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Alshalan A, Alzhrani F. Efficacy of vibrant sound bridge in congenital aural atresia: an updated systematic review. Eur Arch Otorhinolaryngol 2024; 281:2849-2859. [PMID: 38647685 DOI: 10.1007/s00405-024-08629-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/19/2024] [Indexed: 04/25/2024]
Abstract
PURPOSE The indications of Vibrant Soundbridge (VSB) have been expanded to include patients with conductive and mixed hearing loss due to congenital aural atresia (CAA). However, the current evidence supporting the auditory outcomes of VSB is based mainly on case reports and retrospective chart reviews. Therefore, the present systematic review aims to summarize and critically appraise the current evidence regarding the safety and effectiveness of VSB in children and adult patients with CAA. METHODS A systematic literature search retrieved studies that evaluated the outcomes of unilateral or bilateral implantation of VSB in patients with CAA. The bibliographic search was conducted in PubMed, Scopus, EBSCO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases from January 2000 to December 2022. RESULTS Twenty-seven studies were included in the present systematic review. Overall, the speech perception after VSB was good, with a mean word recognition score (WRS) score ranging from 60 to 96.7%. The mean postoperative speech recognition threshold (SRT) after implantation ranged from 20.8 to 50 dB. The effective gain was reported in 15 studies, ranging from 31.3 to 45.5 dB. In terms of user satisfaction with VSB, the included studies showed significant improvements in the patient-reported outcomes, such as the Speech Spatial and Qualities of Hearing scale and Glasgow Hearing Aid Benefit Profile. The VSB implantation was generally safe with low incidence of postoperative complications. CONCLUSION VSB provides significant benefits to individuals with hearing loss owing to CAA, with very good subjective outcomes and a low risk of complications.
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Affiliation(s)
- Afrah Alshalan
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Jouf University, PO Box 72418, 23235, Skaka, Aljouf, Saudi Arabia.
| | - Farid Alzhrani
- King Abdullah Ear Specialist Center (KAESC), King Saud University, Riyadh, Saudi Arabia
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Liu Y, Yang L, Chen P, Yang J, Ren R, Li Y, Wang D, Zhao S. Role of early hearing aid experience in speech recognition in patients with bilateral congenital microtia following Bonebridge implantation: a retrospective cohort study. Eur Arch Otorhinolaryngol 2024; 281:1205-1214. [PMID: 37792216 DOI: 10.1007/s00405-023-08210-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/21/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE To identify audiological and demographic variables that predict speech recognition abilities in patients with bilateral microtia who underwent Bonebridge (BB) implantation. METHODS Fifty patients with bilateral microtia and bilateral conductive hearing loss (CHL) who underwent BB implantation were included. Demographic data, preoperative hearing aid use experience, and audiological outcomes (including pure-tone hearing threshold, sound field hearing threshold [SFHT], and speech recognition ability) for each participant were obtained. The Chinese-Mandarin Speech Test Materials were used to test speech recognition ability. The word recognition score (WRS) of disyllabic words at 65 dB SPL signals was measured before and after BB implantation in quiet and noisy conditions. RESULTS The mean preoperative WRS under quiet and noisy conditions was 10.44 ± 12.73% and 5.90 ± 8.76%, which was significantly improved to 86.38 ± 9.03% and 80.70 ± 11.34%, respectively, following BB fitting. Multiple linear regression analysis revealed that lower preoperative SFHT suggested higher preoperative WRS under both quiet and noisy conditions. Higher age at implantation predicted higher preoperative WRS under quiet conditions. Furthermore, patients with more preoperative hearing aid experience and lower postoperative SFHT were more likely to have higher postoperative WRS under both quiet and noisy testing conditions. CONCLUSIONS This study represents the first attempt to identify predictors of preoperative and postoperative speech recognition abilities in patients with bilateral microtia with BB implantation. These findings emphasize that early hearing intervention before implantation surgery, combined with appropriate postoperative fitting, contributes to optimal benefits in terms of postoperative speech recognition ability.
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Affiliation(s)
- Yujie Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, 100730, China
| | - Lin Yang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, 100730, China
| | - Peiwei Chen
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, 100730, China
| | - Jinsong Yang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, 100730, China
| | - Ran Ren
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, 100730, China
| | - Ying Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, 100730, China
| | - Danni Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, 100730, China.
| | - Shouqin Zhao
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Ministry of Education Key Laboratory of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing, 100730, China.
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Gutierrez JA, Shannon CM, Nguyen SA, Meyer TA, Lambert PR. Comparison of Transcutaneous and Percutaneous Implantable Hearing Devices for the Management of Congenital Aural Atresia: A Systematic Review and Meta-Analysis. Otol Neurotol 2024; 45:1-10. [PMID: 38085758 DOI: 10.1097/mao.0000000000004061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
OBJECTIVE To compare audiometric outcomes, complications, and revisions required for percutaneous (pBCD) versus transcutaneous (tBCD) implantable bone-conduction devices for the treatment of hearing loss associated with congenital aural atresia (CAA).Databases Reviewed.PubMed, Scopus, CINAHL. METHODS A systematic review was performed searching for English language articles from inception to December 14, 2022. Studies reporting audiometric outcomes or complications for either pBCDs or tBCDs for the treatment of CAA were selected for inclusion. A meta-analysis of single means and meta-analysis of proportions with comparison (Δ) of weighted proportions was conducted. RESULTS A total of 56 articles with 756 patients were selected for inclusion. One hundred ninety patients were implanted with pBCDs, whereas the remaining 566 were implanted with tBCDs. Mean pure-tone audiometry improvement in the pBCD group (39.1 ± 1.1 dB) was significantly higher than in the tBCD group (34.6 ± 1.6 dB; Δ4.5 dB; 95% confidence interval, 4.2-4.7 dB; p < 0.0001). The average improvement in speech reception threshold was 38.6 ± 2.5 dB in the percutaneous group as compared with 32.7 ± 1.6 dB in the transcutaneous group (Δ5.9 dB [5.3-6.5 dB], p < 0.0001). Overall complication rates for patients implanted with pBCDs and tBCDs were 29.0% (15.7-44.4%) and 9.4% (6.5%-13.0%), respectively (Δ19.6% [12.0-27.7%], p < 0.0001). CONCLUSIONS Patients with CAA implanted with pBCDs had significantly better audiometric outcomes than those implanted with tBCDs. However, complication rates were significantly higher among the pBCD group.
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Affiliation(s)
- Jorge A Gutierrez
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Silva VAR, Pauna HF, Lavinsky J, Hyppolito MA, Vianna MF, Leal M, Massuda ET, Hamerschmidt R, Bahmad Jr F, Cal RV, Sampaio ALL, Felix F, Chone CT, Castilho AM. Task force Guideline of Brazilian Society of Otology - hearing loss in children - Part II - Treatment. Braz J Otorhinolaryngol 2022; 89:190-206. [PMID: 36528468 PMCID: PMC9874354 DOI: 10.1016/j.bjorl.2022.11.001] [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: 11/06/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0-18 years. 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 childhood hearing loss 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) treatment of sensorineural hearing loss: individual hearing aids, bilateral cochlear implants, cochlear implants in young children, unilateral hearing loss, and auditory neuropathy spectrum disorder; and (2) treatment of conductive/mixed hearing loss: external/middle ear malformations, ventilation tube insertion, and tympanoplasty in children. CONCLUSIONS In children with hearing loss, in addition to speech therapy, Hearing AIDS (HAs) or implantable systems may be indicated. Even in children with profound hearing loss, both the use of HAs and behavioral assessments while using the device are important.
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Affiliation(s)
- Vagner Antonio Rodrigues Silva
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil,Corresponding author.
| | - Henrique Furlan Pauna
- Hospital Universitário Cajuru, Departamento de Otorrinolaringologia, Curitiba, PR, Brazil
| | - Joel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Cirurgia, Porto Alegre, RS, Brazil
| | - Miguel Angelo Hyppolito
- 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 Misericórdia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Mariana Leal
- Universidade Federal de Pernambuco (UFPE), Departamento de Cirurgia, Recife, PE, 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
| | - Rogério Hamerschmidt
- Universidade Federal do Paraná (UFPR), Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil
| | - Fayez Bahmad Jr
- Universidade de Brasília (UnB), Programa de Pós-Graduação em Ciências da Saúde, Brasília, DF, Brazil,Instituto Brasiliense de Otorrinolaringologia (IBO), Brasília, DF, Brazil
| | - Renato Valério Cal
- Centro Universitário do Estado do Pará (CESUPA), Departamento de Otorrinolaringologia, Belém, PA, Brazil
| | - André Luiz Lopes Sampaio
- Universidade de Brasília (UnB), Faculdade de Medicina, Laboratório de Ensino e Pesquisa em Otorrinolaringologia, Brasília, DF, Brazil
| | - Felippe Felix
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho (HUCFF), Departamento de Otorrinolaringologia, Rio de Janeiro, RJ, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Arthur Menino Castilho
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
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Yoshimura H, Takahashi M, Iwasaki S, Shinagawa J, Takashimizu I, Nagai F, Yotsuyanagi T, Usami S. Vibrant soundbridge implantation prior to auricular reconstruction with unilateral microtia-atresia. Clin Case Rep 2021; 9:e04408. [PMID: 34429978 PMCID: PMC8365392 DOI: 10.1002/ccr3.4408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/07/2021] [Accepted: 05/18/2021] [Indexed: 11/24/2022] Open
Abstract
We presented the first successful application of VSB implantation prior to auriculoplasty, which can provide hearing improvement in safe conditions and open new strategies for earlier hearing rehabilitation in unilateral microtia-atresia children.
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Affiliation(s)
- Hidekane Yoshimura
- Department of OtorhinolaryngologyShinshu University School of MedicineMatsumotoJapan
| | - Masahiro Takahashi
- Department of OtorhinolaryngologyInternational University of Health and Welfare Mita HospitalTokyoJapan
| | - Satoshi Iwasaki
- Department of OtorhinolaryngologyInternational University of Health and Welfare Mita HospitalTokyoJapan
| | - Jun Shinagawa
- Department of OtorhinolaryngologyShinshu University School of MedicineMatsumotoJapan
| | - Ikkei Takashimizu
- Department of Plastic and Reconstructive SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Fumio Nagai
- Department of Plastic and Reconstructive SurgeryShinshu University School of MedicineMatsumotoJapan
| | - Takatoshi Yotsuyanagi
- Department of Plastic and Reconstructive SurgerySapporo Medical University School of MedicineSapporoJapan
| | - Shin‐ichi Usami
- Department of Hearing Implant SciencesShinshu University School of MedicineMatsumotoJapan
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Ostevik AV, Hill-Feltham P, Johansson ML, McKinnon BJ, Monksfield P, Sockalingam R, Tysome JR, Wright T, Hodgetts WE. Psychosocial outcome measures for conductive and mixed hearing loss treatment: An overview of the relevant literature. Int J Audiol 2021; 60:641-649. [PMID: 33612075 DOI: 10.1080/14992027.2021.1872805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify the psychosocial assessments utilized with individuals with conductive and/or mixed hearing loss as part of a broader effort by the Auditory Rehabilitation Outcomes Network (AURONET) group to develop a core set of patient-centred outcome measures. DESIGN A review of articles published between 2006 and 2016 was completed. Included studies had more than three adult participants, were available in English, and reported a psychosocial outcome from any treatment of mixed and/or conductive hearing loss. STUDY SAMPLE Sixty-six articles from seven databases. RESULTS Sixty-six articles met our inclusion/exclusion criteria. Within this set, 15 unique psychosocial or patient-reported outcome measures (PROs) were identified, with the Abbreviated Profile of Hearing Aid Benefit (APHAB) and Glasgow Benefit Inventory (GBI) being the most frequently dispensed. Five of the fifteen were only administered in one study. In-house questionnaires (IHQs) were reported in 19 articles. CONCLUSIONS Only 66 (22%) of the 300 articles with outcomes contained a PRO. Some of the mostly frequently employed PROs (e.g., APHAB) were judged to include only social items and no psychological items. Lack of PRO standardization and the use of IHQs make psychosocial comparisons across treatments in this population difficult for patients, clinicians and stakeholders.
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Affiliation(s)
- Amberley V Ostevik
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Canada
| | | | - Martin L Johansson
- Department of Biomaterials, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Oticon Medical, Askim, Sweden
| | | | | | | | - James R Tysome
- University of Cambridge, Cambridge, UK.,Cambridge University Hospitals, Cambridge, UK
| | | | - William E Hodgetts
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Canada.,Institute for Reconstructive Sciences in Medicine, Edmonton, Canada
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Svrakic M, Vambutas A. Medical and Audiological Indications for Implantable Auditory Devices. Otolaryngol Clin North Am 2019; 52:195-210. [DOI: 10.1016/j.otc.2018.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Auricular prostheses attached to osseointegrated implants: multidisciplinary work-up and clinical evaluation. Eur Arch Otorhinolaryngol 2019; 276:1017-1027. [PMID: 30847547 PMCID: PMC6426806 DOI: 10.1007/s00405-019-05311-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/21/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE Not long after the introduction of osseointegrated implants outside the oral cavity, auricular prostheses are retrained on osseointegrated implants. New insights have been gained with the next-generation percutaneous osseointegrated titanium implants for bone conduction hearing since its introduction in 2010. As a result, the same technology was introduced in the Vistafix® system (VXI implant) to retain auricular prostheses. The aim of this study is to evaluate the surgical procedure, clinical outcome, and satisfaction of the patient of osseointegration-retained auricular prosthesis using VXI implants. MATERIALS AND METHODS 11 patients who received an auricular prosthesis using VXI implants between December 2012 and November 2017 were evaluated retrospectively. The patient's medical files were reviewed to assess clinical complications and the necessity for revision surgery. The subjective outcome was measured using the Glasgow benefit inventory (GBI). RESULTS In total, 31 implants were placed in 11 patients. None of these implants were lost nor revision surgery needed. An adverse skin reaction was observed in 13.0% of the implants and in 27.2% of the patients, adequately treated with an antibiotic ointment. The average follow-up time was 2 years and 7 months. The GBI displayed a positive score in every patient. CONCLUSIONS The VXI implants used are a safe and reliable treatment option for retaining auricular prostheses in patients with an absent auricle. Patients were satisfied with their auricular prosthesis and showed benefit in quality of life. Studies with larger numbers and preferably a prospective character are needed to draw statistically significant conclusions.
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Johansson M, Tysome J, Hill-Feltham P, Hodgetts W, Ostevik A, McKinnon B, Monksfield P, Sockalingam R, Wright T. Physical outcome measures for conductive and mixed hearing loss treatment: A systematic review. Clin Otolaryngol 2018; 43:1226-1234. [DOI: 10.1111/coa.13131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2018] [Indexed: 11/26/2022]
Affiliation(s)
- M.L. Johansson
- Department of Biomaterials; Sahlgrenska Academy at University of Gothenburg; Gothenburg Sweden
- Oticon Medical; Askim Sweden
| | - J.R. Tysome
- University of Cambridge; Cambridge UK
- Cambridge University Hospitals; Cambridge UK
| | | | - W.E. Hodgetts
- Institute for Reconstructive Sciences in Medicine; University of Alberta Edmonton; Edmonton AB Canada
| | - A. Ostevik
- Institute for Reconstructive Sciences in Medicine; University of Alberta Edmonton; Edmonton AB Canada
| | - B.J. McKinnon
- Drexel University College of Medicine; Philadelphia PA USA
| | | | | | - T. Wright
- University Hospitals Birmingham; Birmingham UK
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Active Middle Ear Implantation: Long-term Medical and Technical Follow-up, Implant Survival, and Complications. Otol Neurotol 2017; 37:513-9. [PMID: 27023016 DOI: 10.1097/mao.0000000000001015] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the long-term medical and technical results, implant survival, and complications of the semi-implantable vibrant soundbridge (VSB), otologics middle ear transducer (MET), and the otologics fully implantable ossicular stimulator (FIMOS). STUDY DESIGN Retrospective cohort study. PATIENTS Patients with chronic external otitis and either moderate to severe sensorineural or conductive/mixed hearing loss. SETTING Tertiary referral center. INTERVENTION Implantation with the VSB, MET, or FIMOS. MAIN OUTCOME MEASURES Medical complications, number of reimplantations, and explantations. RESULTS Ninety-four patients were implanted, 12 patients with a round window or stapes application. 28 patients were lost to follow-up. The average follow-up duration was 4.4 years (range, 1 month-15 years). 128 devices were evaluated: (92 VSB, 32 MET, 4 FIMOS). 36 devices (28%) have been explanted or replaced (18 VSB, 14 MET, 4 FIMOS). Device failure was 7% for VSB, 28% for MET, and 100% for FIMOS. In 16 patients (17%) revision surgery (n = 20) was performed. Twenty patients (21%) suffered any medical complication. CONCLUSION Medical and technical complications and device failures have mostly occurred in the initial period of active middle ear implants (AMEI) implementation and during clinical trials or experimental procedures. All four FIMOS had technical difficulties. An important decrease in the occurrence of both medical and technical complications was observed. Application in more recent years did not show any complications and the recent device failure rates are acceptable. Magnetic resonance imaging (MRI) incompatibility should be taken into account when indicating AMEI.
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Predictive Factors for Hearing Outcomes After Canaloplasty in Patients With Congenital Aural Atresia. Otol Neurotol 2017; 38:1140-1144. [DOI: 10.1097/mao.0000000000001504] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vibroplasty in Severe Congenital or Acquired Meatal Stenosis by Coupling an Active Middle Ear Implant to the Short Process of the Incus. Otol Neurotol 2017; 38:996-1004. [DOI: 10.1097/mao.0000000000001459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Loos E, Verhaert N, Willaert A, Devriendt K, Swillen A, Hermans R, Op de Beeck K, Hens G. Malformations of the middle and inner ear on CT imaging in 22q11 deletion syndrome. Am J Med Genet A 2016; 170:2975-2983. [DOI: 10.1002/ajmg.a.37872] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 07/08/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Elke Loos
- Department of Otorhinolaryngology-Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
| | - Nicolas Verhaert
- Department of Otorhinolaryngology-Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
- Department of Neurosciences, ExpORL, KU Leuven; University of Leuven; Leuven Belgium
| | - Annelore Willaert
- Department of Otorhinolaryngology-Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
| | | | - Ann Swillen
- Centre for Human Genetics; University Hospitals Leuven; Leuven Belgium
| | - Robert Hermans
- Department of Radiology; University Hospitals Leuven; Leuven Belgium
| | - Katya Op de Beeck
- Department of Radiology; University Hospitals Leuven; Leuven Belgium
| | - Greet Hens
- Department of Otorhinolaryngology-Head and Neck Surgery; University Hospitals Leuven; Leuven Belgium
- Department of Neurosciences, ExpORL, KU Leuven; University of Leuven; Leuven Belgium
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Direct Acoustic Stimulation at the Lateral Canal: An Alternative Route to the Inner Ear? PLoS One 2016; 11:e0160819. [PMID: 27500399 PMCID: PMC4976884 DOI: 10.1371/journal.pone.0160819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 07/26/2016] [Indexed: 11/19/2022] Open
Abstract
Severe to profound mixed hearing loss is associated with hearing rehabilitation difficulties. Recently, promising results for speech understanding were obtained with a direct acoustic cochlear implant (DACI). The surgical implantation of a DACI with standard coupling through a stapedotomy can however be regarded as challenging. Therefore, in this experimental study, the feasibility of direct acoustic stimulation was investigated at an anatomically and surgically more accessible inner ear site. DACI stimulation of the intact, blue-lined and opened lateral semicircular canal (LC) was investigated and compared with standard oval window (OW) coupling. Additionally, stapes footplate fixation was induced. Round window (RW) velocity, as a measure of the performance of the device and its coupling efficiency, was determined in fresh-frozen human cadaver heads. Using single point laser Doppler vibrometry, RW velocity could reliably be measured in low and middle frequency range, and equivalent sound pressure level (LE) output was calculated. Results for the different conditions obtained in five heads were analyzed in subsequent frequency ranges. Comparing the difference in RW membrane velocity showed higher LE in the LC opened condition [mean: 103 equivalent dB SPL], than in LC intact or blue-lined conditions [63 and 74 equivalent dB SPL, respectively]. No difference was observed between the LC opened and the standard OW condition. Inducing stapes fixation, however, led to a difference in the low frequency range of LE compared to LC opened. In conclusion, this feasibility study showed promising results for direct acoustic stimulation at this specific anatomically and surgically more accessible inner ear site. Future studies are needed to address the impact of LC stimulation on cochlear micromechanics and on the vestibular system like dizziness and risks of hearing loss.
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The Vibrant Soundbridge in Children and Adolescents: Preliminary European Multicenter Results. Otol Neurotol 2016; 36:1216-22. [PMID: 26107139 DOI: 10.1097/mao.0000000000000796] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Evaluation of safety and efficacy of the Vibrant Soundbridge in the treatment of hearing loss in children and adolescents with primary focus on improvement in speech discrimination. STUDY DESIGN Prospective, single-subject repeated-measures design in which each subject serves as his/her own control. SETTING Tertiary referral center. PATIENTS Nineteen patients aged 5 to 17 years. INTERVENTION Implantation of an active middle ear implant. MAIN OUTCOME MEASURE Improvement in word recognition scores, speech reception thresholds, and signal-to-noise ratios (SNRs) were evaluated, in addition to air and bone conduction. Oldenburger Kids Satztest/Oldenburger Satztest sentences and Göttinger/Freiburger monosyllables at 65-dB hearing level were tested in two age groups. RESULTS Significant speech discrimination improvement was seen in all patients after 6 months. In children 5 to 9 years old, mean monosyllable recognition improved from 28.9% (unaided) to 95.5% (Soundbridge-aided). Aided 50% sentence discrimination at 44.1 dB and SNR of -4.9 dB were measured. In patients 10 to 17 years old, mean word recognition improved from 18.5% to 89.0%, sentence reception threshold improved to 40.2 dB, and SNR to -3.6 dB. Comparison between age groups indicated a slight trend toward quicker adaptation by older subjects. However, after initial adjustment, a higher level of overall benefit was seen at 6 months in younger children. CONCLUSIONS Currently, the only middle ear implant approved for pediatric patients, the Vibrant Soundbridge, provides an option in cases of congenital aural atresia or disease-induced defects, when surgical intervention and reconstruction is indicated. The 6-month results in this comparatively large study population validated conclusions found in previous trials.
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Wang Z, Hou Q, Wang P, Sun Z, Fan Y, Wang Y, Xue H, Jin Z, Chen X. The image variations in mastoid segment of facial nerve and sinus tympani in congenital aural atresia by HRCT and 3D VR CT. Int J Pediatr Otorhinolaryngol 2015; 79:1412-7. [PMID: 26164212 DOI: 10.1016/j.ijporl.2015.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/09/2015] [Accepted: 06/13/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To find the variations of middle ear structures including the spatial pattern of mastoid segment of facial nerve and the shapes of the sinus tympani in patients with congenital aural atresia (CAA) by using the high-resolution (HR) CT and 3D volume rendered (VR) CT images. METHODS HRCT was performed in 25 patients with congenital aural atresia including six bilateral atresia patients (n=25, 21 males, 4 females, mean age 13.8 years, range 6-19). Along the long axis of the posterior semicircular canal ampulla, the oblique axial multiplanar reconstruction (MPR) was set to view the depiction of the round window and the mastoid segment of facial nerve. Volumetric rending technique was used to demonstrate the morphologic features. HRCT and 3D VR findings in atresia ears were compared with those in 19 normal ears of the unilateral ears of atresia patients. RESULTS On the basic plane, the horizontal line distances between the mastoid segment of the facial nerve and the round window (h-RF) in atresia ears significantly decreased compared to the control ears (P<0.05). There was a significant negative correlation between the sinus tympani area (a-ST) and the distance between the horizontal lines of FN and RW midpoint (h-RF) (P<0.05). The mean area of sinus tympani in atresia group is larger (P<0.05). The shapes of the sinus tympani were classified into three categories: the cup-shaped, the pear-shaped and the boot-shaped. Area measurement indicated that the boot-shaped sinus tympani was a special variation with a large area, which only appears in CAA group. There were a significant difference between the area of the boot-shaped group and the other two groups (P<0.05). The morphologic differences of ST and other middle ear structures can also be observed visually in 3D VR CT images. CONCLUSION HRCT and 3D VR CT could help a better understanding of different kinds of variations in mastoid segment of facial nerve and sinus tympani in CAA ears. And it may further help surgeons to make the correct decision for hearing rehabilitation.
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Affiliation(s)
- Zhen Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China
| | - Qian Hou
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China
| | - Pu Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China
| | - Zhaoyong Sun
- Department of Radiology, Peking Union Medical College Hospital, Beijing, PR China
| | - Yue Fan
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China
| | - Yun Wang
- Department of Radiology, Peking Union Medical College Hospital, Beijing, PR China
| | - Huadan Xue
- Department of Radiology, Peking Union Medical College Hospital, Beijing, PR China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Beijing, PR China
| | - Xiaowei Chen
- Department of Otolaryngology, Peking Union Medical College Hospital, Beijing, PR China.
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Debeaupte M, Decullier E, Tringali S, Devèze A, Mom T, Darrouzet V, Truy E. Evolution of the Reliability of the Fully Implantable Middle Ear Transducer Over Successive Generations. Otol Neurotol 2015; 36:625-30. [DOI: 10.1097/mao.0000000000000718] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
OBJECTIVE To compare surgical methods, functional gain, and speech discrimination using two different coupling methods for an active middle ear implant. Of several couplers enabling placement of the active element at various locations, two function directly at a cochlear membrane, bypassing a missing or malformed ossicular chain. This study evaluates whether either of these methods is more beneficial. STUDY DESIGN Retrospective case review. SETTING ENT surgical clinic. PATIENTS Forty-seven German-speaking patients with moderate to severe mixed hearing loss. INTERVENTIONS Records of patients implanted with either a round window (RW) or oval window (OW) coupler and active implant were examined. Preoperative and postoperative bone and air-conduction thresholds, auditory gain, and speech perception were compared. MAIN OUTCOME MEASURES Functional gain, Freiburger monosyllables in quiet. RESULTS The range of hearing benefit shown by functional gain in patients implanted with the RW coupler (median) was between 22.5 dB (at 0.25 kHz) and 52.5 dB (2 and 3 kHz). In the OW group, improvement was similar, ranging from 21 dB (at 8 kHz) to 50 dB (1 and 2 kHz). Patients in both groups showed a similar improvement in speech recognition. Median preoperative unaided word recognition was 0% at 60 dB HL for both patient groups, improved postoperatively in both groups to median 85% correct at 65 dB HL and 95% at 80 dB HL. CONCLUSION Placement of an active middle ear implant using the RW and the OW coupler was found to be safe, although the surgical methods differ. Safety and efficacy of both couplers present no significant differences.
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Li C, Zhang T, Fu Y, Qing F, Chi F. Congenital aural atresia and stenosis: Surgery strategies and long-term results. Int J Audiol 2014; 53:476-81. [DOI: 10.3109/14992027.2014.890295] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sound Localization Performance Improves After Canaloplasty in Unilateral Congenital Aural Atresia Patients. Otol Neurotol 2014; 35:639-44. [DOI: 10.1097/mao.0000000000000271] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lenarz T, Verhaert N, Desloovere C, Desmet J, D'hondt C, González JCF, Kludt E, Macías AR, Skarżyński H, Van de Heyning P, Vyncke C, Wasowski A. A Comparative Study on Speech in Noise Understanding with a Direct Acoustic Cochlear Implant in Subjects with Severe to Profound Mixed Hearing Loss. Audiol Neurootol 2014; 19:164-74. [DOI: 10.1159/000358004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 12/13/2013] [Indexed: 11/19/2022] Open
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Grading system for the selection of patients with congenital aural atresia for active middle ear implants. Neuroradiology 2013; 55:895-911. [PMID: 23604757 DOI: 10.1007/s00234-013-1177-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 03/19/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Active middle ear implants (aMEI) are being increasingly used for hearing restoration in congenital aural atresia. The existing gradings used for CT findings do not meet the requirements for these implants. Some items are expendable, whereas other important imaging factors are missing. We aimed to create a new grading system that could describe the extent of the malformation and predict the viability and challenges of implanting an aMEI. METHODS One hundred three malformed ears were evaluated using HRCT of the temporal bone. The qualitative items middle ear and mastoid pneumatization, oval window, stapes, round window, tegmen mastoideum displacement and facial nerve displacement were included. An anterior- and posterior round window corridor, oval window and stapes corridor were quantified and novelly included. They describe the size of the surgical field and the sight towards the windows. RESULTS The ears were graded on a 16-point scale (16-13 easy, 12-9 moderate, 8-5 difficult, 4-0 high risk). The strength of agreement between the calculated score and the performed implantations was good. The comparison of the new 16-point scale with the Jahrsdoerfer score showed that both were able to conclusively detect the high-risk group; however, the new 16-point scale was able to further determine which malformed ears were favorable for aMEI, which the Jahrsdoerfer score could not do. CONCLUSION The Active Middle Ear Implant Score for aural atresia (aMEI score) allows more precise risk stratification and decision making regarding the implantation. The use of operative corridors seems to have significantly better prognostic accuracy than the Jahrsdoerfer score.
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Nicholas BD, Kesser BW. Unilateral Aural Atresia: Current Management Issues and Results. CURRENT OTORHINOLARYNGOLOGY REPORTS 2013. [DOI: 10.1007/s40136-013-0014-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Application of the Vibrant Soundbridge middle-ear implant for aural atresia in patients with Treacher Collins syndrome. The Journal of Laryngology & Otology 2012; 126:1216-23. [PMID: 23168240 DOI: 10.1017/s0022215112002344] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To present results for the auditory rehabilitation of patients with Treacher Collins syndrome with bilateral osseous atresia, using middle-ear implantation with a Vibrant Soundbridge. METHODS Three patients underwent vibroplasty for aural atresia with moderate to severe conductive hearing loss. The pre-operative Jahrsdoerfer radiological score was 4 for all patients. Patients underwent active middle-ear implantation of a Vibrant Soundbridge implant (coupling the floating mass transducer to the rudimentary stapes or footplate distally, and positioning it adjacent to the round window membrane proximally), with audiological analysis as follow up. RESULTS After implant activation, the mean air conduction threshold ± standard deviation decreased to 22.8 ± 5.5 dB HL, representing a mean functional gain of 44.5 dB. The mean word recognition score (for bisyllabic words at 65 dB SPL) increased from 0 to 97 per cent. CONCLUSION Vibrant Soundbridge implantation is an effective hearing rehabilitation procedure in patients with Treacher Collins syndrome with bilateral osseous atresia. This is a versatile implant which can achieve coupling even in cases of severe middle-ear malformation.
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Indications and outcome of subtotal petrosectomy for active middle ear implants. Eur Arch Otorhinolaryngol 2012; 270:1243-8. [DOI: 10.1007/s00405-012-2113-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 07/05/2012] [Indexed: 11/26/2022]
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