51
|
Heilingoetter AL, See GB, Brookes J, Campisi P, Cervantes SS, Chadha NK, Chelius D, Chen D, Chun B, Cunningham MJ, D'Souza JN, Din T, Dzongodza T, Francom C, Gallagher TQ, Gerber ME, Gorelik M, Goudy S, Graham ME, Hartley B, Hazkani I, Hong P, Hsu WC, Isaac A, Jatana KR, Johnston DR, Kabagenyi F, Kazahaya K, Koempel J, Leboulanger N, Luscan R, Maurrasse SE, Mercier E, Peer S, Preciado D, Rahbar R, Rastatter J, Richter G, Rosenblatt SD, Shay SG, Sheyn A, Tassew Y, Walz PC, Whigham AS, Wiedermann JP, Yeung J, Maddalozzo J. Comprehensive management and classification of first branchial cleft anomalies: An International Pediatric Otolaryngology Group (IPOG) consensus statement. Int J Pediatr Otorhinolaryngol 2024; 186:112095. [PMID: 39278130 DOI: 10.1016/j.ijporl.2024.112095] [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: 07/26/2024] [Revised: 09/01/2024] [Accepted: 09/06/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVE First branchial cleft anomalies are rare congenital head and neck lesions. Literature pertaining to classification, work up and surgical treatment of these lesions is limited and, in some instances, contradictory. The goal of this work is to provide refinement of the classification system of these lesions and to provide guidance for clinicians to aid in the comprehensive management of children with first branchial cleft anomalies. MATERIALS AND METHODS Delphi method survey of expert opinion under the direction of the International Pediatric Otolaryngology Group (IPOG) was conducted to generate recommendations for the definition and management of first branchial cleft anomalies. The recommendations are the result of expert consensus and critical review of the literature. RESULTS Consensus recommendations include evaluation and diagnostic considerations for children with first branchial cleft anomalies as well as recommendations for surgical management. The current Work classification system was reviewed, and modifications were made to it to provide a more cogent categorization of these lesions. CONCLUSION The mission of the International Pediatric Otolaryngology Group (IPOG) is to develop expertise-based recommendations based on review of the literature for the management of pediatric otolaryngologic disorders. These consensus recommendations are aimed at improving care of children presenting with first branchial cleft anomalies. Here we present a revised classification system based on parotid gland involvement, with a focus on avoiding stratification based on germ layer, in addition to guidelines for management.
Collapse
Affiliation(s)
| | - Goh Bee See
- National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | | | - Paolo Campisi
- The Hospital for Sick Children (SikKids), Ontario, Canada
| | | | - Neil K Chadha
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | | | - Diane Chen
- Riley Children's Hospital, Indianapolis, IN, USA
| | - Bob Chun
- Children's Wisconsin, Milwaukee, WI, USA
| | - Michael J Cunningham
- Harvard Medical School, Boston, MA, USA; Boston Children's Hospital, Boston, MA, USA
| | - Jill N D'Souza
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Taseer Din
- Sidra/Weill Cornell Medicine, Ar-Rayyan, Qatar
| | | | - Christian Francom
- University of Colorado School of Medicine, Aurora, CO, USA; Children's Hospital of Colorado, Aurora, CO, USA
| | - Thomas Q Gallagher
- Children's Hospital of the King's Daughters, Norfolk, VA, USA; Eastern Virginia Medical School, Norfolk, VA, USA
| | | | | | - Steven Goudy
- Emory University, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA
| | | | | | - Inbal Hazkani
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA
| | - Paul Hong
- IWK Health Centre, Nova Scotia, Canada
| | - Wei-Chung Hsu
- National Taiwan University Hospital Children's Hospital, Taipei, Taiwan
| | - Andre Isaac
- Stollery Children's Hospital, Alberta, Canada
| | - Kris R Jatana
- Nationwide Children's Hospital, Columbus, OH, USA; The Ohio State University, Columbus, OH, USA
| | | | | | - Ken Kazahaya
- University of Pennsylvania, Philadelphia, PA, USA; Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jeff Koempel
- Children's Hospital of Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, Los Angeles, CA, USA
| | | | - Romain Luscan
- Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | | | | | - Shazia Peer
- University of Cape Town, Cape Town, South Africa; Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | | | | | | | | | | | | | - Anthony Sheyn
- LeBonheur Children's Hospital, Memphis, TN, USA; University of Tennessee Health Science Center, Memphis, TN, USA
| | - Yilkal Tassew
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Patrick C Walz
- The Ohio State University, Columbus, OH, USA; Makerere University, Kampala, Uganda
| | - Amy S Whigham
- Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | | | - Jeffrey Yeung
- Montreal Children's Hospital, Quebec, Canada; McGill University Health Centre, Quebec, Canada
| | - John Maddalozzo
- Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA.
| |
Collapse
|
52
|
Takeda T, Takeda S, Kakigi A. The clinical manifestation and treatment of Meniere's Disease from the viewpoint of the water homeostasis of the inner ear. Auris Nasus Larynx 2024; 51:905-910. [PMID: 39244939 DOI: 10.1016/j.anl.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] [Received: 06/25/2024] [Revised: 07/29/2024] [Accepted: 08/08/2024] [Indexed: 09/10/2024]
Abstract
Endolymphatic hydrops, a pathological feature of Ménière's disease, has been experimentally and clinically confirmed to be influenced by the blood circulation of vasopressin (VP). VP is a well-known hormonal regulator of water homeostasis. In addition, VP is influenced by various environmental changes, dehydration, fluctuation of atmospheric pressure, pregnancy, and other factors. Furthermore, VP is a key regulator of the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is a major neuroendocrine system that controls reactions to emotional and physical stresses, as well as the sleep/wake cycle (circadian rhythm). Therefore, VP is susceptible to change via the HPA axis. This review considers possible mechanisms of the formation of endolymphatic hydrops from the perspective of the vasopressin-aquaporin 2 system.
Collapse
Affiliation(s)
- Taizo Takeda
- Department of Otolaryngology, Kochi Medical School, Nankoku, Kochi, Japan
| | | | - Akinobu Kakigi
- Department of Otolaryngology-Head & Neck Surgery, Kobe University, Graduate School of Medicine, Hyogo, Japan.
| |
Collapse
|
53
|
Cooperman SP, Wong K, Hwa TP, Alyono J. Recidivism and Recurrence. Otolaryngol Clin North Am 2024:S0030-6665(24)00107-5. [PMID: 39244459 DOI: 10.1016/j.otc.2024.07.010] [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: 09/09/2024]
Abstract
Recidivistic cholesteatoma encompasses residual as well as recurrent disease, and can occur in up to 61% of cases. Pediatric disease may have a higher propensity for recidivism. Serial physical examination and MRI including non-EPI DWI sequences are useful in surveillance. Canal wall down approaches with mastoid obliteration may be an approach to reduce recidivism while minimizing the need for mastoid cavity maintenance. Modern techniques of Eustachian tube dilation and endoscopic ear surgery may yet prove particularly helpful in reducing re-retraction and residual disease in the retrotympanum, respectively; however, they require further study.
Collapse
Affiliation(s)
- Shayna Portanova Cooperman
- Department of Otolaryngology -- Head and Neck Surgery, Stanford Medicine, 801 Welch Road, Stanford, CA 94305, USA.
| | - Kevin Wong
- Department of Otorhinolaryngology: Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 5 Ravdin, Philadelphia, PA 19140, USA
| | - Tiffany Peng Hwa
- Department of Otorhinolaryngology: Head and Neck Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 5 Ravdin, Philadelphia, PA 19140, USA
| | - Jennifer Alyono
- Department of Otolaryngology -- Head and Neck Surgery, Stanford Medicine, 801 Welch Road, Stanford, CA 94305, USA
| |
Collapse
|
54
|
Ertugrul G, Comert A, Aykul Yagcioglu A. Audio-Vestibular Evaluation of Pediatric Pseudo-Conductive Hearing Loss: Third Window Syndromes. Audiol Res 2024; 14:790-798. [PMID: 39311219 PMCID: PMC11417840 DOI: 10.3390/audiolres14050066] [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: 08/07/2024] [Revised: 09/02/2024] [Accepted: 09/05/2024] [Indexed: 09/26/2024] Open
Abstract
Conductive hearing loss caused by external or middle ear problems prevents the transmission of sound waves from the external auditory canal to the cochlea, and it is a common condition, especially in pediatric patients aged 1-5 years. The most common etiological factors are otitis media and cerumen during childhood. In some patients, external and middle ear functions and structures may be normal bilaterally despite the air-bone gap on the audiogram. This condition, which is often a missed diagnosis in children, is defined as a pseudo-conductive hearing loss (PCHL) caused by third window syndromes (TWSs) such as semicircular canal dehiscence, inner ear malformations with third window effect, and perilymphatic fistula. In this review of the literature, the authors emphasize the pitfalls of pediatric audio-vestibular evaluation on TWSs as well as the key aspects of this evaluation for the differential diagnosis of PCHL brought on by TWSs. This literature review will provide audiologists and otologists with early diagnostic guidance for TWSs in pediatric patients.
Collapse
Affiliation(s)
- Gorkem Ertugrul
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, 06230 Ankara, Turkey
| | - Aycan Comert
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, 06230 Ankara, Turkey
| | - Aysenur Aykul Yagcioglu
- Department of Audiology, Faculty of Health Sciences, KTO Karatay University, 42020 Konya, Turkey
| |
Collapse
|
55
|
Chen L, Fu Y, He A, Liu N, Chen Y, Li C, Zhang T. The ideal range of laser hair removal for microtia patients undergoing two-stage ear reconstruction. Lasers Med Sci 2024; 39:234. [PMID: 39240409 DOI: 10.1007/s10103-024-04138-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 07/11/2024] [Indexed: 09/07/2024]
Abstract
Although the technologies for auricular reconstruction in microtia have improved, issues such as low hairlines or excessive hair growth can still pose aesthetic problems for the reconstructed ear. Laser depilation has been reported as a solution for hair problems. However, few studies have discussed the appropriate region for hair removal. A retrospective analysis was performed on 276 patients with unilateral microtia who underwent the Nagata two-stage ear reconstruction. The gender ratio of male to female was 2.5 (198 males/78 females). Intense pulsed light depilation was used to remove hair. To determine the proper hair removal area, we measured the extent of hair removal. Before the first stage, the average vertical distance between the upper point (after localization) and hairline was 3.42 ± 4.75 mm (-10-20 mm). After the first stage, the average vertical distance between the upper point of the reconstructed ear and the hairline was 1.27 ± 2.41 mm (-10-15 mm). By using chi-square test to assess differences in hair removal success rates among various regions, we aimed to identify the suitable depilation region. Before the first stage, a depilation vertical distance ≥ 10 mm led to a 92.1% success rate. After the first stage surgery, among the patients needing additional hair removal, a vertical depilation distance ≥ 4 mm resulted in an 81.3% success rate. Based on our observation, we suggested that a depilation region of ≥ 10 mm (before the first surgery) or ≥ 4 mm (after the first surgery) would be the ideal range for laser hair removal.
Collapse
Affiliation(s)
- Lili Chen
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- ENT institute, Shanghai, China, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Yaoyao Fu
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- ENT institute, Shanghai, China, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Aijuan He
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Ninghua Liu
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Ying Chen
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
- ENT institute, Shanghai, China, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Chenlong Li
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
- ENT institute, Shanghai, China, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Hearing Medicine, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
| | - Tianyu Zhang
- Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
- ENT institute, Shanghai, China, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
- NHC Key Laboratory of Hearing Medicine, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China.
| |
Collapse
|
56
|
Alfonso KP, Alford BR. Congenital Cholesteatoma. Otolaryngol Clin North Am 2024:S0030-6665(24)00120-8. [PMID: 39244457 DOI: 10.1016/j.otc.2024.07.023] [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: 09/09/2024]
Abstract
Congenital cholesteatoma is a cyst of keratinizing squamous cell epithelium in the setting of an intact tympanic membrane, in a patient without a history of otorrhea, tympanic membrane perforation, or otologic surgery. The most common presentation of a congenital cholesteatoma is that of an asymptomatic pearly white mass in the anterosuperior quadrant of the tympanic cavity. The etiology of congenital cholesteatoma has been debated at length, with the leading theory being the epithelial rest theory. Treatment for congenital cholesteatoma is surgical, with advances in endoscopic ear surgery allowing for improved intraoperative visualization and postoperative lowered recidivism rates.
Collapse
Affiliation(s)
- Kristan P Alfonso
- Department of Otolaryngology, Texas Children's Hospital, 6701 Fannin Street, D.640, Houston, TX 77030, USA; Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Bobby R Alford
- Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
57
|
Zarus GM, Ruiz P, Benedict R, Brenner S, Carlson K, Jeong L, Morata TC. Which Environmental Pollutants Are Toxic to Our Ears?-Evidence of the Ototoxicity of Common Substances. TOXICS 2024; 12:650. [PMID: 39330578 PMCID: PMC11435700 DOI: 10.3390/toxics12090650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/28/2024]
Abstract
Ototoxicity refers to the adverse effects of substances on auditory or vestibular functions. This study examines the evidence of ototoxicity's association with exposure to common environmental pollutants, as documented in toxicological profiles by the Agency for Toxic Substances and Disease Registry. Our aim was to evaluate whether the evidence supports modifying the charting of ototoxic effects in the summary tables of these toxicological profiles and providing a guide for scientists to access these data. Health outcomes of interest included hearing loss, vestibular effects, cochlear lesions, tonal alterations, cellular damage, and ototoxicity-related outcomes (neurological, nephrotoxic, hepatic, and developmental effects). We obtained ototoxicity information for 62 substances. Hearing-related effects were reported, along with neurological effects. Overall, 26 profiles reported strong evidence of ototoxicity, including 13 substances previously designated as ototoxic by other health and safety agencies. Commonly studied outcomes included hearing loss, damage to ear anatomy, and auditory dysfunction. Vestibular dysfunction and tinnitus are rarely studied. Our findings highlight the lack of conclusive evidence of ototoxic properties for many substances, especially for pesticides and herbicides. This review supports charting the evidence of ototoxicity separately in toxicological profiles' summary tables. Improving the communication of ototoxicity-related health effects might impact their recognition and prompt further research. A stronger evidence base could support improved prevention efforts in terms of serious health outcomes.
Collapse
Affiliation(s)
- Gregory M. Zarus
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, GA 30341, USA; (P.R.); (R.B.); (S.B.)
| | - Patricia Ruiz
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, GA 30341, USA; (P.R.); (R.B.); (S.B.)
| | - Rae Benedict
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, GA 30341, USA; (P.R.); (R.B.); (S.B.)
| | - Stephan Brenner
- Agency for Toxic Substances and Disease Registry, Office of Innovation and Analytics, Atlanta, GA 30341, USA; (P.R.); (R.B.); (S.B.)
| | - Krystin Carlson
- National Institute for Occupational Safety and Health, Cincinnati, OH 45226, USA; (K.C.); (T.C.M.)
| | - Layna Jeong
- Georgia Tech School of Biological Sciences, Atlanta, GA 30332, USA;
| | - Thais C. Morata
- National Institute for Occupational Safety and Health, Cincinnati, OH 45226, USA; (K.C.); (T.C.M.)
| |
Collapse
|
58
|
Valsted SS, Larsen AT, Callesen HE, Hougaard DD. A Comparison of the Efficacy of Four Repositioning Maneuvers in the Treatment of Posterior Benign Paroxysmal Positional Vertigo. Am J Audiol 2024; 33:1008-1022. [PMID: 38900988 DOI: 10.1044/2024_aja-23-00177] [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: 06/22/2024] Open
Abstract
PURPOSE The purpose of the present review was to report the effectiveness of Epley maneuver compared to other manual repositioning maneuvers (RM) for treatment of posterior benign paroxysmal positional vertigo (P-BPPV). A systematic search of PubMed, Embase, and the Cochrane Library was conducted up until June 30, 2023. RESULTS Primary outcomes focused on complete resolution of vertiginous symptoms measured by either a Visual Analog Scale (VAS) or the Dix-Hallpike (DH) test. Secondary outcomes included conversion of a positive DH test to a negative DH test exclusively looking at positional nystagmus and assessment of side effects (cervical/back pain, posttreatment dizziness, and nausea). Both outcomes were assessed within a maximum of 4-week follow-up. Following systematic search and review, nine randomized controlled trials (RCTs; p = .413) were found. The studies reported on the effectiveness of the Epley maneuver compared to three other specific RM: Semont, Li, and Gans maneuvers. Results revealed a low to very low certainty of evidence. With the primary outcomes, Epley maneuver was superior to Gans maneuver 24-hr posttreatment but not after 1 week. No significant differences were found between the remaining maneuvers. CONCLUSIONS In summary, evidence of low to very low certainty indicates that Epley maneuver is comparable with Semont, Gans, and Li maneuvers for vertiginous symptoms in patients with P-BPPV. Further high-quality studies are needed.
Collapse
Affiliation(s)
- Sebastian Satkunasingam Valsted
- Department of Clinical Medicine, Aalborg University Hospital, Denmark
- Balance & Dizziness Center, Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Denmark
| | | | | | - Dan Dupont Hougaard
- Department of Clinical Medicine, Aalborg University Hospital, Denmark
- Balance & Dizziness Center, Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Denmark
| |
Collapse
|
59
|
Chang HY, Lo TS. Validation of a Bluetooth Self-Fitting Device for People With Mild-to-Moderate Hearing Loss in Quiet or Noisy Environments. Am J Audiol 2024; 33:882-894. [PMID: 39024518 DOI: 10.1044/2024_aja-23-00230] [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: 07/20/2024] Open
Abstract
PURPOSE The purpose of this study was to evaluate the benefits of a Bluetooth self-fitting device using an in situ hearing screening test and self-fitting processes. METHOD Thirty Mandarin-speaking individuals (16 men and 14 women) with mild-to-moderate hearing loss participated in this study. The hearing screening test was conducted using neckband earphones of a Bluetooth self-fitting device controlled by a smartphone app. The hearing screening tests were compared with the pure-tone audiometry in an audiometric booth. The amplification benefits of the self-fitting program-aided condition were evaluated and compared with those of unaided and preset program-aided conditions using the Mandarin Hearing in Noise Test (MHINT) and questionnaires. RESULTS The pure-tone audiometry and hearing screening test results exhibited strong positive correlations at all test frequencies. In the environment with 90° noise, the sentence reception thresholds (SRTs) obtained for the self-fitting program-aided condition were significantly lower (p = .032) than those obtained for the unaided condition, whereas no significant difference was observed between the preset program-aided and the unaided conditions. Moreover, the participants' satisfaction ratings for the devices were consistent with their MHINT results, with a strong positive correlation observed between satisfaction with self-fitting and user satisfaction in smartphone app's control, functionality, and learning. Younger participants were significantly more satisfied in learning to use the app. CONCLUSIONS Bluetooth self-fitting devices can be used for simplified in situ hearing screenings with a sensitivity of 90.4%. The satisfaction ratings and improvements in SRTs indicate significant clinical benefits of the self-fitting program compared with the preset program, particularly in the 90°-noise environments.
Collapse
Affiliation(s)
- Hung-Yue Chang
- Department of Mechanical Engineering, National Chung Hsing University, Taichung, Taiwan
| | - Tun-Shin Lo
- Department of Speech Language Pathology and Audiology, Chung Shan Medical University, Taichung, Taiwan
- Department of Otolaryngology, Chung Shan Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
60
|
Jafari Z, Fitzpatrick EM, Schramm DR, Rouillon I, Koravand A. Prognostic Value of Electrophysiological and MRI Findings for Pediatric Cochlear Implant Outcomes: A Systematic Review. Am J Audiol 2024; 33:1023-1040. [PMID: 39018270 DOI: 10.1044/2024_aja-23-00272] [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: 07/19/2024] Open
Abstract
PURPOSE Magnetic resonance imaging (MRI), electric compound action potential (eCAP), and electric auditory brainstem response (eABR) are among the routine assessments performed before and/or after cochlear implantation. The objective of this review was to systematically summarize and critically appraise existing evidence of the prognostic value of eCAP, eABR, and MRI for predicting post-cochlear implant (CI) speech perception outcomes in children, with a particular focus on the lesion site. METHOD The present systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Three electronic databases (ProQuest, PubMed, and Scopus) were searched with no restrictions on language, publication status, or year of publication. Studies on children identified with sensorineural hearing loss, auditory neuropathy spectrum disorder, cochlear nerve deficiency, or cochleovestibular nerve abnormalities reporting the relevance of eCAP, eABR, and/or MRI results to CI speech perception outcomes were included. The literature search yielded 1,887 publications. Methodological quality and strength of evidence were assessed by the Crowe Critical Appraisal Tool and the Grading of Recommendations Assessment, Development, and Evaluation tool, respectively. RESULTS Of the 25 included studies, the relevance of eCAP, eABR, and/or MRI findings to post-CI speech perception outcomes was reported in 10, 11, and 11 studies, respectively. The studies were strongly in support of the prognostic value of eABR and MRI for CI outcomes. However, the relevance of eCAP findings to speech perception outcomes was uncertain. CONCLUSION Despite the promising findings, caution is warranted in interpreting them due to the observational and retrospective design of the included studies, as well as the heterogeneity of the population and the limited control of confounding factors within these studies. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26169859.
Collapse
Affiliation(s)
- Zahra Jafari
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
| | - Elizabeth M Fitzpatrick
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, Ontario, Canada
| | - David R Schramm
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, Ontario, Canada
| | - Isabelle Rouillon
- Department of Pediatric Otolaryngology, AP-HP, Hôpital Necker - Enfants Malades, Paris, France
| | - Amineh Koravand
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
| |
Collapse
|
61
|
Karaketir S, Berkiten G, Tutar B, Akan O, Kumral TL, Sari H, Atar Y, Göker AE, Ahmed İA, Çelik C, Uyar Y. Evaluation of the audiovestibular system before and after treatment in patients with Idiopathic intracranial hypertension. Acta Otolaryngol 2024:1-8. [PMID: 39225671 DOI: 10.1080/00016489.2024.2395868] [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: 06/11/2024] [Revised: 08/15/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Idiopathic intracranial hypertension (IIH) can affect both hearing and balance due to increased inner ear pressure. AIMS/OBJECTIVES This study aimed to evaluate the impact of increased inner ear pressure on hearing and balance in patients with IIH using auditory and vestibular tests. MATERIAL AND METHODS Twenty-four IIH patients and 28 healthy controls underwent oVEMP, pure tone audiometry, tympanometry, and acoustic reflex tests pre-lumbar punctures. IIH patients received acetazolamide. Pre- and post-treatment results, tinnitus, and vertigo scores were compared. Post-treatment oVEMP and audiometry results were compared between groups. RESULTS Pre-treatment oVEMP showed a significant left N1 latency difference (p = 0.049). Post-treatment, left ear amplitude (p = 0.035) and both ear amplitude ratios (p = 0.044 and p = 0.047) increased significantly. Audiometry had no significant changes (p < 0.05). Tinnitus and vertigo scores decreased significantly (p ≤ 0.001). CONCLUSION Prolonged oVEMP latency suggests IIH may impact the brain stem and vestibular nerve, while increased amplitude values indicate peripheral vestibular involvement. IIH affects hearing across all frequencies, especially at 4000 Hz, impacting both hearing and balance. SIGNIFICANCE Understanding the effects of IIH on auditory and vestibular functions can guide effective treatments, improving quality of life for patients by addressing both hearing and balance issues.
Collapse
Affiliation(s)
- Semih Karaketir
- Department of Otorhinolaryngology, Kozyatağı Central Hospital, Istanbul, Turkey
| | - Güler Berkiten
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Belgin Tutar
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Onur Akan
- Department of Neurology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Tolgar Lütfi Kumral
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Hüseyin Sari
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Yavuz Atar
- Faculty of Medicine, Department of Otorhinolaryngology, Üsküdar University, Istanbul, Turkey
| | - Ayşe Enise Göker
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | | | - Cem Çelik
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Yavuz Uyar
- Department of Otorhinolaryngology, University of Health Sciences, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| |
Collapse
|
62
|
Xue W, Niu J, Chen G, He Y, Du X, Jingqin F. Giant cell tumor of bone of temporal bone and skull base: report of 6 cases. Skeletal Radiol 2024:10.1007/s00256-024-04784-3. [PMID: 39251419 DOI: 10.1007/s00256-024-04784-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 07/26/2024] [Accepted: 08/27/2024] [Indexed: 09/11/2024]
Abstract
OBJECTIVE Five cases of giant cell tumor of bone (GCTB) in the head and neck region were reported, with a main focus on the radiological findings to identify common characteristics for the diagnosis of GCTB in these sites. MATERIALS AND METHODS Five consecutive patients diagnosed with GCTB were retrospectively selected. Radiological features on conventional and advanced MR sequences and CT were analyzed. HE staining and immunohistochemical examination were performed using antibodies against p63 and CD68. RESULTS The common clinical features were local mass (3/5), tinnitus (3/5) and headache (2/5). Radiologically, all the cases were well-circumscribed osteolytic lesion, majority of cases demonstrated an expansile growth pattern and "soap bubble" appearance on CT (4/5). On MRI, the tumors showed predominantly hypointensity both on T1WI and T2WI, and no evidence of restricted diffusion on DWI. Intratumoral hemorrhage (2/5), cystic alternation (2/5) and very low signal on T2WI in the periphery region of the tumor (4/5) was found. Fluid-fluid level was noted in one case, which was eventually verified to be GCTB with secondary aneurysmal bone cyst (ABC). With contrast agent, all the cases showed striking (3/5) or mild to intermediate (2/5) enhancement. CONCLUSIONS Although the above described radiological findings are not specific for GCTB in head and neck region, a well-defined osteolytic lesion in the bones of head and neck region with "soap bubble" appearance on CT and hypointensity on T2WI with very low signal in the peripheral region of the tumor on MRI highly suggest GCTB for patient ages 20 to 40.
Collapse
Affiliation(s)
- Wei Xue
- Department of Radiology, the 940Th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, 730000, China
| | - Juanqin Niu
- Department of Radiology, the 940Th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, 730000, China
| | - Gang Chen
- Department of Radiology, the 940Th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, 730000, China
| | - Yao He
- Department of Radiology, the 940Th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou, 730000, China
| | - Xuesong Du
- Department of Radiology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, China.
- Medical Imaging Research Center, Anhui Medical University, Hefei, 230601, China.
| | - Fang Jingqin
- Department of Ultrasound, Army Medical Center of PLA, Army Medical University, Chongqing, 400024, China.
| |
Collapse
|
63
|
Domínguez-Durán E, Prieto-Sánchez-de-Puerta L, Tena-García B, Acosta-Mosquera ME, Sánchez-Gómez S. Positional End-Point Nystagmus in Patients with Diagnosis of Acute Unilateral Vestibulopathy. Otol Neurotol 2024; 45:e588-e594. [PMID: 39052916 DOI: 10.1097/mao.0000000000004288] [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: 07/27/2024]
Abstract
INTRODUCTION Recently, end-point nystagmus, traditionally observed in an upright position, has been identified in the Dix-Hallpike position among healthy subjects, suggesting a physiological origin.However, its characteristics in individuals with vestibular hypofunction remain unexplored. OBJECTIVE To elucidate the impact of vestibular hypofunction on the characteristics of positional end-point nystagmus. METHODS Thirty-one patients diagnosed with acute unilateral vestibulopathy according to Bárány Society criteria were selected. A video head impulse test was conducted in all participants, followed by McClure and Dix-Hallpike maneuvers with and without gaze fixation, and with the initial position of the eye in the straight-ahead position or in the horizontal end-point position. Nystagmus direction, sense, latency, slow-phase velocity, and duration were recorded. The relationship between these characteristics and video head impulse test values was analyzed. RESULTS Positional end-point nystagmus was observed in 92.6% of subjects with vestibular hypofunction, significantly more than in healthy individuals. Nystagmus direction varied depending on the performed positional test and on the vestibulo-ocular reflex gains. Gaze occlusion and the initial horizontal end-point position increased its frequency. CONCLUSION Vestibular hypofunction influences the manifestation of positional end-point nystagmus. Recognizing this nystagmus can aid in resolving diagnostic uncertainties and preventing the misdiagnosis of benign paroxysmal positional vertigo in subjects with acute unilateral vestibulopathy.
Collapse
Affiliation(s)
| | | | - Beatriz Tena-García
- Servicio de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - Serafín Sánchez-Gómez
- Servicio de Otorrinolaringología, Hospital Universitario Virgen Macarena, Sevilla, Spain
| |
Collapse
|
64
|
Fancello V, Bianchini C, Iannella G, Cammaroto G, Meccariello G, Pelucchi S, Ciorba A. The Evaluation of Vertigo in Children: Which Role for Parental-Camera Recording and Telemedicine? EAR, NOSE & THROAT JOURNAL 2024; 103:NP578-NP580. [PMID: 35107328 DOI: 10.1177/01455613221074739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Virginia Fancello
- ENT and Audiology Unit, Department of Rehabilitation and Neurosciences, University of Ferrara, Italy
| | - Chiara Bianchini
- ENT and Audiology Unit, Department of Rehabilitation and Neurosciences, University of Ferrara, Italy
| | - Giannicola Iannella
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, Forlì, Italy
| | - Giovanni Cammaroto
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, Forlì, Italy
| | - Giuseppe Meccariello
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, Forlì, Italy
| | - Stefano Pelucchi
- ENT and Audiology Unit, Department of Rehabilitation and Neurosciences, University of Ferrara, Italy
| | - Andrea Ciorba
- ENT and Audiology Unit, Department of Rehabilitation and Neurosciences, University of Ferrara, Italy
| |
Collapse
|
65
|
Epperson MV, Mahajan A, Welch CM. Metastasis to the External Auditory Canal: A Systematic Review. Otol Neurotol 2024; 45:e556-e565. [PMID: 39082865 DOI: 10.1097/mao.0000000000004258] [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: 08/02/2024]
Abstract
OBJECTIVE To systematically review the literature and understand the behavior, diagnosis, management, and mortality of metastasis to the external auditory canal (EAC). DATABASES REVIEWED PubMed/Medline, EMBASE, Web of Science. METHODS Studies from 1948 to June 2023 describing metastasis to the EAC were included. Non-English literature was excluded. Data extraction: Study design, age, sex, pathology, primary site, staging, additional sites of metastasis, time to EAC metastasis from diagnosis, time from diagnosis of EAC metastasis to death, symptoms, exam and imaging findings, and management. RESULTS Data were synthesized qualitatively with means calculated. Thirty-two studies met the criteria, totaling 37 patients with EAC metastasis. Mean age was 58 years; 73% were male. The most common pathologies were adenocarcinoma (37.8%), acute myelogenous leukemia (8.1%), and renal cell carcinoma (8.1%). Sites of primary malignancy were hematologic (10.8%), breast (8.1%), esophagus (8.1%), renal (8.1%), and prostate (8.1%). Within the temporal bone, 73% had isolated EAC metastasis. Median time to EAC metastasis from the diagnosis of primary malignancy was 18 months. Metastasis to the EAC was the first presentation of malignancy in 21.6% of patients. Median time to death was 4.5 months. Symptoms included hearing loss (59.5%), otalgia (27.0%), otorrhagia (24.3%), facial paralysis (21.6%), otorrhea (16.2%), and aural fullness (13.5%). On imaging, bony erosion was present in 50% of cases. Treatment was primarily palliative with excision and radiation. CONCLUSIONS EAC metastasis has a distinct presentation from other temporal bone subsites. Early biopsy to establish a diagnosis and intervene is critical.
Collapse
Affiliation(s)
- Madison V Epperson
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan
| | - Arushi Mahajan
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Christopher M Welch
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor, Michigan
| |
Collapse
|
66
|
Geerardyn A, Wils I, Putzeys T, Fierens G, Wouters J, Verhaert N. The impact of round window reinforcement on middle and inner ear mechanics with air and bone conduction stimulation. Hear Res 2024; 450:109049. [PMID: 38850830 DOI: 10.1016/j.heares.2024.109049] [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: 11/28/2023] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
The round window (RW) membrane plays an important role in normal inner ear mechanics. Occlusion or reinforcement of the RW has been described in the context of congenital anomalies or after cochlear implantation and is applied as a surgical treatment for hyperacusis. Multiple lumped and finite element models predict a low-frequency hearing loss with air conduction of up to 20 dB after RW reinforcement and limited to no effect on hearing with bone conduction stimulation. Experimental verification of these results, however, remains limited. Here, we present an experimental study measuring the impact of RW reinforcement on the middle and inner ear mechanics with air and bone conduction stimulation. In a within-specimen repeated measures design with human cadaveric specimens (n = 6), we compared the intracochlear pressures in scala vestibuli (PSV) and scala tympani (PST) before and after RW reinforcement with soft tissue, cartilage, and bone cement. The differential pressure (PDIFF) across the basilar membrane - known to be closely related to the hearing sensation - was calculated as the complex difference between PSV and PST. With air conduction stimulation, both PSV and PSTincreased on average up to 22 dB at frequencies below 1500 Hz with larger effect sizes for PST compared to PSV. The PDIFF, in contrast, decreased up to 11 dB at frequencies between 700 and 800 Hz after reinforcement with bone cement. With bone conduction, the average within-specimen effects were less than 5 dB for either PSV, PST, or PDIFF. The inter-specimen variability with bone conduction, however, was considerably larger than with air conduction. This experimental study shows that RW reinforcement impacts air conduction stimulation at low frequencies. Bone conduction stimulation seems to be largely unaffected. From a clinical point of view, these results support the hypothesis that delayed loss of air conduction hearing after cochlear implantation could be partially explained by the impact of RW reinforcement.
Collapse
Affiliation(s)
- Alexander Geerardyn
- ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium; Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven Belgium
| | - Irina Wils
- ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Tristan Putzeys
- ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium; Laboratory of Soft Matter and Biophysics, Department of Physics and Astronomy, KU Leuven, Leuven, Belgium
| | - Guy Fierens
- ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium; Cochlear Technology Centre, Mechelen, Belgium
| | - Jan Wouters
- ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Nicolas Verhaert
- ExpORL, Department of Neurosciences, KU Leuven, Leuven, Belgium; Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven Belgium.
| |
Collapse
|
67
|
Caputo V, Denoyelle F, Simon F. Educational endoscopic videos improve teaching of middle ear anatomy. Eur Arch Otorhinolaryngol 2024; 281:4649-4655. [PMID: 38642088 DOI: 10.1007/s00405-024-08658-1] [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: 02/18/2024] [Accepted: 04/03/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Videos and images are becoming an educational tool in every domain. The objective was to assess the contribution of short educational endoscopic videos in learning the complex anatomy of the tympanic cavity. METHODS We conducted a prospective study amongst all the otolaryngology residents in 2021 in the greater Paris area (n = 74), from the first year to fifth year. We divided the residents into two groups who had the same 30-min anatomy class based on anatomical drawings. The second group had a 4-min endoscopic educational video at the end, whereas the first group did not. A video test of 10 surgical situations with each time 5 anatomic structures to identify was created. All the residents took the test just after the class, and 1 month later to assess long-term memory. The MERSQI score (design to assess the quality of educational studies) applied to our study was calculated. RESULTS The two groups were comparable in terms of training. The "video" group had significantly better results in the first test, mean score 24.40/50 (± 11.7) versus 16.74/50 (± 11.1) (p = 0.005) and also at 1 month, mean score 23.25/50 (± 12.3) versus 18.01/50 (± 11.3) (p = 0.035). The score in each group, and the difference between both groups, increased with resident seniority. The MERSQI score of our study was 14.5/18. CONCLUSION This study highlights the educational value of videos to help memorise complex 3D anatomy such as in the tympanic cavity.
Collapse
|
68
|
Arat ŞU, İkiz Bozsoy M, Yücel E. The relationships between language, functional hearing, social, and motor development skills in children with early cochlear implants. Eur Arch Otorhinolaryngol 2024; 281:4593-4602. [PMID: 38630274 PMCID: PMC11393127 DOI: 10.1007/s00405-024-08635-8] [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: 01/08/2024] [Accepted: 03/22/2024] [Indexed: 09/14/2024]
Abstract
PURPOSE The purpose of this study was to investigate the relations between functional hearing, language, social, bilateral coordination and manual dexterity skills in children with early cochlear implants (CIs). METHODS Thirty children with CIs were included in this study. The manual dexterity and bilateral coordination development of the participants were evaluated with Manual Dexterity and Bilateral Coordination subtests of Bruininks-Oseretsky Motor Proficiency-2 (BOT-2). Their language skills were assessed by the Test of Early language Development-3. To assess the functional hearing of participants the Functioning After Pediatric Cochlear Implantation scale (FAPCI) was administered their caregivers. Also, the Social Skills Evaluation Scale was administered to participants' teachers to asses their social skills. RESULTS There were significant correlations between participants' receptive and expressive language skills, Manual Dexterity, and FAPCI scores (p < 0.05). There were also significant relationships between the SSES and FAPCI scores of the participants (p < 0.05). However, the Bilateral Coordination subtest did not show any significant correlation with any of the measurements (p > 0.05). CONCLUSION The results suggest that the language, manual dexterity and functional hearing abilities of children with CIs are closely related. Although, there were no significant correlations between all of the measurement, it is important to look beyond hearing and speech evaluations to assess the whole child.
Collapse
Affiliation(s)
- Şevval Utku Arat
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, 06100, Turkey
| | - Merve İkiz Bozsoy
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, 06100, Turkey.
| | - Esra Yücel
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, 06100, Turkey
| |
Collapse
|
69
|
He S, Skidmore J, Bruce IC, Oleson JJ, Yuan Y. Peripheral Neural Synchrony in Postlingually Deafened Adult Cochlear Implant Users. Ear Hear 2024; 45:1125-1137. [PMID: 38503720 PMCID: PMC11333193 DOI: 10.1097/aud.0000000000001502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVES This paper reports a noninvasive method for quantifying neural synchrony in the cochlear nerve (i.e., peripheral neural synchrony) in cochlear implant (CI) users, which allows for evaluating this physiological phenomenon in human CI users for the first time in the literature. In addition, this study assessed how peripheral neural synchrony was correlated with temporal resolution acuity and speech perception outcomes measured in quiet and in noise in postlingually deafened adult CI users. It tested the hypothesis that peripheral neural synchrony was an important factor for temporal resolution acuity and speech perception outcomes in noise in postlingually deafened adult CI users. DESIGN Study participants included 24 postlingually deafened adult CI users with a Cochlear™ Nucleus® device. Three study participants were implanted bilaterally, and each ear was tested separately. For each of the 27 implanted ears tested in this study, 400 sweeps of the electrically evoked compound action potential (eCAP) were measured at four electrode locations across the electrode array. Peripheral neural synchrony was quantified at each electrode location using the phase-locking value (PLV), which is a measure of trial-by-trial phase coherence among eCAP sweeps/trials. Temporal resolution acuity was evaluated by measuring the within-channel gap detection threshold (GDT) using a three-alternative, forced-choice procedure in a subgroup of 20 participants (23 implanted ears). For each ear tested in these participants, GDTs were measured at two electrode locations with a large difference in PLVs. For 26 implanted ears tested in 23 participants, speech perception performance was evaluated using consonant-nucleus-consonant (CNC) word lists presented in quiet and in noise at signal to noise ratios (SNRs) of +10 and +5 dB. Linear Mixed effect Models were used to evaluate the effect of electrode location on the PLV and the effect of the PLV on GDT after controlling for the stimulation level effects. Pearson product-moment correlation tests were used to assess the correlations between PLVs, CNC word scores measured in different conditions, and the degree of noise effect on CNC word scores. RESULTS There was a significant effect of electrode location on the PLV after controlling for the effect of stimulation level. There was a significant effect of the PLV on GDT after controlling for the effects of stimulation level, where higher PLVs (greater synchrony) led to lower GDTs (better temporal resolution acuity). PLVs were not significantly correlated with CNC word scores measured in any listening condition or the effect of competing background noise presented at an SNR of +10 dB on CNC word scores. In contrast, there was a significant negative correlation between the PLV and the degree of noise effect on CNC word scores for a competing background noise presented at an SNR of +5 dB, where higher PLVs (greater synchrony) correlated with smaller noise effects on CNC word scores. CONCLUSIONS This newly developed method can be used to assess peripheral neural synchrony in CI users, a physiological phenomenon that has not been systematically evaluated in electrical hearing. Poorer peripheral neural synchrony leads to lower temporal resolution acuity and is correlated with a larger detrimental effect of competing background noise presented at an SNR of 5 dB on speech perception performance in postlingually deafened adult CI users.
Collapse
Affiliation(s)
- Shuman He
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212
- Department of Audiology, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205
| | - Jeffrey Skidmore
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212
| | - Ian C. Bruce
- Department of Electrical & Computer Engineering, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Jacob J. Oleson
- Department of Biostatistics, The University of Iowa, Iowa City, IA 52242
| | - Yi Yuan
- Department of Otolaryngology – Head and Neck Surgery, The Ohio State University, 915 Olentangy River Road, Columbus, OH 43212
| |
Collapse
|
70
|
Naguib LE, Abdel Azim GS, Elazab SA, Mohamed HS. Ultrasonography as diagnostic and prognostic tool and Therapeutic role of repetitive peripheral magnetic stimulation in acute idiopathic facial nerve palsy. J Ultrasound 2024; 27:707-714. [PMID: 38910221 PMCID: PMC11333389 DOI: 10.1007/s40477-024-00927-3] [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: 03/05/2024] [Accepted: 05/21/2024] [Indexed: 06/25/2024] Open
Abstract
PURPOSE Repetitive Peripheral Magnetic Stimulation [rPMS] is a non-invasive tool that has a potential therapeutic role in many musculoskeletal disorders. We aimed to demonstrate the therapeutic efficacy of high frequency [rPMS] in acute Idiopathic Facial Nerve Palsy [IFP]. And to study the role of neuromuscular ultrasonography in acute idiopathic facial palsy. METHODS Forty patients, aged above 18 years, diagnosed with unilateral acute [within 7 days of onset] idiopathic facial palsy were enrolled and randomly divided into intervention group [20 patients] and control group. Both groups underwent clinical examination, assessment of facial nerve disability by House-Brackmann grading [HBG] score and Facial Disability Index [FDI] score, ultrasonography of facial nerve of both normal and affected sides at baseline and after 6 weeks, medical treatment and routine rehabilitation therapy. The intervention group were subjected to 10 sessions of high frequency r PMS [5/week for 2 successive weeks] on the affected side. RESULTS Both [HBG] and [FDI] showed more significant improvement in the intervention group in comparison to the control group after 6 weeks follow up. Ultrasonographic measures of facial nerve in the affected side were significantly larger than non-affected side at baseline. However, those measures significantly decreased after 6 weeks follow up. Surprisingly, the intervention group showed more significant decrease in facial nerve dimeter at proximal portion [without sheath] in comparison to control group. CONCLUSION high frequency r PMS have an adjuvant role in treatment of acute idiopathic facial palsy. Also, ultrasonography has beneficial role in evaluation and prognosis of [IFP].
Collapse
Affiliation(s)
- Laila Elmously Naguib
- Neurology Department, Faculty of Medicine-for Girls, Al-Azhar University, Cairo, Egypt
| | - Ghada Saed Abdel Azim
- Neurology Department, Faculty of Medicine-for Girls, Al-Azhar University, Cairo, Egypt.
| | - Seham Abdallah Elazab
- Rheumatology and Rehabilitation Department, Faculty of Medicine-for Girls, Al-Azhar University, Cairo, Egypt
| | - Hadeir Said Mohamed
- Neurology Department, Faculty of Medicine-for Girls, Al-Azhar University, Cairo, Egypt
| |
Collapse
|
71
|
Kang YJ, Zheng Y. Current understanding of subjective tinnitus in adults. Eur Arch Otorhinolaryngol 2024; 281:4507-4517. [PMID: 38632112 DOI: 10.1007/s00405-024-08633-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE An up-to-date overview of epidemiology, etiology and pathophysiological mechanisms, diagnostic and evaluation methods, current treatment status and future directions of subjective tinnitus in adults. METHODS Review of current evidence-based literature on subjective tinnitus in adults. RESULTS The prevalence of subjective tinnitus in the adult population is estimated to be around 14%, and it tends to increase with age. Subjective tinnitus is a complex condition with multiple factors contributing to its origin. However, the exact causes and underlying mechanisms remain unknown. Potential causes may include hearing loss, dysfunction in the somatosensory system, and auditory cortical dysfunction, although severe underlying pathology is rare. Currently, diagnosis primarily relies on patient self-reported medical history and physician-based clinical assessment due to the lack of objective testing. Various treatment and management options have been proposed, but their effectiveness varies, and there is no universally agreed-upon treatment option. CONCLUSIONS Tinnitus is a complex and heterogeneous disease with a high incidence rate and a tendency to increase with age. A holistic perspective is needed to understand the generation, perception, and emotional responses to tinnitus. Diagnosis requires a comprehensive assessment based on medical history and relevant examinations, identification of concurrent psychosomatic comorbidities, and active pursuit of objective diagnostic methods. At the same time, on the basis of existing treatment plans and combining emerging technologies, we will develop new personalized, precise, and combined treatment plans.
Collapse
Affiliation(s)
- Yao-Jie Kang
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Otolaryngology-Head and Neck Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Tujia and Miao Autonomous Prefecture, China
| | - Yun Zheng
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China.
| |
Collapse
|
72
|
Franke-Trieger A, Mattheus W, Seebacher J, Zelger P, Zahnert T, Neudert M. Stapedius reflex thresholds obtained in a free sound field as an indicator for over- and understimulation in cochlear implant listeners. Int J Audiol 2024; 63:695-702. [PMID: 37656611 DOI: 10.1080/14992027.2023.2245141] [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: 09/15/2022] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE The goal of this study was to determine open field stapedius reflex thresholds (oSRTs) in CI patients with fittings based on subjective loudness ratings. A further objective was to compare these oSRTs and those of eSRT-based fittings that are similar to the oSRTs of normal hearing. DESIGN Impedance measurements of the ear drum were taken while subjects were wearing their audio processors. The stapedius reflex was elicited by electrical stimulation transmitted through the activated CI system in response to an acoustic stimulus presented in the free sound field. STUDY SAMPLE Subjects were 50 experienced CI users (n = 57 ears) with CI fittings based on subjective loudness scaling. RESULTS A reference range for the oSRTs was defined that was identified in CI patients with eSRT-based fittings. Sound levels for stapedius reflex detection were inside the reference target range in 70% of the cases, below the reference range (i.e. down to 40 dB HL) in 20% of the cases, and above the reference range in 10% of the cases. CONCLUSION Stapedius reflex detection in a free sound field may help detect fittings with too high or too low stimulation levels that might reduce audiological performance.
Collapse
Affiliation(s)
- Annett Franke-Trieger
- Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine (and University Hospital) Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Willy Mattheus
- Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine (and University Hospital) Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Josef Seebacher
- Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Zelger
- Department for Hearing, Speech and Voice Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Zahnert
- Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine (and University Hospital) Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Marcus Neudert
- Saxonian Cochlear Implant Centre, Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine (and University Hospital) Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
73
|
Dorismond C, Smetak MR, Perkins EL, Foust AM, Sarma A, Virgin FW. High Prevalence of Cochlear Nerve Deficiency in Pediatric Patients With Cochlear Aperture Stenosis. Otolaryngol Head Neck Surg 2024; 171:872-877. [PMID: 38606641 DOI: 10.1002/ohn.774] [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: 11/07/2023] [Revised: 03/04/2024] [Accepted: 03/27/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE Cochlear nerve deficiency (CND) is a common radiologic finding among unilateral sensorineural hearing loss (USNHL) patients. It is generally detected with magnetic resonance imaging (MRI), which is associated with higher cost, less availability, and possible need for sedation. Therefore, identifying computed tomography (CT) findings, such as cochlear aperture stenosis (CAS), that can reliably predict CND is valuable. Our study aimed to determine the prevalence of CND in pediatric patients with CT-diagnosed CAS. STUDY DESIGN Retrospective study. SETTING Tertiary care center. METHODS We included pediatric patients diagnosed with CAS on temporal bone CT and with available temporal bone MRI. For each patient, an otolaryngologist and a pediatric neuroradiologist measured the cochlear aperture width on CT to confirm CAS (cochlear aperture < 1.4 mm) and assessed the status of the cochlear nerve on MRI. RESULTS Fifty-five patients, representing 65 ears, had CAS on CT measurement. Median cochlear aperture width in CAS ears was 0.70 mm (interquartile range [IQR]: 0.40-1.05 mm) versus 2.00 mm in non-CAS ears (IQR: 1.80-2.30 mm, P < .001). CND was found in 98.5% (n = 64/65) of CAS ears, while a normal cochlear nerve was found in 1.5% (n = 1/65) of CAS ears. CONCLUSION CND is highly prevalent among pediatric patients with CAS. This suggests that MRI may not be needed to assess for CND in USNHL patients with CAS, as initial CT may provide sufficient information to determine cochlear implant candidacy. We recommend thoughtful shared decision-making with parents of USNHL patients when determining whether to pursue MRI in the setting of a CAS diagnosis.
Collapse
Affiliation(s)
- Christina Dorismond
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Miriam R Smetak
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Elizabeth L Perkins
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alexandra M Foust
- Department of Radiology, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Asha Sarma
- Department of Radiology, Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Frank W Virgin
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
74
|
Xu Y, Bei Z, Li M, Ye L, Chu B, Zhao Y, Qian Z. Biomedical application of materials for external auditory canal: History, challenges, and clinical prospects. Bioact Mater 2024; 39:317-335. [PMID: 38827173 PMCID: PMC11139775 DOI: 10.1016/j.bioactmat.2024.05.035] [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: 12/13/2023] [Revised: 05/14/2024] [Accepted: 05/19/2024] [Indexed: 06/04/2024] Open
Abstract
Biomaterials play an integral role in treatment of external auditory canal (EAC) diseases. Regarding the special anatomic structure and physiological characteristics of EAC, careful selection of applicable biomaterials was essential step towards effective management of EAC conditions. The bioactive materials can provide reasonable biocompatibility, reduce risk of host pro-inflammatory response and immune rejection, and promote the healing process. In therapeutic procedure, biomaterials were employed for covering or packing the wound, protection of the damaged tissue, and maintaining of normal structures and functions of the EAC. Therefore, understanding and application of biomaterials was key to obtaining great rehabilitation in therapy of EAC diseases. In clinical practice, biomaterials were recognized as an important part in the treatment of different EAC diseases. The choice of biomaterials was distinct according to the requirements of various diseases. As a result, awareness of property regarding different biomaterials was fundamental for appropriate selection of therapeutic substances in different EAC diseases. In this review, we firstly introduced the characteristics of EAC structures and physiology, and EAC pathologies were summarized secondarily. From the viewpoint of biomaterials, the different materials applied to individual diseases were outlined in categories. Besides, the underlying future of therapeutic EAC biomaterials was discussed.
Collapse
Affiliation(s)
- Yang Xu
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhongwu Bei
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mei Li
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Ye
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bingyang Chu
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhao
- Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhiyong Qian
- Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
75
|
Goldberg-Bockhorn E, Hurzlmeier C, Vahl JM, Stupp F, Janda A, von Baum H, Hoffmann TK. Increase in acute mastoiditis at the end of the COVID-19 pandemic. Eur Arch Otorhinolaryngol 2024; 281:4747-4756. [PMID: 38740579 PMCID: PMC11393142 DOI: 10.1007/s00405-024-08704-y] [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: 08/19/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE Common respiratory infections were significantly reduced during the COVID-19 pandemic due to general protective and hygiene measures. The gradual withdrawal of these non-pharmaceutical interventions (NPI) was associated with a notable increase in these infections, particularly in pediatric and adult otorhinolaryngology. The aim of this retrospective monocentric study was to evaluate the impact of NPI during the COVID-19 pandemic on the incidence and severity of acute mastoiditis (AM). METHODS Pre-pandemic clinical data of AM cases from 2011 to 2019 were compared with infection counts from January 2020 to June 2023 for seasonal periodicity, age-specific differences, pathogens, and complication rates in a German third-level hospital. RESULTS Out of 196 patients with AM 133 were children, the majority between 1 and 5 years of age. Complications of AM, such as meningitis, brain abscess, and sinus vein thrombosis, were more common in adults (87%) than in children (17%). Morbidity and mortality rates were similar before, during and after the pandemic. Pneumococci were the most common pathogen in both age groups, with a post-pandemic cumulation of Streptococcus pyogenes infections in children. While pre-pandemic cases clustered in spring, seasonality was absent in all age groups during the main phase of the pandemic. The cessation of NPI caused a steep rise in AM cases in both age groups starting from December 2022. CONCLUSION NPI during the COVID-19 pandemic reduced the incidence of AM. Their reversal led to a substantial increase in the incidence of AM during the post-pandemic period, which may be due to a general increase in viral respiratory infections and an insufficiently trained immune system.
Collapse
Affiliation(s)
- Eva Goldberg-Bockhorn
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany.
| | - Clara Hurzlmeier
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Julius M Vahl
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Franziska Stupp
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| | - Aleš Janda
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Eythstraße 24, 89075, Ulm, Germany
| | - Heike von Baum
- Institute of Medical Microbiology and Hospital Hygiene, Ulm University Medical Center, Albert-Einstein-Allee 23, 89081, Ulm, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany
| |
Collapse
|
76
|
Silva AL, Stumpf IMDS, Lacroix LP, Alves DMF, Silveira ALD, Costa SSD, Rosito LPS. Language development in children from a public cochlear implant program. Braz J Otorhinolaryngol 2024; 90:101458. [PMID: 39032465 PMCID: PMC11315129 DOI: 10.1016/j.bjorl.2024.101458] [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: 11/06/2023] [Revised: 05/16/2024] [Accepted: 06/03/2024] [Indexed: 07/23/2024] Open
Abstract
OBJECTIVE To evaluate the rate of loss to follow-up in a cochlear implant program from the public health system in Southern Brazil as well as the characteristics of hearing loss, sociodemographic, sociocultural and the development of oral language in children with prelingual deafness. METHODS Retrospective cohort study with children who underwent CI surgery between 2010 and 2020. Data was collected through of interviews and review of medical records. The language development assessment was performed using the MUSS, MAIS and IT-MAIS scales. For the classification of language development, we used as parameters the values (mean ± SD) found in a previous national study. From those values, the Z-score for each patient at each hearing age (time of experience with the cochlear implant) was calculated. RESULTS Of the 225 children implanted between 2010-2020, 129 were included in this study. The rate of loss to follow-up in the program was 42.6%. The mean age at first surgery was 40.5 (±16.9) months, with 77.5% of patients having received a unilateral implant. Language results below the expected for hearing age ( CONCLUSIONS Most patients had an elevated mean age at cochlear implantation and there was a high rate of loss to follow-up and low attendance to speech and programming sessions. An overall poor language performance was found for this pediatric cochlear implant program from the public health system in Southern Brazil. LEVEL OF EVIDENCE Level 3 (Non-randomized cohort study).
Collapse
Affiliation(s)
- Alice Lang Silva
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil.
| | | | - Laura Prolla Lacroix
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Porto Alegre, RS, Brazil
| | | | | | - Sady Selaimen da Costa
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Otorrinolaringologia, Porto Alegre, RS, Brazil
| | - Letícia Petersen Schmidt Rosito
- Hospital de Clínicas de Porto Alegre (HCPA), Serviço de Otorrinolaringologia, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina, Porto Alegre, RS, Brazil
| |
Collapse
|
77
|
Almuzaini H, Müller J, Wilhelm F, Polterauer D, Schuster M. Simultaneous closure of a perilymphatic fistula and placement of cochlear implant in a case of complex inner ear malformation. Clin Case Rep 2024; 12:e9423. [PMID: 39229297 PMCID: PMC11369637 DOI: 10.1002/ccr3.9423] [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: 06/15/2024] [Revised: 08/06/2024] [Accepted: 08/15/2024] [Indexed: 09/05/2024] Open
Abstract
Key Clinical Message In young infants, under the age of one-year, cochlear malformation with profound hearing loss complicated by a perilymphatic fistula (PLF), presents a serious clinical challenge, warranting immediate audiological and surgical intervention. Timely PLF detection and closure, along with an early CI can significantly improve the prognosis of such patients and helps them in achieving their maximum hearing and developmental potential, in the long term. Abstract Inner ear malformation (IEM) with incomplete partition and cystic cochlea is mostly accompanied by profound hearing loss. It gets further complicated with other malformations such as a perilymphatic fistula (PLF). This case concerns an 8-month-old child cochlear malformation and profound hearing loss. Surgical intervention identified a PLF at the stapedial footplate, which was successfully closed. The surgery also included the placement of a cochlear implant (CI) in the right ear, via the round window. The left ear was equipped with hearing aids, with persistent hearing thresholds at 70-80 db. At the age of 6 years, the child showed a good hearing outcome with the CI, with only moderate speech delay. Cochlear malformation accompanied by a perilymphatic leakage warrants immediate surgical closure of the PLF, to minimize the risk of bacterial meningitis. Wherever possible, the feasibility of a CI should be explored in such cases and a CI should be placed for treatment of hearing loss. Audiological and speech outcomes may vary with the use of the CI, especially in cases of IEM. However, an early CI coupled with timely PLF detection and closure can help children with profound hearing loss, in achieving their maximum hearing and developmental potential, in the long run.
Collapse
Affiliation(s)
- Hanan Almuzaini
- General and Specialized Surgery DepartmentMedicine College, Taibah UniversityMadinah, KSSaudi Arabia
| | - J. Müller
- Department of Otorhinolaryngology, Head and Neck SurgeryLudwig‐Maximilians‐University of MunichMunichGermany
| | - Flatz Wilhelm
- Department of RadiologyLudwig‐Maximilians‐University of MunichMunichGermany
| | - D. Polterauer
- Department of Otorhinolaryngology, Head and Neck SurgeryLudwig‐Maximilians‐University of MunichMunichGermany
| | - M. Schuster
- Department of Otorhinolaryngology, Head and Neck SurgeryLudwig‐Maximilians‐University of MunichMunichGermany
| |
Collapse
|
78
|
Panario J, Bester C, O'Leary S. Predicting Postoperative Speech Perception and Audiometric Thresholds Using Intracochlear Electrocochleography in Cochlear Implant Recipients. Ear Hear 2024; 45:1173-1190. [PMID: 38816899 DOI: 10.1097/aud.0000000000001506] [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: 06/01/2024]
Abstract
OBJECTIVES Electrocochleography (ECochG) appears to offer the most accurate prediction of post-cochlear implant hearing outcomes. This may be related to its capacity to interrogate the health of underlying cochlear tissue. The four major components of ECochG (cochlear microphonic [CM], summating potential [SP], compound action potential [CAP], and auditory nerve neurophonic [ANN]) are generated by different cochlear tissue components. Analyzing characteristics of these components can reveal the state of hair and neural cell in a cochlea. There is limited evidence on the characteristics of intracochlear (IC) ECochG recordings measured across the array postinsertion but compared with extracochlear recordings has better signal to noise ratio and spatial specificity. The present study aimed to examine the relationship between ECochG components recorded from an IC approach and postoperative speech perception or audiometric thresholds. DESIGN In 113 human subjects, responses to 500 Hz tone bursts were recorded at 11 IC electrodes across a 22-electrode cochlear implant array immediately following insertion. Responses to condensation and rarefaction stimuli were then subtracted from one another to emphasize the CM and added to one another to emphasize the SP, ANN, and CAP. Maximum amplitudes and extracochlear electrode locations were recorded for each of these ECochG components. These were added stepwise to a multi-factor generalized additive model to develop a best-fit model predictive model for pure-tone audiometric thresholds (PTA) and speech perception scores (speech recognition threshold [SRT] and consonant-vowel-consonant phoneme [CVC-P]) at 3- and 12-month postoperative timepoints. This best-fit model was tested against a generalized additive model using clinical factors alone (preoperative score, age, and gender) as a null model proxy. RESULTS ECochG-factor models were superior to clinical factor models in predicting postoperative PTA, CVC-P, and SRT outcomes at both timepoints. Clinical factor models explained a moderate amount of PTA variance ( r2 = 45.9% at 3-month, 31.8% at 12-month, both p < 0.001) and smaller variances of CVC-P and SRT ( r2 range = 6 to 13.7%, p = 0.008 to 0.113). Age was not a significant predictive factor. ECochG models explained more variance at the 12-month timepoint ( r2 for PTA = 52.9%, CVC-P = 39.6%, SRT = 36.4%) compared with the 3-month one timepoint ( r2 for PTA = 49.4%, CVC-P = 26.5%, SRT = 22.3%). The ECochG model was based on three factors: maximum SP deflection amplitude, and electrode position of CM and SP peaks. Adding neural (ANN and/or CAP) factors to the model did not improve variance explanation. Large negative SP deflection was associated with poorer outcomes and a large positive SP deflection with better postoperative outcomes. Mid-array peaks of SP and CM were both associated with poorer outcomes. CONCLUSIONS Postinsertion IC-ECochG recordings across the array can explain a moderate amount of postoperative speech perception and audiometric thresholds. Maximum SP deflection and its location across the array appear to have a significant predictive value which may reflect the underlying state of cochlear health.
Collapse
Affiliation(s)
- Jared Panario
- Department Otolaryngology, University of Melbourne, Melbourne, Victoria, Australia
| | - Christofer Bester
- Department Otolaryngology, University of Melbourne, Melbourne, Victoria, Australia
| | - Stephen O'Leary
- Department Otolaryngology, University of Melbourne, Melbourne, Victoria, Australia
- Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| |
Collapse
|
79
|
Olaison S, Berglund M, Taj T, Knutsson J, Westman E, Eriksson PO, Bonnard Å. Hearing Outcomes After Ossiculoplasty With Bone or Titanium Prostheses-A Nationwide Register-Based Study. Clin Otolaryngol 2024; 49:660-669. [PMID: 38932647 DOI: 10.1111/coa.14191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 04/05/2024] [Accepted: 06/01/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES This study compares hearing outcomes of two prosthesis materials, bone and titanium, used in ossiculoplasty. DESIGN This retrospective nationwide registry-based study uses data systematically collected by the Swedish Quality Registry for Ear Surgery (SwedEar). SETTING The data were obtained from clinics in Sweden that perform ossiculoplasty. PARTICIPANTS Patients who underwent ossiculoplasty using either bone or titanium prostheses were registered in SwedEar between 2013 and 2019. MAIN OUTCOME MEASURES Hearing outcome expressed as air-bone gap (ABG) gain. RESULTS The study found no differences between bone and titanium for ABG or air conduction (AC) for either partial ossicular replacement prostheses (PORP) or total ossicular replacement prostheses (TORP). In a comparison between PORP and TORP for ABG and AC outcomes, regardless of the material used, PORP showed a small advantage, with an additional improvement of 3.3 dB (95% CI [confidence interval], 0.1-4.4) in ABG and 2.2 dB (95% CI, 1.7-4.8) in AC. In secondary surgery using TORP, titanium produced slightly better results for high-frequency pure tone average. The success rate, a postoperative ABG ≤20 dB, was achieved in 62% of the operations for the whole group. CONCLUSION Both bone and titanium used to reconstruct the ossicular chain produce similar hearing outcomes for both PORP and TORP procedures. However, titanium may be a preferable option for secondary surgeries involving TORP. The success rate, a postoperative ABG ≤20 dB, is consistent with other studies, but there is room for improvement in patient selection criteria and surgical techniques.
Collapse
Affiliation(s)
- Sara Olaison
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Otolaryngology, Örebro University Hospital, Örebro, Sweden
| | - Malin Berglund
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, NU Hospital Group, Trollhättan, Sweden
| | - Tahir Taj
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Johan Knutsson
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Otolaryngology, Vasteras Hospital, Västerås, Sweden
- Centre for Clinical Research, Vastmanland Hospital Vasteras, Region Vastmanland - Uppsala University, Västerås, Sweden
| | - Eva Westman
- Department of Clinical Sciences, Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Per Olof Eriksson
- Department of Surgical Sciences, Otorhinolaryngology, Uppsala University, Uppsala, Sweden
| | - Åsa Bonnard
- MU ENT, H&B, Karolinska University Hospital, Stockholm, Sweden Department of CLINTEC, Division of Ear, Nose and Throat Diseases, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
80
|
Garaycochea O, Pérez-Fernández N. Variants of posterior semicircular canal involvement in benign paroxysmal positional vertigo. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2024; 75:324-334. [PMID: 38438080 DOI: 10.1016/j.otoeng.2024.01.013] [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: 10/18/2023] [Accepted: 01/24/2024] [Indexed: 03/06/2024]
Abstract
Benign paroxysmal positional vertigo is the most common cause of peripheral vertigo. It is characterized by short and recurrent episodes of vertigo, trigged by specific head movements that displace otoconia within the semicircular canals. The movement of dislodge otoconia from the utricle cause abnormal positional endolymphatic currents. Primary treatment involves reposition maneuvers aimed at moving the displaced otoconia out the affected canal, therefore correct identification of the affected canal is essential for the diagnosis. The posterior semicircular canal (PSC) is the most frequently affected due to its spatial orientation and the force of gravity. Recent technological advances have allowed for better assessment of positional nystagmus during diagnostic and therapeutic maneuvers, revealing various possible scenarios of PSC involvement. Regarding the PSC, otoconia may be found in different parts of the canal, and not just in the expected location, floating in the long arm of the canal. The understanding of these variants is crucial, as the prognosis and the disease progression differ in such cases. This review aims to describe the six possible variants of PSC involvement described so far.
Collapse
Affiliation(s)
- Octavio Garaycochea
- Departamento de Otorrinolaringología, Hospital Vall d'Hebron, Barcelona, Spain.
| | | |
Collapse
|
81
|
Boya MN, Blumenstein N, Redleaf M. External Auditory Canal Erosion at the 6 O'clock Spot. Otol Neurotol 2024; 45:e581-e587. [PMID: 39142310 DOI: 10.1097/mao.0000000000004280] [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: 08/16/2024]
Abstract
OBJECTIVE To report a common site of external ear canal erosion in multiple pathologies, located inferiorly at 6 o'clock. PATIENTS Otology patients who came in 2023 for treatment of external auditory canal erosions. INTERVENTION This clinical capsule is an observational report of the external canal's propensity to erosion at the 6 o'clock location. Patient treatments were canalplasty, mastoidectomy, and medical management. MAIN OUTCOME MEASURE Documentation of the propensity to erosion at the 6 o'clock location in the external auditory canal. Locations of the niduses of prior series of external auditory canal pathologies are documented. RESULTS Eight patients are presented with external auditory canal erosion in 10 ears originating at the 6 o'clock position medial to the bony-cartilaginous junction. No other patient with spontaneous canal erosion presented with their nidus of pathology in another canal location. (A review of 42 case series of 291 patients found that keratosis obturans and bisphosphonate-induced osteonecrosis tended to arise from the same 6 o'clock lateral bony canal location, while 26% of necrotizing otitis externa cases arose there.). CONCLUSIONS The "6 o'clock spot" in the external canal is a common location of canal erosion for spontaneous wax and keratin collections and may be the precursor to keratosis obturans, bisphosphonate-induced osteonecrosis of the ear canal, and necrotizing otitis externa.
Collapse
Affiliation(s)
- Mounika Naidu Boya
- Department of Otolaryngology-Head and Neck Surgery, University of Illinois Chicago, Chicago, Illinois
| | | | | |
Collapse
|
82
|
Zhu J, Gao M, Liu Y, Wang Y, Wang D, Zhao S. Clinical evaluation of temporal bone anatomical abnormalities and surgical method selection in patients with congenital aural atresia. Am J Otolaryngol 2024; 45:104430. [PMID: 39059172 DOI: 10.1016/j.amjoto.2024.104430] [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: 05/24/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES To analyze anatomic variations of the temporal bone in congenital aural atresia (CAA) and their correlation with the Jahrsdoerfer score, in order to guide clinical selection of surgical treatment methods. MATERIAL AND METHODS We retrospectively studied 53 patients (72 ears) with unilateral or bilateral CAA, including 34 ears with normal hearing as controls. Audiological and imaging data were collected and analyzed. We evaluated the Jahrsdoerfer score and anatomical variations, including tegmen mastoideum position, anterior sigmoid sinus displacement, and elevated jugular bulb. RESULTS The average air conduction hearing threshold (PTA4) ranged from 0.5 to 4 kHz was 65.48 ± 8.19 dBHL, with an average Jahrsdoerfer score of 4.93 ± 2.78. In CAA group, there was a higher prevalence and severity of anterior sigmoid sinus and low position of the tegmen mastoideum (P < 0.01). However, there was no significant difference in incidence rates among groups with high jugular bulb (P > 0.05). Anterior sigmoid sinus and high jugular bulb showed no correlation with the Jahrsdoerfer score, while the low position of the tegmen mastoideum had a weak correlation. The Jahrsdoerfer score did not adequately predict temporal bone anatomical abnormalities in CAA patients. CONCLUSION CAA exhibit a higher incidence and greater severity of temporal bone anatomical abnormalities compared to the control group, and the Jahrsdoerfer score inadequately assesses these abnormalities. Anomalies like low position of the tegmen mastoideum, anterior sigmoid sinus, and high jugular bulb should also be considered as independent factors influencing surgical decisions for atresiaplasty.
Collapse
Affiliation(s)
- Jikai Zhu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing 100730, China
| | - Mengdie Gao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing 100730, China
| | - Yujie Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing 100730, China
| | - Yuan Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing 100730, China
| | - Danni Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing 100730, China
| | - Shouqin Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing 100730, China.
| |
Collapse
|
83
|
Asghar A, Priya A, Narayan RK, Patra A, Walocha J, Skrzat J. An evaluation of morphometry and dehiscence of facial canal: a systematic review and meta-analysis of observational studies. Surg Radiol Anat 2024; 46:1501-1516. [PMID: 38997588 DOI: 10.1007/s00276-024-03435-5] [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: 04/26/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024]
Abstract
INTRODUCTION The facial canal (FC) is an extensive bony canal that houses the facial nerve and occupies a central position in the petrous part of temporal bone. It is of utmost significance to otologists due to its dehiscence and relationship to the inner or middle ear components. The main objectives of current investigation are to detect variations in the reported values of FC anatomy that may occur due to different methodology and to elucidate the influence of age and ethnic factors on the morphological features of FC. METHODS The methodology is adapted to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pooled weighted estimation was performed to calculate the mean length, angle, and prevalence of dehiscence. RESULTS The cross-sectional shape of FC varied from circular to ellipsoid index and is 1.45 [95% CI, 0.86-2.6]. The mean length of the FC is 34.42 mm [95% CI, 27.62-40.13 mm] and the mean width or diameter is 1.35 mm [95% CI, 1.013-1.63 mm]. The length of the FC in fetuses and children is 21.79 mm [95% CI, 18.44-25.15 mm], and 26.92 mm [95% CI, 23.3-28.3 mm], respectively. In meta-regression, age is observed as a predictor and accounts for 36% of the heterogeneity. The prevalence of FC dehiscence in healthy temporal bones is 29% [95% CI, 20-40%]. CONCLUSION The different segments of the FC exhibit significant variability and an unusually high incidence of dehiscence, which could potentially have clinical implications for the etiopathogenesis of facial nerve dysfunction.
Collapse
Affiliation(s)
- Adil Asghar
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
| | - Ananya Priya
- Department of Anatomy, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Ravi Kant Narayan
- Department of Anatomy, All India Institute of Medical Sciences, Bhubaneshwar, India
| | - Apurba Patra
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, India.
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Janusz Skrzat
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| |
Collapse
|
84
|
Ahmadian D, Young K, Gallego C, Miller M. Cochlear Implantation in Post-Meningitis Deafness: Audiological, Imaging, and Postoperative Outcomes: A Systematic Review With Qualitative Synthesis. Otol Neurotol 2024; 45:840-848. [PMID: 39142304 DOI: 10.1097/mao.0000000000004270] [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: 08/16/2024]
Abstract
INTRODUCTION Post-meningitis deafness (PMD) is a potentially devastating cause of hearing loss among pediatric and adult patients, for which hearing rehabilitation with cochlear implants (CIs) remains the standard of care. To date, there have been limited systematic studies on the impact of cochlear ossification (CO) and time-to-implantation (TTI) on audiological outcomes. METHODS An online database search was performed on the PubMed, Embase, and Scopus databases for articles within the past 20 years pertaining to audiological outcomes among pediatric and adult patients with PMD. Information on study characteristics, patient demographics, clinical outcomes, and postoperative complications was collected and analyzed. RESULTS From 8,325 articles generated in the original search, 11 were included in the final analysis, representing 376 patients in total. Of the articles discussing TTI, the majority (3 of 4) found that a shorter TTI of 6 months on average led to improved audiological outcomes compared with control groups with a longer TTI. Of the articles that discussed the impact of preoperative CO, the majority (4 of 6) found that the presence of CO had a detrimental effect on postoperative audiological outcomes after CI. Finally, of the articles that discussed long-term audiological outcomes for PMD compared with the non-PMD control group after CI, the majority (4 of 7) found that PMD patients had inferior long-term outcomes. CONCLUSION CI is a safe and effective treatment modality for PMD, with the majority of literature demonstrating improved long-term outcomes for patients without CO and a reduced TTI.
Collapse
Affiliation(s)
- David Ahmadian
- University of Arizona, College of Medicine-Tucson, Tucson, Arizona
| | - Kurtis Young
- Department of Otolaryngology-Head and Neck Surgery, University of Nevada, Las Vegas, Las Vegas, Nevada
| | - Charles Gallego
- University of Arizona, College of Medicine-Tucson, Tucson, Arizona
| | - Mia Miller
- Cedars-Sinai-Department of Otolaryngology, Los Angeles, California
| |
Collapse
|
85
|
de Quillettes R, Kaandorp M, Merkus P, Kramer SE, Smits C. Experienced Adult Cochlear Implant Users Show Improved Speech Recognition When Target Fitting Parameters Are Applied. Ear Hear 2024; 45:1264-1273. [PMID: 38755742 PMCID: PMC11325977 DOI: 10.1097/aud.0000000000001513] [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: 06/30/2023] [Accepted: 03/31/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES The aim of the present study was to investigate whether prediction models built by de Graaff et al. (2020 ) can be used to improve speech recognition in experienced adult postlingual implanted Cochlear CI users. de Graaff et al. (2020 ) found relationships between elevated aided thresholds and a not optimal electrical dynamic range (<50 CL or >60 CL), and poorer speech recognition in quiet and in noise. The primary hypothesis of the present study was that speech recognition improves both in quiet and in noise when the sound processor is refitted to match targets derived from the prediction models from de Graaff et al. (2020 ). A second hypothesis was that subjectively, most of the CI users would find the new setting too loud because of an increase in C levels, and therefore, prefer the old settings. DESIGN A within-participant repeated measures design with 18 adult Cochlear CI users was used. T- and C-levels were changed to "optimized settings," as predicted by the model of de Graaff et al. (2020 ). Aided thresholds, speech recognition in quiet, and speech recognition in noise were measured with the old settings and after a 4-week acclimatization period with the optimized settings. Subjective benefit was measured using the Device Oriented Subjective Outcome Scale questionnaire. RESULTS The mean electrical dynamic range changed from 41.1 (SD = 6.6) CL to 48.6 (SD = 3.0) CL. No significant change in aided thresholds was measured. Speech recognition improved for 16 out of 18 participants and remained stable for 2 participants. Average speech recognition scores in quiet significantly improved by 4.9% (SD = 3.8%). No significant change for speech recognition in noise was found. A significant improvement in subjective benefit was found for one of the Device Oriented Subjective Outcome subscales (speech cues) between the old and optimized settings. All participants chose to keep the optimized settings at the end of the study. CONCLUSIONS We were able to improve speech recognition in quiet by optimizing the electrical dynamic range of experienced adult CI users, according to the prediction models built by de Graaff et al. (2020 ). There was no significant change in aided thresholds nor in speech recognition in noise. The findings of the present study suggest that improved performance for speech recognition in quiet in adult Cochlear CI users can be achieved by setting the dynamic range as close as possible to values between 50 and 60 CL when the volume level is at 10.
Collapse
Affiliation(s)
- Richard de Quillettes
- Amsterdam UMC, Location Vrije Universiteit, Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Marre Kaandorp
- Amsterdam UMC, Location Vrije Universiteit, Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Paul Merkus
- Amsterdam UMC, Location Vrije Universiteit, Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Sophia E. Kramer
- Amsterdam UMC, Location Vrije Universiteit, Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Cas Smits
- Amsterdam UMC, Location University of Amsterdam, Otolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| |
Collapse
|
86
|
Li J, Jin X, Kong X, Hu N, Li X, Wang L, Liu M, Li C, Liu Y, Sun L, Gong R. Correlation of endolymphatic hydrops and perilymphatic enhancement with the clinical features of Ménière's disease. Eur Radiol 2024; 34:6036-6046. [PMID: 38308680 DOI: 10.1007/s00330-024-10620-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVES To use three-dimensional real inversion recovery (3D-real IR) MRI to investigate correlations between endolymphatic hydrops (EH) grades or the degree of perilymphatic enhancement (PE) and clinical features of Ménière's disease (MD), as previous findings have been inconsistent. METHODS A total of 273 consecutive patients with definite unilateral MD were retrospectively enrolled from September 2020 to October 2021. All patients underwent 3D-real IR and 3D-T2WI 6 h after intravenous gadolinium injection. MD-related symptom duration and vertigo frequency were recorded. EH grades were evaluated, the signal intensity ratio (SIR) was measured, and correlations between clinical features and EH, PE were assessed respectively. RESULTS The study included 123 males and 150 females, with a mean age of 53.0 years. A longer duration of vertigo was associated with higher cochlear EH grades, whereas the opposite was true for the duration of aural fullness. A longer time since vertigo onset was associated with higher vestibular EH grades; the opposite was true for the duration of individual vertigo attacks. The multiple regression analysis revealed that age, tinnitus duration, and vestibular EH were risk factors for SIR. Furthermore, the low-frequency hearing threshold (HT) was a risk factor for cochlear and vestibular EH, and the SIR. CONCLUSION The EH grade and SIR (an indicator for the quantitative evaluation of PE) were correlated with clinical features and HT of MD; thus, imaging can be a valuable tool in planning individualised treatment. CLINICAL RELEVANCE STATEMENT This study revealed that the grade of endolymphatic hydrops and degree of perilymphatic enhancement positively correlates with the length of time since onset of clinical symptoms and hearing thresholds in patients with Ménière's disease, facilitating the tailored treatment. KEY POINTS • Relationships between 3-dimensional real inversion recovery features and clinical symptoms in Ménière's disease are unknown. • Symptom duration and hearing thresholds correlated with endolymphatic hydrops grades and degree of perilymphatic enhancement. • MRI features correlate with MD severity; thus, imaging is valuable for planning tailored treatment.
Collapse
Affiliation(s)
- Jinye Li
- Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, 4 Duan Xing-Xi Road, Jinan, People's Republic of China
| | - Xianwen Jin
- Department of Radiology, Shandong Maternal and Child Health Care Hospital, Jinan, People's Republic of China
| | - Xiao Kong
- Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, 4 Duan Xing-Xi Road, Jinan, People's Republic of China
| | - Na Hu
- Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, 4 Duan Xing-Xi Road, Jinan, People's Republic of China
| | - Xiaoqin Li
- Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, 4 Duan Xing-Xi Road, Jinan, People's Republic of China
| | - Linsheng Wang
- Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, 4 Duan Xing-Xi Road, Jinan, People's Republic of China
| | - Mengxiao Liu
- Diagnostic Imaging, MR scientific Marketing, Siemens Healthineers Ltd, Shanghai, People's Republic of China
| | - Chuanting Li
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China
| | - Yafei Liu
- Shandong Mental Health Center, Shandong University, 49 Wenhua Dong Road, Jinan, People's Republic of China.
| | - Lixin Sun
- Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, 4 Duan Xing-Xi Road, Jinan, People's Republic of China.
| | - Ruozhen Gong
- Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, People's Republic of China
| |
Collapse
|
87
|
Iannella G, Pace A, Mucchino A, Greco A, De Virgilio A, Lechien JR, Maniaci A, Cocuzza S, Perrone T, Messineo D, Magliulo G. A new 3D-printed temporal bone: 'the SAPIENS'-specific anatomical printed-3D-model in education and new surgical simulations. Eur Arch Otorhinolaryngol 2024; 281:4617-4626. [PMID: 38683361 PMCID: PMC11393115 DOI: 10.1007/s00405-024-08645-6] [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: 01/28/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE Otology and neuro-otology surgeries pose significant challenges due to the intricate and variable anatomy of the temporal bone (TB), requiring extensive training. In the last years 3D-printed temporal bone models for otological dissection are becoming increasingly popular. In this study, we presented a new 3D-printed temporal bone model named 'SAPIENS', tailored for educational and surgical simulation purposes. METHODS The 'SAPIENS' model was a collaborative effort involving a multidisciplinary team, including radiologists, software engineers, ENT specialists, and 3D-printing experts. The development process spanned from June 2022 to October 2023 at the Department of Sense Organs, Sapienza University of Rome. Acquisition of human temporal bone images; temporal bone rendering; 3D-printing; post-printing phase; 3D-printed temporal bone model dissection and validation. RESULTS The 'SAPIENS' 3D-printed temporal bone model demonstrated a high level of anatomical accuracy, resembling the human temporal bone in both middle and inner ear anatomy. The questionnaire-based assessment by five experienced ENT surgeons yielded an average total score of 49.4 ± 1.8 out of 61, indicating a model highly similar to the human TB for both anatomy and dissection. Specific areas of excellence included external contour, sigmoid sinus contour, cortical mastoidectomy simulation, and its utility as a surgical practice simulator. CONCLUSION We have designed and developed a 3D model of the temporal bone that closely resembles the human temporal bone. This model enables the surgical dissection of the middle ear and mastoid with an excellent degree of similarity to the dissection performed on cadaveric temporal bones.
Collapse
Affiliation(s)
- Giannicola Iannella
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Annalisa Pace
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy.
| | - Alessandro Mucchino
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Antonio Greco
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Armando De Virgilio
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Jerome R Lechien
- Faculty of Medicine and Pharmacy, University of Mons (UMons), Mons, Belgium
| | | | - Salvatore Cocuzza
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, Catania, Italy
| | - Tiziano Perrone
- Department of Otolaryngology, Civil Hospital of Alghero, Alghero, Italy
| | - Daniela Messineo
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| | - Giuseppe Magliulo
- Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185, Rome, Italy
| |
Collapse
|
88
|
Almalki F. Review and research gap identification in genetics causes of syndromic and nonsyndromic hearing loss in Saudi Arabia. Ann Hum Genet 2024; 88:364-381. [PMID: 38517009 DOI: 10.1111/ahg.12559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/13/2024] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
Congenital hearing loss is one of the most common sensory disabilities worldwide. The genetic causes of hearing loss account for 50% of hearing loss. Genetic causes of hearing loss can be classified as nonsyndromic hearing loss (NSHL) or syndromic hearing loss (SHL). NSHL is defined as a partial or complete hearing loss without additional phenotypes; however, SHL, known as hearing loss, is associated with other phenotypes. Both types follow a simple Mendelian inheritance fashion. Several studies have been conducted to uncover the genetic factors contributing to NSHL and SHL in Saudi patients. However, these studies have encountered certain limitations. This review assesses and discusses the genetic factors underpinning NSHL and SHL globally, with a specific emphasis on the Saudi Arabian context. It also explores the prevalence of the most observed genetic causes of NSHL and SHL in Saudi Arabia. It also sheds light on areas where further research is needed to fully understand the genetic foundations of hearing loss in the Saudi population. This review identifies several gaps in research in NSHL and SHL and provides insights into potential research to be conducted.
Collapse
Affiliation(s)
- Faisal Almalki
- Medical Laboratories Technology Department, College of Applied Medical Sciences, Taibah University, Al Madinah Al Munwarah, Saudi Arabia
| |
Collapse
|
89
|
Rueda Vega M, López Granados C, Arístegui Torrano I, Martín Sanz E, Arístegui Ruiz M. Superior semicircular canal dehiscence in relation with the superior petrosal sinus: our experience, surgical management and systematic review of literature. Eur Arch Otorhinolaryngol 2024; 281:4665-4675. [PMID: 38698161 DOI: 10.1007/s00405-024-08682-1] [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: 02/13/2024] [Accepted: 04/12/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE Most of Superior Semicircular Canal Dehiscence (SSCD) are located in the apical region of the SSC. However, in a small number of cases, it may be situated in the medial wall, causing the SSC to contact with the superior petrosal sinus (SPS). The aim of this study is to describe four patients with SSCD involving the superior petrosal sinus (SSCD-SPS) and to perform a review of the literature. METHODS Observational retrospective study of patients diagnosed of SSCD-SPS in a tertiary referral center. A systematic review was made, identifying 7 articles in the literature. Clinical presentation, complementary test (pure-tone audiometry, PTA; vestibular evoked myogenic potential, VEMP; computed tomography, CT), therapeutic management and outcomes were reported. RESULTS Four new cases of SSCD-SPS are reported, in three of them a transmastoid plugging was performed. 54 patients with SSCD-SPS (57 dehiscences) were reported in the literature. The most frequent symptoms were aural pressure (57.41%) and vertigo provoked by pressure/Valsalva (55.55%). Conductive hearing loss was the most common finding in PTA (47.37%). Abnormally low thresholds were observed in 59.46% of reported VEMP. Transmastoid approach was used in ten cases, middle fossa approach in four, round window reinforcement in one, and occlusion of the SPS using coils in two. CONCLUSIONS Within SSCD, we have encountered a rare subtype characterized by its medial wall location in close proximity to the SPS. This subgroup needs special consideration as it has shown its own distinct characteristics. Regarding therapeutic management, we advocate a transmastoid approach.
Collapse
Affiliation(s)
- Monica Rueda Vega
- Department of Otolaryngology-Head and Neck Surgery, Hospital General Universitario Gregorio Marañón., C/ Doctor Esquerdo, 46, 28007, Madrid, Spain.
| | - Carolina López Granados
- Department of Otolaryngology-Head and Neck Surgery, Hospital General Universitario Gregorio Marañón., C/ Doctor Esquerdo, 46, 28007, Madrid, Spain
| | - Ignacio Arístegui Torrano
- Department of Otolaryngology-Head and Neck Surgery, Hospital General Universitario Gregorio Marañón., C/ Doctor Esquerdo, 46, 28007, Madrid, Spain
| | - Eduardo Martín Sanz
- Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario de Getafe, Getafe, Madrid, Spain
| | - Miguel Arístegui Ruiz
- Department of Otolaryngology-Head and Neck Surgery, Hospital General Universitario Gregorio Marañón., C/ Doctor Esquerdo, 46, 28007, Madrid, Spain
| |
Collapse
|
90
|
Otsuka A, Koyama H, Kashio A, Matsumoto Y, Yamasoba T. Comparison of Endoscopic and Microscopic Surgery for the Treatment of Acquired Cholesteatoma by EAONO/JOS Staging. Healthcare (Basel) 2024; 12:1737. [PMID: 39273760 PMCID: PMC11395086 DOI: 10.3390/healthcare12171737] [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: 07/18/2024] [Revised: 08/23/2024] [Accepted: 08/29/2024] [Indexed: 09/15/2024] Open
Abstract
Cholesteatoma is a benign tumor of the middle ear. Tympanoplasty is performed to remove cholesteatoma, prevent recurrence, and avoid complications. Previously, microscopy was used for tympanoplasty; however, endoscopy has become increasingly popular for this procedure. The effectiveness of endoscopy and the appropriate candidacy for endoscopic ear surgery remain controversial. In this retrospective chart review study, we enrolled 107 patients with cholesteatoma who underwent tympanoplasty and compared the microscopic approach (71 patients) and the endoscopic approach (36 patients) at different stages to clarify the benefits of using endoscopy and to determine candidacy for endoscopic ear surgery. Approach selection, complication rate, recurrence rate, and postoperative hearing threshold were compared between microscopic and endoscopic approaches in stages I, II, and III. Endoscopy was used more often than microscopy for early-stage (stage I) cholesteatoma (p = 0.005) and less frequently for advanced-stage (stage II) cholesteatoma (p = 0.02). Endoscopy surgery resulted in chorda tympani injury less often than microscopic surgery (p = 0.049); however, there were no significant differences between these two groups in terms of recurrence rate or postoperative hearing outcome. Endoscopy is particularly useful for early-stage cholesteatoma, and both approaches show no difference in hearing outcome in stage I and II; nevertheless, further research is required to determine an appropriate approach for more advanced stages (stage III).
Collapse
Affiliation(s)
- Ayaka Otsuka
- Department of Otorhinolaryngology, Mitsui Memorial Hospital, Tokyo 101-8643, Japan
| | - Hajime Koyama
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo 113-8655, Japan
| | - Akinori Kashio
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yu Matsumoto
- Department of Otorhinolaryngology, Tokyo Metropolitan Police Hospital, Tokyo 164-8541, Japan
| | - Tatsuya Yamasoba
- Department of Otorhinolaryngology, Tokyo Teishin Hospital, Tokyo 102-8798, Japan
| |
Collapse
|
91
|
Sharifi A, Rabbani Anari M, Hasanzadeh A, Ghaffari ME, Ghaedsharaf S, Zojaji M, Kouhi A. Exploring the Association of Serum Uric Acid Levels with Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis. EAR, NOSE & THROAT JOURNAL 2024:1455613241272455. [PMID: 39215477 DOI: 10.1177/01455613241272455] [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: 09/04/2024] Open
Abstract
Objectives: The role of uric acid in pathogenesis of benign paroxysmal positional vertigo (BPPV) is not fully understood. It is aimed to assess the serum uric acid levels in BPPV patients compared to healthy controls. Study design: Systematic review and meta-analysis. Methods: Web of science, PubMed, Scopus, Google Scholar, Embase, Medline, and Cochrane library were systematically searched. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Results: In total, 20 studies including 3967 participants met the inclusion criteria. Ten studies (50%) reported higher uric acid (UA) levels in BPPV patients, 4 studies (20%) indicated lower UA levels in BPPV patients, while 6 studies (30%) found no significant difference in UA levels between BPPV patients and healthy controls. The overall mean serum levels of UA (SMD: 0.265, [-0.163 to 0.693]) were higher in BPPV patients than control group. However, this difference was not statistically significant (P-value: .225). Conclusion: There is no significant difference in serum level of UA between BPPV patients and healthy controls. It means that serum level of UA (whether low or high) is not likely the underlying factor of development of BPPV.
Collapse
Affiliation(s)
- Alireza Sharifi
- Otorhinolaryngology Research Center, Department of Otolaryngology Head and Neck Surgery, Tehran University of Medical Sciences, Amir A'lam Hospital, Tehran, Iran
| | - Mahtab Rabbani Anari
- Otorhinolaryngology Research Center, Department of Otolaryngology Head and Neck Surgery, Tehran University of Medical Sciences, Amir A'lam Hospital, Tehran, Iran
| | - Armin Hasanzadeh
- Otorhinolaryngology Research Center, Department of Otolaryngology Head and Neck Surgery, Tehran University of Medical Sciences, Amir A'lam Hospital, Tehran, Iran
| | - Mohammad E Ghaffari
- Faculty of Health, Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom, Iran
| | | | - Mohaddeseh Zojaji
- Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Kouhi
- Otorhinolaryngology Research Center, Department of Otolaryngology Head and Neck Surgery, Tehran University of Medical Sciences, Amir A'lam Hospital, Tehran, Iran
| |
Collapse
|
92
|
Becker AL, Scholle L, Klause CH, Staege MS, Strauss C, Otto M, Rampp S, Scheller C, Leisz S. Correlation of Immunomodulatory Cytokines with Tumor Volume and Cerebrospinal Fluid in Vestibular Schwannoma Patients. Cancers (Basel) 2024; 16:3002. [PMID: 39272860 PMCID: PMC11394145 DOI: 10.3390/cancers16173002] [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: 07/23/2024] [Revised: 08/26/2024] [Accepted: 08/27/2024] [Indexed: 09/15/2024] Open
Abstract
Sporadic vestibular schwannomas (VSs) often exhibit slow or negligible growth. Nevertheless, some VSs increase significantly in volume within a few months or grow continuously. Recent evidence indicates a role of inflammation in promoting VS growth. Therefore, our study aimed to identify cytokines, which are associated with larger VSs. The expression of different cytokines in VS tumor samples and VS primary cultures was investigated. Additionally, the concentration of cytokines in cell culture supernatants of VS primary cultures and cerebrospinal fluid (CSF) of VS patients and healthy controls were determined. Correlation analysis of cytokine levels with tumor volume, growth rate, Koos grade, age, and hearing was examined with Spearman's-rank test. The mRNA expression of CC-chemokine ligand (CCL) 18, growth differentiation factor (GDF) 15, and interferon regulatory factor 4 correlated positively with tumor volume. Moreover, the amount of GDF15 in the cell culture supernatant of primary cells correlated positively with tumor volume. The concentrations of the cytokines CCL2, CCL5, and CCL18 and transforming growth factor beta (TGFB) 1 in the CSF of the patients were significantly different from those in the CSF controls. Inhibition of immune cell infiltration could be a putative approach to prevent and control VS growth.
Collapse
Affiliation(s)
- Anna-Louisa Becker
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Leila Scholle
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Clara Helene Klause
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Martin Sebastian Staege
- Department of Surgical and Conservative Pediatrics and Adolescent Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Christian Strauss
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Markus Otto
- Department of Neurology, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Stefan Rampp
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
- Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
- Department of Neuroradiology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Christian Scheller
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Sandra Leisz
- Department of Neurosurgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| |
Collapse
|
93
|
Masalski M, Morawski K. The multilingual digits-in-noise (DIN) test: development and evaluation. Int J Audiol 2024:1-11. [PMID: 39207918 DOI: 10.1080/14992027.2024.2397068] [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: 09/15/2023] [Revised: 07/22/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To develop a methodologically uniform digits-in-noise (DIN) test in 17 different languages. DESIGN The DIN test was developed for Android devices as an extension to the open-access Hearing Test™ app, available on the Google Play store. It utilised professionally recorded female speech, speech-shaped noise, a digit scoring method and a variable step size. The test was adaptively optimised and evaluated as the results of tests taken online by users of the app became available. STUDY SAMPLE Optimisation using 35,534 ears, evaluation using 6012 ears. RESULTS Optimisation improved the slopes of the psychometric functions for all languages by an average of 6.8%/dB. Evaluation included calculation of normative speech reception thresholds (SRTs) and estimation of test-retest standard deviations. Normative values for SRTs ranged from -14.2 dB SNR (95% CI -14.3 to -14.0) for Chinese to -11.2 dB SNR (95% CI -11.3 to -11.1) for Japanese, with reliability estimates ranging from 0.48 dB (95% CI 0.36-0.64) for Portuguese to 0.91 dB (95% CI 0.73-1.21) for Romanian. CONCLUSIONS The optimisation of each language version was confirmed by the improvement in the slopes of the psychometric functions. The normative values obtained from the test evaluation were in agreement with literature data. TRIAL REGISTRATION Science Support Centre of Wroclaw Medical University BW-59/2020.
Collapse
Affiliation(s)
- Marcin Masalski
- Department and Clinic of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland
- Department of Biomedical Engineering, Faculty of Fundamental Problems of Technology, Wroclaw University of Science and Technology, Wrocław, Poland
| | - Krzysztof Morawski
- Department of Otolaryngology and Institute of Medical Sciences, University of Opole, Opole, Poland
| |
Collapse
|
94
|
Qian J, Lu P, He B, Liu T. Splicing of Helix Framework in Modified Nagata Method Stage I for Auricle Reconstruction in Patients With Insufficient 8th Rib Cartilage. Ann Plast Surg 2024:00000637-990000000-00533. [PMID: 39207864 DOI: 10.1097/sap.0000000000004082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND The 8th rib cartilage was sometimes insufficient to construct a complete external helix in ear reconstruction for microtia. The aim of this study was to investigate the splicing technique of 8th rib cartilage in modified Nagata method stage I. METHODS Between September 2022 and May 2023, 231 consecutive patients with microtia underwent auricular reconstruction with modified Nagata method stage I. Thirty-four patients with insufficient 8th rib cartilage were screened out by three-dimensional (3D) computed tomography preoperatively, who were included in the study prospectively. The 8th rib was spliced to create the external helix when fabricating the ear framework in the stage I surgery for the 34 patients. The median duration of follow-up was 12.1 months (8-15 months). RESULTS There were no perioperative complications in our study. During follow-up, all patients had satisfying outcomes, with no inward collapse, displacement, or absorption of the spliced external helix. The splicing point was not obvious. CONCLUSIONS It was safe and effective to splice the 8th rib cartilage for external helix of the cartilage framework in ear reconstruction for microtia.
Collapse
Affiliation(s)
- Jin Qian
- From the Department of Auricular Plastic and Reconstructive Surgery, Chinese Academy of Medical Sciences & Peking Union Medical College Plastic Surgery Hospital and Institute, Beijing, China
| | | | | | | |
Collapse
|
95
|
Francavilla B, Marzocchella G, Alagna A, Tilotta S, Di Leo E, Omer GL, Di Girolamo S. Personalized Sound Therapy Combined with Low and High-Frequency Electromagnetic Stimulation for Chronic Tinnitus. J Pers Med 2024; 14:912. [PMID: 39338167 PMCID: PMC11432753 DOI: 10.3390/jpm14090912] [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: 07/24/2024] [Revised: 08/25/2024] [Accepted: 08/27/2024] [Indexed: 09/30/2024] Open
Abstract
This study investigates a novel multimodal treatment for chronic tinnitus, a condition that significantly affects quality of life, by combining personalized sound therapy with both low- and high-frequency electromagnetic wave stimulation. Conducted at Tor Vergata University Hospital in Rome, the research involved 55 patients and employed a portable medical device for therapy delivery. Treatment effectiveness was measured through the Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), Hyperacusis Questionnaire (HQ), and Short Form-36 Health Survey (SF-36), encompassing initial sound therapy and subsequent multimodal treatment phases. Remarkably, 73% of participants experienced notable improvements in TFI scores, with 39% reporting a significant enhancement of 13 points or more. This improvement was mirrored in secondary outcomes like THI, VAS, and HQ scores, along with certain SF-36 domains, indicating enhanced life quality and reduced tinnitus distress. The study underscored high compliance and no adverse effects, suggesting the combined therapy's promising potential in chronic tinnitus management. The findings advocate for further research to discern the distinct contributions of each treatment modality, positing that this innovative approach could ameliorate tinnitus symptoms and improve patient well-being, confirming its safety and efficacy.
Collapse
Affiliation(s)
- Beatrice Francavilla
- Department of Otorhinolaryngology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giulia Marzocchella
- Department of Otorhinolaryngology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Arianna Alagna
- Department of Otorhinolaryngology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Stefania Tilotta
- Department of Otorhinolaryngology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Elisa Di Leo
- Department of Otorhinolaryngology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Goran Latif Omer
- Department of Otorhinolaryngology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Stefano Di Girolamo
- Department of Otorhinolaryngology, University of Rome Tor Vergata, 00133 Rome, Italy
| |
Collapse
|
96
|
Radeloff K, Sandmann P, Klüner C, Radeloff A. [Rehabilitation with cochlear implants in children with malformations of the inner ear]. HNO 2024:10.1007/s00106-024-01507-x. [PMID: 39198295 DOI: 10.1007/s00106-024-01507-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 09/01/2024]
Abstract
Cochlear implants (CIs) are the treatment of choice for hearing rehabilitation in children with congenital or acquired profound hearing loss or deafness in order to ensure appropriate speech development and avoid social deprivation. However, in the case of a radiologically detectable malformation of the inner ear structures and potentially associated hypo- or aplasia of the vestibulocochlear nerve, application of a CI is either not possible, or the functional outcome may be of limited predictability. In addition, the risk of surgical complications is also increased in these patients. Counseling parents and developing an appropriate individual therapeutic decision can therefore be a major challenge for the medical team. The current paper is intended to provide support in this regard. It presents criteria for various inner ear malformations and discusses possible treatment options.
Collapse
Affiliation(s)
- Katrin Radeloff
- Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Evangelisches Krankenhaus Oldenburg, Steinweg 13-17, 26122, Oldenburg, Deutschland.
| | - Pascale Sandmann
- Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Evangelisches Krankenhaus Oldenburg, Steinweg 13-17, 26122, Oldenburg, Deutschland
- Klinische Audiologie, Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Evangelisches Krankenhaus Oldenburg, Oldenburg, Deutschland
- Cluster of Excellence "Hearing 4 All", Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | - Claudia Klüner
- Institut für Radiologie & Neuroradiologie, Evangelisches Krankenhaus Oldenburg, Oldenburg, Deutschland
| | - Andreas Radeloff
- Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Evangelisches Krankenhaus Oldenburg, Steinweg 13-17, 26122, Oldenburg, Deutschland
- Cluster of Excellence "Hearing 4 All", Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| |
Collapse
|
97
|
Xiao L, Li L, Wu C, Zhang W. Bilateral Internal Auditory Canal Metastasis From Lung Cancer on FDG PET/CT. Clin Nucl Med 2024:00003072-990000000-01262. [PMID: 39192510 DOI: 10.1097/rlu.0000000000005421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
ABSTRACT The occurrence of metastatic tumor in the internal auditory canal is very rare. Thus, we report FDG PET/CT findings of bilateral Internal auditory canal metastasis from lung cancer in a 67-year-old man. FDG PET/CT and MRI showed nodules in the bilateral internal auditory canal with an SUVmax of 5.2. This case hints us that bilateral metastasis should be considered as differential diagnosis when we encounter bilateral nodule in the internal auditory.
Collapse
Affiliation(s)
- Liu Xiao
- From the Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Lin Li
- From the Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Chunyan Wu
- NHC Key Laboratory of Nuclear Technology Medical Transformation (Mianyang Central Hospital), Mianyang, Sichuan Province, China
| | - Wenjie Zhang
- From the Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| |
Collapse
|
98
|
Liu X, Guo P, Wang D, Hsieh YL, Shi S, Dai Z, Wang D, Li H, Wang W. Applications of Machine Learning in Meniere's Disease Assessment Based on Pure-Tone Audiometry. Otolaryngol Head Neck Surg 2024. [PMID: 39194410 DOI: 10.1002/ohn.956] [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: 01/22/2024] [Revised: 07/03/2024] [Accepted: 08/10/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVE To apply machine learning models based on air conduction thresholds of pure-tone audiometry for automatic diagnosis of Meniere's disease (MD) and prediction of endolymphatic hydrops (EH). STUDY DESIGN Retrospective study. SETTING Tertiary medical center. METHODS Gadolinium-enhanced magnetic resonance imaging sequences and pure-tone audiometry data were collected. Subsequently, basic and multiple analytical features were engineered based on the air conduction thresholds of pure-tone audiometry. Later, 5 classical machine learning models were trained to diagnose MD using the engineered features. The models demonstrating excellent performance were also selected to predict EH. The model's effectiveness in MD diagnosis was compared with experienced otolaryngologists. RESULTS First, the winning light gradient boosting (LGB) machine learning model trained by multiple features demonstrates a remarkable performance on the diagnosis of MD, achieving an accuracy rate of 87%, sensitivity of 83%, specificity of 90%, and a robust area under the receiver operating characteristic curve of 0.95, which compares favorably with experienced clinicians. Second, the LGB model, with an accuracy of 78% on EH prediction, outperformed the other 3 machine learning models. Finally, a feature importance analysis reveals a pivotal role of the specific pure-tone audiometry features that are essential for both MD diagnosis and EH prediction. Highlighted features include standard deviation and mean of the whole-frequency hearing, the peak of the audiogram, and hearing at low frequencies, notably at 250 Hz. CONCLUSION An efficient machine learning model based on pure-tone audiometry features was produced to diagnose MD, which also showed the potential to predict the subtypes of EH. The innovative approach demonstrated a game-changing strategy for MD screening and promising cost-effective benefits for the health care enterprise.
Collapse
Affiliation(s)
- Xu Liu
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, China
- Department of Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Ping Guo
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, China
- Department of Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Dan Wang
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, China
- Department of Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Yue-Lin Hsieh
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, China
- Department of Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Suming Shi
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, China
- Department of Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Zhijian Dai
- Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Wenzhou Medical College, Wenzhou, China
| | - Deping Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongzhe Li
- Research Service, VA Loma Linda Healthcare System, Loma Linda, California, USA
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, California, USA
| | - Wuqing Wang
- Department of Otorhinolaryngology, Eye and ENT Hospital, ENT Institute, Fudan University, Shanghai, China
- Department of Otorhinolaryngology, NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| |
Collapse
|
99
|
Skare TL, de Carvalho JF, de Medeiros IRT, Shoenfeld Y. Ear abnormalities in chronic fatigue syndrome (CFS), fibromyalgia (FM), Coronavirus-19 infectious disease (COVID) and long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/inflammatory syndrome induced by adjuvants (ASIA): A systematic review. Autoimmun Rev 2024:103606. [PMID: 39209013 DOI: 10.1016/j.autrev.2024.103606] [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: 05/26/2024] [Accepted: 05/30/2024] [Indexed: 09/04/2024]
Abstract
Chronic fatigue syndrome (CFS), fibromyalgia (FM), silicone breast implants (SBI), Coronavirus-19 infectious disease (COVID), COVID-19 vaccination (post-COVIDvac-syndrome), Long-COVID syndrome (PCS), sick-building syndrome (SBS), post-orthostatic tachycardia syndrome (PoTS), and autoimmune/ inflammatory syndrome induced by adjuvants (ASIA) are a cluster of poorly understood medical conditions that have in common a group of ill-defined symptoms and dysautonomic features. Most of the clinical findings of this group of diseases are unspecific, such as fatigue, diffuse pain, cognitive impairment, paresthesia, tachycardia, anxiety, and depression. Hearing disturbances and vertigo have also been described in this context, the underlying pathophysiologic process for these conditions might rely on autonomic autoimmune dysbalance. The authors procced a literature review regarding to hearing and labyrinthic disturbances in CSF, FM, SBI, COVID, post-COVIDvac-syndrome, PCS, SBS, POTS, and ASIA. The PRISMA guidelines were followed, and the literature reviewed encompassed papers from January 1990 to January 2024. After the initial evaluation of the articles found in the search through Pubmed, Scielo and Embase, a total of 172 articles were read and included in this review. The prevalence of hearing loss, dizziness, vertigo and tinnitus was described and correlated with the diseases investigated in this study. There are great variability in the frequencies of symptoms found, but cochlear complaints are the most frequent in most studies. Vestibular symptoms are less reported. The main pathophysiological mechanisms are discussed. Direct effects of the virus in the inner ear or nervous pathways, impaired vascular perfusion, cross-reaction or autoimmune immunoreactivity, oxidative stress, DNA methylation, epigenetic modifications and gene activation were implicated in the generation of the investigated symptoms. In clinical practice, all patients with these autoimmune conditions who have any audiological complaint an ENT consultation followed by an audiometry are needed.
Collapse
Affiliation(s)
- Thelma L Skare
- Serviço de Reumatologia, Hospital Universitário Evangélico Mackenzie, Curitiba, PR, Brazil
| | - Jozélio Freire de Carvalho
- Núcleo de Pesquisa em Doenças Crônicas não Transmissíveis (NUPEN), School of Nutrition from the Federal University of Bahia, Salvador, Bahia, Brazil.
| | | | - Yehuda Shoenfeld
- Reichman University, Herzelia, Israel; Zabludowicz Center for Autoimmune Diseases (Founder), Sheba Medical Center, Tel-Hashomer, Israel
| |
Collapse
|
100
|
Abari J, Neudert M, Bornitz M, Van Gompel G, Provyn S, Al-Qubay M, Topsakal V. Noise exposure of the inner ear during robotic drilling. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08925-1. [PMID: 39198307 DOI: 10.1007/s00405-024-08925-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 08/19/2024] [Indexed: 09/01/2024]
Abstract
INTRODUCTION Preserving the cochlear structures and thus hearing preservation, has become a prominent topic of discussion in cochlear implant (CI) surgery. Various approaches and soft surgical techniques have been described when approaching the inner ear. Robot-assisted cochlear implant surgery (RACIS) reaches the round window in a minimally invasive manner by following a trajectory of minimal trauma. This involves the drilling of a keyhole trajectory to the round window, through the facial recess, with no need for a complete mastoidectomy. It involves less drilling, less drilling time and less structural damage. A lot of attention has been paid to the structural traumatic causes of hearing loss but acoustic trauma during the exposure of the inner ear appears to be neglected topic. AIM The aim was to measure the noise exposure of the inner ear during the robotic drilling of the mastoid and bony overhang of the round window. The results were compared with the milling in conventional cochlear implantation surgery. INTERVENTION RACIS on fresh frozen human cadavers. OUTCOME MEASUREMENTS The equivalent frequency-weighted and time-averaged sound pressure level LAF in dB and the noise dose in % derived from a noise damage model, both obtained during RACIS. MATERIALS AND METHODS The robotic drilling of 6 trajectories towards the inner ear were performed, including 4 trajectories through round window access and 2 trajectories through cochleostomy. The results were compared with the data of 7 cases of conventional CI surgery that have been described in literature. The induced equivalent sound pressure level LAF was determined via an accelleration sensor at the zygomatic arch and a calibration according to bone conduction audiometry. A noise dose for the whole procedure was calculated from the equivalent sound pressure level LAF and the exposure time using a noise damage model. A noise dose of 100% is considered a critical exposure limit and values above are considered potentially harmful, with the risk of hearing impairment. RESULTS The maximum LAF was 82 dB during fiducial screw placement; 87 dB during middle ear access; 95 dB for the accesses through the round window and 88 dB for the accesses through cochleostomy. The noise dose due to the HEARO®-procedure was always far below the critical value of 100%. There was no acoustic trauma of the inner ear in all cases with the noise dose being smaller than 0.1% in five out of the six cases. The maximum LAF in the seven cases of conventional CI surgery was 118 dB with a maximum cumulative noise dose of 172.6%. The critical exposure limit of 100% was exceeded in three cases of conventional CI surgery. CONCLUSION RACIS provokes significantly less acoustic trauma than conventional mastoid surgery in our findings. There were no observable differences in noise exposure levels between a cochleostomy or a round window approach where the bony overhang needed to be drilled.
Collapse
Affiliation(s)
- Jaouad Abari
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
| | - Marcus Neudert
- Faculty of Medicine Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Dresden, Saxony, Germany
| | - Matthias Bornitz
- Faculty of Medicine Carl Gustav Carus, Department of Otorhinolaryngology, Head and Neck Surgery, Technische Universität Dresden, Dresden, Saxony, Germany
| | - Gert Van Gompel
- Department of Radiology, University Hospital UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Steven Provyn
- Anatomical Research and Clinical Studies, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Vedat Topsakal
- Vrije Universiteit Brussel, Brussels Health Campus, Brussels, Belgium
| |
Collapse
|