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Zhang S, Wang L, Gong S, Gao F, Liu P, Song X, Wang Q, Wang W, Landsberger H, Peng KA. Auditory and speech performance after unilateral cochlear implantation for cochlear nerve canal stenosis. EAR, NOSE & THROAT JOURNAL 2024; 103:222-226. [PMID: 34590888 DOI: 10.1177/01455613211045563] [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: 11/17/2022] Open
Abstract
To explore the correlation between the width of the bony cochlear nerve canal (CNC) and long-term auditory rehabilitation after unilateral cochlear implantation (CI) in pediatric patients with congenital deafness and bilateral cochlear nerve canal stenosis (CNCS). A retrospective review was performed on 10 patients with bilateral CNCS and bilateral congenital profound hearing loss who each underwent unilateral cochlear implantation. The width of the CNC was determined on computed tomography (CT) imaging and following CI, auditory and speech performance following CI were graded using categories of auditory performance (CAP), speech intelligibility rating (SIR), and the meaningful auditory integration scale (MAIS) at 24 months following implantation. No correlation was noted between CAP score and CNCS at 24 months post CI (P > .05). A positive correlation was noted between SIR score and CNC width (ρ = .81, P < .05). Similarly, a positive correlation was noted between MAIS and CNC width (ρ = .71, P < .05). The width of the CNC in patients with CNCS is positively correlated with some long-term auditory and speech outcomes after CI.
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Affiliation(s)
- Si Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Line Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shusheng Gong
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fenqi Gao
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pan Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xinyu Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qimei Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wei Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hannah Landsberger
- Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Davie, FL, USA
| | - Kevin A Peng
- House Clinic and House Ear Institute, Los Angeles, CA, USA
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Wu SS, Sawaf T, Vovos R, Goldberg D, Hadford S, Anne S. Intraoperative Neural Response Telemetry and Auditory Outcomes in Pediatric Cochlear Implantation. Otolaryngol Head Neck Surg 2023; 168:1178-1184. [PMID: 36939531 DOI: 10.1002/ohn.176] [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: 07/13/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 02/10/2023]
Abstract
OBJECTIVE To evaluate the relationship between intraoperative neural response telemetry (NRT) and postoperative auditory testing outcomes in children. STUDY DESIGN Retrospective study. SETTING Tertiary-care academic center. METHODS Children who underwent cochlear implantation using the Cochlear Corporation device between 2010 and 2019 were included. Associations of average NRT and the slope of amplitude with postoperative auditory outcomes including functional auditory measure Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), and speech perception testing (consonant-nucleus-consonant [CNC], Pediatric AzBio [BABY BIO], Hearing In Noise Test [HINT], and Northwestern University Children's Perception of Speech [NU-CHIPS]), measured between 6 and 57 months after implantation, were assessed using Spearman's rank correlation (ρ). RESULTS Thirty-eight patients (19 female, 19 male) and 54 ears were included. The median age of implantation was 20.6 months (range 9.6 months to 10.6 years). Eight (21%) children had neurologic disorders such as stroke, epilepsy, cerebral palsy, and other causes. Thirteen (34%) children had connexin mutations. Average NRT was not significantly correlated with postoperative auditory outcomes (IT-MAIS [ρ = -0.08, p = .74], CNC [ρ = 0.19, p = .32], BABY BIO [ρ = 0.21, p = .29], HINT [ρ = 0.05, p = .83]) and NU-CHIPS (ρ = 0.21, p = .28). The average slopes of amplitude and comfort level were not strongly correlated with any auditory outcomes (p > .05). CONCLUSIONS Intraoperative NRT was not correlated with any postoperative functional auditory outcomes. Patient counseling should include discussions that a subpar intraoperative cochlear response does not preclude favorable speech and auditory outcomes.
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Affiliation(s)
- Shannon S Wu
- Department of Otolaryngology, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
| | - Tuleen Sawaf
- Department of Otolaryngology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Rachel Vovos
- Head and Neck Institute, Department of Otolaryngology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Donald Goldberg
- Head and Neck Institute, Department of Otolaryngology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Stephen Hadford
- Head and Neck Institute, Department of Otolaryngology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Samantha Anne
- Head and Neck Institute, Department of Otolaryngology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Söderqvist S, Sivonen V, Lamminmäki S, Ylönen J, Markkola A, Sinkkonen ST. Investigating the association of electrically-evoked compound action potential thresholds with inner-ear dimensions in pediatric cochlear implantation. Int J Pediatr Otorhinolaryngol 2022; 158:111160. [PMID: 35544967 DOI: 10.1016/j.ijporl.2022.111160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/12/2022] [Accepted: 04/23/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES A narrow bony cochlear nerve canal (BCNC), as well as a hypoplastic and aplastic cochlear nerve (CN) have been associated with increased electrically-evoked compound action potential (eCAP) thresholds in some studies, suggesting poorer neural excitability in cochlear implantation. Also, in large cochleae the extent of activated spiral ganglion neurons with electrical stimulation is less than in smaller ones. However, a detailed description of the relationship between eCAP thresholds for a lateral-wall electrode array and dimensions of the inner-ear structures and internal auditory canal (IAC) is missing. DESIGN The study subjects were 52 pediatric patients with congenital severe-to-profound hearing loss (27 females and 25 males; ages 0.7-2.0 years; 1.0 ± 0.3 years, mean ± SD) implanted bilaterally with Cochlear Nucleus CI422, CI522, or CI622 implants with full insertion of the Slim Straight electrode array. Diameters of the cochlea and the BCNC as well as the widths and heights of the IAC and the CN were evaluated from preoperative computed tomography and magnetic resonance images. These anatomical dimensions were compared with each other and with the patients' intraoperative eCAP thresholds. RESULTS The eCAP thresholds increased from the apical to basal direction (r = 0.89, p < 0.001). After sorting the cochleae into four size categories, higher eCAP thresholds were found in larger than in smaller cochleae (p < 0.001). With similar categorization, the eCAP thresholds were higher in cochleae with a larger BCNC than in cochleae with a smaller BCNC (p < 0.001). Neither IAC nor CN cross-sectional areas affected the eCAP thresholds. Correlations were found between cochlea and BCNC diameters and between IAC and CN cross-sectional areas (r = 0.39 and r = 0.48, respectively, p < 0.001 for both). CONCLUSIONS In the basal part of the electrode array, higher stimulation levels to elicit measurable neural responses (eCAP thresholds) were required than in the apical part. Increased eCAP thresholds associated with a larger cochlear diameter, but contrary to the earlier studies, not with a small size of the BCNC or the CN. Instead, the BCNC diameter correlated significantly with the cochlea diameter.
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Affiliation(s)
- Samuel Söderqvist
- Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Ville Sivonen
- Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Satu Lamminmäki
- Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jere Ylönen
- Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Otorhinolaryngology, Päijät-Häme Central Hospital, Päijät-Häme Joint Authority for Health and Wellbeing, Finland
| | - Antti Markkola
- Department of Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Saku T Sinkkonen
- Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Liang W, Wang L, Wang Z, Zhao P, Wang Q, Peng KA. Clinical characteristics in unilateral cochlear nerve canal stenosis. EAR, NOSE & THROAT JOURNAL 2022:1455613221082625. [PMID: 35649218 DOI: 10.1177/01455613221082625] [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: 11/17/2022] Open
Abstract
OBJECTIVE To characterize the clinical features of patients with congenital hearing loss and unilateral cochlear nerve canal stenosis (CNCS). METHODS A retrospective review of 12 patients with unilateral CNCS diagnosed between January 2018 and December 2019 at a tertiary referral hospital was performed. RESULTS Of the 12 patients identified, there were 6 males and 6 females. All patients presented with hearing loss, with no other chief complaints. Two patients had accessory auricles. Eleven patients had a severe to profound sensorineural hearing loss on the affected side, while 1 patient had an isolated high-frequency hearing loss. Nine patients demonstrated atresia of the cochlear nerve canal (CNC), while three patients had a stenotic, but patent, CNC. CONCLUSION Prompt radiologic diagnosis of patients with unilateral CNCS is important for patient counseling and appropriate rehabilitation.
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Affiliation(s)
- Wenqi Liang
- Department of Otorhinolaryngology - Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Line Wang
- Department of Otorhinolaryngology - Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Zhenxiao Wang
- Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
| | - Pengfei Zhao
- Department of Otorhinolaryngology - Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qimei Wang
- Department of Otorhinolaryngology - Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Kevin A Peng
- Shandong Provincial Hospital, Shandong First Medical University, Jinan, Shandong, China
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Liang W, Wang L, Song X, Gao F, Liu P, Lee TH, Peng KA. Cochlear Nerve Canal Stenosis: Association With MYH14 and MYH9 Genes. EAR, NOSE & THROAT JOURNAL 2021; 100:343S-346S. [PMID: 33683976 DOI: 10.1177/0145561321996839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The bony cochlear nerve canal transmits the cochlear nerve as it passes from the fundus of the internal auditory canal to the cochlea. Stenosis of the cochlear nerve canal, defined as a diameter less than 1.0 mm in transverse diameter, is associated with inner ear anomalies and severe to profound congenital hearing loss. We describe an 11-month-old infant with nonsyndromic congenital sensorineural hearing loss with cochlear nerve canal stenosis. Next-generation sequencing revealed heterozygous mutations in MYH9 and MYH14, encoding for the inner ear proteins myosin heavy chain IIA and IIC. The patient's hearing was rehabilitated with bilateral cochlear implantation.
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Affiliation(s)
- Wenqi Liang
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, People's Republic of China
| | - Line Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, People's Republic of China
| | - Xinyu Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, People's Republic of China
| | - Fenqi Gao
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, People's Republic of China
| | - Pan Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, 26455Capital Medical University, Beijing, People's Republic of China
| | | | - Kevin A Peng
- House Clinic and House Ear Institute, Los Angeles, CA, USA
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Jang JH, Kim H, Mun HA, Choo OS, Park HY, Ha EJ, Choung YH. Can radiological measurements of cochlear nerve parameters predict cochlear implant outcome? Our experience in 87 ears. Clin Otolaryngol 2019; 44:1142-1146. [PMID: 31442002 DOI: 10.1111/coa.13419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/30/2019] [Accepted: 08/18/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Jeong Hun Jang
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Hantai Kim
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Hyung Ah Mun
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Oak Sung Choo
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Hun Yi Park
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea
| | - Eun Ju Ha
- Department of Radiology, Ajou University School of Medicine, Suwon, Korea
| | - Yun-Hoon Choung
- Department of Otolaryngology, Ajou University School of Medicine, Suwon, Korea.,Bk21 Plus Research Center for Biomedical Sciences, Ajou University Graduate School of Medicine Suwon, Suwon, Korea
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