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Jiang W, Li X, Mu Y, Zhang H, Konduru N, Qiao Y, Zhao F, Liu W. Predictive accuracy of wideband absorbance in children with large vestibular aqueduct syndrome: A single-center retrospective study. Heliyon 2024; 10:e33776. [PMID: 39040356 PMCID: PMC11261878 DOI: 10.1016/j.heliyon.2024.e33776] [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: 03/28/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/24/2024] Open
Abstract
Objectives This study aimed to assess the clinical significance of Wideband Absorbance (WBA) in children with Large Vestibular Aqueduct Syndrome (LVAS), which could potentially serve as diagnostic and predictive markers for LVAS in children. Design This was a single-center retrospective case-control study. Audiological measurements and Wideband Acoustic Immittance (WAI) were performed. Propensity score matching (PSM) was considered to treat group imbalance. The Receiver Operating Characteristic (ROC) curves and area under the ROC curve (AUC) were used to evaluate the sensitivity and specificity of WBA. Study sample Participants included 42 children with LVAS and 163 normal children aged 6 months -11 years recruited from clinical audiology settings between 2019 and 2021. Results The WBA at Tympanometric Peak Pressure (WBATPP) and Ambient Pressure (WBAA) in the LVAS group were significantly lower than those of the control group at 1259-2000 Hz but higher at 4000-6349 Hz (p < 0.05, power >0.8). The WBAA (1587 Hz) AUC value was 0.805, identifying a score ≤0.565 as indicative of a LVAS risk. Conclusions WBA holds promise in distinguishing LVAS from the normal condition and warrants further exploration as a tool to examine the influence of inner ear pressure on acoustic energy transmission in the middle ear.
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Affiliation(s)
- Wen Jiang
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Xuanyi Li
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Yi Mu
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Huiying Zhang
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Naveena Konduru
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
| | - Yuehua Qiao
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
- The College of Medical Technology, Xuzhou Medical University, Xuzhou, 221000, China
| | - Fei Zhao
- Centre for SLT and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, CF5 2YB, UK, Wales
| | - Wen Liu
- Department of Otolaryngology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, China
- The Second College of Clinical Medicine, Xuzhou Medical University, Xuzhou, 221000, China
- Auditory Engineering Laboratory of Jiangsu Province, Xuzhou, 221000, China
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Alahmadi A, Abdelsamad Y, Salamah M, Alenzi S, Badr KM, Alghamdi S, Alsanosi A. Cochlear implantation in adults and pediatrics with enlarged vestibular aqueduct: a systematic review on the surgical findings and patients' performance. Eur Arch Otorhinolaryngol 2022; 279:5497-5509. [PMID: 35771280 DOI: 10.1007/s00405-022-07511-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/13/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE Cochlear implantation (CI) has been considered a safe and effective management option for patients with severe to profound hearing loss. Patients with enlarged vestibular aqueduct (EVA) could be challenging with some variations in surgical approaches, intraoperative surgical notes, and clinical outcomes. This study aimed to review the surgical and clinical outcomes of cochlear implantation among patients with EVA. MATERIALS AND METHODS A systematic literature search was carried out in five major databases. All original studies reporting cochlear implantation in patients with EVA were included for qualitative data synthesis. The risk of bias was independently assessed through the National Intuitional of Health tool. The review protocol was registered in PROSPERO (reference number: CRD42021225900). RESULTS A total of 34 studies with 4035 subjects were included. Of them, 853 (21.14%) had EVA and underwent CI. Mondini malformation was the most frequently associated anomaly (n = 78, 11.1%). Unilateral implantation was performed in 258 cases while bilateral in 119 subjects. Postoperative complications included CSF/perilymph gusher (n = 112), CSF oozing (n = 18), and partial electrode insertion (n = 6). Closing the cochleostomy with temporalis fascia, muscle, connective tissue, or fibrin glue was the most frequently reported approach to manage CSF/perilymph gusher (n = 67, 56.7%) while packing was performed in six patients. CONCLUSION Patients with EVA demonstrated audiometric and speech performance improvement after CI. However, many patients had intra- or postoperative complications. Further research is needed as the outcomes may be affected by associated temporal bone pathology, the timing of implant, and hearing condition.
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Affiliation(s)
- Asma Alahmadi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box; 245, Riyadh, 11411, Saudi Arabia.
| | | | - Marzouqi Salamah
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box; 245, Riyadh, 11411, Saudi Arabia
| | - Saad Alenzi
- King Fahad Specialist Hospital, MOH, Tabuk, Saudi Arabia
| | | | | | - Abdulrahman Alsanosi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, P.O. Box; 245, Riyadh, 11411, Saudi Arabia
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Trecca EMC, Adunka OF, Mattingly JK, Hiss MM, Cassano M, Malhotra PS, Riggs WJ. Electrocochleography Observations in a Series of Cochlear Implant Electrode Tip Fold-Overs. Otol Neurotol 2021; 42:e433-e437. [PMID: 33196531 DOI: 10.1097/mao.0000000000003008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Tip fold-over is a rare but serious complication of cochlear implant (CI) surgery. The purpose of this study was to present intraoperative electrocochleography (ECochG) observations in a series of CI electrode tip fold-overs. PATIENTS Five pediatric subjects undergoing CI surgery through a round window (RW) approach with a perimodiolar electrode array, who were diagnosed with either auditory neuropathy spectrum disorder or enlarged vestibular aqueduct. INTERVENTIONS Intraoperative RW ECochG during CI surgery: tone burst stimuli were presented from 95 to 110 dB SPL. MAIN OUTCOME MEASURES Magnitude and phase characteristics of ECochG responses obtained intraoperatively before and immediately after electrode insertion were examined for patients with and without tip fold-over. RESULTS Three subjects presented with tip fold-over and two formed the control group. Among fold-over cases, one participant exhibited an inversion in the starting phase of the cochlear microphonic response and a decrease in spectral magnitude from pre- to postinsertion. Both subjects who did not exhibit a change in phase had an increase in the ECochG-total response (ECochG-TR) magnitude. No case in the control group exhibited a change in starting phase. In regard to the ECochG-TR, all controls showed a decrease in the magnitude. CONCLUSIONS Despite the small number of patients, heterogeneous ECochG response patterns were observed within the fold-over group. Though these results are not conclusive, they can serve as a framework to begin to understand ECochG's utility in detecting intraoperative tip fold-over.
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Affiliation(s)
- Eleonora M C Trecca
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.,Department of Otolaryngology - Head and Neck Surgery, University Hospital of Foggia, Foggia, Italy
| | - Oliver F Adunka
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Jameson K Mattingly
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Meghan M Hiss
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Michele Cassano
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Foggia, Foggia, Italy
| | - Prashant S Malhotra
- Department of Otolaryngology - Head and Neck Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - William J Riggs
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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