COM patients undergoing myringoplasty with platelet concentrates (platelet-rich plasma or platelet-rich fibrin) compared to myringoplasty alone. The primary outcomes were graft uptake and air-bone gap (ABG) gain, while the secondary outcome was complication rate. We used odds ratio (OR) and standardized mean difference (SMD) to represent dichotomous and continuous outcomes, respectively. RESULTS Thirteen trials (n = 1179) were deemed eligible. Platelet concentrates significantly improved graft uptake after 6 months (OR: 2.45, 95% confidence interval [CI]: 1.34-4.47, P = .004, I2 = 0%, high certainty), ABG gain (SMD: 0.36, 95% CI: 0.17-0.55, P = .0002, I2 = 0%, moderate certainty), and complication rate (OR: 0.38, 95% CI: 0.18-0.82, P = .01, I2 = 0%, low certainty). CONCLUSION Our results showed that platelet concentrates may improve graft uptake and ABG gain and reduce complications in COM patients undergoing myringoplasty. Caution is warranted given to the relatively small sample size, as well as inconsistent reporting across included trials.
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Affiliation(s)
- Rana A Alahmadi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Ghassan Bin Lajdam
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Afnan Aghashami
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Dalia Hamdan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Abdulaziz H Almalki
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Atheer A Altalhi
- Otolaryngology-Head and Neck Surgery Department, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
| | - Hosam A Amoodi
- Department of Surgery, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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25
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Zborayova K, Barrenäs ML, Granåsen G, Kerber K, Salzer J. Dizziness and vertigo sick leave before and after insurance restrictions - a descriptive Swedish nationwide register linkage study. BMC Public Health 2024; 24:2591. [PMID: 39333959 PMCID: PMC11430563 DOI: 10.1186/s12889-024-20119-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 09/17/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Vertigo and dizziness can be disabling symptoms that result in sick leave. Research regarding sickness absence due to dizziness has focused on specific vestibular diagnoses rather than the nonspecific vertigo/dizziness diagnoses. Strict sick leave regulations were introduced in Sweden in 2008. The aim of this study was to describe the vertigo/dizziness sick leave prevalence and duration considering both specific and nonspecific diagnoses according to International Classification of diseases 10th revision (ICD-10) on the 3-digit level, including the less specific "R" diagnoses. METHODS Through Swedish nationwide registers we identified individuals aged 16-64 years who during the years 2005-2018 were sickness absent > 14 consecutive days - minimum register threshold - due to vertigo/dizziness diagnoses according to ICD10 codes: specific diagnoses (H81.0, H81.1, H81.2, H81.3, H81.4, G11x) and nonspecific (R42, R26, R27, H81.9). We described the demographic characteristics, prevalence and duration of such sick-leave spells. Data were stratified according to diagnostic groups: ataxias, vestibular and nonspecific. RESULTS We identified 52,179 dizziness/vertigo sick leave episodes > 14 days in 45,353 unique individuals between 2005-2018, which constitutes 0.83% from all sick leave episodes in the given period.The nonspecific diagnoses represented 72% (n = 37741) of sick leave episodes and specific vestibular H-diagnoses 27% (n = 14083). The most common specific vestibular codes was Benign paroxysmal positional vertigo (BPPV) 9.4% (n = 4929). The median duration of sick leave was 31 days (IQR 21-61). Women on sick leave were younger than men (47 vs 51 years, p < 0.05) and had a higher proportion of nonspecific diagnoses compared with men (74% vs 70%, p < 0.05). CONCLUSIONS The vast majority of vertigo/dizziness sick leave episodes were coded as nonspecific diagnoses and occurred in women. BPPV, a curable vestibular condition, was the most common specific diagnosis. This suggests a potential for improved diagnostics. Women on sick leave due to dizziness/vertigo were younger and more often received nonspecific diagnostic codes. Future studies should determine the frequency of use of evidence based therapies and investigate further the gender differences.
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Affiliation(s)
- Katarina Zborayova
- Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Umeå, Sweden.
| | | | - Gabriel Granåsen
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Kevin Kerber
- Department of Neurology, Ohio State University, Columbus, OH, USA
| | - Jonatan Salzer
- Department of Clinical Sciences, Neurosciences, Umeå University, Umeå, Sweden
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26
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Xie L, Zeng L. Congenital Middle Ear Cholesteatoma: A Report of 3 Cases and a Literature Review. EAR, NOSE & THROAT JOURNAL 2024:1455613241283799. [PMID: 39315430 DOI: 10.1177/01455613241283799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/25/2024] Open
Abstract
Background: Congenital cholesteatoma is defined as a white mass behind an intact eardrum without a history of otitis media or previous otologic procedures. Congenital cholesteatoma is a relatively rare disease that accounts for about 2% to 5% of all cholesteatomas. However, the actual incidence rate of congenital cholesteatoma may be underestimated. Conductive hearing loss is the most common presenting symptom. The current study aims to describe the clinical characteristics and management of patients with congenital cholesteatoma and promote awareness of the disease in unilateral or asymmetric conductive hearing loss patients. Methods: In this study, we report a case series of 3 patients including 1 child, 1 adolescent, and 1 young adult, managed in our department between June and August 2023, and present a summary of the literature. Results: Congenital cholesteatoma is primarily a pediatric disease, but it has also been reported in adults. Two cases presented with unilateral secretory otitis media, and 1 case presented with asymmetric unilateral conductive hearing loss. Two patients of Potsic stage III congenital middle ear cholesteatomas underwent transcanal endoscopic ear surgery, and 1 patient of Potsic stage IV underwent conventional microscopic approach canal wall-up mastoidectomy combined with endoscopy. Conclusions: In children or young adults with persistent unilateral or asymmetric conductive hearing loss, congenital middle ear cholesteatoma should be considered. Congenital cholesteatoma cannot be ruled out in children with unilateral secretory otitis media.
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Affiliation(s)
- Li Xie
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lingling Zeng
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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27
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Mungan Durankaya S, Olgun Y, Kiremitçi I, Evin Eskicioğlu H, Güneri EA, Kirazli G, Gürkan S, Erdağ TK, Kirkim G. The effect of percutaneous and transcutaneous BAHA on hearing and subjective auditory abilities: A comparative study. Medicine (Baltimore) 2024; 103:e39697. [PMID: 39312344 PMCID: PMC11419514 DOI: 10.1097/md.0000000000039697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 08/23/2024] [Indexed: 09/25/2024] Open
Abstract
Hearing loss significantly affects communication, social interactions, and the overall quality of life. The bone-anchored hearing aid (BAHA) is an implantable system that bypasses the outer and middle ear to directly stimulate the cochlea through bone conduction. This study aimed to compare hearing performance and subjective auditory ability improvements between transcutaneous and percutaneous BAHA devices using audiological assessments and Speech, Spatial and Qualities of Hearing Scale. This cross-sectional prospective study included 29 participants aged 14 to 69 years who had used BAHA for at least 6 months. Both Cochlear Baha System's percutaneous (connect) and transcutaneous (attract) implants were evaluated. Audiological assessments involved pure-tone audiometry, speech recognition threshold, and free-field (FF) audiometry, while subjective auditory ability was measured using the Turkish Speech, Spatial and Qualities of Hearing scale (Tr-SSQ). Significant improvements in FF audiometry averages and speech recognition thresholds were observed with BAHA compared to without BAHA (P < .001). Both implant types provided similar FF averages, speech audiometry results, and Tr-SSQ outcomes, with no significant differences between them. Tr-SSQ scores showed substantial satisfaction, indicating significant improvements in speech perception, spatial perception, and hearing quality with BAHA (P < .001). The findings align with previous research, demonstrating that BAHA is a reliable and effective solution for hearing rehabilitation. The study also emphasized the importance of using both audiological test results and daily hearing function scales to comprehensively evaluate the benefits of hearing rehabilitation in real-world environments. In conclusion, BAHA, regardless of the implant type, can provide predictable and lasting improvements in hearing thresholds and daily hearing abilities, making it a valuable option for patients with conductive hearing loss.
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Affiliation(s)
- Serpil Mungan Durankaya
- Department of Audiology, Vocational School of Healthcare, Dokuz Eylül University, Izmir, Türkiye
- Department of Otorhinolaryngology, Audiology, Dokuz Eylül University Hospital, Izmir, Türkiye
| | - Yüksel Olgun
- Department of Otorhinolaryngology, School of Medicine, Dokuz Eylül University, Izmir, Türkiye
| | - Ilayda Kiremitçi
- Department of Otorhinolaryngology, Audiology, Institute of Health Sciences, Dokuz Eylül University, Izmir, Türkiye
| | - Hande Evin Eskicioğlu
- Department of Audiology, Vocational School of Healthcare, Dokuz Eylül University, Izmir, Türkiye
- Department of Otorhinolaryngology, Audiology, Dokuz Eylül University Hospital, Izmir, Türkiye
| | - Enis Alpin Güneri
- Department of Otorhinolaryngology, School of Medicine, Dokuz Eylül University, Izmir, Türkiye
| | - Gülce Kirazli
- Department of Audiology, Faculty of Health Sciences, Ege University, Izmir, Türkiye
| | - Selhan Gürkan
- Department of Audiology, Vocational School of Healthcare, Dokuz Eylül University, Izmir, Türkiye
- Department of Otorhinolaryngology, Audiology, Dokuz Eylül University Hospital, Izmir, Türkiye
| | - Taner Kemal Erdağ
- Department of Otorhinolaryngology, School of Medicine, Dokuz Eylül University, Izmir, Türkiye
| | - Gunay Kirkim
- Department of Audiology, Vocational School of Healthcare, Dokuz Eylül University, Izmir, Türkiye
- Department of Otorhinolaryngology, Audiology, Dokuz Eylül University Hospital, Izmir, Türkiye
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28
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Guan R, Hong Z, Pan L, Wang Y, Li Y. Mechanism and future prospect of treatment of facial paralysis caused by herpes zoster virus infection with acupuncture combined with medicine: A review. Medicine (Baltimore) 2024; 103:e39652. [PMID: 39312375 PMCID: PMC11419547 DOI: 10.1097/md.0000000000039652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 08/22/2024] [Indexed: 09/25/2024] Open
Abstract
Herpes zoster virus infectious facial paralysis is caused by the reactivation and replication of varicella-zoster virus, which leads to herpetic inflammatory lesions, resulting in peripheral facial paralysis associated with herpes rash in the auricle and external ear, and vestibular cochlear dysfunction. It is also known as Ramsey-Hunter syndrome (Hunt syndrome). Facial paralysis caused by herpes zoster is difficult to cure due to its easy loss of treatment and mistreatment. Cause a greater burden on the patient's body and mind. However, the treatment of Western medicine has lagged behind and there are many adverse reactions, which cannot be completely cured, and new alternatives are urgently needed. This article briefly reviews the advantages and disadvantages of modern medical treatment of Hunt syndrome. This paper expounds the unique ideas of traditional Chinese medicine in the treatment of Hunt syndrome from the perspectives of antiviral, antibacterial, improving blood circulation, protecting cardiovascular, cerebrovascular, and nerve. This article discusses the superiority of traditional Chinese medicine in the treatment of Hunt syndrome from 2 aspects of Chinese medicine therapy and acupuncture therapy, and points out the feasibility of combined treatment of acupuncture and traditional Chinese medicine. So as to provide a new treatment for Hunt syndrome.
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Affiliation(s)
- Ruiqian Guan
- Heilongjiang University of Chinese Medicine/Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin City, Heilongjiang Province, China
| | - Zhibo Hong
- Heilongjiang University of Chinese Medicine, Harbin City, Heilongjiang Province, China
| | - Limin Pan
- Heilongjiang University of Chinese Medicine/The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin City, Heilongjiang Province, China
| | - Yusu Wang
- Heilongjiang University of Chinese Medicine, Harbin City, Heilongjiang Province, China
| | - Yeyao Li
- Heilongjiang University of Chinese Medicine, Harbin City, Heilongjiang Province, China
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29
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Chen X, Tian J, Wen J, Pan J, Wang Y, Zhang C. Imaging findings of isolated congenital middle ear malformation on high-resolution computed tomography. Neuroradiology 2024:10.1007/s00234-024-03465-1. [PMID: 39297952 DOI: 10.1007/s00234-024-03465-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 09/05/2024] [Indexed: 09/21/2024]
Abstract
PURPOSE This study aims to analyze the imaging features of isolated congenital middle ear malformation (CMEM) on high-resolution computed tomography (HRCT). METHODS We retrospectively collected patients with surgically confirmed diagnosis of isolated CMEM in our hospital between January 2018 and June 2023. All patients underwent HRCT before surgery. The preoperative imaging findings were analyzed by neuroradiologists with full knowledge of the intraoperative findings. RESULTS 37 patients were included in this study, including 25 males and 12 females, with a median age of 16 years. A total of 44 ears underwent surgery. The most commonly affected structures were incudostapedial joint, incus long process, and stapes superstructure, followed by stapes footplate, oval window, incudomalleolar join, tympanic segment of the facial nerve canal, incus body, incus short process and malleus. All incus defect/hypoplasia/malposition, stapes superstructure deformity, malleus deformity, incudostapedial joint discontinuity, and facial nerve canal malposition/abnormal bifurcation could be observed on HRCT. Additionally, 96.0% of stapes superstructure defect, 85.7% of oval window atresia, and 41.7% of incudomalleolar joint fusion, could be visualized on HRCT. HRCT could not show ossicular soft tissue pseudo-connection and stapes footplate fixation. CONCLUSIONS Preoperative HRCT is an important tool for diagnosing isolated CMEM. The advantages of HRCT lie in its ability to detect ossicular defects/deformities, incudostapedial joint discontinuity, oval window atresia, and facial nerve abnormalities. However, it has a low detection rate for incudomalleolar joint fusion and cannot show ossicular soft tissue pseudo-connection and stapes footplate fixation.
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Affiliation(s)
- Xiaoxi Chen
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Jiajie Tian
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Jing Wen
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Jiayu Pan
- Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Yang Wang
- Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Chunlin Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
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30
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Marinelli JP, Carlson ML. Hearing preservation in pediatric cochlear implantation. Curr Opin Otolaryngol Head Neck Surg 2024:00020840-990000000-00152. [PMID: 39365266 DOI: 10.1097/moo.0000000000001011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2024]
Abstract
PURPOSE OF REVIEW Pediatric cochlear implantation has evolved considerably over the past three decades to include more patients at earlier ages with greater degrees of residual hearing. As an extension, a significant focus of research over the past decade has surrounded preservation of existing acoustic hearing. RECENT FINDINGS Multiple studies published within the last 5 years demonstrate aidable acoustic hearing preservation in 60-90% of pediatric patients, with 40-60% experiencing complete hearing preservation following cochlear implantation. Durability of preserved hearing varies among patients, with some patients losing residual hearing within 1 year of surgery whereas others maintain acoustic hearing through at least 5 years of follow-up. Speech outcomes appear superior among patients with preserved acoustic hearing, particularly in the presence of background noise. Several recent studies suggest a music appreciation advantage in children with preserved acoustic hearing following cochlear implantation. SUMMARY Hearing preservation rates during cochlear implantation in children matches, if not often exceeds, hearing preservation rates observed among adults. Preservation of acoustic hearing during cochlear implantation confers multiple advantages for the pediatric population. Beyond improved speech understanding and music appreciation, minimizing intracochlear trauma and resultant scarring facilitates potential future regenerative treatments or revision surgery.
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Affiliation(s)
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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31
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Le M, Šarkić B, Anderson R. Prevalence of tinnitus following non-blast related traumatic brain injury: a systematic review of literature. Brain Inj 2024; 38:859-868. [PMID: 38775672 DOI: 10.1080/02699052.2024.2353798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 05/05/2024] [Accepted: 05/05/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVES To establish the prevalence of tinnitus in adults who have sustained non-blast related traumatic brain injury (TBI), as well as the prevalence of tinnitus following TBI in the absence of hearing loss. METHODS A systematic search was carried out using MEDLINE, EMBASE, PsycINFO, CINAHL from January 1st 1990 to August 14th 2023. TBI, tinnitus and auditory findings were extracted from all eligible studies, and a descriptive synthesis performed. This systematic review was registered with PROSPERO (Registration number: CRD42022377637). RESULTS Based on the Oxford Centre of Evidence-Based Medicine (OCEBM) (2011) criteria, the highest quality evidence identified was at Level 2b, with the bulk of the included studies predominantly populating the lower evidence tiers. While there was a substantial variability in the methods used to establish and report the presence of tinnitus, its occurrence following TBI was evident in adults with and without hearing loss. CONCLUSION The need for prospective, longitudinal research into tinnitus following non-blast related TBI is evident. Such comprehensive studies hold the potential to inform and enhance the clinical diagnosis and management of this patient population.
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Affiliation(s)
- Michelle Le
- Audiology department, Barwon Health, Geelong, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Bojana Šarkić
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Richard Anderson
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
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Geal-Dor M, Adelman C, Sohmer H. Issues Concerning the Mechanisms of Bone Conduction. Audiol Res 2024; 14:840-843. [PMID: 39311223 PMCID: PMC11417774 DOI: 10.3390/audiolres14050070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 09/01/2024] [Accepted: 09/14/2024] [Indexed: 09/26/2024] Open
Abstract
Air and bone conduction thresholds are used to differentiate between conductive and sensori-neural hearing losses because bone conduction is thought to bypass the conductive apparatus, directly activating the inner ear. However, the suggested bone conduction mechanisms involve the outer and middle ears. Also, normal bone conduction thresholds have been reported in cases of lesions to the conduction pathway. Therefore, further investigation of bone conduction mechanisms is required.
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Affiliation(s)
- Miriam Geal-Dor
- Speech & Hearing Center, Hebrew University-Hadassah Medical Center, Jerusalem 91200, Israel;
- Department of Communication Disorders, Hadassah Academic College, Jerusalem 91200, Israel
| | - Cahtia Adelman
- Speech & Hearing Center, Hebrew University-Hadassah Medical Center, Jerusalem 91200, Israel;
- Department of Communication Disorders, Hadassah Academic College, Jerusalem 91200, Israel
| | - Haim Sohmer
- Department of Medical Neurobiology (Physiology), Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel;
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Pan Y, Xiao Y. Language and executive function in Mandarin-speaking deaf and hard-of-hearing children aged 3-5. JOURNAL OF DEAF STUDIES AND DEAF EDUCATION 2024:enae037. [PMID: 39277795 DOI: 10.1093/jdsade/enae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 08/09/2024] [Accepted: 08/27/2024] [Indexed: 09/17/2024]
Abstract
The study aimed to explore spoken language and executive function (EF) characteristics in 3-5-year-old prelingually deaf and hard-of-hearing (DHH) children, and evaluate the impact of demographic variables and EF on spoken language skills. 48 DHH children and 48 typically developing children who use auditory-oral communication were recruited. All participants underwent EF tests, including auditory working memory (WM), inhibitory control, cognitive flexibility, and the EF performance reported by parents. Using Mandarin Clinical Evaluation of Language for Preschoolers (MCELP), vocabulary comprehension, sentence comprehension, vocabulary naming, sentence structure imitation, and story narration were evaluated only in the DHH group, and their results were compared with the typical developmental level provided by MCELP. Results showed that DHH children exhibit deficiencies in different spoken language domains and EF components. While the spoken language skills of DHH children tend to improve as they age, a growing proportion of individuals fail to reach the typical developmental level. The spoken language ability in DHH children was positively correlated with age and EFs, and negatively correlated with aided hearing threshold, while auditory WM could positively predict their spoken language performance.
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Affiliation(s)
- Yuchen Pan
- School of Chinese Language and Culture, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Yongtao Xiao
- School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Kirsch V, Boegle R, Gerb J, Kierig E, Ertl-Wagner BB, Becker-Bense S, Brandt T, Dieterich M. Imaging endolymphatic space of the inner ear in vestibular migraine. J Neurol Neurosurg Psychiatry 2024:jnnp-2024-334419. [PMID: 39271244 DOI: 10.1136/jnnp-2024-334419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 07/29/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Vestibular migraine (VM), the most frequent episodic vertigo, is difficult to distinguish from Ménière's disease (MD) because reliable biomarkers are missing. The classical proof of MD was an endolymphatic hydrops (EH). However, a few intravenous gadolinium-enhanced MRI studies of the inner ear (iMRI) also revealed an EH in VM. The major questions were the frequency and distribution characteristics of EH in VM for diagnostic use. METHODS In a prospective case-control study of 200 participants, 75 patients with VM (49 females; mean age 46 years) and 75 with MD (36 females; mean age 55 years), according to the Bárány and International Headache Society, and 50 age-matched participants with normal vestibulocochlear testing (HP), were enrolled. Analyses of iMRI of the endolymphatic space included volumetric quantification, stepwise regression, correlation with neurotological parameters and support vector machine classification. RESULTS EH was maximal in MD (80%), less in VM (32%) and minimal in HP (22%). EH was milder in VM (mean grade 0.3) compared with MD (mean grade 1.3). The intralabyrinthine distribution was preferably found in the vestibulum in VM, but mainly in the cochlea in MD. There was no interaural lateralisation of EH in VM but in the affected ear in MD. The grade of EH in the vestibulum was correlated in both conditions with the frequency and duration of the attacks. CONCLUSION Three features of the iMRI evaluation were most supportive for the diagnosis of VM at group and individual levels: (1) the bilateral manifestation, (2) the low-grade EH and (3) the intraaural distribution.
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Affiliation(s)
- Valerie Kirsch
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-University, Munich, Germany
| | - Rainer Boegle
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-University, Munich, Germany
| | - Johannes Gerb
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Emilie Kierig
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | | | - Sandra Becker-Bense
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Thomas Brandt
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-University, Munich, Germany
| | - Marianne Dieterich
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
- SyNergy, Munich Cluster of Systems Neurology, Munich, Germany
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Bal F, Kırış M. Effectiveness of Eye Movement Desensitization and Reprocessing-EMDR Method in Patients with Chronic Subjective Tinnitus. Brain Sci 2024; 14:918. [PMID: 39335413 PMCID: PMC11429632 DOI: 10.3390/brainsci14090918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 09/11/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024] Open
Abstract
This research aimed to investigate the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) method on chronic subjective tinnitus. The research was planned as an observational study. The study group comprises individuals who applied to the training and research hospital in Ankara between 2019 and 2020 and were aged between 15 and 60 years old. They were identified as having tinnitus. The study samples were determined as 36 participants selected through purposeful sampling. The samples of the 36 participants included in the study. 12 were assigned to the 1st Group EMDR and Masking Group, 12 to the 2nd Group Masking and EMDR Group, and 12 to the 3rd Control Group. The study's dependent variable was the tinnitus levels of the participants, and the independent variable was EMDR and the Masking method. The dependent variable data of the study was collected with the Visual Analog Scale and Tinnitus Handicap Inventory (THI). EMDR and Masking methods used as independent variables in the study were conducted in eight sessions for two months. As a result of the Wilcoxon Sign test used to determine whether the EMDR Method is effective on tinnitus severity level, the difference between tinnitus severity level pretest and post-test median scores of tinnitus patients was found to be statistically significant. Our research findings show that the EMDR method reduces and improves chronic subjective tinnitus, and further studies with a larger sample size could confirm our results.
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Affiliation(s)
- Fatih Bal
- Department of Psychology, Sakarya University, Sakarya 54187, Türkiye
| | - Muzaffer Kırış
- Department of Ear, Nose and Throat Diseases, Ankara Yıldırım Beyazıt University, Ankara 06010, Türkiye
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Olszewska E, De Vito A, Heiser C, Vanderveken O, O’Connor-Reina C, Baptista P, Kotecha B, Vicini C. Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 3 Palatal Surgery, Outcomes and Follow-Up, Complications, and Post-Operative Management. J Clin Med 2024; 13:5438. [PMID: 39336926 PMCID: PMC11431938 DOI: 10.3390/jcm13185438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Revised: 09/06/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
Background/Objectives: Exploring and establishing a consensus on palatal surgery, the outcomes and follow-up after the palatal surgery, the complications of palatal surgery, and the post-operative management after palatal surgery for snoring and obstructive sleep apnea (OSA) among sleep surgeons is critical in the surgical management of patients with such conditions. Methods: Using the Delphi method, a set of statements was developed based on the literature and circulated among a panel of eight European experts. Responses included agreeing and disagreeing with each statement, and the comments were used to assess the level of consensus and to develop a revised version. The new version with the level of consensus and anonymized comments was sent to each panel member as the second round. This was repeated over a total of five rounds. Results: The final set included a total of 111 statements, 27 of which were stand-alone questions and 21 of which contained 84 sub-statements. Of the 34 statements regarding palatal surgery, consensus was achieved among all eight, seven, and six panelists for 50%, 35.3%, and 5.9% of the questions, respectively. Of the 43 statements regarding the outcomes and follow-up after the palatal surgery, consensus was achieved among all eight, seven, and six panelists for 53.5%, 23.3%, and 4.7% of the questions, respectively. Of the 24 statements regarding complications after the palatal surgery, consensus was achieved among all eight, seven, and six panelists for 91.7%, 0%, and 4.2% of the questions, respectively. Of the 10 statements regarding post-operative management after palatal surgery, consensus was achieved among all eight, seven, and six panelists for 10%, 30%, and 30% of the papers, respectively. Conclusions: This consensus provides an overview of the work of European sleep surgeons to develop a set of statements on palatal surgery for the treatment of snoring and OSA, the outcomes and follow-up, the complications, and the post-operative management of palatal surgery. We believe that this will be helpful in everyday practice. It also indicates key areas for further studies in sleep surgery.
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Affiliation(s)
- Ewa Olszewska
- Department of Otolaryngology, Sleep Apnea Surgery Center, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Andrea De Vito
- Department of Surgery, Morgagni-Pierantoni Hospital, Health Local Agency of Romagna, 47121 Forlì, Italy
| | - Clemens Heiser
- Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium
- Department of Otorhinolaryngology/Head and Neck Surgery, Klinikum Rechts der Isar, Technical University of Munich, 80333 München, Germany
| | - Olivier Vanderveken
- Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, 2650 Antwerp, Belgium
| | | | - Peter Baptista
- Departmento de Orl, Clinica Universidad da Navarra, 31008 Pamplona, Spain;
| | - Bhik Kotecha
- Nuffield Health Brentwood, Essex, Brentwood CM15 8EH, UK;
- UME Health, 17 Harley Street, London W1G 9QH, UK
| | - Claudio Vicini
- GVM Care & Research ENT Consultant, GVM Primus Medica Center, GVM San Pier Damiano Hospital, 48018 Faenza, Italy;
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Eggink MC, de Wolf MJF, Ebbens FA, de Win MML, Dikkers FG, van Spronsen E. MRI-DWI detection of residual cholesteatoma: moving toward an optimum follow-up scheme. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08939-9. [PMID: 39269619 DOI: 10.1007/s00405-024-08939-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 08/20/2024] [Indexed: 09/15/2024]
Abstract
PURPOSE To analyse diagnostic accuracy of MRI-DWI in detecting residual disease after cholesteatoma surgery and propose an optimum follow-up (FU) scheme. METHOD A retrospective chart review of patients who had cholesteatoma surgery in a tertiary referral centre. 3.0 T non-echo planar diffusion weighted imaging was performed as part of routine FU or indicated on the basis of clinical suspicion of disease. Imaging outcome was verified per-operatively during a second-look procedure or ossicular chain reconstruction. Diagnostic parameters were calculated and stratified by FU length. RESULTS For the FU of 664 cholesteatoma surgeries, 1208 MRI-DWI were obtained and 235 second-look procedures were performed. Most MRI-DWI were obtained within 1.5 yrs of surgery. In this period, significantly less true positive MRI-DWI and significantly more false negative MRI-DWI for residual disease were found compared to other FU periods. Scanning after approximately 3 yrs yielded a significantly higher rate of true positive MRI-DWI, while sensitivity surpassed 80%. Younger patients had a higher risk of developing residual disease. Patients undergoing canal wall up surgery, as well as patients < 12 yrs, were at risk for false negative MRI-DWI. Obliteration reduces the risk of residual disease, while leading to less false negative MRI-DWI. CONCLUSION A novel radiologic FU scheme for detecting residual disease is suggested for stable ears after cholesteatoma surgery: standard MRI-DWI approximately 3 and 5 yrs after primary surgery, as well as MRI-DWI after approximately 9 yrs for patients with specific risk factors (i.e., patients < 12 yrs or patients undergoing canal wall up surgery without obliteration).
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Affiliation(s)
- Maura C Eggink
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam University Medical Centre, Location University of Amsterdam, Amsterdam, The Netherlands.
| | - Maarten J F de Wolf
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam University Medical Centre, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Fenna A Ebbens
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam University Medical Centre, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Maartje M L de Win
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centre, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Frederik G Dikkers
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam University Medical Centre, Location University of Amsterdam, Amsterdam, The Netherlands
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik van Spronsen
- Department of Otorhinolaryngology, Head and Neck Surgery, Amsterdam University Medical Centre, Location University of Amsterdam, Amsterdam, The Netherlands
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Agarwal A, Garg D, Priya S, Bylappa PS, Garg A, Shamim SA, Elhence A, Radhakrishnan DM, Pandit AK, Srivastava AK. Acute bilateral sensorineural hearing loss as presentation of leptomeningeal metastases. Pract Neurol 2024; 24:407-409. [PMID: 38772628 DOI: 10.1136/pn-2024-004167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/23/2024]
Abstract
We describe a rare occurrence of bilateral acute severe sensorineural hearing loss in a middle-aged man that heralded the diagnosis of metastatic gastric cancer.
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Affiliation(s)
| | | | | | | | - Ajay Garg
- Neuroimaging and Interventional Neuroradiology, AIIMS, New Delhi, Delhi, India
| | - Shamim Ahmed Shamim
- Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Anshuman Elhence
- Gastroenterology, All India Institute of Medical Sciences, New Delhi, India
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Fouad A, Mandour M, Tomoum MO, Lasheen RM. Effectiveness of bisphosphonate for alleviating tinnitus associated with otosclerosis: a prospective case-control study. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08935-z. [PMID: 39269620 DOI: 10.1007/s00405-024-08935-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Accepted: 08/19/2024] [Indexed: 09/15/2024]
Abstract
PURPOSE To investigate the short-term efficacy of third-generation bisphosphonate in the management of tinnitus associated with otosclerosis. METHODS A prospective case-control study included 100 patients with otosclerosis-associated bothersome tinnitus. Patients were assigned to two groups: group A (control): 25 patients who planned to receive only complementary supplements, oral vitamin D plus calcium, and group B (case): 75 patients who planned to receive oral bisphosphonate plus routine vitamin D and calcium supplements. Group B was subdivided into B1: 25 patients without any previous intervention, B2: 25 patients with persistent tinnitus for more than 6 months after a previous uncomplicated stapedotomy in the same ear, and B3: 25 patients with persistent tinnitus for more than 6 months after hearing aid fitting. The outcome was tinnitus assessment both subjectively (tinnitus intensity, frequency, and questionnaire) and objectively (tinnitus intensity and frequency). RESULTS The female-to-male ratio was 1.6:1 with ages ranging from 40 to 61 years. The baseline revealed no statistically significant differences between the groups. After 6 months, there were statistically significant differences, both objectively and subjectively. The tinnitus questionnaire median (IQR) for group B was 16 (30), whereas control group A had 52 (24). The tinnitus severity median (IQR) for group B was 20 (30), compared to group A's 52 (42). After 6 months, 40% of the cases in group B demonstrated complete improvement, compared to 0% in control group A. CONCLUSION We demonstrated significant tinnitus improvement in cases treated with bisphosphonate compared to the control group.
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Affiliation(s)
- Ayman Fouad
- Otolaryngology Department, Faculty of Medicine, Tanta University, El Geish St., Tanta, 31527, Gharbeya, Egypt.
| | - Mahmoud Mandour
- Otolaryngology Department, Faculty of Medicine, Tanta University, El Geish St., Tanta, 31527, Gharbeya, Egypt
| | - Mohamed Osama Tomoum
- Otolaryngology Department, Faculty of Medicine, Tanta University, El Geish St., Tanta, 31527, Gharbeya, Egypt
| | - Reham Mamdouh Lasheen
- Otolaryngology Department, Faculty of Medicine, Audiovestibular Unit, Tanta University, Tanta, Egypt
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Arya P, Salmerón Y, Quimby AE, Wong K, Brant JA, Hwa TP. The Impact of Monoclonal Antibody Usage on Hearing Outcomes: A Systematic Review. Laryngoscope 2024. [PMID: 39268884 DOI: 10.1002/lary.31763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 08/20/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024]
Abstract
OBJECTIVE To ascertain trends in ototoxicity observed with monoclonal antibodies (mABs) and understand the impact they may have on hearing function. DATA SOURCES PubMed, Embase, Scopus. REVIEW METHODS A systematic review was performed following PRISMA guidelines. Data were reviewed for demographics, utilized mABs with respective indication and dosing, audiometric outcomes, and treatment for otologic effects. RESULTS Of 757 studies reviewed, a total of 44 were included, encompassing 18,046 patients treated with mABs. Mean age of the sample was 57.8 years old. The search yielded 18 agents of ototoxicity, with reported symptoms of ototoxicity such as hearing loss, tinnitus, and/or aural fullness occurring in 1079 of total patients. Main agents causing ototoxicity were teprotumumab (n = 17/44 studies), nivolumab (n = 10/44), ipilimumab (n = 9/44), pembrolizumab (n = 5/44), and rituximab (n = 4/44). Thirty-one of 44 studies encompassing eight agents reported audiometric data for ototoxic agents, showing sensorineural hearing loss primarily in the high-frequency range. Only two articles performed ultrahigh-frequency audiograms. CONCLUSION Monoclonal antibody usage is expanding, but the vast majority of studies lack substantial audiometric data. Where reported, study design and inclusion criteria vary greatly. Future studies would benefit from rigid inclusion of audiometric data, prospective study design, and consideration of formal ototoxicity screening. Otolaryngologists should be aware of the cochlear immune response and potential impact of this expanding medication class on hearing function. Laryngoscope, 2024.
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Affiliation(s)
- Priya Arya
- Department of Otolaryngology-Head and Neck Surgery, Mercer University School of Medicine, Savannah, Georgia, U.S.A
| | - Yansy Salmerón
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Alexandra E Quimby
- Department of Otorhinolaryngology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Kevin Wong
- Department of Otorhinolaryngology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Jason A Brant
- Department of Otorhinolaryngology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
- Department of Otolaryngology-Head and Neck Surgery, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, U.S.A
| | - Tiffany P Hwa
- Department of Otorhinolaryngology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
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Nuseir A, Alomari A, Alzoubi F. Transmuscular pocket: a modified technique to overcome thick musculocutaneous flap in cochlear implant surgery. Cochlear Implants Int 2024:1-5. [PMID: 39264013 DOI: 10.1080/14670100.2024.2401242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
OBJECTIVE To describe and evaluate a modified cochlear implant surgical procedure for patients with a thick musculocutaneous flap. MATERIALS AND METHODS A prospective study for cochlear implant surgery in selected patients with a musculocutaneous flap thicker than 7 mm. RESULTS Fourteen patients with a thick scalp flap underwent cochlear implantation between July 2019 and December 2020. The patient age ranged between 17 and 53 years. The flap thickness was between 7 mm and 14 mm. The mean follow uptime post operatively was 16.5 months. The cochlear implant receiver coil was successfully implanted using the transmuscular technique without complications and with normal audiological function. CONCLUSION The transmuscular pocket modified technique is a safe and effective method to overcome a thick musculocutaneous flap in cochlear implant surgery.
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Affiliation(s)
- Amjad Nuseir
- Department of Otolaryngology, Jordan University of Science and Technology, Irbid, Jordan
| | - Ahmad Alomari
- Department of Otolaryngology, Jordan University of Science and Technology, Irbid, Jordan
| | - Firas Alzoubi
- Department of Otolaryngology, Jordan University of Science and Technology, Irbid, Jordan
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Lim J, Abily A, Ben Salem D, Gaillandre L, Attye A, Ognard J. Training and validation of a deep learning U-net architecture general model for automated segmentation of inner ear from CT. Eur Radiol Exp 2024; 8:104. [PMID: 39266784 PMCID: PMC11393264 DOI: 10.1186/s41747-024-00508-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 08/21/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND The intricate three-dimensional anatomy of the inner ear presents significant challenges in diagnostic procedures and critical surgical interventions. Recent advancements in deep learning (DL), particularly convolutional neural networks (CNN), have shown promise for segmenting specific structures in medical imaging. This study aimed to train and externally validate an open-source U-net DL general model for automated segmentation of the inner ear from computed tomography (CT) scans, using quantitative and qualitative assessments. METHODS In this multicenter study, we retrospectively collected a dataset of 271 CT scans to train an open-source U-net CNN model. An external set of 70 CT scans was used to evaluate the performance of the trained model. The model's efficacy was quantitatively assessed using the Dice similarity coefficient (DSC) and qualitatively assessed using a 4-level Likert score. For comparative analysis, manual segmentation served as the reference standard, with assessments made on both training and validation datasets, as well as stratified analysis of normal and pathological subgroups. RESULTS The optimized model yielded a mean DSC of 0.83 and achieved a Likert score of 1 in 42% of the cases, in conjunction with a significantly reduced processing time. Nevertheless, 27% of the patients received an indeterminate Likert score of 4. Overall, the mean DSCs were notably higher in the validation dataset than in the training dataset. CONCLUSION This study supports the external validation of an open-source U-net model for the automated segmentation of the inner ear from CT scans. RELEVANCE STATEMENT This study optimized and assessed an open-source general deep learning model for automated segmentation of the inner ear using temporal CT scans, offering perspectives for application in clinical routine. The model weights, study datasets, and baseline model are worldwide accessible. KEY POINTS A general open-source deep learning model was trained for CT automated inner ear segmentation. The Dice similarity coefficient was 0.83 and a Likert score of 1 was attributed to 42% of automated segmentations. The influence of scanning protocols on the model performances remains to be assessed.
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Affiliation(s)
- Jonathan Lim
- Department of Neuroradiology-Brest University Hospital, Boulevard Tanguy Prigent, 29200, Brest, France.
| | - Aurore Abily
- Department of Neuroradiology-Brest University Hospital, Boulevard Tanguy Prigent, 29200, Brest, France
| | - Douraïed Ben Salem
- Department of Neuroradiology-Brest University Hospital, Boulevard Tanguy Prigent, 29200, Brest, France
- Inserm, UMR 1101 (Laboratoire de Traitement de l'Information Médicale-LaTIM), Université de Bretagne Occidentale, 5 Avenue Foch, 29200, Brest, France
| | | | | | - Julien Ognard
- Department of Neuroradiology-Brest University Hospital, Boulevard Tanguy Prigent, 29200, Brest, France
- Inserm, UMR 1101 (Laboratoire de Traitement de l'Information Médicale-LaTIM), Université de Bretagne Occidentale, 5 Avenue Foch, 29200, Brest, France
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Angeli SI, Chang KW. Principles of Cholesteatoma Management. Otolaryngol Clin North Am 2024:S0030-6665(24)00146-4. [PMID: 39266390 DOI: 10.1016/j.otc.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
Surgery for cholesteatoma should be tailored to individual patients, considering demographic and disease factors, to obtain a dry, safe, and functional ear. The EAONO/JOS classification and staging system provide a valuable framework for data collection and outcome assessment. Canal wall-up and canal wall-down surgical approaches each have their advantages and disadvantages, though it is not definitive that one approach is clearly more advantageous than the other. Mastoid obliteration techniques show promise in reducing recidivistic disease rates but require further research and standardization. Endoscopic ear surgery further augments our surgical capabilities to visualize and eradicate cholesteatoma.
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Affiliation(s)
- Simon I Angeli
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kay W Chang
- Department of Otolaryngology, Stanford University, Palo Alto, CA, USA.
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Karabulut M, Viechtbauer W, Van Laer L, Mohamad A, Van Rompaey V, Guinand N, Perez Fornos A, Gerards MC, van de Berg R. Chronic Unilateral Vestibular Hypofunction: Insights into Etiologies, Clinical Subtypes, Diagnostics and Quality of Life. J Clin Med 2024; 13:5381. [PMID: 39336868 PMCID: PMC11432443 DOI: 10.3390/jcm13185381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 09/06/2024] [Accepted: 09/09/2024] [Indexed: 09/30/2024] Open
Abstract
Background/Objectives: Chronic unilateral vestibular hypofunction (UVH) can lead to disabling vestibular symptoms and a decrease in quality of life. The aim of this study was to investigate etiologies, clinical subtypes, symptoms, and quality of life (QoL) in patients with chronic UVH. Methods: A retrospective study was performed on 251 UVH patients in a tertiary referral center. Inclusion criteria comprised reduced or absent caloric responses, with a caloric asymmetry ratio ≥25%. Patients with central vestibular pathology, symptom duration <3 months, and incomplete responses to questionnaires were excluded. Patient records were assessed for etiologies, secondary vestibular diagnoses, clinical subtypes, and questionnaires related to QoL. Additionally, multiple linear regression analysis was performed to evaluate factors influencing QoL. Results: Thirteen different etiologies were identified, with Menière's Disease as the most prevalent (31%, n = 79). The most frequently reported secondary vestibular diagnoses were benign paroxysmal positional vertigo (BPPV) (21%, n = 54) and persistent postural perceptual dizziness (PPPD) (19%, n = 47). Five distinct clinical subtypes were identified: recurrent vertigo with UVH (47%), rapidly progressive UVH (25%), idiopathic/unknown UVH (18%), slowly progressive UVH (8%), and congenital UVH (2%). Over 80% of UVH patients experienced moderate-to-severe handicap, as indicated by the Dizziness Handicap Inventory. Approximately 20-25% of UVH patients exhibited moderate-to-severe depression and anxiety, based on the Hospital Anxiety and Depression Scale. Multiple linear regression analyses demonstrated that the presence of PPPD significantly reduced QoL in chronic UVH patients. Conclusions: Chronic UVH is a heterogeneous disorder. Secondary vestibular diagnoses like BPPV and PPPD often co-exist and can significantly impact QoL. A structured diagnostic approach and tailored interventions are crucial to address the diverse needs of UVH patients.
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Affiliation(s)
- Mustafa Karabulut
- Division of Vestibular Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, Maastricht University, 6229HX Maastricht, The Netherlands
| | - Lien Van Laer
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Science, University of Antwerp, 2000 Antwerp, Belgium
- Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp, 2000 Antwerp, Belgium
| | - Alfarghal Mohamad
- Department of Ear Nose Throat, King Abdul Aziz Medical City, Jeddah 22384, Saudi Arabia
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium
| | - Nils Guinand
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Angélica Perez Fornos
- Service of Otorhinolaryngology Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Marie-Cecile Gerards
- Division of Vestibular Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands
| | - Raymond van de Berg
- Division of Vestibular Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, School for Mental Health and Neuroscience, Maastricht University Medical Center, 6229HX Maastricht, The Netherlands
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Neeff M, Broderick D, Douglas RG, Biswas K. Anaerobic bacteria dominate the cholesteatoma tissue of chronic suppurative otitis media patients. Microb Pathog 2024; 196:106935. [PMID: 39270753 DOI: 10.1016/j.micpath.2024.106935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 08/19/2024] [Accepted: 09/10/2024] [Indexed: 09/15/2024]
Abstract
The aim of this study was to investigate both the microbial composition and absolute abundance of clinically relevant bacteria in tissue specimens from patients with chronic suppurative otitis media with cholesteatoma (CSOM with cholesteatoma). Mastoid mucosa and cholesteatoma tissue from eleven subjects with CSOM with cholesteatoma, and mastoid mucosa from ten controls were examined using standard hospital culture swabs, Gram staining, bacterial 16S rRNA gene sequencing, Droplet Digital PCR (ddPCR), and multiplex PCR. Positive results from culture swabs were reported in half the CSOM with cholesteatoma samples and 1 control sample. In contrast, ddPCR detected bacterial genes copies in all 11 mucosa and cholesteatoma of CSOM subjects and 3 control samples. The average bacterial gene copies in tissue samples with CSOM with cholesteaotoma (1.6 ± 0.7 log10) was significantly higher compared to healthy controls (0.3 ± 1.6). These results were corroborated with Gram-staining that identified the large presence of Gram-positive cocci cells in the cholesteatoma tissue of CSOM subjects which were not seen in the mucosa of controls. The most abundant genus detected by sequencing in the mucosa and cholesteatoma of CSOM samples was Anaerococcus (93.5% of all reads), and genus Meiothermus (0.9%) in the control sample. The 3 samples with the highest sequencing reads (>300) were further analysed using multiplex PCR to identify the dominant Anaerococcus species. Anaerococcus hydrogenalis was the dominant species identified in these samples. In contract, commonly named ear pathogens, genera Staphylococcus and Pseudomonas, were detected in low numbers (<0.001% of all sequencing reads) and low prevalence (2/16 samples) in the tissue samples of this study. The results show that culture severely underestimated the bacterial diversity in CSOM samples and investigating tissue rather than standard culture swabs might be advantageous to understanding the disease process. The high abundance of bacteria and the large presence of Gram-positive cells detected in the cholesteatoma tissue of CSOM compared to mucosa of CSOM or controls could be members from the genus Anaerococcus. Anaerococcus may well be a pathogen in CSOM with cholesteatoma, but their role in this condition requires further investigation.
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Affiliation(s)
- Michel Neeff
- Department of Surgery, The University of Auckland, Auckland, 1023, New Zealand; Te Whatu Ora - Te Toka Tumai Auckland, Health New Zealand, Auckland 1142, New Zealand
| | - David Broderick
- Department of Surgery, The University of Auckland, Auckland, 1023, New Zealand
| | - Richard G Douglas
- Department of Surgery, The University of Auckland, Auckland, 1023, New Zealand; Te Whatu Ora - Te Toka Tumai Auckland, Health New Zealand, Auckland 1142, New Zealand
| | - Kristi Biswas
- Department of Surgery, The University of Auckland, Auckland, 1023, New Zealand.
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Taghizade T, Akbarzadeh-Baghban A, Navab Safa N. The effect of cold plasma on the treatment of external otitis: an experimental study in rats. AMB Express 2024; 14:101. [PMID: 39261403 PMCID: PMC11390991 DOI: 10.1186/s13568-024-01748-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 08/08/2024] [Indexed: 09/13/2024] Open
Abstract
In this paper we investigate the influence of cold plasma as novel method on the external otitis treatment which is a frequent cause of earache. 24 infected external auditory canals in 24 rats were categorized in four experimental groups including control, plasma exposed, ciprofloxacin drug and mixed of plasma-ciprofloxacin groups. In plasma group, dielectric barrier discharge was employed as the source of cold plasma in 5 days. All rats were observed with otoscope daily and a scoring system was used to evaluate swelling and effusion of the ear canal. Number of colonies in microbiological culture were counted in each group during the first 5 days after treatment. For the multiple group comparisons of swelling and effusion measured in the external auditory canal, Kruskal-Wallis analysis was applied and one-way anova and Kruskal-Wallis analysis was used for the statistical analysis of the results of the cultures in different days. Also, Tukey and Mann-Whitney tests was applied for multiple comparisons. Our findings show that swelling and effusion were obviously reduced in plasma group compared to control group (P < 0.01). Number of colonies in control group was statistically different from those in drug, plasma, and mixed group on the second to fifth day (p < 0.001). According to the results cold plasma can be introduced as an impressive method for external otitis treatment. Moreover, when cold plasma joined to antibiotic method, it leads to a superior performance respecting plasma or antibiotic method alone.
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Affiliation(s)
- Tayebe Taghizade
- Department of Audiology, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh-Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Navab Safa
- Department of Physics, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
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Shoushtarian M, Esmaelpoor J, Bravo MMG, Fallon JB. Cochlear implant induced changes in cortical networks associated with tinnitus severity. J Neural Eng 2024; 21:056009. [PMID: 39178903 DOI: 10.1088/1741-2552/ad731d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 08/23/2024] [Indexed: 08/26/2024]
Abstract
Objective.We investigated tinnitus-related cortical networks in cochlear implant users who experience tinnitus and whose perception of tinnitus changes with use of their implant. Tinnitus, the perception of unwanted sounds which are not present externally, can be a debilitating condition. In individuals with cochlear implants, use of the implant is known to modulate tinnitus, often improving symptoms but worsening them in some cases. Little is known about underlying cortical changes with use of the implant, which lead to changes in tinnitus perception. In this study we investigated whether changes in brain networks with the cochlear implant turned on and off, were associated with changes in tinnitus perception, as rated subjectively.Approach.Using functional near-infrared spectroscopy, we recorded cortical activity at rest, from 14 cochlear implant users who experienced tinnitus. Recordings were performed with the cochlear implant turned off and on. For each condition, participants rated the loudness and annoyance of their tinnitus using a visual rating scale. Changes in neural synchrony have been reported in humans and animal models of tinnitus. To assess neural synchrony, functional connectivity networks with the implant turned on and off, were compared using two network features: node strength and diversity coefficient.Main results.Changes in subjective ratings of loudness were significantly correlated with changes in node strength, averaged across occipital channels (r=-0.65, p=0.01). Changes in both loudness and annoyance were significantly correlated with changes in diversity coefficient averaged across all channels (r=-0.79,p<0.001 and r=-0.86,p<0.001). More distributed connectivity with the implant on, compared to implant off, was associated with a reduction in tinnitus loudness and annoyance.Significance.A better understanding of neural mechanisms underlying tinnitus suppression with cochlear implant use, could lead to their application as a tinnitus treatment and pave the way for effective use of other less invasive stimulation-based treatments.
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Affiliation(s)
- Mehrnaz Shoushtarian
- The Bionics Institute, East Melbourne, Victoria, Australia
- Medical Bionics Department, The University of Melbourne, Melbourne, Australia
| | - Jamal Esmaelpoor
- The Bionics Institute, East Melbourne, Victoria, Australia
- Medical Bionics Department, The University of Melbourne, Melbourne, Australia
| | | | - James B Fallon
- The Bionics Institute, East Melbourne, Victoria, Australia
- Medical Bionics Department, The University of Melbourne, Melbourne, Australia
- Department of Otolaryngology, The University of Melbourne, Melbourne, Australia
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González-García M, Prieto-Sánchez-de-Puerta L, Domínguez-Durán E, Sánchez-Gómez S. Auditory Prognosis of Patients With Sudden Sensorineural Hearing Loss in Relation to the Presence of Acute Vestibular Syndrome: A Systematic Literature Review and Meta-Analysis. Ear Hear 2024:00003446-990000000-00340. [PMID: 39252156 DOI: 10.1097/aud.0000000000001576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Abstract
OBJECTIVES Hearing recovery following idiopathic sudden sensorineural hearing loss (ISSNHL) is influenced by various prognostic factors, and the presence of acute vestibular syndrome (AVS) may adversely impact auditory outcomes. Evaluating vestibular function in SSNHL patients could offer insights into predicting hearing recovery. This systematic review aims to assess whether the presence of AVS exacerbates the audiological prognosis of ISSNHL. DESIGN A comprehensive systematic review was conducted using databases such as PubMed, Cochrane Library, EMBASE, and Scopus, encompassing articles published in the last decade. Included were retrospective and prospective case-control and cohort studies, as well as randomized clinical trials. Meta-analysis was performed based on the findings from these studies. RESULTS Among 386 articles identified, six addressed the systematic review's question, all being retrospective studies. These articles collectively involved 393 patients for the meta-analysis. Vestibular function assessment methods varied widely, posing challenges for direct comparisons. The likelihood of unfavorable hearing outcomes was 2.29 times higher in patients with associated AVS. Hearing recovery was 3.22 times more likely to be worse in patients with altered cervical vestibular evoked myogenic potentials-air-conducted sound. Abnormal caloric test results showed no significant association with worse hearing prognosis, although patients with unaltered caloric tests demonstrated a significantly greater improvement in pure-tone audiometry. CONCLUSIONS Hearing recovery from ISSNHL appears to be diminished in patients with associated AVS and abnormal vestibular test results.
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Affiliation(s)
| | | | - Emilio Domínguez-Durán
- Department of Otolaryngology, Hospital Universitario Virgen Macarena, Seville, Spain
- Department of Otolaryngology, Hospital QuironSalud "Infanta Luisa", Seville, Spain
| | - Serafín Sánchez-Gómez
- Department of Otolaryngology, Hospital Universitario Virgen Macarena, Seville, Spain
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Tramontano M, Casagrande Conti L, Orejel Bustos AS, Ferri N, Lelli T, Nocentini U, Grasso MG, Turolla A, Pillastrini P, Manzari L. Abnormal Vestibulo-Ocular Reflex Function Correlates with Balance and Gait Impairment in People with Multiple Sclerosis. Audiol Res 2024; 14:799-808. [PMID: 39311220 PMCID: PMC11417908 DOI: 10.3390/audiolres14050067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Revised: 08/30/2024] [Accepted: 09/06/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Multiple Sclerosis (MS) is the most prevalent autoimmune neurological condition in the world, leading to a wide variety of symptoms, including balance disorders. OBJECTIVE To evaluate the angular vestibulo-ocular reflex (aVOR) of all six semicircular canals (SCCs) through Head Impulse (HIMP) and Suppression HIMP (SHIMP) paradigms and any correlations with clinical balance scales. METHODS All participants were assessed using the Expanded Disability Status Scale (EDSS), Berg Balance Scale (BBS), and Mini-BESTest (MBT). Vestibular function was measured by video Head Impulse Test (vHIT), obtaining aVOR gain for each SSC. RESULTS Twenty-seven PwMS (mean age 47.93 ± 8.51 years old, 18 females) were recruited. Most of the patients (81.48%) presented abnormal aVOR gains for at least one SSC. A moderate to strong correlation between aVOR gains of the left anterior SSC and, respectively, the MBT and the BBS was found. The subgroup analysis, based on the EDSS class, confirmed the correlation with the BBS in the patients with the most significant disability. CONCLUSIONS People with MS may present impairments of the aVOR in one or more semicircular canals. The aVOR gain impairment of the vertical semicircular canals correlates with balance and gait disorders identified through clinical scales in PwMS.
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Affiliation(s)
- Marco Tramontano
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy; (N.F.); (A.T.); (P.P.)
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Laura Casagrande Conti
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy; (L.C.C.); (A.S.O.B.); (T.L.); (U.N.); (M.G.G.)
| | - Amaranta Soledad Orejel Bustos
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy; (L.C.C.); (A.S.O.B.); (T.L.); (U.N.); (M.G.G.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Nicola Ferri
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy; (N.F.); (A.T.); (P.P.)
| | - Tommaso Lelli
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy; (L.C.C.); (A.S.O.B.); (T.L.); (U.N.); (M.G.G.)
| | - Ugo Nocentini
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy; (L.C.C.); (A.S.O.B.); (T.L.); (U.N.); (M.G.G.)
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Maria Grazia Grasso
- Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy; (L.C.C.); (A.S.O.B.); (T.L.); (U.N.); (M.G.G.)
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy; (N.F.); (A.T.); (P.P.)
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy; (N.F.); (A.T.); (P.P.)
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
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Fennessy JR, Cornett KMD, Donlevy GA, Mckay MJ, Burns J, Menezes MP. Long-term outcomes in children with riboflavin transporter deficiency and surveillance recommendations. Dev Med Child Neurol 2024. [PMID: 39252496 DOI: 10.1111/dmcn.16083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/03/2024] [Accepted: 08/07/2024] [Indexed: 09/11/2024]
Abstract
The aim of this longitudinal case series was to describe long-term functional outcome in a group of individuals with riboflavin transporter deficiency (RTD) treated with high-dose oral riboflavin. Data were collected between 2012 to 2022. Eleven individuals with RTD were assessed at 12-month intervals for monitoring of disease progression. Patients had commenced high-dose oral riboflavin from the time of genetic diagnosis. Individuals for whom riboflavin supplementation was initiated early after disease onset had better outcomes compared to those in whom diagnosis was delayed. Despite ongoing riboflavin supplementation, the Charcot-Marie-Tooth disease Pediatric Scale (CMTPedS) total score and the subitems of balance and the 6-Minute Walk Test distance as well as respiratory function worsened, while grip strength improved. There was evidence of improvement in hearing loss and optic atrophy limited to the first 12 months of treatment. While treatment with riboflavin slowed disease progression, patients were left with residual disability. To track disease progression and response to riboflavin supplementation over time, we recommend using the RTD Pediatric Scale and provide a list of clinical measures for regular surveillance of children with RTD.
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Affiliation(s)
- Jack R Fennessy
- Faculty of Medicine and Health, University of Sydney School of Health Sciences, Sydney, New South Wales, Australia
| | - Kayla M D Cornett
- Faculty of Medicine and Health, University of Sydney School of Health Sciences, Sydney, New South Wales, Australia
- Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Gabrielle A Donlevy
- Faculty of Medicine and Health, University of Sydney School of Health Sciences, Sydney, New South Wales, Australia
- Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Marnee J Mckay
- Faculty of Medicine and Health, University of Sydney School of Health Sciences, Sydney, New South Wales, Australia
| | - Joshua Burns
- Faculty of Medicine and Health, University of Sydney School of Health Sciences, Sydney, New South Wales, Australia
- Paediatric Gait Analysis Service of New South Wales, Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Manoj P Menezes
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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