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Güven B, Erdem D. Are there relationship otosclerosis with serum HE4 and CA125 level? A pilot study. Acta Otolaryngol 2024:1-4. [PMID: 39121351 DOI: 10.1080/00016489.2024.2389176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Accepted: 08/01/2024] [Indexed: 08/11/2024]
Abstract
BACKGROUND HE4 and CA 125 are identified as a potential biomarker for the detection of some diseases with fibrosis. OBJECTIVES The purpose of this pilot study was to evaluate the value of human epididymis protein 4 (HE4) and cancer antigen-125 (CA-125) in otosclerosis patients. MATERIAL AND METHODS The study population consisted of 60 people (30 otosclerosis patients, 30 control group). We collected blood samples for HE4 and CA-125 levels. Serum HE4 and CA-125 levels were measured by enzyme-linked immunosorbent assay (ELISA). We compared the results between otosclerosis patients and the normal subject. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic value. RESULTS There was no differences in CA-125 level between the otosclerosis (20.3 U/mL [10.4-42.1] and control group (19.3 U/mL [15.3-49.8]) (p > 0.05). HE4 level was significantly higher in the otosclerosis group (60.9 pmol/L [32.1-101.8])] than the control group (25.3 pmol/L [12.4-91.9]) (p < 0.001). The AUC in ROC analysis of HE4 was 0.768 (p < 0.001). CONCLUSIONS AND SIGNIFICANCE Serum HE4 level may be a useful biomarker in otosclerosis. Further studies with a larger number of patients are required to confirm our pilot results.
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Affiliation(s)
- Berrak Güven
- Department of Biochemistry, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Duygu Erdem
- Department of Otorhinolaryngology, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
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Lee S, Motegi M, Koike T. Effectiveness of active middle ear implant placement methods in pathological conditions: basilar membrane vibration simulation. Front Neurol 2024; 15:1417711. [PMID: 39175763 PMCID: PMC11339716 DOI: 10.3389/fneur.2024.1417711] [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: 05/22/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024] Open
Abstract
Active middle ear implants (AMEI) amplify mechanical vibrations in the middle ear and transmit them to the cochlea. The AMEI includes a floating mass transducer (FMT) that can be placed using two different surgical approaches: "oval window (OW) vibroplasty" and "round window (RW) vibroplasty." The OW and RW are windows located on the cochlea. Normally, sound stimulus is transmitted from the middle ear to cochlea via the OW. RW vibroplasty has been suggested as an alternative method due to the difficulty of applying OW vibroplasty in patients with ossicle dysfunction. Several reports compare the advantages of each approach through pre and postoperative hearing tests. However, quantitatively assessing the treatment effect is challenging due to individual differences in pathologies. This study investigates the vibration transmission efficiency of each surgical approach using a finite-element model of the human cochlea. Vibration of the basilar membrane (BM) of the cochlea is simulated by applying the stimulus through the OW or RW. Pathological conditions, such as impaired stapes mobility, are simulated by increasing the stiffness of the stapedial annular ligament. RW closure due to chronic middle ear diseases is a common clinical occurrence and is simulated by increasing the stiffness of the RW membrane in the model. The results show that the vibration amplitude of the BM is larger when the stimulus is applied to the RW compared to the OW, except for cases of RW membrane ossification. The difference in these amplitudes is particularly significant when stapedial mobility is limited. These results suggest that RW vibroplasty would be advantageous, especially in cases of accompanying stapedial mobility impairment. Additionally, it is suggested that transitioning to OW vibroplasty could still ensure a sufficient level of vibratory transmission efficiency when placing the FMT on the RW membrane is difficult due to anatomical problems in the tympanic cavity or confirmed severe pathological conditions around the RW.
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Affiliation(s)
- Sinyoung Lee
- Department of Mechanical Engineering, Faculty of Engineering, Graduate Faculty of Interdisciplinary Research, University of Yamanashi, Yamanashi, Japan
| | - Masaomi Motegi
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Takuji Koike
- Department of Mechanical and Intelligent Systems Engineering, Graduate School of Informatics and Engineering, The University of Electro-Communications, Tokyo, Japan
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Speck I, Gundlach E, Schmidt S, Spyckermann N, Lesinski-Schiedat A, Rauch AK, Aschendorff A, Thangavelu K, Reimann K, Arndt S. Auditory capacity of the better-hearing ear in asymmetric hearing loss. Eur Arch Otorhinolaryngol 2024; 281:2303-2312. [PMID: 38006462 PMCID: PMC11024001 DOI: 10.1007/s00405-023-08342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 11/06/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE Our aim was to investigate the course of the hearing capacity of the better-hearing ear in single-sided deafness (SSD) and asymmetric hearing loss (AHL) over time, in a multicenter study. METHODS We included 2086 pure-tone audiograms from 323 patients with SSD and AHL from four hospitals and 156 private practice otorhinolaryngologists. We collected: age, gender, etiology, duration of deafness, treatment with CI, number and monosyllabic speech recognition, numerical rating scale (NRS) of tinnitus intensity, and the tinnitus questionnaire according to Goebel and Hiller. We compared the pure tone audiogram of the better-hearing ear in patients with SSD with age- and gender-controlled hearing thresholds from ISO 7029:2017. RESULTS First, individuals with SSD showed a significantly higher hearing threshold from 0.125 to 8 kHz in the better-hearing ear compared to the ISO 7029:2017. The duration of deafness of the poorer-hearing ear showed no relationship with the hearing threshold of the better-hearing ear. The hearing threshold was significantly higher in typically bilaterally presenting etiologies (chronic otitis media, otosclerosis, and congenital hearing loss), except for Menière's disease. Second, subjects that developed AHL did so in 5.19 ± 5.91 years and showed significant reduction in monosyllabic word and number recognition. CONCLUSIONS Individuals with SSD show significantly poorer hearing in the better-hearing ear than individuals with NH from the ISO 7029:2017. In clinical practice, we should, therefore, inform our SSD patients that their disease is accompanied by a reduced hearing capacity on the contralateral side, especially in certain etiologies.
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Affiliation(s)
- Iva Speck
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany.
| | - Elisabeth Gundlach
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
| | - Sandra Schmidt
- Department of Oto-Rhino-Laryngology, Central Army Hospital Koblenz, Ruebenacher Str. 170, 56072, Koblenz, Germany
| | - Nadine Spyckermann
- Department of Oto-Rhino-Laryngology, Central Army Hospital Koblenz, Ruebenacher Str. 170, 56072, Koblenz, Germany
| | - Anke Lesinski-Schiedat
- Department of Otorhinolaryngology, Medical University Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Ann-Kathrin Rauch
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
| | - Antje Aschendorff
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
| | - Kruthika Thangavelu
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | - Katrin Reimann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-University Marburg, Marburg, Germany
| | - Susan Arndt
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center, Faculty of Medicine, University of Freiburg, Killianstr. 5, 79110, Freiburg, Germany
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Chen PH, Lin KN, Lin HY, Yu RB, Liu PY, Shih WT, Chen JW. Factors Associated With Hearing Outcomes After Stapedotomy in Taiwanese Patients With Clinical Otosclerosis. EAR, NOSE & THROAT JOURNAL 2024; 103:NP76-NP84. [PMID: 34409887 DOI: 10.1177/01455613211037645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine the clinical factors associated with the effectiveness of stapedotomy in improving hearing sensitivity in Taiwanese patients with otosclerosis. METHODS In this retrospective study, we reviewed the medical records of 31 patients (36 ears) with otosclerosis undergoing stapedotomy performed by a single surgeon. Preoperative and postoperative hearing results were analyzed to identify factors associated with hearing outcomes after stapedotomy in the Taiwanese population with clinical otosclerosis. RESULTS Compared with preoperative pure tone averages (PTAs), stapedotomy significantly improved postoperative air conduction (AC) thresholds (P < .0001), bone conduction (BC) thresholds (P = .025), and air-bone gaps (ABGs; P < .0001). Postoperative closure of ABGs less than 10 or 20 dB was achieved in 16 (44.4%) and 33 (91.7%) of 36 surgical ears. Improvement in postoperative AC thresholds and ABGs and the size of preoperative ABGs were significantly correlated (r = .650, P < .001 and r = .745, P < .001, respectively). Gender-stratified analysis indicated a stronger correlation between improvement in postoperative AC thresholds and preoperative ABGs in male patients than in female patients (r = .893, P < .001 and r = .476, P = .014, respectively), and in postoperative and preoperative ABGs (r = .933, P < .001 and r = .626, P < .001, respectively). With the more stringent criteria for surgical success, factors including age (≤50 years), type (conductive, BC ≤25 dB), and degree (PTA ≤55 dB) of preoperative hearing loss led to more favorable outcomes. CONCLUSIONS We reported evidence supporting a potential gender difference on hearing outcomes after stapedotomy in Taiwanese patients with otosclerosis. Age, type, and degree of preoperative hearing loss may affect the surgical success rate.
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Affiliation(s)
- Pei-Hsin Chen
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Taipei City
- * Pei-Hsin Chen, Kai-Nan Lin, and Hsiu-Yin Lin have equal contributions to this study
| | - Kai-Nan Lin
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Taipei City
- * Pei-Hsin Chen, Kai-Nan Lin, and Hsiu-Yin Lin have equal contributions to this study
| | - Hsiu-Yin Lin
- Department of Audiology, Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City
- * Pei-Hsin Chen, Kai-Nan Lin, and Hsiu-Yin Lin have equal contributions to this study
| | - Rui-Bin Yu
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Taipei City
| | - Pi-Yun Liu
- Department of Audiology, Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City
| | - Wan-Ting Shih
- Department of Audiology, Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital, New Taipei City
| | - Jeng-Wen Chen
- Department of Otolaryngology-Head and Neck Surgery, Cardinal Tien Hospital and School of Medicine, Fu Jen Catholic University, New Taipei City
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, Taipei City
- Department of Medical Education and Research, Cardinal Tien Hospital, New Taipei City
- Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei City
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Darjazini Nahas L, Trabulsi M, Alsawah R, Hamsho A, Al-Masalmeh MS, Omar A. The Clinical Picture of Otosclerosis and the Surgery Effect on Bone Conduction Thresholds on Audiograms. Indian J Otolaryngol Head Neck Surg 2023; 75:3628-3635. [PMID: 37974740 PMCID: PMC10645766 DOI: 10.1007/s12070-023-04034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 06/23/2023] [Indexed: 11/19/2023] Open
Abstract
Our study aims to illustrate the clinical picture of otosclerosis in patients and the effect of surgery on the bone conduction thresholds compared to audiometry tests before surgery. A retrospective study included 36 patients that fit the inclusion criteria based on the patient's files and Pure Tone Audiometry of the patients before and after surgery. The questionnaire used is attached at the end of the study. According to Our sample, 77.8% were females, and 22.2% were males. The youngest was 17 years old, the eldest was 61, and the mean age was 38.2 years old. Hearing loss was the most common symptom in 100% of patients, while tinnitus was found in 66.7% and vertigo in 11%. The Injury was bilateral in 72% of the cases. Before surgery, the mean air conduction threshold (ACT) was 54.7 dB, the mean value of the air-bone gap (ABG) was 38.3 dB, and the mean bone conduction threshold (BCT) was 16.1 dB. Meanwhile, after the surgery, the mean BCT was 18.2 dB. Otosclerosis is more common in middle-aged females. Most cases are bilateral. Two-thirds of the cases of hearing loss were associated with tinnitus, while only a few had vertigo. A slight increase was noticed in BCTs after surgeries, especially at 4000 Hz. Stapedectomy caused a noticeable decrease in the values of BCTs on the frequency 4000 Hz. Stapedotomy improved the BCTs after surgery by about 5.3 dB at 4000 Hz.
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Affiliation(s)
- Louei Darjazini Nahas
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Otorhinolaryngology, Syrian Private University, Damascus, Syrian Arab Republic
| | - Mouhammad Trabulsi
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Urology, Damascus, Syrian Arab Republic
| | - Rama Alsawah
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Internal Medicine, Damascus University, Damascus, Syrian Arab Republic
| | - Ahmad Hamsho
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Otorhinolaryngology, Damascus, Syrian Arab Republic
| | - Mohammad Sadek Al-Masalmeh
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Otorhinolaryngology, Damascus University, Damascus, Syrian Arab Republic
| | - Abdullah Omar
- Faculty of Medicine, Syrian Private University, Damascus, Syrian Arab Republic
- Department of Dermatology and Venerology, Damascus, Syrian Arab Republic
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Polspoel S, Moore DR, Swanepoel DW, Kramer SE, Smits C. Sensitivity of the antiphasic digits-in-noise test to simulated unilateral and bilateral conductive hearing loss. Int J Audiol 2023; 62:1022-1030. [PMID: 36121040 DOI: 10.1080/14992027.2022.2119611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/28/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The objective of this study is (1) to assess whether the presentation level of the antiphasic digits-in-noise (DIN) test affects the speech recognition threshold (SRT), (2) to evaluate how accurately simulated unilateral and bilateral conductive hearing loss is detected (CHL) and (3) to determine whether increasing the presentation level normalises the antiphasic DIN SRT. DESIGN Participants performed antiphasic and diotic DINs at different presentation levels with unilateral, bilateral or no earplugs. STUDY SAMPLE Twenty-four and twelve normal hearing adults. RESULTS Without earplugs, antiphasic DIN SRTs did not differ between 60 and 80 dB SPL. At 60 dB SPL, the antiphasic DIN correctly classified 92% of the unilateral earplug cases; the diotic DIN 25%. The binaural intelligibility level difference did not differ between the no-earplug condition and the condition with bilateral earplugs when the presentation was increased with the attenuation level. CONCLUSIONS In normal hearing participants, diotic and antiphasic DIN SRTs are independent of presentation level above a minimum level of 60 dB SPL. The antiphasic DIN is more sensitive than the diotic DIN for detecting unilateral CHL; not for bilateral CHL. The effect of CHL on DIN SRTs can be largely compensated by increasing the presentation level. Audibility plays an important role in the antiphasic and diotic DIN.
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Affiliation(s)
- Sigrid Polspoel
- Otolaryngology-Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, De Boelelaan, The Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, The Netherlands
| | - David R Moore
- Communication Sciences Research Center, Cincinnati Childrens' Hospital Medical Center and University of Cincinnati, Cincinnati, OH, USA
- Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, UK
| | - De Wet Swanepoel
- Ear Sciences Centre, School of Surgery, University of Western Australia, Perth, WA, Australia
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Sophia E Kramer
- Otolaryngology-Head and Neck Surgery, Section Ear and Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, De Boelelaan, The Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, The Netherlands
| | - Cas Smits
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, The Netherlands
- Amsterdam UMC location University of Amsterdam, Otolaryngology-Head and Neck Surgery, Ear and Hearing, Meibergdreef, Amsterdam, The Netherlands
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Silva VAR, Pauna HF, Lavinsky J, Guimarães GC, Abrahão NM, Massuda ET, Vianna MF, Ikino CMY, Santos VM, Polanski JF, Silva MNLD, Sampaio ALL, Zanini RVR, Lourençone LFM, Denaro MMDC, Calil DB, Chone CT, Castilho AM. Brazilian Society of Otology task force - Otosclerosis: evaluation and treatment. Braz J Otorhinolaryngol 2023; 89:101303. [PMID: 37647735 PMCID: PMC10474207 DOI: 10.1016/j.bjorl.2023.101303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/06/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES To review and provide evidence-based recommendations for the diagnosis and treatment of otosclerosis. METHODS Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on otosclerosis were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. RESULTS The topics were divided into 2 parts: 1) Diagnosis - audiologic and radiologic; 2) Treatment - hearing AIDS, pharmacological therapy, stapes surgery, and implantable devices - bone-anchored devices, active middle ear implants, and Cochlear Implants (CI). CONCLUSIONS The pathophysiology of otosclerosis has not yet been fully elucidated, but environmental factors and unidentified genes are likely to play a significant role in it. Women with otosclerosis are not at increased risk of worsening clinical condition due to the use of contraceptives or during pregnancy. Drug treatment has shown little benefit. If the patient does not want to undergo stapedotomy, the use of hearing aids is well indicated. Implantable systems should be indicated only in rare cases, and the CI should be indicated in cases of profound deafness.
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Affiliation(s)
- Vagner Antonio Rodrigues Silva
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Henrique Furlan Pauna
- Hospital Universitário Cajuru, Departamento de Otorrinolaringologia, Curitiba, PR, Brazil
| | - Joel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Ciências Morfológicas, Porto Alegre, RS, Brazil
| | - Guilherme Corrêa Guimarães
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Nicolau Moreira Abrahão
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Eduardo Tanaka Massuda
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Melissa Ferreira Vianna
- Irmandade Santa Casa de Misericordia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Cláudio Márcio Yudi Ikino
- Universidade Federal de Santa Catarina, Departamento de Cirurgia e Hospital Universitário, Florianópolis, SC, Brazil
| | - Vanessa Mazanek Santos
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil
| | - José Fernando Polanski
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil; Faculdade Evangélica Mackensie do Paraná, Curitiba, PR, Brazil
| | | | - André Luiz Lopes Sampaio
- Universidade de Brasília (UnB), Faculdade de Medicina, Laboratório de Ensino e Pesquisa em Otorrinolaringologia, Brasília, DF, Brazil
| | | | - Luiz Fernando Manzoni Lourençone
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Bauru, SP, Brazil; Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Bauru, SP, Brazil
| | | | - Daniela Bortoloti Calil
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Arthur Menino Castilho
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas (FCM), Departamento de Otorrinolaringologia, Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.
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Couvreur F, Schlegel-Wagner C, Linder T. Impact of manual crimping on stapedotomy outcomes. J Laryngol Otol 2023; 137:1027-1033. [PMID: 36263732 DOI: 10.1017/s0022215122002316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The impact of tight stapes crimping on hearing is a matter of debate. Several studies postulate that tight crimping is essential for lifelong success, whereas others have debated whether firm attachment leads to incus necrosis. Several types of prostheses with different coupling mechanisms have been developed, and manual crimping remains the most frequently used technique. This study investigates whether tightness really does affect hearing outcome. METHODS The hearing results of patients who underwent primary stapedotomies using three different titanium pistons were analysed. The surgeons categorised the firmness of the piston attachment into 'tight' and 'loose' crimping groups. Hearing outcome and reasons for revision surgical procedures were investigated. RESULTS The mean post-operative air-bone gap for frequencies of 0.5-4 kHz was 8.80 dB for the tight crimping group (n = 308) and 9.55 dB for the loose crimping group (n = 39). No significant difference was found (p = 0.4650). Findings at revision procedures were comparable (1.6 per cent vs 5 per cent). CONCLUSION Although firm crimping is strongly advised, a movable loop upon palpation does not lead to unsatisfactory hearing results, and does not mandate piston replacement or bone cement use.
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Affiliation(s)
- F Couvreur
- Department of Otorhinolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, AZ Sint-Jan Hospital, Bruges, Belgium
| | - C Schlegel-Wagner
- Department of Otorhinolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
| | - T Linder
- Department of Otorhinolaryngology, Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
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Normant S, Gendre A, Boucher S, Godey B, Bordure P, Michel G. Predictive factors of revision stapes surgery in otosclerosis. J Laryngol Otol 2023; 137:906-909. [PMID: 36511130 DOI: 10.1017/s0022215122002572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This study aimed to investigate predictive factors for revision surgery in otosclerosis. METHODS This was a retrospective, multicentre study in four tertiary centres. The primary objective was to investigate factors that were predictive of the need for revision stapes surgery. RESULTS The 'revision' group included 145 patients, and the 'control' group included 143 patients. This study identified statistically significant predictive factors for the need for revision surgery: younger age, active smoking status, dyslipidaemia and high blood pressure. There was no statistically significant difference between the two groups in terms of surgical technique or stapedotomy technique. CONCLUSION This study showed that patients who are candidates for primary stapes surgery with younger age, active smoking status, dyslipidaemia and high blood pressure are at higher risk of needing revision surgery. A holistic approach prior to stapes surgery with multidisciplinary assessment is recommended. These results are important for better patient counselling on expected outcomes and risks.
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Affiliation(s)
- S Normant
- Department of Otorhinolaryngology, University Hospital of Nantes, France
| | - A Gendre
- Department of Otorhinolaryngology, University Hospital of Nantes, France
| | - S Boucher
- Department of Otorhinolaryngology, University Hospital of Angers, France
| | - B Godey
- Department of Otorhinolaryngology, University Hospital of Rennes, France
| | - P Bordure
- Department of Otorhinolaryngology, University Hospital of Nantes, France
| | - G Michel
- Department of Otorhinolaryngology, University Hospital of Nantes, France
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Taybeh EO, Naser AY. Hospital Admission Profile Related to Inner Ear Diseases in England and Wales. Healthcare (Basel) 2023; 11:healthcare11101457. [PMID: 37239743 DOI: 10.3390/healthcare11101457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/25/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Due to an expansion in the usage of medications (such as anticancer therapies), increased exposure to noise, and an increase in life expectancy, the prevalence of inner ear disease-related hearing loss is rising. Diseases of the inner ear are frequently accompanied by other conditions, such as chronic heart failure, systemic inflammation, arterial hypertension, and cerebrovascular disease. The aim of this study was to investigate the profile of hospital admissions linked to inner ear diseases in England and Wales. METHOD This was an ecological descriptive study using public medical databases in England and Wales. Diagnostic codes for diseases of the inner ear (H80-H83) were used to identify all hospital admissions. Between 1999 and 2020, the chi-squared test was used to assess the difference between the admission rates. RESULTS From 5704 in 1999 to 19,097 in 2020, the total annual number of hospital admissions increased by 234.8%, which corresponds to a 192.3% increase in the admission rate [from 10.94 (95% CI 10.66-11.22) in 1999 to 31.98 (95% CI 31.52-32.43) in 2020 per 100,000 people, p < 0.01]. "Disorders of vestibular function" and "other inner ear diseases" were the most frequent causes of hospital admissions due to inner ear diseases, accounting for 47.6% and 43.6%, respectively. The age range of 15 to 59 years accounted for 42.3% of all diseases of the inner ear hospital admissions. Around 59.6% of all admissions were made by females. The female admission rate increased by 210.1% (from 12.43 (95% CI 12.01-12.85) in 1999 to 38.54 (95% CI 37.84-39.24) in 2020 per 100,000 people). The male admission rate for diseases of the inner ear increased by 169.6% [from 9.37 (95% CI 9.00-9.75) in 1999 to 25.26 (95% CI 24.69-25.84) per 100,000 people] in 2020. CONCLUSION Inner ear disease admissions increased markedly in England and Wales during the past two decades. Females and the middle-aged population were at higher risk of being admitted for inner ear diseases. Further cohort studies are warranted to identify other risk factors and develop effective prevention strategies.
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Affiliation(s)
- Esra' O Taybeh
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
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11
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Bălaşa Vîrzob CR, Cloşca RM, Poenaru M, Morar R, Balica NC, Sarău CA, Ioniţă I, Baderca F. Otosclerosis under the magnifying glass. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2023; 64:189-197. [PMID: 37518876 PMCID: PMC10520382 DOI: 10.47162/rjme.64.2.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/22/2023] [Indexed: 08/01/2023]
Abstract
Otosclerosis is a bone condition affecting the stapes bone within the otic capsule, and its exact cause is still unknown. It is characterized by a lack of proper remodeling of newly formed vascular and woven bone, leading to the development of abnormal osteons and the formation of sclerotic bone. Bilateral otosclerosis is seen in 80% of patients and 60% of otosclerosis patients have a family history of the condition. The etiology of this disease is still unknown, there are lots of theories to explain it. The histopathological (HP) studies of otosclerosis showed that osteoblasts, osteoclasts, vascular proliferation, fibroblasts, and histiocytes were observed in the stapes footplate. The onset of the symptoms occurs by the early third decade of life, usually it doesn't start later. In otosclerosis, the energy exerted by sound at the level of the tympanic membrane is reduced in the inner ear due to the fixation and rigidity of the ossicular chain, leading to hearing loss, especially for low frequencies. The primary clinical symptom of otosclerosis is conductive hearing loss but it is important to note that sensorineural hearing loss and mixed hearing loss can also occur as secondary symptoms of the condition. Another symptom present in patients with otosclerosis is tinnitus. The paper carried out a retrospective study of 70 patients diagnosed with otosclerosis in the Department of Otorhinolaryngology of Emergency City Hospital, Timişoara, Romania, between January 2021 to December 2022. Tissue fragments were processed at Service of Pathology by standard Hematoxylin-Eosin staining. The HP diagnosis was completed using Masson's trichrome staining, Giemsa histochemical staining, and immunohistochemical (IHC) reactions with anti-cluster of differentiation (CD)20, anti-CD3, anti-CD4, anti-CD8, anti-CD34, and anti-CD31 antibodies. The microscopic examination showed a chronic diffuse inflammatory infiltrate that consisted predominantly of mature T-lymphocytes, immunohistochemically positive for CD3, CD4 and CD8. There were also present rare CD20-positive B-lymphocytes. Among the lymphocytes, relatively numerous mast cells were identified, highlighted histochemically by the Giemsa staining. They had numerous purple-violet intracytoplasmic granules. In the connective tissue support, a relatively rich vascular network was identified, consisting of hyperemic capillaries, highlighted immunohistochemically with anti-CD31 and anti-CD34 antibodies. Bone tissues trabeculae showed extensive areas of fibrosis. The collagen fibers were highlighted by Masson's trichrome staining, being stained in green, blue, or bluish green.
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Association between Otosclerosis and Rubella in Taiwan: A Nationwide Case-Control Study. J Clin Med 2023; 12:jcm12051761. [PMID: 36902548 PMCID: PMC10003269 DOI: 10.3390/jcm12051761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Otosclerosis is an early adult-onset disease that is associated with 5-9% and 18-22% of all cases of hearing and conductive hearing loss, respectively, and it is suspected to have a viral etiology. However, the role of viral infection in otosclerosis is still inconclusive. This study aimed to investigate whether rubella infection was associated with otosclerosis risk. We conducted a nationwide case-control study in Taiwan. Data were retrospectively analyzed from the Taiwan National health Insurance Research Database. Cases consisted of all patients who were aged ≥6 years and had a first-time diagnosis of otosclerosis for the period between 2001 and 2012. The controls were exact matched to cases in a 4:1 ratio by birth year, sex, and must survive in the index year of their matched cases. Adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated by using conditional logistic regression. We examined 647 otosclerosis cases and 2588 controls without otosclerosis. Among the 647 patients with otosclerosis, 241 (37.2%) were male and 406 (62.8%) were female, with most aged between 40 and 59 years, with a mean age of 44.9 years. After adjusting for age and sex, conditional logistic regression revealed that exposure to rubella was not associated with a significant increase in otosclerosis risk (adjusted OR, 2.0; 95% CI, 0.18-22.06, p = 0.57). In conclusion, this study did not show that rubella infection was associated with the risk of otosclerosis in Taiwan.
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Rajati M, Jafarzadeh S, Javadzadeh R, Disfani MF, Yousefi R. Comprehensive vestibular evaluation in patients with Otosclerosis: a case control study. Indian J Otolaryngol Head Neck Surg 2022; 74:582-587. [PMID: 36514435 PMCID: PMC9741689 DOI: 10.1007/s12070-022-03147-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 08/19/2022] [Indexed: 11/06/2022] Open
Abstract
Aim Otosclerosis is one of the common otologic diseases. The mechanism and the probable site of vestibular involvement are not yet fully understood. The present study aimed to perform a comprehensive vestibular evaluation in patients with otosclerosis, compared to the cases without otosclerosis. Materials and methods patients underwent a comprehensive cochleovestibular evaluation, including audiometry, ocular and cervical vestibular evoked myogenic potential (o-VEMP and c-VEMP), video head impulse (vHIT) and caloric tests. The results were compared with those obtained from the non-otosclerosis control group. Results A total of 61 individuals were included in the study who were divided into two groups of the case (50.82%) and control (49.18%). The results showed that there was a significant difference in the mean vHIT gain between the case and control groups (P < 0.05). However, the mean gain was still within the normal range. Besides, the patients with otosclerosis had significant bilateral or unilateral weaknesses according to caloric test results. Moreover, their o-VEMP and c-VEMP results were significantly abnormal as well (P < 0.05). Conclusion Based on the results of the present study, the vestibular system even in asymptomatic cases, is affected by otosclerosis. Furthermore, it seems that the otolithic system has a higher chance of involvement, compared to the semicircular canals. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03147-5.
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Affiliation(s)
- Mohsen Rajati
- Sinus and Surgical Endoscopic Research Center, Department of Otorhinolaryngology, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sadegh Jafarzadeh
- Department of Audiology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Audiology, School of Paramedical Sciences, campus of Mashhad, University of Medical Sciences, park square, Mashhad, Iran
| | - Raziyeh Javadzadeh
- Department of Otorhinolaryngology, School of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahboobeh Feiz Disfani
- Resident of otolaryngology, Ghaem Hospital, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Razieh Yousefi
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
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Motasaddi Zarandy M, Amirzargar B, Golpayegani G, Motasaddizarandy M, Emami H. Fixed vs Measured Length of Stapes Prosthesis in Stapes Surgery. Indian J Otolaryngol Head Neck Surg 2022; 74:3883-3886. [PMID: 36742824 PMCID: PMC9895487 DOI: 10.1007/s12070-021-02707-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/20/2021] [Indexed: 02/07/2023] Open
Abstract
Aims The aim of this study is to assess the relationship between the prosthesis length and the outcome of the primary stapes surgery in patients with otosclerosis. Material and Methods This was a retrospective cohort study. We reviewed medical records of 218 patients between January 2015 and August 2020 in two different referral centers. It was conducted in two hospitals by two different well experienced otologic surgeons that one of them believes in fixed length (4.75 mm) of stapes prosthesis (group A) and, the other one believes in measuring the distance between the footplate and incus long process to choose the proper length of prosthesis (group B). The surgery success rates and complications between these two groups were compared 3 months postoperatively. Results Mean age, preoperative bone conduction (BC) audiometric threshold and air-bone gap, postoperative BC and air-bone gap were similar in both groups (All p > 0.05). Vertigo frequency was not significantly different between the two groups (p = 0.303). There were no significant differences regarding the number of favorable postoperative outcomes between group A and B (70 (97.2%) vs. 142(97.3%) respectively) (p = 0.632). Conclusion This study found no significant difference regarding the hearing outcomes between fixed length vs measured length of stapes prosthesis.
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Affiliation(s)
| | - Behrooz Amirzargar
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Goli Golpayegani
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Motasaddizarandy
- Department of Neurology & Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC H3A 2B4 Canada
| | - Hamed Emami
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Prevalence and associated risk factors of tinnitus among adult Palestinians: a cross-sectional study. Sci Rep 2022; 12:20617. [PMID: 36450754 PMCID: PMC9712604 DOI: 10.1038/s41598-022-24015-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
Tinnitus is a common complaint with potentially negative impact on quality of life. Prevalence of tinnitus ranges from 5 to 43% worldwide. This variation could be due to the heterogeneity of tinnitus assessment. This has limited the progress in understanding tinnitus. Therefore, we employed a standardized and a validated assessment method to determine the prevalence and related risk factors of tinnitus among Palestinians for the first time. This is a cross-sectional study in which we questioned a representative sample of 618 subjects in one-to-one interviews. The prevalence of any tinnitus was 30.6% among adult Palestinians. Participants from the oldest age group were almost five times more likely to have tinnitus. Moreover, participants with head and neck pain syndrome, severe hearing impairment, sleeping disorders or frequent complaints of vertigo were approximately two times more likely to have tinnitus. Our study provides novel information regarding tinnitus in Palestine and improves our understanding of tinnitus. This will improve the diagnosis and consequently will contribute in reducing the prevalence and perhaps in preventing tinnitus. As tinnitus still has no known cure, further investigations of modifiable risk factors and causes of tinnitus are crucial to prevent it in the future.
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Tuset M, Baptiste A, Cyna Gorse F, Sterkers O, Nguyen Y, Lahlou G, Ferrary E, Mosnier I. Facial nerve stimulation in adult cochlear implant recipients with far advanced otosclerosis. Laryngoscope Investig Otolaryngol 2022; 8:220-229. [PMID: 36846428 PMCID: PMC9948588 DOI: 10.1002/lio2.984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022] Open
Abstract
Objectives The objective of this study was to predict occurrence of facial nerve stimulation (FNS) in cochlear implanted patients for far-advanced otosclerosis (FAO) by correlating preoperative computed tomography (CT)-scan data to FNS and to evaluate FNS impact on hearing outcomes. Methods Retrospective analysis on 91 ears (76 patients) implanted for FAO. Electrodes were straight (50%) or perimodiolar (50%). Demographic data, extension of otosclerosis on preoperative CT scan, occurrence of FNS, and speech performance were analyzed. Results Prevalence of FNS was 21% (19 ears). FNS appeared during the first month (21%), 1-6 months (26%), 6-12 months (21%), and over 1 year (32%) postimplantation. Cumulative incidence of FNS at 15 years was 33% (95% CI = [14-47%]). Extension of otosclerotic lesions on preimplantation CT-scan was more severe in FNS ears compared to No-FNS (p < .05): for Stage III, 13/19 (68%) and 18/72 (25%) ears for FNS and No-FNS groups, respectively (p < .05). Location of otosclerotic lesions relative to the facial nerve canal was similar whatever the presence or not of FNS. Electrode array had no impact on FNS occurrence. At 1 year post-implantation, duration of profound hearing loss (≥5 years) and previous stapedotomy were negatively associated with speech performance. FNS did not impact hearing outcomes, despite a lower percentage of activated electrodes (p < .01) in the FNS group. Nevertheless, FNS were associated with a decrease of speech performance both in quiet (p < .001) and in noise (p < .05). Conclusion Cochlear implanted patients for FAO are at greater risk of developing FNS affecting speech performance over time, probably due to a higher percentage of deactivated electrodes. High resolution CT-scan is an essential tool allowing FNS prediction but not time of onset. Level of evidence 2b, Laryngoscope Investigative Otolaryngology, 2022.
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Affiliation(s)
- Maria‐Pia Tuset
- Unité Fonctionnelle Implants Auditifs, ORL, GH Pitié‐SalpêtrièreAP‐HP Sorbonne UniversitéParisFrance
| | - Amandine Baptiste
- Département de Biostatistique, Santé Publique et Information médicale, GH Pitié‐SalpêtrièreAP‐HP Sorbonne UniversitéParisFrance
| | | | - Olivier Sterkers
- Unité Fonctionnelle Implants Auditifs, ORL, GH Pitié‐SalpêtrièreAP‐HP Sorbonne UniversitéParisFrance,Technologies et thérapie génique pour la surdité, Institut de l'auditionInstitut Pasteur / Inserm / Université Paris CitéParisFrance
| | - Yann Nguyen
- Unité Fonctionnelle Implants Auditifs, ORL, GH Pitié‐SalpêtrièreAP‐HP Sorbonne UniversitéParisFrance,Technologies et thérapie génique pour la surdité, Institut de l'auditionInstitut Pasteur / Inserm / Université Paris CitéParisFrance
| | - Ghizlène Lahlou
- Unité Fonctionnelle Implants Auditifs, ORL, GH Pitié‐SalpêtrièreAP‐HP Sorbonne UniversitéParisFrance,Technologies et thérapie génique pour la surdité, Institut de l'auditionInstitut Pasteur / Inserm / Université Paris CitéParisFrance
| | - Evelyne Ferrary
- Unité Fonctionnelle Implants Auditifs, ORL, GH Pitié‐SalpêtrièreAP‐HP Sorbonne UniversitéParisFrance,Technologies et thérapie génique pour la surdité, Institut de l'auditionInstitut Pasteur / Inserm / Université Paris CitéParisFrance
| | - Isabelle Mosnier
- Unité Fonctionnelle Implants Auditifs, ORL, GH Pitié‐SalpêtrièreAP‐HP Sorbonne UniversitéParisFrance,Technologies et thérapie génique pour la surdité, Institut de l'auditionInstitut Pasteur / Inserm / Université Paris CitéParisFrance
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Management of Juvenile Otosclerosis: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9111787. [PMID: 36421236 PMCID: PMC9688878 DOI: 10.3390/children9111787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 11/23/2022]
Abstract
Background. Otosclerosis can occur during childhood, resulting in the early onset of conductive hearing loss. The approach to a child with otosclerosis can present some difficulties in terms of diagnosis and treatment, and the literature on juvenile otosclerosis (JO) is still relatively limited. Aim. To explore the current approaches to JO, in order to clear the management of this condition and evaluate the outcomes and the possible complications of surgical treatment. Methods. A systematic review was performed according to PRISMA guidelines, searching Medline and Embase from January 2002 through to 30 September 2022. A total of 759 papers were identified but based on specified criteria, nine were included in this study. Results. There were 94 children affected by JO and treated by stapes surgery. According to the available data, Male: Female ratio was 1:3−4, whilst the mean ages ranged from 10 to 16.3 years at the time of stapes surgery. After stapes surgery, the target of ABG < 10 dB was achieved in most of the patients. Overall, the 4 complications were reported (4/94= 4%): stenosis of the external ear canal, deterioration of hearing, anacusis with vertigo, tinnitus. Conclusions. The heterogeneity of the available studies does not allow us to draw straight conclusions on this topic, currently. More data about the natural history of the disease in children could help in approaching the treatment correctly, and possibly in drawing guidelines. Studies with a prolonged follow-up could be helpful for assisting clinicians and families in taking the most favorable decision about treatment.
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18
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The Spatial Distribution of Cellular Voids in the Human Otic Capsule: An Unbiased Quantification of Osteocyte-Depleted Areas. Otol Neurotol 2022; 43:e804-e809. [PMID: 35941668 DOI: 10.1097/mao.0000000000003626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to describe the spatial distribution of osteocyte-depleted areas, so-called cellular voids, in the human otic capsule and compare it with that of otosclerosis. BACKGROUND Systematic histological studies of the bony otic capsule have revealed an osteoprotegerin (OPG)-mediated inhibition of normal bone remodeling around the inner ear. The resulting accumulation of bony degeneration and dead osteocytes has been thoroughly documented, and the spatial distribution of dead osteocytes and matrix microcracks resembles that of the human ear disease otosclerosis. Clusters of dead osteocytes that may interfere with osteocyte connectivity and thereby the OPG signaling pathway have been described in human temporal bones. It is possible that these cellular voids create disruptions in the antiresorptive OPG signal that may give rise to local pathological remodeling. METHODS Recently, a method of detecting cellular voids was developed. This study uses unbiased stereology to document the spatial distribution of cellular voids in bulk-stained undecalcified human temporal bone. RESULTS Cellular voids accumulate around the inner ear and increase in number and size with age. Furthermore, cellular voids are more frequently found in the anterior and lateral regions of the otic capsule, which are known predilection sites of otosclerosis. CONCLUSION This colocalization of cellular voids and otosclerosis suggests a causal relationship between focal degeneration and otosclerotic remodeling.
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Unexpected Motherhood-Triggered Hearing Loss in the Two-Pore Channel (TPC) Mutant Mouse. Biomedicines 2022; 10:biomedicines10071708. [PMID: 35885013 PMCID: PMC9312904 DOI: 10.3390/biomedicines10071708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 12/02/2022] Open
Abstract
Calcium signaling is crucial for many physiological processes and can mobilize intracellular calcium stores in response to environmental sensory stimuli. The endolysosomal two-pore channel (TPC), regulated by the second messenger nicotinic acid adenine dinucleotide phosphate (NAADP), is one of the key components in calcium signaling. However, its role in neuronal physiology remains largely unknown. Here, we investigated to what extent the acoustic thresholds differed between the WT mice and the TPC KO mice. We determined the thresholds based on the auditory brainstem responses (ABRs) at five frequencies (between 4 and 32 kHz) and found no threshold difference between the WT and KO in virgin female mice. Surprisingly, in lactating mothers (at P9–P10), the thresholds were higher from 8 to 32 kHz in the TPC KO mice compared to the WT mice. This result indicates that in the TPC KO mice, physiological events occurring during parturition altered the detection of sounds already at the brainstem level, or even earlier.
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A Systematic Review of the Effectiveness of Bisphosphonates for Otosclerosis. Otol Neurotol 2022; 43:530-537. [PMID: 35213475 DOI: 10.1097/mao.0000000000003510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To systematically review the evidence for the use of bisphosphonate therapy in otosclerosis through clinically relevant outcomes. DATABASES REVIEWED MEDLINE, EMBASE, PubMed, and CINAHL databases were searched up to July 12, 2021. METHODS RCTs and cohort studies investigating the effect of bisphosphate therapy on adults or children diagnosed with otosclerosis were included. The risk of bias within trials was examined using the ROB2 tool for RCTs, and the ROBINS-I for non-RCTs. RESULTS Three studies reported over five publications were included in the systematic review. Data from one RCT at 6 months did not demonstrate any improvement nor deterioration in audiological outcomes in participants treated with Sodium Alendronate. Data from MRI in this group demonstrated improvements in the SI of the otosclerotic foci at the RAOW compared to participants taking placebo. In another RCT, improvements in audiological outcomes were seen at 12 and 24 months in individuals treated with Etidronate Sodium. Long-term data from a retrospective cohort study demonstrated stabilisation of hearing in individuals with otosclerosis and progressive SNHL. CONCLUSION There is insufficient evidence to recommend the routine use of bisphosphonates in otosclerosis patients at present. Long-term retrospective data has suggested a role for bisphosphonates in the subset of patients with deteriorating sensorineural hearing loss with the aim of hearing stabilisation. Adequately powered RCTs with long term follow up will be required to evaluate this further.
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Walker BA, Thorwarth RM, Stull LL, Hoxworth JM, Deep NL, Weisskopf PA. Incidence of Concomitant Semicircular Canal Dehiscence With Otosclerosis. OTOLOGY & NEUROTOLOGY OPEN 2022; 2:e012. [PMID: 38516327 PMCID: PMC10950147 DOI: 10.1097/ono.0000000000000012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 03/23/2024]
Abstract
Objective The concurrence of otosclerosis and superior semicircular canal dehiscence (SSCD) presents a diagnostic challenge and failure to differentiate between these 2 diagnoses results in mischaracterization and unsuccessful surgery. The objective of this study is to identify the incidence of SSCD in patients who have computed tomography (CT) evidence of otosclerosis. Study Design Retrospective chart review. Setting Tertiary referral hospital. Patients Adults with CT scan of the temporal bone diagnosed with radiological unilateral or bilateral fenestral otosclerosis from January 1995 to April 2018. Methods Retrospective review of patient imaging from a multi-center tertiary-referral health system from January 1995 to April 2018. Imaging was reviewed to quantify the incidence of SSCD among patients with CT-diagnosed bilateral fenestral otosclerosis. Poor quality imaging was excluded from review. Results One-thousand two-hundred eight patients (1214 CT scans) were identified with otosclerosis, of which 373 were diagnosed with fenestral otosclerosis (663 ears) with imaging of sufficient quality for review. This population was predominantly female (57.2%) with bilateral fenestral otosclerosis (78%). Of these, 23 ears (3.5%) had definitive evidence of SSCD, with an additional 15 ears (2.3%) with possible radiographic evidence of SSCD. There was no significant difference in laterality between the SSCD and otosclerosis. Conclusions Among 373 patients with fenestral otosclerosis per CT temporal bone imaging at a tertiary referral hospital, as many as 8.3% of patients had radiographic evidence of SSCD. Given this incidence, it continues to be important to consider SSCD when diagnosing and treating otosclerosis.
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Affiliation(s)
- Brian A. Walker
- Department of Otorhinolaryngology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Ryan M. Thorwarth
- Department of Otorhinolaryngology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Lindsey L. Stull
- Department of Otorhinolaryngology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Joseph M. Hoxworth
- Department of Radiology, Division of Neuroradiology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Nicholas L. Deep
- Department of Otorhinolaryngology, Division of Neurotology, The Mayo Clinic in Arizona, Phoenix, AZ
| | - Peter A. Weisskopf
- Department of Otorhinolaryngology, Division of Neurotology, The Mayo Clinic in Arizona, Phoenix, AZ
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22
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Sandison A. Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumours: Tumours of the Ear. Head Neck Pathol 2022; 16:76-86. [PMID: 35397067 PMCID: PMC9018943 DOI: 10.1007/s12105-022-01450-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/21/2022] [Indexed: 11/27/2022]
Abstract
In the recently published 5th Edition of the World Health Organisation Classification of Head and Neck Tumours, there are relatively few changes to report in terms of nomenclature in lesions of ear and temporal bone and fewer developments in molecular pathogenesis in comparison to other sites, particularly in sinonasal tract. Ear and temporal bone tumours are rare and biopsy material is limited. As a result, resources in the literature are scarce with few large series, no controlled clinical trials and the approaches to staging and management are not standardised. New entities are difficult to characterise. The number of entries has, however, increased for tumours of the ear and temporal bone (thirteen) compared to the 4th Edition (eleven). Some lesions previously included in the 4th Edition considered to have no site-specific features have been excluded to be discussed elsewhere and other benign lesions that are specific to this site have been included. The tumours and tumour-like entities of ear and temporal bone are discussed here mindful that the chapter in the 5th edition better correlates disease processes with clinical information and imaging and as far as possible standardises nomenclature.
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Affiliation(s)
- Ann Sandison
- Guy’s & St Thomas’ NHS Foundation Trust, King’s College London, London, UK
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McManus B, Harbarger C, Grillis A, Prewitt MG, Baiduc R, Block D, Paul O, Spankovich C. Otoscopy and tympanometry outcomes from the National Health and Nutrition Examination Survey (NHANES). Am J Otolaryngol 2022; 43:103332. [PMID: 34953248 DOI: 10.1016/j.amjoto.2021.103332] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/12/2021] [Accepted: 12/09/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of the study was to estimate the prevalence of conductive pathologies based on tympanometric and otoscopic findings in adults in the U.S. and examine relationships between abnormal findings and audiometrically defined or reported perceived hearing loss and tinnitus. MATERIALS AND METHODS Data from 3409 individuals aged 20-69 years from the 1999-2000 and 2000-2002 cycles of the National Health and Nutrition Examination Survey (NHANES) were analyzed. Outcomes included report of ear tubes, self-perceived hearing loss, and tinnitus (yes or no). Otoscopy involved screening for presence of cerumen (ear wax) and physical abnormality for each ear. Ear-specific tympanometry included measures of middle ear pressure, external ear volume, tympanometric width, and admittance/compliance for each ear. Mean and prevalence estimates are provided applying sample weights. A multivariate ordinal regression model adjusting for age, sex, race/ethnicity, and education was used to examine relationships between otoscopy or tympanometry measures with hearing loss and tinnitus. RESULTS Approximately 12% of the sample showed evidence of abnormal tympanometry and 12% showed evidence of abnormal otoscopy in at least one ear. Measured hearing loss was consistently related to tympanometry outcomes, in both univariate and adjusted models, but perceived hearing loss and tinnitus were not related to abnormal tympanometry or otoscopy. The most common reason for abnormal otoscopy was presence of excessive or impacted cerumen, representing an estimated 10% of the population. CONCLUSIONS With 1 out of 10 adults having excessive cerumen, adults considering over-the-counter (OTC) hearings aids may benefit from an ear examination prior to purchase.
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Cancer diagnosis and anosmia recovery in the pandemic update, cholesteatoma diagnosis, otosclerosis in pregnancy, and no renaissance of maxillary sinus irrigation. The Journal of Laryngology & Otology 2022; 136:189-190. [DOI: 10.1017/s0022215122000688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ricci G, Gambacorta V, Lapenna R, della Volpe A, La Mantia I, Ralli M, Di Stadio A. The effect of female hormone in otosclerosis. A comparative study and speculation about their effect on the ossicular chain based on the clinical results. Eur Arch Otorhinolaryngol 2022; 279:4831-4838. [PMID: 35187596 PMCID: PMC9474451 DOI: 10.1007/s00405-022-07295-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/31/2022] [Indexed: 01/08/2023]
Abstract
Abstract
Purpose
This study aimed at identifying gender differences in the hearing thresholds in a sample of patients with otosclerosis before and after surgery to understand the impact of female hormones on auditory thresholds.
Methods
This retrospective study analyzed 184 patients (123 women and 61 men) affected by otosclerosis. All the patients were affected by conductive hearing loss and treated by stapedoplasty. Auditory thresholds at the baseline (T0) and one month after surgery (T30) were collected. Air and bone thresholds and Air Bone Gap (ABG) were compared between females and males using one-way ANOVA.
Results
Statistically significant differences were observed comparing the air threshold at T0 vs T30 both in women and men (p < 0.0001). No statistically significant differences were observed in the bone conduction thresholds before and after surgery. The comparison between females and males showed statistically significant differences both at T0 (p < 0.01) and T30 (p < 0.05) for air conduction thresholds and ABG at 4000 Hz.
Conclusion
Although stapedoplasty reduced the difference between females and males in the air conduction thresholds and ABG, women showed better recovery of their middle ear function with better auditory thresholds and ABG. The female hormones might positively impact the ligaments of the incudostapedial joint improving chain flexibility. This benefit might explain the statistically significant difference observed in women at 4000 Hz before and after surgery.
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Yao W, Gao L, Su J, Karpeta N, Xie W, Duan M. Effects of lesions of the organ of corti on hearing. Acta Otolaryngol 2022; 142:118-126. [PMID: 35098870 DOI: 10.1080/00016489.2022.2027517] [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] [Indexed: 11/01/2022]
Abstract
BACKGROUND Lesions causing changes in the microstructure of the organ of Corti may lead to hearing impairment. AIMS/OBJECTIVES The aim of this study was to investigate the effect of various structural lesions on the organ of Corti and the auditory function. METHODS A finite element method of the cochlea and the organ of Corti were established based on computed tomography scanning and anatomical data. We evaluated the accuracy of the model by comparing the simulation results to reported experimental data. We simulated and analyzed the impact of the lesions on the sound-sensing function of the cochlea by adjusting the biomaterial parameters of each component of the cochlea. RESULTS In the explored frequency range, the stereocilia and outer hair cells and basilar membrane sclerosis resulted in 23.4%, 47.2%, and 57.8% reduction of basilar membrane displacement, respectively. Lesions of the basilar membrane and stereocilia and outer hair cells in the Corti caused a hearing response curve shift to higher frequencies and a decrease of the amplitude of the basilar membrane. CONCLUSIONS AND SIGNIFICANCE Lesions of the internal structure of the Corti cause diminished movement of basement membrane and decreased sensorial function, which ultimately lead to hearing loss.
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Affiliation(s)
- Wenjuan Yao
- School of Mechanics and Engineering Science, Shanghai University, Shanghai, P.R. China
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai, P.R. China
| | - Lei Gao
- School of Mechanics and Engineering Science, Shanghai University, Shanghai, P.R. China
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai, P.R. China
| | - Jiangtao Su
- School of Mechanics and Engineering Science, Shanghai University, Shanghai, P.R. China
| | - Niki Karpeta
- Division of ENT section, Department of Clinical Science, Intervention and Technology and Department of Otolaryngology Head and Neck & Audiology and Neurotology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Wen Xie
- Department of Otolaryngology, Head and Neck Surgery, the Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Maoli Duan
- Division of ENT section, Department of Clinical Science, Intervention and Technology and Department of Otolaryngology Head and Neck & Audiology and Neurotology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
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Bonnafous S, Margier J, Bartier S, Tournegros R, Tringali S, Fieux M. Estimated Costs Associated With Management of Otosclerosis With Hearing Aids vs Surgery in Europe. JAMA Netw Open 2022; 5:e2148932. [PMID: 35175343 PMCID: PMC8855228 DOI: 10.1001/jamanetworkopen.2021.48932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Surgery and hearing aids have similar outcomes in terms of hearing acuity but differ in terms of cost, aesthetics, and patient quality of life. The cost-effectiveness and budget impact of otosclerosis treatments have never been studied in Europe. OBJECTIVES To compare the estimated mean costs per patient over 10 years of surgery vs hearing aids for the treatment of otosclerosis and to estimate the budget impact of an increase in the proportion of patients receiving surgical treatment. DESIGN, SETTING, AND PARTICIPANTS This economic evaluation analyzed French and European epidemiological data on the surgical management of symptomatic otosclerosis and compared them with data from the literature to build economic models. The analysis was conducted in January 2021. EXPOSURES Two care pathways were considered in the treatment of otosclerosis, either hearing aid or surgery. MAIN OUTCOMES AND MEASURES Costs were studied over 10 years using Markov models of the 2 care pathways (hearing aid vs surgery). The budget impact analysis was performed over 5 and 10 years, assuming a 1-percentage point yearly increase in the proportion of patients receiving surgical treatment. RESULTS Over 10 years, the estimated mean cost per patient was significantly lower in the surgery group compared with the hearing aid group (€3446.9 vs €6088.4; mean difference, -€2641.5; 95% CI -€4064.8 to -€1379.4 [US $3913.4 vs US $6912.4; mean difference, -US $2999.0; 95% CI, -US $4614.9 to -US $1566.1]). Increasing surgical treatment by 1 percentage point per year for 10 years would lead to overall savings of €1 762 304 (US $2 000 798) in France, with an increase of €1 322 920 (US $1 501 952) at 10 years for the public health insurance system and a decrease of €3 085 224 (US $3 502 750) at 10 years for patients and private health insurers. Sensitivity analyses showed that these results were robust. CONCLUSIONS AND RELEVANCE These results suggest that in France, treating otosclerosis surgically is slightly less expensive over 10 years than using hearing aids, when considering all payers. The proposed models developed in this study could be adjusted to perform the same analysis in other countries.
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Affiliation(s)
- Sophie Bonnafous
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d’oto-rhino-laryngologie, d’otoneurochirurgie et de chirurgie cervico-faciale, Lyon, France
| | - Jennifer Margier
- Hospices Civils de Lyon, Pôle de Santé Publique, Service d’ Évaluation Économique en Santé, Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Sophie Bartier
- Service d’oto-rhino-laryngologie, de chirurgie cervico faciale, Hôpital Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France
- Univ Paris Est Creteil, INSERM, Institut Mondor de Recherche Biomédicale, Créteil, France
- Centre National de la Recherche Scientifique, Equipe Mixte de Recherche 7000, Créteil, France
| | - Romain Tournegros
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d’oto-rhino-laryngologie, d’otoneurochirurgie et de chirurgie cervico-faciale, Lyon, France
| | - Stéphane Tringali
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d’oto-rhino-laryngologie, d’otoneurochirurgie et de chirurgie cervico-faciale, Lyon, France
- Université de Lyon, Université Lyon 1, Lyon, France
| | - Maxime Fieux
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d’oto-rhino-laryngologie, d’otoneurochirurgie et de chirurgie cervico-faciale, Lyon, France
- Univ Paris Est Creteil, INSERM, Institut Mondor de Recherche Biomédicale, Créteil, France
- Centre National de la Recherche Scientifique, Equipe Mixte de Recherche 7000, Créteil, France
- Université de Lyon, Université Lyon 1, Lyon, France
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Does Pregnancy Have an Influence on Otosclerosis? The Journal of Laryngology & Otology 2021; 136:191-196. [PMID: 34819176 DOI: 10.1017/s0022215121003601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Audio-vestibular disorders and pregnancy: A systematic review. Am J Otolaryngol 2021; 42:103136. [PMID: 34182351 DOI: 10.1016/j.amjoto.2021.103136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/13/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE During pregnancy a woman's body undergoes many physiological changes that involve all systems and organs, including sensory ones. We conducted this systematic review to highlight current evidence and treatment options in pregnant women with audio-vestibular disorders. MATERIALS AND METHODS A search was made on the following databases: PubMed, PubMed Central, Web of Science and Scopus. This research protocol was deposited in the PROSPERO Database. RESULTS After application of inclusion-exclusion criteria, 30 manuscripts were included in the review. Many authors (14/15) found a slight alteration of audiometric tests during pregnancy, with a reported recovery postpartum in most of the studies (5/7). Regarding sudden sensorineural hearing loss (SSNHL), we found four articles for a total of 69 patients: the treatment of choice was intravenous Dextran 40 and intra-tympanic corticosteroids. Most included studies (4/6) found neither clinical nor epidemiological associations between otosclerosis and pregnancy in large-based sample studies. Few investigations regarded Eustachian tube function and vertigo. CONCLUSIONS According to our results, many variations of hearing acuity during pregnancy are slight and transient and require only clinical observation. In large samples, otosclerosis appeared not to be associated with pregnancy. Clinicians should consider intra-tympanic steroids in managing SSNHL during pregnancy. Further more accurate research is needed to deepen and clarify the association between pregnancy and audio-vestibular disorders.
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The Price of Otologic Procedures: Variation in Markup by Surgical Procedure and Geography in the United States. Otol Neurotol 2021; 42:1184-1191. [PMID: 33782261 DOI: 10.1097/mao.0000000000003151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To characterize and analyze variation in price markup of seven common otologic surgeries by procedure and geographic region. STUDY DESIGN Retrospective Analysis of the Centers for Medicare and Medicaid Services database of 2017 Medicare Provider Utilization and Payment Public File. SETTING Inpatient and outpatient centers delivering Medicare-reimbursed services. PATIENTS Full sample of patients undergoing procedures with Medicare fee-for-service final action claims during 2017. INTERVENTIONS Seven procedures (myringotomy, tympanoplasty, mastoidectomy, tympanomastoidectomy stapedotomy/stapedectomy, cochlear implant, bone-anchored hearing aid). MAIN OUTCOME MEASURES Markup ratio (MUR) is defined as the ratio of total charges to Medicare-allowable-costs; Variation in MUR was measured using coefficient of variation (CoV). RESULTS Among all providers, the median MUR was 2.4 (interquartile range: 1.9-3.1). MUR varied significantly by procedure, from 2.3 for myringotomy to 8.7 for mastoidectomy (p < 0.01). MUR also varied significantly within procedure, with the least variation found in myringotomy (CoV = 0.46), and the greatest in cochlear implants (CoV = 0.92). Using the national average as baseline, MUR varied 71% between states, ranging from 1.75 to 6.24. Within the same state, significant variation was also noted, varying by 4% (CoV = 0.04) in Montana compared with 138% (CoV = 1.38) in Pennsylvania. MUR was not significantly correlated with patient comorbidity or Centers for Medicare and Medicaid Services risk scores. CONCLUSIONS There was significant variation in the price of otologic surgery across geographic regions and procedures. The MUR for otology is lower or comparable to that reported in other surgical fields.
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Malak W, Hagiwara M, Nguyen V. Neuroimaging of Dizziness and Vertigo. Otolaryngol Clin North Am 2021; 54:893-911. [PMID: 34312007 DOI: 10.1016/j.otc.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Dizziness and vertigo are common symptoms in the primary care and emergency settings, resulting in a significant decrease in quality of life and a high cost burden to the US health care system. The etiology of these symptoms is difficult to elucidate owing to a wide range of diseases with overlapping manifestations. The broad differential diagnosis based on whether the disease process is central or peripheral is showcased. Each differential will be categorized into neoplastic, infectious or inflammatory, structural, traumatic, and iatrogenic causes. Computed tomography scans, MRI, and vascular imaging are frequently complimentary in providing diagnoses and guidance in management.
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Affiliation(s)
- Wassim Malak
- Department of Radiology, NYU Langone Health, 222 East 41st Street, 5th Floor Radiology, New York, NY 10017, USA
| | - Mari Hagiwara
- Department of Radiology, NYU Langone Health, 222 East 41st Street, 5th Floor Radiology, New York, NY 10017, USA
| | - Vinh Nguyen
- Department of Radiology, NYU Langone Health, 222 East 41st Street, 5th Floor Radiology, New York, NY 10017, USA.
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Hansen LJ, Bloch SL, Frisch T, Sørensen MS. Distribution of microcrack surface density in the human otic capsule. Acta Otolaryngol 2021; 141:567-571. [PMID: 33825609 DOI: 10.1080/00016489.2021.1905875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The bony otic capsule is comprised of highly mineralized and dense compact bone. It is rarely remodelled and degenerative changes, therefore, accumulate around the inner ear. It is also a predilection site for the pathological remodelling seen in otosclerosis. Morphometric studies have documented increased numbers of dead osteocytes and microcracks in the human otic capsule. Microcracks may disrupt the lacuno-canalicular network and cause osteocyte apoptosis ultimately breaking up the perilabyrinthine bone signalling pathways and dynamics. This may be important to understand the pathogenesis of remodelling diseases like otosclerosis. AIMS/OBJECTIVES This study describes the spatial and regional distribution of microcrack surface density in relation to the inner ear and compares it to that previously recorded for otosclerosis. MATERIAL AND METHODS Forty-two temporal bones and five ribs were used. All samples were undecalcified, bulk stained in basic fuchsin and plastic embedded. Unbiased stereology was used to estimate the true surface density of microcracks (mm2/mm3) in perilabyrinthine bone. RESULTS The surface density of microcracks accumulates around the inner ear spaces, particularly in the lateral window regions, and increases with age. CONCLUSIONS AND SIGNIFICANCE This study documents the spatial and temporal association between microfractures and otosclerosis in the otic capsule.
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Affiliation(s)
- Lars Juul Hansen
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Denmark
| | - Sune Land Bloch
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Denmark
| | - Thomas Frisch
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Denmark
| | - Mads Sølvsten Sørensen
- Otopathology Laboratory, Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, University Hospital of Copenhagen, Rigshospitalet, Denmark
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Lu S, Wei X, Chen B, Chen J, Zhang L, Yang M, Sun Z, Shi Y, Kong Y, Liu S, Li Y. A new phenomenon of cochlear otosclerosis: an acquired or congenital disease? - A clinical report of cochlear otosclerosis. Acta Otolaryngol 2021; 141:551-556. [PMID: 33819124 DOI: 10.1080/00016489.2021.1906947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND No cochlear otosclerosis in infants with congenital bilateral SNHL has been reported. AIMS/OBJECTIVES We report an infant male with bilateral cochlear otosclerosis, suggesting that cochlear otosclerosis may be a congenital disease and to further analyze the etiology of and genetic expression in congenital bilateral cochlear otosclerosis. We also describe the clinical characteristics and experience of patients with bilateral cochlear otosclerosis treated with cochlear implants (CIs). MATERIALS AND METHODS Seven patients, including an infant, who were diagnosed with cochlear otosclerosis underwent CI surgery. Their medical records, audiological and radiological results, surgical procedures, and CI outcomes were collected and reviewed. RESULTS The median age at hearing loss was 38 years, ranging from 0 to 47 years. The child had bilateral hearing loss at birth and received a CI at 1 year of age. He also had growth retardation and was diagnosed with 3q+/3p- syndrome. All patients (8 ears) had better postoperative auditory performance than that preoperatively. CONCLUSIONS AND SIGNIFICANCE Although cochlear otosclerosis often starts at middle age and progresses slowly, it may be a congenital disease that is related to chromosome abnormality. This disease presents with SNHL or MHL, and treatment with a CI is beneficial.
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Affiliation(s)
- Simeng Lu
- Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, P. R. China
| | - Xingmei Wei
- Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, P. R. China
| | - Biao Chen
- Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, P. R. China
| | - Jingyuan Chen
- Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, P. R. China
| | - Lifang Zhang
- Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, P. R. China
| | - Mengge Yang
- Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, P. R. China
| | - Zhiming Sun
- Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, P. R. China
| | - Ying Shi
- Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, P. R. China
| | - Ying Kong
- Beijing Institute of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
| | - Sha Liu
- Beijing Institute of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
| | - Yongxin Li
- Department of Otorhinolaryngology and Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, P. R. China
- Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing, P. R. China
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Abstract
OBJECTIVE Several reports have suggested that the incidence of otosclerosis is declining. However, due to the limitations of epidemiologic databases within the United States, little is known about the incidence of congenital stapes footplate fixation (CSFF), much less epidemiological trends over the past 50 years. The current study was conceived to characterize the epidemiology of CSFF over the past five decades using the unique resources of the Rochester Epidemiology Project (REP). STUDY DESIGN Population-based study. PATIENTS The medical records of every resident of Olmsted County, Minnesota who was diagnosed with CSFF was reviewed from January 1, 1970 to December 12, 2017 using the REP. The population of Olmsted County on January 1, 2017 was 159,689 persons. MAIN OUTCOME MEASURE Incidence of CSFF. RESULTS Sixteen cases of CSFF were identified at a median age at diagnosis of 8 years (IQR, 6-17), eight of whom confirmed by exploratory tympanotomy. Three of the 16 (19%) cases were bilateral, and the median pure-tone average (500, 1k, 2k, 3k Hz) at time of diagnosis was 37 dB (IQR, 31-48). Two (13%) cases were identified in patients bearing a syndromic condition and one (6%) case demonstrated a malformed external ear on physical examination. The incidence rate of surgically confirmed cases among residents of Olmsted County was 0.31 per 100,000 person-years from 1970 to 1979 and 0.28 from 2000 to 2009. No incident cases among residents of Olmsted County were identified since 2010. CONCLUSIONS CSFF constitutes a rare disease. Unlike epidemiological trends in otosclerosis, the incidence of surgically confirmed cases of CSFF remained stable over the past 50 years.
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Poutoglidis A, Tsetsos N, Vardaxi C, Fyrmpas G, Poutoglidou F, Kilmpasanis A, Vlachtsis K. Conventional Microscopic Stapedotomy: An Obsolete Technique or Still the Gold Standard for the Management of Otosclerosis? Cureus 2021; 13:e14126. [PMID: 33927934 PMCID: PMC8075829 DOI: 10.7759/cureus.14126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and objectives Clinical otosclerosis is a relatively common entity, accounting for 0.5%-2% of the general population. Otosclerosis is characterized by an abnormal bone formation in the temporal bone that eventually causes conductive hearing loss. Bilateral involvement is fairly common. Treatment can be either conservative with medications and a hearing aid, or surgical. Stapedotomy is considered, nowadays, the most effective surgical technique for the management of otosclerosis. The purpose of the present study is to present our long-term results with stapedectomy, the audiological outcome, as well as the complications encountered. Subjects and methods This is a retrospective single-centre study. All patients diagnosed with otosclerosis and treated operatively with a stapedotomy from January 2010 to December 2019 were included in the study. Demographic data, air and bone conduction thresholds, complications and length of the prosthesis were recorded. Results The study included a total of 72 patients. The audiological results showed a statistically significant improvement in the air conduction thresholds in all the affected frequencies (p<0.001). Post-operative complications included deterioration or severe hearing loss up to 100 dB (n=1, 1.39%), loss or distortion of taste (n=4, 5.6%) and tinnitus (n=2, 2.8%). Conclusions Our results demonstrate that stapedotomy is an effective technique for the management of otosclerosis. Stapedotomy, when performed by an experienced surgeon, provides excellent outcomes, with limited complications.
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Affiliation(s)
- Alexandros Poutoglidis
- Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, GRC
| | - Nikolaos Tsetsos
- Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, GRC
| | - Chrysa Vardaxi
- Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, GRC
| | - Georgios Fyrmpas
- Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, GRC
| | - Frideriki Poutoglidou
- Department of Clinical Pharmacology, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Adamantios Kilmpasanis
- Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, GRC
| | - Konstantinos Vlachtsis
- Department of Otorhinolaryngology-Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, GRC
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Comparison of hearing outcomes in stapedotomy with fat and Hyaluronic acid gel as a sealing material: a prospective double-blind randomized clinical trial. Eur Arch Otorhinolaryngol 2021; 278:4279-4287. [PMID: 33426570 DOI: 10.1007/s00405-020-06554-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE In the literature on stapes surgery, various materials have been used to seal the vestibulotomy. To date, there are only a few published randomized clinical trials with focus on hearing outcomes, using different sealing materials. Hence, the aim of this study was to compare hearing outcomes when using fat or Hyaluronic acid gel (HAG) to seal the stapedotomy. METHODS The present double-blind, prospective, randomized clinical trial was conducted on ears undergoing stapedotomy in Dasthgheib Hospital, a referral otology center in Southern Iran, and Dena private hospital, Shiraz Iran. A total of 150 primary stapedotomies were evaluated, and sealing material was fat in 77 ears and HAG in 73. RESULTS 60 (77.9%) of the fat group ears and 63 (86.3%) of the HAG group ears obtained postoperative air-bone gap (ABG) within 20 dB, but the difference was not significant (p = 0.182). CONCLUSION As a sealing material in stapedotomy, HAG is comparable with fat in terms of hearing outcomes. Therefore, HAG is recommended as a safe sealing material in stapedotomy.
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Choi JS, Sweeney AD, Alava I, Lovin BD, Lindquist NR, Appelbaum EN, Vrabec JT. Otosclerosis in an Urban Population. Otol Neurotol 2021; 42:24-29. [PMID: 33201078 DOI: 10.1097/mao.0000000000002870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the evolving prevalence of otosclerosis in a large urban population. METHODS A retrospective review of patients in a large, urban, public health system was conducted from January 2010 to August 2019 to identify subjects with otosclerosis. Diagnostic testing included audiometry and computed tomography scans. Sex, age at diagnosis, treatment received, race, ethnicity, and country of birth were analyzed for each subject and compared with all eligible patients in the reference population. RESULTS A total of 134 patients from a reference population of 672,839 were diagnosed with otosclerosis and analyzed. The otosclerosis patients were predominantly Hispanic (73%), of which the majority were foreign born (87%). The average age at onset was 46 years and 59% were women. The overall prevalence of otosclerosis was 20 of 100,000 patients. The crude prevalence of otosclerosis by ethnicity was 43 of 100,000 for Hispanics, 12.6 of 100,000 for Caucasians, and 3 of 100,000 for African Americans. Within the Hispanic population, the prevalence of otosclerosis was 60 of 100,000 for foreign-born individuals and 16 of 100,000 for those born in the USA (odds ratio [OR] = 3.69, [95% confidence interval [CI], 2.02-6.76], p < 0.0001). Prevalence was not significantly different among Caucasians and US-born Hispanics. CONCLUSION Otosclerosis in the studied population was most common among Hispanic patients, though it was strongly influenced by country of birth. The "imported" otosclerosis cases are best explained by environmental influence rather than ethnic susceptibility. This discrepancy is likely due to variance in measles immunization rates among North and Central American countries before 1990.
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Affiliation(s)
- Jonathan S Choi
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine
| | - Alex D Sweeney
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine
| | - Ibrahim Alava
- Department of Otorhinolaryngology, University of Texas Medical School at Houston
| | - Benjamin D Lovin
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine
| | - Nathan R Lindquist
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine
| | - Eric N Appelbaum
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine
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Macielak RJ, Marinelli JP, Totten DJ, Lohse CM, Grossardt BR, Carlson ML. Pregnancy, Estrogen Exposure, and the Development of Otosclerosis: A Case-Control Study of 1196 Women. Otolaryngol Head Neck Surg 2020; 164:1294-1298. [PMID: 33107781 DOI: 10.1177/0194599820966295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study sought to determine whether a history of pregnancy or bilateral oophorectomy is associated with subsequent otosclerosis development or disease severity. STUDY DESIGN Population-based case-control study. SETTING Olmsted County, Minnesota. METHODS Women diagnosed with otosclerosis were matched to 3 women without otosclerosis based on age and historical depth of medical records. Associations of prior delivery and bilateral oophorectomy with subsequent development of otosclerosis and with pure-tone average (PTA) at the time of otosclerosis diagnosis were evaluated. RESULTS We studied 1196 women: 299 cases of otosclerosis and 897 matched controls. The odds ratio for the association of ≥1 delivery with otosclerosis was 1.16 (95% confidence interval [CI] 0.85-1.60; P = .35). Odds ratios for the associations of 1, 2, 3, or ≥4 deliveries with otosclerosis were 1.22 (0.83-1.80), 1.09 (0.71-1.68), 1.28 (0.77-2.12), and 1.00 (0.54-1.84), respectively. The odds ratio for the association of prior bilateral oophorectomy with otosclerosis was 1.12 (0.58-2.18; P = .73). In cases with otosclerosis, PTA at diagnosis was not significantly higher for women with ≥1 delivery as compared with those without (median 45 dB hearing loss [HL] [interquartile range {IQR} 36-55] vs 43 [IQR 34-53]; P = 0.18) but was significantly higher for women with bilateral oophorectomy compared with those without (median 54 dB HL [IQR 44-61] vs 44 [IQR 34-53]; P = .03). CONCLUSION These data do not support a relationship between endogenous estrogen exposure and development of otosclerosis. Women with otosclerosis who had a history of pregnancy did not have significantly worse hearing at the time of diagnosis, suggesting that pregnancy is not associated with disease severity.
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Affiliation(s)
- Robert J Macielak
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - John P Marinelli
- Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas, USA
| | - Douglas J Totten
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Christine M Lohse
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Brandon R Grossardt
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Oziębło D, Domagała S, Leja ML, Skarżyński H, Ołdak M. Analysis of major otosclerosis-associated variants in RELN and TGFB1 genes in Polish patients. Arch Med Sci 2020; 20:962-966. [PMID: 39050165 PMCID: PMC11264066 DOI: 10.5114/aoms.2020.99011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 12/26/2019] [Indexed: 07/27/2024] Open
Abstract
Introduction Otosclerosis (OTSC) is one of the most common causes of progressive adult-onset hearing loss in the Caucasian population, with a female preponderance. The etiology of OTSC is complex and there are a number of genetic variants reported to be associated with OTSC susceptibility, but no data on the genetic background of OTSC in patients originating from the central-eastern part of Europe have been available. The purpose of our study was to investigate in Polish patients the frequency of genetic variants previously reported to be most strongly associated with OTSC. Material and methods Genomic DNA was isolated from blood samples or buccal swabs. Variants in TGFB1 (rs1800472) and RELN (rs39335, rs39350, rs39374) were genotyped in surgically confirmed OTSC patients (n = 94) and a control group (n = 198) using custom TaqMan SNP genotyping assays and real-time PCR. Allele and genotype frequencies were compared between the groups in statistical analysis and the odds ratios with 95% confidence intervals were calculated to estimate the risk. Results For all of the tested variants the distributions of alleles and genotypes were not statistically significantly different between OTCS patients and the control group. There were also no statistically significant differences in relation to gender of the tested subjects. Conclusions Despite multiple confirmatory studies on TGFB1 and RELN association with OTSC development in some populations, no significant association between the studied variants and OTSC was found in Polish patients. Our results indicate the presence of inter-population differences in OTSC susceptibility factors and confirm the large genetic heterogeneity of this disorder.
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Affiliation(s)
- Dominika Oziębło
- Department of Genetics, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
- Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Sara Domagała
- Department of Genetics, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Marcin L. Leja
- Department of Genetics, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
- Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Henryk Skarżyński
- Oto-Rhino-Laryngology Surgery Clinic, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Monika Ołdak
- Department of Genetics, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
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Sagar PR, Shah P, Bollampally VC, Alhumaidi N, Malik BH. Otosclerosis and Measles: Do Measles Have a Role in Otosclerosis? A Review Article. Cureus 2020; 12:e9908. [PMID: 32968571 PMCID: PMC7505640 DOI: 10.7759/cureus.9908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Otosclerosis is a common cause of conductive hearing loss which is an autoimmune inflammatory disorder related to abnormal bone remodeling of the human otic capsule that has complex etiopathogenesis attributed to genetics, autoimmunity, viral infection, inflammation, hormonal factor, environmental factor, and disturbed bone metabolism. It has a prevalence of 0.3%-0.4% in Caucasians, which makes up 5-9% of all hearing loss and 18-22% of all conductive hearing loss. This review article aims to study the postulated role of sustained measles virus infection in the etiopathogenesis of otosclerosis, among others. A PubMed search of the related topic identified 97,990 articles. After we applied the inclusion and exclusion criteria, it was determined that 52 articles were relevant, which included 38 observational studies, 13 review articles, and a systematic review. Among them, 33 observational studies, 13 review articles and a systematic review spotted a positive association between persistent measles virus infection and otosclerosis. On the contrary, five observational studies reported no evidence of the association. The majority of the current literature supported the presence of the measles virus component in the otosclerotic stapes samples and its role in the etiopathogenesis of otosclerosis. Measles virus infection may have the amplitude to initiate a pathological process, which in the presence of other factors like autoimmunity and genes plays a significant role in causing otosclerosis. However, other studies have failed to show the presence of the measles virus component in otosclerotic stapes. So, more studies are needed to probe the role of persistent measles virus infection in the etiopathogenesis of otosclerosis.
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Affiliation(s)
- Prem Raj Sagar
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Puja Shah
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Norah Alhumaidi
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Bilal Haider Malik
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Rajput MSA, Arain AA, Rajput AA, Adeel M, Suahil A, Awan MS. Otosclerosis: Experience With Stapes Surgery. Cureus 2020; 12:e7927. [PMID: 32499972 PMCID: PMC7265776 DOI: 10.7759/cureus.7927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/02/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction Otosclerosis is a disorder in which the footplate of the stapes is replaced by an abnormal bone, thereby affecting sound transmission to the inner ear at the level of the oval window. The solution to this condition is to reestablish this mechanism back to normal via the ossicular chain to the inner ear. The aim of stapes surgery is to improve the hearing level to thresholds appropriate enough to obviate the need for hearing aid. The hearing improvement achieved after surgery often lasts for many years. The purpose of the current study was to review our experience and find out the rate of success related to hearing outcomes after stapedotomy. Methods The patients who were operated for otosclerosis between January 2000 and December 2010 at Aga Khan University Hospital, Karachi, Pakistan were included in the study. The charts were reviewed to collect clinical data regarding stapes surgery. The values of speech reception threshold (SRT) were recorded, and the preoperative and postoperative means were compared with a t-test. The bone conduction (BC) and air conduction (AC) thresholds were evaluated at 0.5 kHz, 1.0 kHz, 2.0 kHz, and 3.0 kHz. The preoperative and postoperative means of air-bone gap (AB-gap) were compared with a t-test. The descriptive frequency was calculated to evaluate postoperative AB-gap in individual patients; patients were grouped with a difference of 10 dB of AB-gap. The SPSS Statistics software (IBM, Armonk, NY) was used for statistical analysis. Results A total of 46 patients were included in the study. There were 15 males and 31 females. The mean age was 35 years (range: 20-56). Thirty-three patients had bilateral otosclerosis; two patients had surgery for both ears, taking the total number of ears operated to 48. The mean preoperative AB-gap was 39, while the mean postoperative AB-gap was 11. The means were compared with a t-test and a p-value of <0.05 was considered significant. The means of preoperative and postoperative SRT were 56.25 and 24.27 respectively. Both means were compared with a t-test, and a p-value of <0.05 was considred significant. Postoperatively, 34 ears had AB-gap of 10 dB (70.8%), 11 (22.9%) had within 20 dB, and three (6.3%) had within 30 dB. Conclusions The success rate related to hearing outcomes in patients operated for otosclerosis was excellent and comparable to that found in the current literature. The wide AB-gap noticed in the majority of our patients may represent a delayed presentation to otolaryngologists, which requires further evaluation.
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Affiliation(s)
- Muhammad Shaheryar Ahmed Rajput
- Otolaryngology, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
- Otolaryngology and Head and Neck Surgery, Aga Khan University Hospital, Karachi, PAK
- Otolaryngology and Head and Neck Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | | | | | - Mohammad Adeel
- Otolaryngology, Bradford Royal Infirmary, Bradford, GBR
- Otolaryngology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
- Head and Neck Oncology, Sheffield Teaching Hospitals National Health Service Foundation Trust, Sheffield, GBR
| | - Anwar Suahil
- Otolaryngology and Head and Neck Surgery, Aga Khan University Hospital, Karachi, PAK
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