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Casile M, Thivat E, Giraudet F, Ginzac A, Molnar I, Biau J, Brehant J, Lourenco B, Avan P, Durando X. Non-invasive intracranial pressure monitoring for high-grade gliomas patients treated with radiotherapy: results of the GMaPIC trial. Front Oncol 2024; 14:1302977. [PMID: 38919520 PMCID: PMC11196594 DOI: 10.3389/fonc.2024.1302977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction Patients with high-grade gliomas are at risk of developing increased intracranial hypertension (ICHT) in relation to the increase in volume of their tumor. ICP change cannot be measured by invasive method but can be estimated by using routine clinical signs, in combination with a standard imaging method, magnetic resonance imaging (MRI). A non-invasive monitoring of ICP could be of interest in high-grade glioma, in particular after radiotherapy treatment with as major side effect a cerebral oedema. Patients and Methods This prospective clinical study aimed to compare the ICP changes (estimated by a non-invasive method based upon distortion product otoacoustic emissions (DPOAE) monitoring) with volume changes observed on MRI in patients with high-grade gliomas treated with radiotherapy. DPOAE measurements were performed one month after the end of radiotherapy and then every 3 months for one year. At each visit, the patient also underwent MRI as well as an evaluation of clinical signs. Results The variation in the estimate of intracranial pressure readout measured at each follow-up visit (in absolute value with respect to the baseline measurements) was significantly associated with the variation of T2/FLAIR volume (n=125; p<0.001) with a cut off value of change ICP readout of 40.2 degrees (e.i. an estimated change of 16 mm Hg). Discussion The GMaPIC trial confirm the hypothesis that the ICP change estimated by DPOAEs measurement using a non-invasive medical device is correlated with the change of the tumor or edema in high grade glioma after radiotherapy. The device could thus become an easy-to-use and non-invasive intracranial pressure monitoring tool for these patients. Clinical Trial Registration Clinicaltrials.gov, identifier (NCT02520492).
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Affiliation(s)
- Mélanie Casile
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Emilie Thivat
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Fabrice Giraudet
- INSERM 1107, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Angeline Ginzac
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Ioana Molnar
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Julian Biau
- Radiation Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Julien Brehant
- Radiology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Blandine Lourenco
- INSERM 1107, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Paul Avan
- INSERM 1107, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Xavier Durando
- INSERM U1240 IMoST, University of Clermont Auvergne, Clermont-Ferrand, France
- UMR 501, Clinical Investigation Centre, Clermont-Ferrand, France
- Clinical Research and Innovation Department, Centre Jean Perrin, Clermont-Ferrand, France
- Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
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2
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Sharp S, Silbert PL, Davies S, Friedland P. Spontaneous Intracranial Hypotension: An Uncommon Cause of Postural Vestibulocochlear Symptoms. EAR, NOSE & THROAT JOURNAL 2023:1455613231194431. [PMID: 37596853 DOI: 10.1177/01455613231194431] [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: 08/20/2023] Open
Abstract
Spontaneous intracranial hypotension is an uncommon but increasingly recognized condition characterized by an orthostatic headache secondary to low cerebrospinal fluid pressure. Vestibulocochlear symptoms are common but rarely the only presenting feature and can be challenging to differentiate from Meniere's disease. We present a case series that highlights the common vestibulocochlear symptoms and a review of the literature to increase awareness amongst otolaryngologists and highlight the path to diagnosis and management of this condition.
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Affiliation(s)
- Samuel Sharp
- Department of Otolaryngology Head and Neck Surgery, Joondalup Health Campus, Perth, WA, Australia
| | - Peter L Silbert
- Medical School, University Western Australia, Perth, WA, Australia
| | - Scott Davies
- Interventional Neuroradiology, Royal Perth Hospital, Perth, WA, Australia
| | - Peter Friedland
- Department of Otolaryngology Head and Neck Surgery, Joondalup Health Campus, Perth, WA, Australia
- Medical School, University Western Australia, Perth, WA, Australia
- School of Medicine, Notre Dame University, Perth, WA, Australia
- Department of Otolaryngology, Head and Neck Surgery, Sir Charles Gairdner Hospital, Perth, WA, Australia
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Bom Braga GO, Parrilli A, Zboray R, Bulatović M, Wagner F. Quantitative Evaluation of the 3D Anatomy of the Human Osseous Spiral Lamina Using MicroCT. J Assoc Res Otolaryngol 2023; 24:441-452. [PMID: 37407801 PMCID: PMC10504225 DOI: 10.1007/s10162-023-00904-3] [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: 07/18/2022] [Accepted: 06/20/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE The osseous spiral lamina (OSL) is an inner cochlear bony structure that projects from the modiolus from base to apex, separating the cochlear canal into the scala vestibuli and scala tympani. The porosity of the OSL has recently attracted the attention of scientists due to its potential impact on the overall sound transduction. The bony pillars between the vestibular and tympanic plates of the OSL are not always visible in conventional histopathological studies, so imaging of such structures is usually lacking or incomplete. With this pilot study, we aimed, for the first time, to anatomically demonstrate the OSL in great detail and in 3D. METHODS We measured width, thickness, and porosity of the human OSL by microCT using increasing nominal resolutions up to 2.5-µm voxel size. Additionally, 3D models of the individual plates at the basal and middle turns and the apex were created from the CT datasets. RESULTS We found a constant presence of porosity in both tympanic plate and vestibular plate from basal turn to the apex. The tympanic plate appears to be more porous than vestibular plate in the basal and middle turns, while it is less porous in the apex. Furthermore, the 3D reconstruction allowed the bony pillars that lie between the OSL plates to be observed in great detail. CONCLUSION By enhancing our comprehension of the OSL, we can advance our comprehension of hearing mechanisms and enhance the accuracy and effectiveness of cochlear models.
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Affiliation(s)
- Gabriela O Bom Braga
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Annapaola Parrilli
- Center for X-Ray Analytics, Empa - Swiss Federal Laboratories for Materials Science and Technology, Überlandstrasse 129, 8600, Dübendorf, Switzerland.
| | - Robert Zboray
- Center for X-Ray Analytics, Empa - Swiss Federal Laboratories for Materials Science and Technology, Überlandstrasse 129, 8600, Dübendorf, Switzerland
| | - Milica Bulatović
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Franca Wagner
- Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Palma S, Forli F, Rossi C, Filice R, D'adamo C, Roversi MF, Monzani D, Lorenzoni F, Botti C, Berrettini S, Bruschini L, Berardi A, Genovese E, Canelli R. The Audiological Follow-Up of Children with Symptomatic Congenital Cytomegalovirus Infection: An Experience in Two Italian Centers. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1136. [PMID: 37508638 PMCID: PMC10378266 DOI: 10.3390/children10071136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Congenital cytomegalovirus (cCMV) infection is the leading cause of non-hereditary sensorineural hearing loss in children. While about 10% of children reportedly display symptoms at birth, 85-90% of cCMV infection cases are asymptomatic. However, 10-15% of these asymptomatic infants may later develop hearing, visual, or neurodevelopmental impairments. This study aimed to evaluate the impact of cCMV infection on newborns' hearing function with a particular emphasis on progressive and late-onset cases. METHODS This study is a retrospective chart analysis with longitudinal character and was conducted in two Italian centers: Center 1 (from 1 November 2007 to 31 December 2021) and Center 2 (from 1 January 2012 to 31 December 2021). Data collected included newborn hearing screening results, characterization of hearing loss (unilateral/bilateral, degree of impairment), and audiological follow-up. RESULTS The cohort consisted of 103 children (42% males, 58% females). In total, 28 children presented with hearing impairment; 71.4% (20 out of 28) of the cases of hearing loss were severe/profound, with 35.7% of the cases due to unilateral hearing loss. Out of twenty-eight, six experienced progression of hearing loss and four had late-onset hearing loss. CONCLUSIONS In the absence of universal cCMV screening, hearing screening at birth for cCMV remains a critical factor for early diagnosis. A significant percentage of children affected by cCMV with normal audiological evaluations at birth is easily lost to follow-up. Close collaboration between neonatologists, pediatricians, and audiological services is fundamental to ensure timely diagnosis and treatment of cCMV-related hearing loss.
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Affiliation(s)
- Silvia Palma
- Audiology, Primary Care Department, AUSL of Modena, 41100 Modena, Italy
| | - Francesca Forli
- Department of Medical and Surgical Sciences for Children and Adults, Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria, 56121 Pisa, Italy
| | - Cecilia Rossi
- Department of Neonatal Intensive Care Unit, Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Riccardo Filice
- Department of Neonatal Intensive Care Unit, Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Concetta D'adamo
- Department of Medical and Surgical Sciences for Children and Adults, Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Maria Federica Roversi
- Department of Neonatal Intensive Care Unit, Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Daniele Monzani
- ENT, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Borgo Roma Hospital, 37100 Verona, Italy
| | - Francesca Lorenzoni
- Division of Neonatology and NICU, Department of Clinical and Experimental Medicine, 56124 Pisa, Italy
| | - Cecilia Botti
- PhD Program in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 21124 Modena, Italy
| | - Stefano Berrettini
- Department of Medical and Surgical Sciences for Children and Adults, Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria, 56121 Pisa, Italy
| | - Luca Bruschini
- Department of Medical and Surgical Sciences for Children and Adults, Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria, 56121 Pisa, Italy
| | - Alberto Berardi
- Department of Neonatal Intensive Care Unit, Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Elisabetta Genovese
- Department of Medical and Surgical Sciences for Children and Adults, Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria of Modena, 41125 Modena, Italy
| | - Rachele Canelli
- Department of Medical and Surgical Sciences for Children and Adults, Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria, 56121 Pisa, Italy
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Tang H, Wang H, Wang S, Hu SW, Lv J, Xun M, Gao K, Wang F, Chen Y, Wang D, Wang W, Li H, Shu Y. Hearing of Otof-deficient mice restored by trans-splicing of N- and C-terminal otoferlin. Hum Genet 2023; 142:289-304. [PMID: 36383253 DOI: 10.1007/s00439-022-02504-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022]
Abstract
Mutations to the OTOF gene are among the most common reasons for auditory neuropathy. Although cochlear implants are often effective in restoring sound transduction, there are currently no biological treatments for individuals with variants of OTOF. Previous studies have reported the rescue of hearing in DFNB9 mice using OTOF gene replacement although the efficacy needs improvement. Here, we developed a novel dual-AAV-mediated gene therapy system based on the principles of protein trans-splicing, and we show that this system can reverse bilateral deafness in Otof -/- mice after a single unilateral injection. The system effectively expressed exogenous mouse or human otoferlin after injection on postnatal day 0-2. Human otoferlin restored hearing to near wild-type levels for at least 6 months and restored the release of synaptic vesicles in inner hair cells. Our study not only provides a preferential clinical strategy for the treatment of OTOF-related auditory neuropathies, but also describes a route of development for other large-gene therapies and protein engineering techniques.
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Affiliation(s)
- Honghai Tang
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China
| | - Hui Wang
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China
| | - Shengyi Wang
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China
| | - Shao Wei Hu
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China
| | - Jun Lv
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China
| | - Mengzhao Xun
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China
| | - Kaiyu Gao
- Shanghai Refreshgene Therapeutics Co., Ltd., Waigaoqiao Free Trade Zone, Room 2001, Building 7-5, Free Trade No.1 Park, 160 Basheng Road, Shanghai, 200131, China
| | - Fang Wang
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China
| | - Yuxin Chen
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China
| | - Daqi Wang
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China.,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China.,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China
| | - Wuqing Wang
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China. .,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China. .,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China.
| | - Huawei Li
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China. .,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China. .,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China.
| | - Yilai Shu
- ENT Institute and Department of Otorhinolaryngology, Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, China. .,Institute of Biomedical Science, Fudan University, Shanghai, 200032, China. .,NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200032, China.
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Oney RM, Sloneker DR, Bloom AG, Avillion MP, Crawford JV, Chen BS. Cerebrospinal Fluid Otorrhea After a Routine Tympanostomy Tube Placement: A Review of the Literature on Hyrtl Fissure. EAR, NOSE & THROAT JOURNAL 2022:1455613211039045. [PMID: 36345799 DOI: 10.1177/01455613211039045] [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: 12/22/2023] Open
Abstract
OBJECTIVE To review the literature on Hyrtl fissure (HF) and contribute our experience with a 2-year old who developed cerebrospinal fluid (CSF) otorrhea during routine tympanostomy tube placement. METHODS Data Sources: Pubmed and Google Scholar searches were conducted of articles in the English language literature from all time periods using the words Hyrtl, Hyrtl's fissure, HF, and tympanomeningeal fissure. Study Selection: All relevant articles were reviewed to identify cases of HF. RESULTS Data Extraction: Nineteen cases, including ours, are described. Patient characteristics, method(s) of diagnosis and repair, and outcomes are reported. Computed tomography and intraoperative endoscopic images from our case are included. Presentation is more common in children (66.7% of cases where age was stated, n = 10) than in adults (33.3%, n = 5), and is most commonly unilateral (89.5%, n = 17). Cerebrospinal fluid otorrhea was the most common presentation. Six were discovered after tympanostomy tube placements while 3 were identified during cochlear implant work-up or after device failure. Surgical approaches described include endaural, transcanal, retrosigmoid, postauricular, and posterior fossa endoscopic. Multiple materials including bone wax, bone pate, fascia, muscle, and tissue sealant have been used. Our case describes an endoscopic repair in a child, which was successful at a 2-year follow-up. Data Synthesis: The small number of cases limits the utility of statistical analysis (n = 19). CONCLUSIONS Hyrtl fissure is a rare but important entity that may be discovered when routine procedures have unexpected results. Hyrtl fissure should be included in the differential diagnosis when there is persistent clear otorrhea after a tympanostomy tube, cochlear implant misinsertion, meningitis, or unexplained middle ear effusion in an adult.
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Affiliation(s)
- Rebecca M Oney
- Department of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, USA
| | - Del R Sloneker
- Department of Otolaryngology-Head and Neck Surgery, Womack Army Medical Center, Fort Bragg, NC, USA
| | - Ashlie G Bloom
- Department of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, USA
| | - Michael P Avillion
- Department of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, USA
| | | | - Brian S Chen
- Department of Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, USA
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7
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Liu G, Benson JC, Carr CM, Lane JI. Normal Enhancement within the Vestibular Aqueduct: An Anatomic Review with High-Resolution MRI. AJNR Am J Neuroradiol 2022; 43:1346-1349. [PMID: 36007946 PMCID: PMC9451638 DOI: 10.3174/ajnr.a7615] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/28/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE The normal appearance of the vestibular aqueduct on postcontrast MR images has not been adequately described in the literature. This study set out to characterize the expected appearance of the vestibular aqueduct, with particular emphasis on the enhancement of the structure on both 3D FSE T1 and 3D-FLAIR sequences. MATERIALS AND METHODS All MR imaging examinations of the internal auditory canals performed between March 1, 2021, and May 20, 2021, were retrospectively reviewed. All studies included high-resolution (≤0.5-mm section thickness) pre- and postgadolinium 3D FSE T1 with fat-saturated and postgadolinium 3D-FLAIR sequences. Two neuroradiologists independently reviewed the MR images of the vestibular aqueduct for the presence or absence of enhancement on both T1 and FLAIR images and compared the relative intensity of enhancement between sequences. The presence or absence of an enlarged vestibular aqueduct was also noted. RESULTS Ninety-five patients made up the patient cohort, of whom 5 did not have postcontrast FLAIR images available (50 women [55.6%]). On both sides, enhancement was significantly more commonly seen on postgadolinium FLAIR (76/180, 42.2%) than on T1 fat-saturated images (41/190, 21.6%) (P < .001). The intensity of enhancement was significantly greater on postgadolinium FLAIR images than on T1 fat-saturated images (38.9% versus 3.7%, respectively; P < .001). CONCLUSIONS Enhancement within the vestibular aqueduct is an expected finding on MR imaging and is both more common and more intense on postgadolinium 3D-FLAIR than on T1 fat-saturated sequences. Such enhancement should not be confused with pathology on MR imaging unless other suspicious findings are present.
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Affiliation(s)
- G Liu
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - J C Benson
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - C M Carr
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - J I Lane
- From the Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Triamcinolone acetonide can be detected in cerebrospinal fluid after intratympanic injection. Eur J Pharm Biopharm 2021; 170:52-58. [PMID: 34864199 DOI: 10.1016/j.ejpb.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/30/2021] [Accepted: 11/28/2021] [Indexed: 11/21/2022]
Abstract
Intratympanically applied treatments are of increasing interest to the otologic community to treat sudden sensorineural hearing loss or vestibular disorders but also to deliver gene therapy agents, or biologics to the inner ear. Further diversion from the middle ear and perilymph to blood circulation and cerebrospinal fluid via the cochlear aqueduct are one of the limiting factors and so far not understood well enough. In this study, intratympanically applied triamcinolone acetonide was determined in cerebrospinal fluid. Additionally, perilymph was sampled through the round window membrane as well as at the lateral semicircular canal to determine drug levels. Of the twenty-one included patients, triamcinolone acetonide was quantifiable in cerebrospinal fluid in 43% at very low levels (range 0 ng/ml - 6.2 ng/ml) which did not correlate with perilymph levels. Drug levels at the two different perilymph sampling sites were within a range of 13.5 ng/ml to 1180.0 ng/ml. Results suggest an equal distribution of triamcinolone acetonide to semicircular canals, which might support the use of triamcinolone acetonide as a treatment option for vestibular pathologies such as Menièrés disease. On the other hand, the distribution to cerebrospinal fluid might be limiting current approaches in gene therapy where a central distribution is unwanted.
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9
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Clinical Evaluation and Treatment of Patients with Postconcussion Syndrome. Neurol Res Int 2021; 2021:5567695. [PMID: 34194843 PMCID: PMC8181109 DOI: 10.1155/2021/5567695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/13/2021] [Indexed: 12/30/2022] Open
Abstract
Postconcussion syndrome (PCS) is a complex set of symptoms occurring in a small percentage of patients following concussion. The condition is characterized by headaches, dizziness, cognitive difficulties, somatosensory issues, and a variety of other symptoms with varying durations. There is a lack of objective markers and standard treatment protocols. With the complexity created by premorbid conditions, psychosomatic issues, secondary gains, and litigations, providers often find themselves in a tough situation in the care of these patients. This article combines literature review and clinical insights with a focus on the underlying pathophysiology of PCS to provide a roadmap for evaluating and treating this condition.
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10
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Snels C, Roland JT, Treaba C, Jethanamest D, Huinck W, Friedmann DR, Dhooge I, Mylanus E. Force and pressure measurements in temporal bones. Am J Otolaryngol 2021; 42:102859. [PMID: 33440250 DOI: 10.1016/j.amjoto.2020.102859] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Some cochlear implant (CI) patients lose their residual hearing during surgery. Two factors that might play a role in residual hearing loss are the change in intracochlear hydraulic pressure and force on the cochlear wall during electrode insertion. The aim of this study is to investigate whether a difference in peak hydraulic pressure and peak force on the cochlear wall exists during a CI electrode insertion with different insertion techniques. MATERIALS AND METHODS Twenty fresh frozen temporal bones were used. Hydraulic pressure and force on the cochlear wall were recorded during straight electrode insertions with 1) slow versus fast insertion speed, 2) manual versus automatic insertion method and 3) round window approach (RWA) versus extended RWA (ERWA). RESULTS When inserting with a slow compared to a fast insertion speed, the peak hydraulic pressure is 239% (95% CI: 130-399%) higher with a RWA and 58% (95% CI: 6-137%) higher with an ERWA. However, the peak force on the cochlear wall is a factor 29% less (95% CI: 13-43%) with a slow insertion speed. No effect was found of opening and insertion method. CONCLUSIONS As contradictory findings were found for hydraulic pressure and force on the cochlear wall on insertion speed, it remains unclear which insertion speed (slow versus fast) is less traumatic to inner ear structure.
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Attyé A, Eliezer M. Endolymph magnetic resonance imaging: Contribution of saccule and utricle analysis in the management of patients with sensorineural ear disorders. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:47-51. [DOI: 10.1016/j.anorl.2019.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ohlemiller KK. Mouse methods and models for studies in hearing. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:3668. [PMID: 31795658 DOI: 10.1121/1.5132550] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Laboratory mice have become the dominant animal model for hearing research. The mouse cochlea operates according to standard "mammalian" principles, uses the same cochlear cell types, and exhibits the same types of injury as found in other mammals. The typical mouse lifespan is less than 3 years, yet the age-associated pathologies that may be found are quite similar to longer-lived mammals. All Schuknecht's types of presbycusis have been identified in existing mouse lines, some favoring hair cell loss while others favor strial degeneration. Although noise exposure generally affects the mouse cochlea in a manner similar to other mammals, mice appear more prone to permanent alterations to hair cells or the organ of Corti than to hair cell loss. Therapeutic compounds may be applied systemically or locally through the tympanic membrane or onto (or through) the round window membrane. The thinness of the mouse cochlear capsule and annular ligament may promote drug entry from the middle ear, although an extremely active middle ear lining may quickly remove most drugs. Preclinical testing of any therapeutic will always require tests in multiple animal models. Mice constitute one model providing supporting evidence for any therapeutic, while genetically engineered mice can test hypotheses about mechanisms.
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Affiliation(s)
- Kevin K Ohlemiller
- Department of Otolaryngology, Central Institute for the Deaf at Washington University School of Medicine, Washington University School of Medicine, Fay and Carl Simons Center for Hearing and Deafness, Saint Louis, Missouri 63110, USA
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Singh A, Singh SK, Mitra D, Datta R. Unilateral Sudden Sensorineural Hearing Loss: A Rare Presentation of Cerebral Venous Thrombosis. Indian J Otolaryngol Head Neck Surg 2018; 71:1458-1461. [PMID: 31750196 DOI: 10.1007/s12070-018-1550-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/04/2018] [Indexed: 11/28/2022] Open
Abstract
Sudden sensorineural hearing loss (SNHL) is postulated to be caused due to a multitude of factors, but a definitive cause is seldom found despite extensive investigations. We present a rare case of sudden SNHL in which central venous thrombosis was found on magnetic resonance imaging. The case highlights the importance of neuroimaging in all cases of sudden SNHL before being labelled as "idiopathic" so that targeted therapy can be given.
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Affiliation(s)
- Anubhav Singh
- 1Department of ORL-HNS, Armed Forces Medical College, Pune, 411040 India
| | - Sanajeet K Singh
- 2Department of ORL-HNS, Army Hospital (R&R), New Delhi, 110010 India
| | - Debjit Mitra
- 3Department of Neurology, Command Hospital, Pune, 411040 India
| | - Rakesh Datta
- 1Department of ORL-HNS, Armed Forces Medical College, Pune, 411040 India
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Evensen KB, Paulat K, Prieur F, Holm S, Eide PK. Utility of the Tympanic Membrane Pressure Waveform for Non-invasive Estimation of The Intracranial Pressure Waveform. Sci Rep 2018; 8:15776. [PMID: 30361489 PMCID: PMC6202360 DOI: 10.1038/s41598-018-34083-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/11/2018] [Indexed: 11/09/2022] Open
Abstract
Time domain analysis of the intracranial pressure (ICP) waveform provides important information about the intracranial pressure-volume reserve capacity. The aim here was to explore whether the tympanic membrane pressure (TMP) waveform can be used to non-invasively estimate the ICP waveform. Simultaneous invasive ICP and non-invasive TMP signals were measured in a total of 28 individuals who underwent invasive ICP measurements as a part of their clinical work up (surveillance after subarachnoid hemorrhage in 9 individuals and diagnostic for CSF circulation disorders in 19 individuals). For each individual, a transfer function estimate between the invasive ICP and non-invasive TMP signals was established in order to explore the potential of the method. To validate the results, ICP waveform parameters including the mean wave amplitude (MWA) were computed in the time domain for both the ICP estimates and the invasively measured ICP. The patient-specific non-invasive ICP signals predicted MWA rather satisfactorily in 4/28 individuals (14%). In these four patients the differences between original and estimated MWA were <1.0 mmHg in more than 50% of observations, and <0.5 mmHg in more than 20% of observations. The study further disclosed that the cochlear aqueduct worked as a physical lowpass filter.
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Affiliation(s)
- Karen Brastad Evensen
- Department of Informatics, University of Oslo, Oslo, Norway.,Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Klaus Paulat
- Institute of Medical Engineering and Mechatronics, Hochschule Ulm, Ulm, Germany
| | - Fabrice Prieur
- Department of Informatics, University of Oslo, Oslo, Norway
| | - Sverre Holm
- Department of Informatics, University of Oslo, Oslo, Norway
| | - Per Kristian Eide
- Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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Akil O, Blits B, Lustig LR, Leake PA. Virally Mediated Overexpression of Glial-Derived Neurotrophic Factor Elicits Age- and Dose-Dependent Neuronal Toxicity and Hearing Loss. Hum Gene Ther 2018; 30:88-105. [PMID: 30183384 DOI: 10.1089/hum.2018.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Contemporary cochlear implants (CI) are generally very effective for remediation of severe to profound sensorineural hearing loss, but outcomes are still highly variable. Auditory nerve survival is likely one of the major factors underlying this variability. Neurotrophin therapy therefore has been proposed for CI recipients, with the goal of improving outcomes by promoting improved survival of cochlear spiral ganglion neurons (SGN) and/or residual hair cells. Previous studies have shown that glial-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor, and neurotrophin-3 can rescue SGNs following insult. The current study was designed to determine whether adeno-associated virus vector serotype 5 (AAV-5) encoding either green fluorescent protein or GDNF can transduce cells in the mouse cochlea to express useful levels of neurotrophin and to approximate the optimum therapeutic dose(s) for transducing hair cells and SGN. The findings demonstrate that AAV-5 is a potentially useful gene therapy vector for the cochlea, resulting in extremely high levels of transgene expression in the cochlear inner hair cells and SGN. However, overexpression of human GDNF in newborn mice caused severe neurological symptoms and hearing loss, likely due to Purkinje cell loss and cochlear nucleus pathology. Thus, extremely high levels of transgene protein expression should be avoided, particularly for proteins that have neurological function in neonatal subjects.
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Affiliation(s)
- Omar Akil
- 1 Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California
| | - Bas Blits
- 2 Department of Research and Development, UniQure Biopharma B.V., Amsterdam, The Netherlands
| | - Lawrence R Lustig
- 3 Department of Otolaryngology-Head and Neck Surgery, Columbia University Medical Center, New York, New York
| | - Patricia A Leake
- 1 Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California
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Xia P, Zhang SR, Zhou ZJ, Shao YQ, Hu XY. Benign paroxysmal positional vertigo in spontaneous intracranial hypotension. Neurol Res 2018; 40:868-873. [PMID: 30052143 DOI: 10.1080/01616412.2018.1495883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To assess the prevalence and related factors of benign paroxysmal positional vertigo (BPPV) in patients with spontaneous intracranial hypotension (SIH). METHODS We retrospectively reviewed 156 consecutive inpatients with SIH, and collected the clinical and radiological data. These patients were divided into BPPV group and non-BPPV group according to the clinical manifestation and the results of Dix-Hallpike or supine roll tests during hospitalization period. We performed a univariate analysis and a further multiple logistic regression analysis to identify the related factors of the development of BPPV in SIH patients. RESULTS BPPV was detected in 18 patients among the total 156 SIH patients (11.54%). The univariate analysis showed a low cerebrospinal fluid (CSF) pressure (P = 0.018), a small pontomesencephalic angle (P = 0.012) and a positive venous distension sign (VDS) (P = 0.045) were associated with the presence of BPPV. But the multivariate analysis only demonstrated a low CSF pressure was related to the presence of BPPV (OR = 1.022, 95% CI: 1.001-1.043, P = 0.044). CONCLUSION BPPV is common in SIH patients. SIH patients with low CSF pressure may be prone to develop BPPV.
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Affiliation(s)
- Ping Xia
- a Department of Neurology , Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University , Hangzhou , China
| | - Si-Ran Zhang
- b Department of Neurology , Zhejiang Hospital , Hangzhou , China
| | - Zhi-Jie Zhou
- c Department of Orthopaedic Surgery , Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University , Hangzhou , China
| | - Yu-Quan Shao
- a Department of Neurology , Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University , Hangzhou , China
| | - Xing-Yue Hu
- a Department of Neurology , Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University , Hangzhou , China
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Salt AN, Hirose K. Communication pathways to and from the inner ear and their contributions to drug delivery. Hear Res 2018; 362:25-37. [PMID: 29277248 PMCID: PMC5911243 DOI: 10.1016/j.heares.2017.12.010] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 11/08/2017] [Accepted: 12/05/2017] [Indexed: 01/04/2023]
Abstract
The environment of the inner ear is highly regulated in a manner that some solutes are permitted to enter while others are excluded or transported out. Drug therapies targeting the sensory and supporting cells of the auditory and vestibular systems require the agent to gain entry to the fluid spaces of the inner ear, perilymph or endolymph, which surround the sensory organs. Access to the inner ear fluids from the vasculature is limited by the blood-labyrinth barriers, which include the blood-perilymph and blood-strial barriers. Intratympanic applications provide an alternative approach in which drugs are applied locally. Drug from the applied solution enters perilymph through the round window membrane, through the stapes, and under some circumstances, through thin bone in the otic capsule. The amount of drug applied to the middle ear is always substantially more than the amount entering perilymph. As a result, significant amounts of the applied drug can pass to the digestive system, to the vasculature, and to the brain. Drugs in perilymph pass to the vasculature and to cerebrospinal fluid via the cochlear aqueduct. Conversely, drugs applied to cerebrospinal fluid, including those given intrathecally, can enter perilymph through the cochlear aqueduct. Other possible routes in or out of the ear include passage by neuronal pathways, passage via endolymph and the endolymphatic sac, and possibly via lymphatic pathways. A better understanding of the pathways for drug movements in and out of the ear will enable better intervention strategies.
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Affiliation(s)
- Alec N Salt
- Department of Otolaryngology, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO, USA.
| | - Keiko Hirose
- Department of Otolaryngology, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO, USA
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Finch LC, Marchbanks RJ, Bulters D, Birch AA. Refining non-invasive techniques to measure intracranial pressure: comparing evoked and spontaneous tympanic membrane displacements. Physiol Meas 2018; 39:025007. [DOI: 10.1088/1361-6579/aaa9f8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Campbell-Bell CM, Birch AA, Vignali D, Bulters D, Marchbanks RJ. Reference intervals for the evoked tympanic membrane displacement measurement: a non-invasive measure of intracranial pressure. Physiol Meas 2018; 39:015008. [DOI: 10.1088/1361-6579/aaa1d3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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20
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Electrode design and insertional depth-dependent intra-cochlear pressure changes: a model experiment. The Journal of Laryngology & Otology 2017; 132:224-229. [PMID: 29103379 DOI: 10.1017/s0022215117002195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Preservation of residual hearing is one of the major goals in modern cochlear implant surgery. Intra-cochlear fluid pressure changes influence residual hearing, and should be kept low before, during and after cochlear implant insertion. METHODS Experiments were performed in an artificial cochlear model. A pressure sensor was inserted in the apical part. Five insertions were performed on two electrode arrays. Each insertion was divided into three parts, and statistically evaluated in terms of pressure peak frequency and pressure peak amplitude. RESULTS The peak frequency over each third part of the electrode increased in both electrode arrays. A slight increase was seen in peak amplitude in the lateral wall electrode array, but not in the midscalar electrode array. Significant differences were found in the first third of both electrode arrays. CONCLUSION The midscalar and lateral wall electrode arrays have different intra-cochlear fluid pressure changes associated with intra-cochlear placement, electrode characteristics and insertion.
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Todt I, Mittmann M, Ernst A, Mittmann P. Comparison of the effects of four different cochlear implant electrodes on intra-cochlear pressure in a model. Acta Otolaryngol 2017; 137:235-241. [PMID: 27661767 DOI: 10.1080/00016489.2016.1232490] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSION Based on this model experiment, a small tip and low volume electrode show lowest intra-cochlear pressure values. Insertional support by a tool minimizes fast pressure changes. Higher electrodes volumes affect slow and fast pressure changes as well. OBJECTIVE Insertion causing low intra-cochlear pressure is assumed to be important for atraumatic cochlear implant surgery to preserve residual hearing. Cochlear implant electrodes differ in terms of parameters like tip size, length, volume, and technique of insertion. The aim of this study was to observe the effect of different cochlear implant electrodes on insertional intra-cochlear pressure in a cochlear model. MATERIALS AND METHODS Cochlear implant electrode insertions were performed in an artificial cochlear model and intra-cochlear pressure changes were recorded in parallel with a micro-pressure sensor positioned in the apical region of the cochlear model to follow the maximum values, temporal changes, maximum amplitude, and frequency of changes in intra-cochlear pressure. Insertions were performed with four different electrodes (Advanced Bionics 1j, Helix, HFMS, and LW23). RESULTS This study found statistically significant differences in the occurrence of initial maximum pressure values correlating with the electrode tip size. The different electrodes and the technique of insertion significantly affected the occurrence of maximum value, amplitude, and frequency of intra-cochlear pressure occurrence.
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22
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Mittmann M, Ernst A, Mittmann P, Todt I. Insertional depth-dependent intracochlear pressure changes in a model of cochlear implantation. Acta Otolaryngol 2017; 137:113-118. [PMID: 27575779 DOI: 10.1080/00016489.2016.1219918] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSION Over time, a homogenous increase in intracochlear pressure was seen in every experiment. Significant reductions in terms of amplitude variation and insertion depth were observed over time, using the one-point-supported insertion method. The frequency of peaks between the thirds was significantly lower when using the two-points-supported insertion method. OBJECTIVES The preservation of residual hearing and minimization of intracochlear trauma are two of the major goals in modern cochlear implantation (CI) surgery. It is assumed that intracochlear pressure measurements yield information about the intracochlear behavior of the electrode itself in the cochlea. The aim of this study was to investigate temporal intracochlear fluid pressure changes using two different kinds of insertion conditions. METHOD Cochlear implantations with the Advanced Bionics IJ® electrode were performed in an artificial cochlear model with a constant insertional speed of 0.5 mm/s provided by a linear actor. Amplitude pressure changes and number of pressure peaks were evaluated for every part. RESULT Intracochlear fluid pressure changes are assumed to affect the preservation of residual hearing and should be minimized. The stability and reduction of movement of a lateral wall IJ® electrode increase at deeper insertion and affect intracochlear fluid pressure amplitude.
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Affiliation(s)
- Marlene Mittmann
- Department of Otolaryngology, Head and Neck Surgery, Unfallkrankenhaus, Berlin, Germany
| | - Arneborg Ernst
- Department of Otolaryngology, Head and Neck Surgery, Unfallkrankenhaus, Berlin, Germany
| | - Philipp Mittmann
- Department of Otolaryngology, Head and Neck Surgery, Unfallkrankenhaus, Berlin, Germany
| | - Ingo Todt
- Department of Otolaryngology, Head and Neck Surgery, Unfallkrankenhaus, Berlin, Germany
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Ohlemiller KK, Jones SM, Johnson KR. Application of Mouse Models to Research in Hearing and Balance. J Assoc Res Otolaryngol 2016; 17:493-523. [PMID: 27752925 PMCID: PMC5112220 DOI: 10.1007/s10162-016-0589-1] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 09/15/2016] [Indexed: 01/10/2023] Open
Abstract
Laboratory mice (Mus musculus) have become the major model species for inner ear research. The major uses of mice include gene discovery, characterization, and confirmation. Every application of mice is founded on assumptions about what mice represent and how the information gained may be generalized. A host of successes support the continued use of mice to understand hearing and balance. Depending on the research question, however, some mouse models and research designs will be more appropriate than others. Here, we recount some of the history and successes of the use of mice in hearing and vestibular studies and offer guidelines to those considering how to apply mouse models.
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Affiliation(s)
- Kevin K Ohlemiller
- Department of Otolaryngology, Central Institute for the Deaf, Fay and Carl Simons Center for Hearing and Deafness, Washington University School of Medicine, 660 S. Euclid, Saint Louis, MO, 63110, USA.
| | - Sherri M Jones
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, NE, 68583, USA
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Todt I, Ernst A, Mittmann P. Effects of Round Window Opening Size and Moisturized Electrodes on Intracochlear Pressure Related to the Insertion of a Cochlear Implant Electrode. AUDIOLOGY AND NEUROTOLOGY EXTRA 2016. [DOI: 10.1159/000442515] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Intracochlear pressure changes during the cochlear implant insertion are assumed to be an important contributor to hearing preservation. The aim was to observe intracochlear pressure changes by different round window opening sizes and different hydrophilic electrode conditions. The experiments were performed in a cochlear model with a micropressure sensor in the helicotrema area. Different artificial round window membrane and different moisturized electrode conditions were compared. A punctured round window causes a significantly higher and an indirect moisturized electrode condition a significantly lower intracochlear pressure change. The degree of round window opening and the hydrophilic character of an electrode during insertion affect the intracochlear pressure significantly in a model.
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Ciuman RR. Morbus Menière: Were the last 50 years of molecular biological research fruitless for Menière’s disease? World J Otorhinolaryngol 2015; 5:90-92. [DOI: 10.5319/wjo.v5.i4.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 07/04/2015] [Accepted: 09/08/2015] [Indexed: 02/06/2023] Open
Abstract
After discovering an inner ear hemorrhage, Prosper Menière ascribed disease to the inner ear for the first time. Since that time, a lot of efforts have been made to determine the pathophysiologic causes of the classical symptoms sensorineural hearing loss, vertigo attacks, tinnitus and ear fullness. According to its express pattern Menière’s disease may appear as classical and atypical disease. In the last decades, huge advances have taken place in biochemical and physiological research and in pathophysiological understanding of the inner ear and its diseases. This encloses stimulus perception and conduction, regulation of inner-ear fluid homeostasis and inner ear diseases with underlying genetics. Menière’s disease pathophysiologic correlate is an endolymphatic hydrops which is characterized by changes of inner ear homeostasis with its parameters volume, concentration, osmolarity and pressure of the endolymph. Hormones, autonomous system and the immunsystem together with purinergic, adrenergic and muscarinic receptors, steroids, vasopressin, atrial natriuretic peptide and aquaporin channels regulate inner ear homeostasis. Consequently, general diagnostics comprise a magnetic resonance imaging with gadolinium, vestibular diagnostics and tone audiometry. Standard therapy for acute inner ear symptoms is limited to cortisone infusions together with a rheologic agent or a radical scavenger. For acute vertigo attacks and for the mainstay therapy antivertiginous pharmaceuticals are given. In severe cases destruction of the vestibular hair cells by ototoxic antibiotics, endolymphatic sac surgery or neurectomy of the vestibular nerve might be necessary. Certainly, in research there is a move from simple pharmaceutical therapy forward to nanoparticle-based, genetic-based and stem cell therapy.
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Audiovestibular impairments associated with intracranial hypotension. J Neurol Sci 2015; 357:96-100. [DOI: 10.1016/j.jns.2015.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 06/04/2015] [Accepted: 07/01/2015] [Indexed: 11/22/2022]
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Olzowy B, Abendroth S, von Gleichenstein G, Mees K, Stelter K. No Evidence of Intracranial Hypertension in Trekkers with Acute Mountain Sickness When Assessed Noninvasively with Distortion Product Otoacoustic Emissions. High Alt Med Biol 2014; 15:364-70. [DOI: 10.1089/ham.2013.1120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bernhard Olzowy
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock Medical Center, Rostock, Germany
| | | | | | - Klaus Mees
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilians University of Munich Medical Center, München, Germany
| | - Klaus Stelter
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilians University of Munich Medical Center, München, Germany
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Intracochlear fluid pressure changes related to the insertional speed of a CI electrode. BIOMED RESEARCH INTERNATIONAL 2014; 2014:507241. [PMID: 25140316 PMCID: PMC4124802 DOI: 10.1155/2014/507241] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/02/2014] [Accepted: 07/06/2014] [Indexed: 11/17/2022]
Abstract
Introduction. To preserve residual hearing the atraumaticity of the cochlea electrode insertion has become a focus of cochlear implant research. In addition to other factors, the speed of insertion is thought to be a contributing factor in the concept of atraumatic implantation. The aim of our study was to observe intracochlear fluid pressure changes due to different insertional speeds of an implant electrode in a cochlear model. Materials and Methods. The experiments were performed using an artificial cochlear model. A linear actuator was mounted on an Advanced Bionics IJ insertional tool. The intracochlear fluid pressure was recorded through a pressure sensor which was placed in the helicotrema area. Defined insertions were randomly performed with speeds of 0.1 mm/sec, 0.25 mm/sec, 0.5 mm/sec, 1 mm/sec, and 2 mm/sec. Results. A direct correlation between speed and pressure was observed. Mean maximum values of intracochlear fluid pressure varied between 0.41 mm Hg and 1.27 mm Hg. Conclusion. We provide the first results of fluid pressure changes due to insertional speeds of CI electrodes in a cochlear model. A relationship between the insertional speed and intracochlear fluid pressure was observed. Further experiments are needed to apply these results to the in vivo situation.
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Ciuman RR. Inner ear symptoms and disease: pathophysiological understanding and therapeutic options. Med Sci Monit 2013; 19:1195-210. [PMID: 24362017 PMCID: PMC3872449 DOI: 10.12659/msm.889815] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 10/11/2013] [Indexed: 12/13/2022] Open
Abstract
In recent years, huge advances have taken place in understanding of inner ear pathophysiology causing sensorineural hearing loss, tinnitus, and vertigo. Advances in understanding comprise biochemical and physiological research of stimulus perception and conduction, inner ear homeostasis, and hereditary diseases with underlying genetics. This review describes and tabulates the various causes of inner ear disease and defines inner ear and non-inner ear causes of hearing loss, tinnitus, and vertigo. The aim of this review was to comprehensively breakdown this field of otorhinolaryngology for specialists and non-specialists and to discuss current therapeutic options in distinct diseases and promising research for future therapies, especially pharmaceutic, genetic, or stem cell therapy.
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Sudden Unilateral Hearing Loss as First Sign of Cerebral Sinus Venous Thrombosis? A 3-Year Retrospective Analysis. Otol Neurotol 2013; 34:657-61. [DOI: 10.1097/mao.0b013e31828dae68] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Furihata K, Yamashita M. Transfer function for vital infrasound pressures between the carotid artery and the tympanic membrane. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2013; 133:1169-1186. [PMID: 23363133 DOI: 10.1121/1.4773270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
While occupational injury is associated with numerous individual and work-related risk factors, including long working hours and short sleep duration, the complex mechanisms causing such injuries are not yet fully understood. The relationship between the infrasound pressures of the tympanic membrane [ear canal pressure (ECP)], detected using an earplug embedded with a low-frequency microphone, and the carotid artery [carotid artery pressure (CAP)], detected using a stethoscope fitted with the same microphone, can be quantitatively characterized using systems analysis. The transfer functions of 40 normal workers (19 to 57 years old) were characterized, involving the analysis of 446 data points. The ECP waveform exhibits a pulsatile character with a slow respiratory component, which is superimposed on a biphasic recording that is synchronous with the cardiac cycle. The respiratory ECP waveform correlates with the instantaneous heart rate. The results also revealed that various fatigue-related risk factors may affect the mean magnitudes of the measured pressures and the delay transfer functions between CAP and ECP in the study population; these factors include systolic blood pressure, salivary amylase activity, age, sleep duration, postural changes, chronic fatigue, and pulse rate.
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Affiliation(s)
- Kenji Furihata
- Department of Electrical and Electronic Engineering, Faculty of Engineering, Shinshu University, 4-17-1 Wakasato, Nagano, 380-8533 Japan.
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The relationship between vestibular aqueduct diameter and sensorineural hearing loss is linear: a review and meta-analysis of large case series. The Journal of Laryngology & Otology 2012; 126:1086-90. [PMID: 22963842 DOI: 10.1017/s0022215112002010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Inner ear homeostasis is dependent on the vestibular aqueduct and its content, the endolymphatic duct. Narrow and enlarged vestibular aqueducts have both been associated with hearing loss in Ménière's and large vestibular aqueduct syndromes. This review investigated the correlation between vestibular aqueduct diameter and pure tone average, and the effect of measurement site (i.e. the midpoint or the external aperture). MATERIALS AND METHODS A systematic review of the literature and meta-analysis of large case series published on the Allied and Complementary Medicine, British Nursing Index, Cumulative Index to Nursing and Allied Health, Embase, Health Business Elite, Health Management Information Consortium, Medline, PsycInfo and PubMed databases. References and personal books were also scrutinised. RESULTS A linear relationship between vestibular aqueduct diameter and hearing loss was observed, with a projected increase of 6 dBHL per unit of vestibular aqueduct diameter (95 per cent confidence interval, 2-10; p = 0.003). This relationship was independent of measurement site. DISCUSSION This dose-dependent or linear relationship supports the role of flow and/or pressure change as aetiological factors in the pathogenesis of hearing loss, as per Poiseuille's law. This aetiological association is strengthened by the fact that the observed relationship is independent of measurement site.
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A perspective from magnetic resonance imaging findings of the inner ear: Relationships among cerebrospinal, ocular and inner ear fluids. Auris Nasus Larynx 2012; 39:345-55. [DOI: 10.1016/j.anl.2011.05.005] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Revised: 05/06/2011] [Accepted: 05/17/2011] [Indexed: 02/06/2023]
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Current Opinion in Otolaryngology & Head and Neck Surgery. Current world literature. Curr Opin Otolaryngol Head Neck Surg 2010; 18:466-74. [PMID: 20827086 DOI: 10.1097/moo.0b013e32833f3865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Santos S, Sgambatti L, Bueno A, Albi G, Suárez A, Domínguez MJ. Hipoacusia en niños con acueducto vestibular dilatado. Estudio de 55 casos. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 61:338-44. [DOI: 10.1016/j.otorri.2010.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 03/28/2010] [Accepted: 04/07/2010] [Indexed: 10/19/2022]
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Santos S, Sgambatti L, Bueno A, Albi G, Suárez A, Jesús Domínguez M. Enlarged vestibular aqueduct syndrome. A review of 55 paediatric patients. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010. [DOI: 10.1016/s2173-5735(10)70062-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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