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Lui E, Conlan O, Hunter K, Mason A, Kubba H. Annual hearing screening in children with osteogenesis imperfecta: Results from the first five years in glasgow. Int J Pediatr Otorhinolaryngol 2024; 186:112096. [PMID: 39255606 DOI: 10.1016/j.ijporl.2024.112096] [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: 07/16/2024] [Revised: 09/02/2024] [Accepted: 09/06/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Hearing loss is common in people with osteogenesis imperfecta (OI), although exactly how common is unknown. The prevalence of hearing loss in children with OI has been reported to be anything from 0 to 77 %. Brittle Bone Society guidelines suggest that, unless there are ear symptoms, children with OI should have their hearing tested every three years starting at age three. There is limited evidence to support this recommendation. We postulate that annual hearing screening would be easier to manage and would have a worthwhile pick-up rate. METHODS In March 2019 we began a programme of annual hearing screening for all children (ages 0-16) with OI. We collected data on age, genotype, otoscopy findings, tympanometry findings, audiometric test results and subsequent outcomes for the first five years of our programme (2019-2024). RESULTS Nineteen children with OI participated in the screening programme. Only one abnormality was found: a unilateral mild hearing impairment with a type B tympanogram, suggesting middle ear effusion. This was present in year 2 of the programme but resolved by year 3. CONCLUSION The screening programme has a low pickup rate (5 %) for new otological problems in the paediatric population. However, we believe that the low cost and small workload associated with the screening programme justifies continuing it until further conclusions can be drawn.
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Affiliation(s)
- Emmett Lui
- Department of Child Health, University of Glasgow, Glasgow, G12 8QQ, Scotland, UK; Department of Otolaryngology, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, Scotland, UK.
| | - Owen Conlan
- Department of Surgery, University Hospital Ayr, Dalmellington Road, Ayr, KA6 6DX, Scotland, UK
| | - Karen Hunter
- Department of Audiology, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, Scotland, UK
| | - Avril Mason
- Department of Child Health, University of Glasgow, Glasgow, G12 8QQ, Scotland, UK; Department of Endocrinology, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, Scotland, UK
| | - Haytham Kubba
- Department of Child Health, University of Glasgow, Glasgow, G12 8QQ, Scotland, UK; Department of Otolaryngology, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, Scotland, UK
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Ugarteburu M, Cardoso L, Richter CP, Carriero A. Treatments for hearing loss in osteogenesis imperfecta: a systematic review and meta-analysis on their efficacy. Sci Rep 2022; 12:17125. [PMID: 36224204 PMCID: PMC9556526 DOI: 10.1038/s41598-022-20169-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/09/2022] [Indexed: 01/04/2023] Open
Abstract
About 70% of people with osteogenesis imperfecta (OI) experience hearing loss. There is no cure for OI, and therapies to ameliorate hearing loss rely on conventional treatments for auditory impairments in the general population. The success rate of these treatments in the OI population with poor collagenous tissues is still unclear. Here, we conduct a systematic review and meta-analysis on the efficacy of treatments addressing hearing loss in OI. This study conforms to the reporting standards of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Data sources include published articles in Medline via PubMed, Web of Science, Scopus, and Embase, from their inception to November 2020. Studies included individuals with OI undergoing a hearing loss treatment, having pre- and postoperative objective assessment of hearing function at a specified follow-up length. Our search identified 1144 articles, of which 67 were reviewed at full-text screening. A random-effects meta-analysis was conducted on the selected articles (n = 12) of people with OI that underwent stapes surgery. Success was assessed as the proportion of ears with a postoperative Air-Bone Gap (ABG) ≤ 10 dB. A systematic review was conducted on the remaining articles (n = 13) reporting on other treatments. No meta-analysis was conducted on the latter due to the low number of articles on the topic and the nature of single case studies. The meta-analysis shows that stapes surgeries have a low success rate of 59.08 (95% CI 45.87 to 71.66) in the OI population. The systematic review revealed that cochlear implants, bone-anchored hearing aids, and other implantable hearing aids proved to be feasible, although challenging, in the OI population, with only 2 unsuccessful cases among the 16 reviewed single cases. This analysis of published data on OI shows poor clinical outcomes for the procedures addressing hearing loss. Further studies on hearing loss treatments for OI people are needed. Notably, the mechanisms of hearing loss in OI need to be determined to develop successful and possibly non-invasive treatment strategies.
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Affiliation(s)
- Maialen Ugarteburu
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA
| | - Luis Cardoso
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA
| | - Claus-Peter Richter
- Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
- The Hugh Knowles Center, Northwestern University, Evanston, IL, USA
| | - Alessandra Carriero
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA.
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Carré F, Achard S, Rouillon I, Parodi M, Loundon N. Hearing impairment and osteogenesis imperfecta: Literature review. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:379-383. [DOI: 10.1016/j.anorl.2019.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Streubel SO, Lustig LR. Cochlear implantation in patients with osteogenesis imperfecta. Otolaryngol Head Neck Surg 2016; 132:735-40. [PMID: 15886627 DOI: 10.1016/j.otohns.2004.12.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE: Hearing loss has been shown to occur in 42% to 58% of patients with osteogenesis imperfecta (OI), with deafness arising in 25% to 60% of the patients. Implantation in patients with OI is relatively rare, with only 4 prior single case reports published in the English-language literature. The goal of this study was to evaluate the feasibility and functional outcome of cochlear implantation in 2 patients with OI tarda type I with profound sensorineural hearing loss. STUDY DESIGN: Case series. SETTING:. The implantations were performed in a tertiary academic referral center (Johns Hopkins University). RESULTS: Though promontory vascularity was encountered, full insertion of a normal cochlear implant array could be achieved in both cases. One-year postimplant scores demonstrated 20 to 40 dB hearing thresholds, Consonant-Nucleus-Consonant Test word scores of 54% and 70%, Consonant-Nucleus-Consonant Test phoneme scores of 75% and 83%, Hearing in Noise Test scores of 76% and 99%, and Central Institute of the Deaf Sentence Score sentence scores of 99% and 100%, for patients 1 and 2, respectively. CONCLUSIONS: Cochlear implantation in patients with OI is not only technically possible but the results are similar to implant outcomes for patients with sensorineural hearing loss from a variety of other causes. EBM rating: C (Otolaryngol Head Neck Surg 2005;132:735-40.)
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Affiliation(s)
- Sven-Olrik Streubel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Cochlear implantation in a patient with osteogenesis imperfecta. Auris Nasus Larynx 2013; 40:510-3. [DOI: 10.1016/j.anl.2012.10.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 09/24/2012] [Accepted: 11/09/2012] [Indexed: 11/15/2022]
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Benatti A, Castiglione A, Trevisi P, Bovo R, Rosignoli M, Manara R, Martini A. Endocochlear inflammation in cochlear implant users: case report and literature review. Int J Pediatr Otorhinolaryngol 2013; 77:885-93. [PMID: 23578804 DOI: 10.1016/j.ijporl.2013.03.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 03/07/2013] [Accepted: 03/10/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Cochlear implantation is a relatively safe procedure with a low complication rate. The overall rate of complications among cochlear implant patients ranges from 6% to 20%. Major complications are those that are life-threatening or require surgery, whereas minor complications are those that can be medically treated. Nonetheless, certain complications, even if highly rare, may require specific investigations and treatments. Among these rare complications are those with endocochlear involvement, such as cochleitis or labyrinthitis, with fibrosis or ossification that could lead to explantation. The aims of the present study were to report a particular case of post-operative cochleitis and to review the rate of complications after cochlear implantation, emphasising those conditions with proven endocochlear involvement. METHODS We refer to the case of an eight-year-old Italian boy affected by the sudden onset of headache, ipsilateral otalgia and facial paresis, who presented to our clinic for inexplicable worsening of the performance of his implant and his residual hearing, six years after surgery. A complete investigation including (clinical history, routine, autoimmune and serological blood tests, electrophysiological measurements from the cochlear implant and neuroimaging) was performed and is herein described. Additionally, a comprehensive review of the literature was conducted using internet search engines; 274 papers were selected, 88 of which were best suited to our purposes. RESULTS In our case, the progression of the symptoms and the performance decrement required explantation, followed by a complete recovery. Reviewing the literature revealed only three reports concerning cases of proven endocochlear phlogosis that required revision surgery. Wound swelling/infection and vertigo remain the two most common complications of cochlear implantation. Failure of the device is the third most frequent complication (10.06% of all complications and 1.53% of cochlear implantations). Other rare conditions (such as granulating labyrinthitis with cochlear fibrosis, ossification and erosion, silicone allergy and the formation of a biofilm around the internal device) are possible and unpredictable. Although rare (approximately 1%), such cases may require explantation. CONCLUSIONS Despite efforts by both surgeons and manufacturers, device-related and surgical complications still occur. These and other rare conditions demand specific management, and their frequency may be underestimated. Further studies are needed to assess more realistic rates of complications and devise more efficient strategies for early diagnosis and treatment.
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Affiliation(s)
- Alice Benatti
- Operative Unit of Otolaryngology and Otosurgery, Padua University, Via Giustiniani, 2, Padua, Italy.
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Swinnen FKR, Casselman JW, De Leenheer EMR, Cremers CWRJ, Dhooge IJM. Temporal bone imaging in osteogenesis imperfecta patients with hearing loss. Laryngoscope 2013; 123:1988-95. [DOI: 10.1002/lary.23963] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 08/22/2012] [Accepted: 12/06/2012] [Indexed: 11/12/2022]
Affiliation(s)
- Freya K. R. Swinnen
- Department of Otorhinolaryngology; Ghent University Hospital; Ghent; Belgium
| | - Jan W. Casselman
- Department of Medical Imaging; Sint-Jan Hospital; Bruges; Belgium
| | | | - Cor W. R. J. Cremers
- FC Donders Institute for Neurosciences; Radboud University Nijmegen Medical Centre; Department of Otorhinolaryngology; Nijmegen; The Netherlands
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Rotteveel LJC, Beynon AJ, Mens LHM, Snik AFM, Mulder JJ, Mylanus EAM. Cochlear implantation in 3 patients with osteogenesis imperfecta: imaging, surgery and programming issues. Audiol Neurootol 2007; 13:73-85. [PMID: 18057871 DOI: 10.1159/000111779] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Accepted: 07/06/2007] [Indexed: 11/19/2022] Open
Abstract
Osteogenesis imperfecta (OI) is a heterogeneous disease of the connective tissue caused by a defective gene that is responsible for the production of collagen type I, leading to defective bone matrix and connective tissue. Hearing loss affects 35-60% of the patients and will progress to deafness in 2-11% of OI patients for whom cochlear implantation may become the only remaining treatment option. Three patients with OI were retrieved from the Nijmegen Cochlear Implant Centre's database. Most of the specific observations in ear surgery on patients with OI, such as brittle scutum, sclerotic thickening of the cochlea, hyperplastic mucosa in the middle ear and persistent bleeding, were encountered in these 3 patients. In case 3, with severe deformities on the CT scan, misplacement of the electrode array into the horizontal semicircular canal occurred. In all 3 cases, programming was hindered by nonauditory stimulation. Even after reimplantation, nonauditory sensations lead to case 3 becoming a nonuser. Averaged electrode voltages in case 3 were deviant in accordance with an abnormally conductive otic capsule. Spatial spread of neural excitation responses in cases 1 and 2 suggested intracochlear channel interaction for several electrodes, often in combination with facial nerve stimulation (FNS). In case 1, the estimated pitch of the electrodes that caused FNS varied consistently. Despite the electrophysiological changes, after 1-year follow-up, open set phoneme scores of 81% and 78% were reached in cases 1 and 2, respectively. When aware and prepared for the specific changes of the temporal bone in OI, cochlear implantation can be a safe and feasible procedure. Preoperative imaging is recommended to be fully informed on the morphology of the petrosal bone. In case of severe deformities on the CT scan, during counseling the possibility of misplacement should be mentioned. Rehabilitation is often hindered by FNS requiring frequent refitting.
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Affiliation(s)
- Liselotte J C Rotteveel
- Department of Otorhinolaryngology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Migirov L, Henkin Y, Hildesheimer M, Kronenberg J. Cochlear implantation in a child with osteogenesis imperfecta. Int J Pediatr Otorhinolaryngol 2003; 67:677-80. [PMID: 12745164 DOI: 10.1016/s0165-5876(03)00073-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Osteogenesis imperfecta (OI) is a hereditary disease of connective tissue and affects bone, dentine, sclera, joint, tendon, blood vessels, heart valves, and skin. Approximately 50% of the adult patients with OI have associated hearing impairment. To date, only three cases of cochlear implantation in adults with OI have been reported, but none in children. We present a case of cochlear implantation in a congenitally deaf 6-year-old boy with OI. The Nucleus 24 Contour device was successfully implanted using the suprameatal approach (SMA). At 6 months post-initial stimulation there was no evidence of non-acoustic nerve excitation (i.e. facial twitching) or discomfort, and significant progress in auditory abilities was manifested by open set word identification.
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Affiliation(s)
- Lela Migirov
- Department of Otolaryngology and Head and Neck Surgery, Sheba Medical Center, Tel Hashomer 52621, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Abstract
Cochlear implants are electronic auditory prostheses used to rehabilitate deafened persons who have lost their hair cells. They are partly worn externally and partly implanted in the ear. They provide a direct stimulation of the spiral ganglion cells of the cochlear nerve by bypassing the destroyed hair cells. The objectives of this article are to summarise what head and neck surgeons need to know before cochlear implantation and to describe the imaging study protocol used and anomalies to look for. A few explanations are resumed about placement of a brainstem implant.
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Affiliation(s)
- K Marsot-Dupuch
- Service de Neuroradiologie du Pr, P Lasjaunias, Hôpital Bicêtre, 78 avenue du Général-Leclerc, 94275 Le Kremlin Bicêtre Cedex, France.
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