1
|
D'Arco F, Kandemirli SG, Dahmoush HM, Alves CAPF, Severino M, Dellepiane F, Robson CD, Lequin MH, Rossi-Espagnet C, O'Brien WT, Nash R, Clement E, Juliano AF. Incomplete partition type II in its various manifestations: isolated, in association with EVA, syndromic, and beyond; a multicentre international study. Neuroradiology 2024; 66:1397-1403. [PMID: 38833161 DOI: 10.1007/s00234-024-03386-z] [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: 02/12/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE Incomplete partition type II (IP-II) is characterized by specific histological features and radiological appearance. It may occur in isolation or in association with an enlarged vestibular aqueduct (EVA). Among those with IP-II and EVA, a subset has a diagnosis of Pendred syndrome. This study aimed to explore the prevalence of isolated IP-II, IP-II with EVA, and cases with a genetic or syndromic basis in our cohort. METHODS From a large, multicentre database of dysplastic cochleae (446 patients, 892 temporal bones), those with imaging features of IP-II were examined in detail, including whether there was a genetic or syndromic association. RESULTS A total of 78 patients with IP-II were identified. Among these, 55 patients had bilateral IP-II and EVA (only 12 with typical Mondini triad), 8 with bilateral IP-II and normal VA, 2 with bilateral IP-II and unilateral EVA, and 13 with unilateral IP-II (9 with unilateral EVA). Among the group with bilateral IP-II and bilateral EVA in whom genetic analysis was available, 14 out of 29 (48%) had SLC26A4 mutations and a diagnosis of Pendred syndrome, 1 had a FOXI1 mutation, and a few other genetic abnormalities; none had KCNJ10 pathogenic variants. CONCLUSION Bilateral IP-II-bilateral EVA may be seen in the context of Pendred syndrome (SLC26A4 or FOXI1 mutations) but, in the majority of our cohort, no genetic abnormalities were found, suggesting the possibility of unknown genetic associations. IP-II in isolation (without EVA) is favored to be genetic when bilateral, although the cause is often unknown.
Collapse
Affiliation(s)
- Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Sedat G Kandemirli
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Hisham M Dahmoush
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, USA
| | - Cesar A P F Alves
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | | | | | - Caroline D Robson
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Maarten H Lequin
- Department of Radiology, Texas Children's Hospital, North Campus, Austin, TX, USA
| | - Camilla Rossi-Espagnet
- Functional and Interventional Neuroradiology Unit, Bambino Gesù Children's Hospital, IRCCS , Rome, Italy
| | - William T O'Brien
- Department of Radiology, Orlando Health - Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Robert Nash
- Department of Paediatric Otolaryngology, Great Ormond Street Hospital, London, UK
| | - Emma Clement
- Department of Clinical Genetics, Great Ormond Street Hospital for Children, London, UK
| | - Amy F Juliano
- Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles St, 02114, Boston, MA, USA.
| |
Collapse
|
2
|
Xue S, Wei X, Kong Y, Chen B, Chen J, Li Y. Trends in research on cochlear implantation with inner ear malformation: a bibliometric and visualization analysis from 1986 to 2024. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08777-9. [PMID: 38977476 DOI: 10.1007/s00405-024-08777-9] [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: 04/21/2024] [Accepted: 06/03/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE The aim of this study was to conduct a bibliometric and visualization analysis of research on cochlear implantation (CI) for inner ear malformations (IEMs) from 1986 to 2024. METHODS A comprehensive literature search was performed using the Web of Science Core Collection Database, resulting in the identification of 431 relevant publications. Various data analysis and visualization tools, including VOSviewer, CiteSpace, and Bibliometrix, were utilized to analyze annual publication outputs, countries/regions and institutions, authors, journals and studies, keywords, and theme evolution. RESULTS The study revealed an overall increasing trend in research output on CI for IEMs, with significant contributions from countries such as the United States, China, Turkey, Germany, and Italy. The analysis also identified key authors, research teams, journals, and studies that have made substantial contributions to the field. Furthermore, the study highlighted important research hotspots and trends, such as the classification of IEMs, outcomes of CI for IEMs, and the management of pediatric patients with IEMs. CONCLUSION The findings of this study provide a comprehensive overview of the research landscape surrounding CI for IEMs. The results serve as a basis for future research topic selection and emphasize the need for enhanced international collaboration and the publication of high-impact research to further advance this field.
Collapse
Affiliation(s)
- Shujin Xue
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 1 DongjiaoMinxiang Avenue, DongCheng District, Beijing, 100730, China
| | - Xingmei Wei
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 1 DongjiaoMinxiang Avenue, DongCheng District, Beijing, 100730, China
| | - Ying Kong
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 1 DongjiaoMinxiang Avenue, DongCheng District, Beijing, 100730, China
| | - Biao Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 1 DongjiaoMinxiang Avenue, DongCheng District, Beijing, 100730, China
| | - Jingyuan Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 1 DongjiaoMinxiang Avenue, DongCheng District, Beijing, 100730, China
| | - Yongxin Li
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, 1 DongjiaoMinxiang Avenue, DongCheng District, Beijing, 100730, China.
| |
Collapse
|
3
|
Hameed N, Keshri A, Manogaran RS, Muraleedharan M, Chidambaram KS, Jain R, Aqib M. Cochlear Implantation by Veria Technique in Abnormal Cochlea: Our Experience. Indian J Otolaryngol Head Neck Surg 2024; 76:2646-2653. [PMID: 38883484 PMCID: PMC11169411 DOI: 10.1007/s12070-024-04492-3] [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: 11/20/2023] [Accepted: 12/31/2023] [Indexed: 06/18/2024] Open
Abstract
This study describes the clinical profile, operative findings, surgical technique, type of implant and complications encountered in implantation of abnormal cochlea by the transcanal (veria) technique in a tertiary care centre. This is a retrospective study done amongst 337 patients who underwent cochlear implantation by veria technique between January 2013 to August 2023. Based on pre-operative imaging with high-resolution computed tomography and magnetic resonance imaging the cochleovestibular malformations in this study were classified according to Sennaroglu classification and the cochlear ossification was graded from I to IV. Amongst the 337 patients who underwent cochlear implantation during the study period there were 79 cases (23.4%) with abnormalities of cochlea. This included 45 patients (13.4%) with congenital malformations, 20 patients (5.9%) with cochlear fibrosis and 14 patients (4.2%) with cochlear ossification. The commonest cochlear malformation was Incomplete Partition 2 which was present in 21 patients (46.7%). The other common malformations were cochlear hypoplasia (31.1%), Incomplete Partition 1(13.3%) and common cavity (8.9%). Out of the 20 patients with cochlear fibrosis, 17 patients had fibrosis only in the basal turn. Out of the 14 patients with cochlear ossification 8 patients (57.1%) had a grade 1 ossification, 2 patients (14.3%) had a grade 2 ossification and 4 patients (28.6%) had a grade 3 ossification. One of the patients required re-exploration for correcting the placement of electrode. The type of implant were chosen depending on individual malformation or length of ossification and fibrosis. In the past, inner ear anomalies were considered as a contraindication for cochlear implantation however it is now possible to implant most of these abnormal cochlea by careful planning, a modification of the surgical technique and the type of electrode used.
Collapse
Affiliation(s)
- Nazrin Hameed
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Amit Keshri
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | | | | | - Rajat Jain
- King George Medical College, Lucknow, India
| | - Mohd Aqib
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| |
Collapse
|
4
|
Szleper A, Lachowska M, Wojciechowski T, Niemczyk K. Computed tomography multi-planar and 3D image assessment protocol for detailed analysis of inner ear malformations in patients undergoing cochlear implantation counseling. OTOLARYNGOLOGIA POLSKA 2024; 78:35-43. [PMID: 38623860 DOI: 10.5604/01.3001.0054.2567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
<b><br>Introduction:</b> Congenital inner ear malformations resulting from embryogenesis may be visualized in radiological scans. Many attempts have been made to describe and classify the defects of the inner ear based on anatomical and radiological findings.</br> <b><br>Aim:</b> The aim was to propose and discuss computed tomography multi-planar and 3D image assessment protocols for detailed analysis of inner ear malformations in patients undergoing cochlear implantation counseling.</br> <b><br>Material and methods:</b> A retrospective analysis of 22 malformed inner ears. CT scans were analyzed using the Multi-Planar Reconstruction (MPR) option and 3D reconstruction.</br> <b><br>Results:</b> The protocol of image interpretation was developed to allow reproducibility for evaluating each set of images. The following malformations were identified: common cavity, cochlear hypoplasia type II, III, and IV, incomplete partition type II and III, and various combinations of vestibule labyrinth malformations. All anomalies have been presented and highlighted in figures with appropriate descriptions for easier identification. Figures of normal inner ears were also included for comparison. 3D reconstructions for each malformation were presented, adding clinical value to the detailed analysis.</br> <b><br>Conclusions:</b> Properly analyzing CT scans in cochlear implantation counseling is a necessary and beneficial tool for appropriate candidate selection and preparation for surgery. As proposed in this study, the unified scans evaluation scheme simplifies the identification of malformations and reduces the risk of omitting particular anomalies. Multi-planar assessment of scans provides most of the necessary details. The 3D reconstruction technique is valuable in addition to diagnostics influencing the decision-making process. It can minimize the risk of misdiagnosis. Disclosure of the inner ear defect and its precise imaging provides detailed anatomical knowledge of each ear, enabling the selection of the appropriate cochlear implant electrode and the optimal surgical technique.</br>.
Collapse
Affiliation(s)
- Agata Szleper
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, Poland
| | - Magdalena Lachowska
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland
| | - Tomasz Wojciechowski
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, Poland
| |
Collapse
|
5
|
Said NM, Telmesani LS, Telmesani LM. Effect of congenital inner ear malformations (IEMs) on electrically evoked compound action potential (ECAP) responses in cochlear implant children. Eur Arch Otorhinolaryngol 2023; 280:5193-5204. [PMID: 37606729 DOI: 10.1007/s00405-023-08196-2] [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: 06/17/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE The study was designed to assess the electrically evoked compound action potential (ECAP) responses in children with inner ear malformations compared to children with normal inner ear anatomy. METHODS The study included 235 prelingual deaf children who were implanted in cochlear implant unit in King Fahad University hospital-Imam Abdulrahman Bin Faisel University. Subjects were using either Cochlear Nucleus or Medel cochlear implant devices. We had 171 (64.5%) subjects with normal inner ear anatomy and 94 (35.5%) subjects with inner ear malformations (IEMs) and they were classified into 6 groups according to inner ear anatomy. Fourteen subjects (14.9%) subjects had enlarged vestibular aqueduct (EVA), 30 (32%) subjects had Mondini deformity, 25 (26.6%) subjects had incomplete partition type two (IPII), 9 (9.6%) subjects had incomplete partition type one (IPI) and 16 (17%) subjects had hypoplastic cochlea type III or IV. Intraoperative electrically evoked compound action potential (ECAP) responses were analyzed and compared in all subjects. RESULTS AND CONCLUSIONS Measurable ECAP responses can be elicited in patients with IEMs in most of the channels. Severe malformations can affect the prevalence of measuring ECAP and getting identifiable waveform morphology. Additionally, increased thresholds and lower slope of AGF was observed in IEMs specially in more severe malformations (e.g. IPI). IPI patients with better word recognition scores tended to show more identifiable ECAP measurements. This could suggest the presence of some correlation between ECAP responses and patients' performance after cochlear implantation.
Collapse
Affiliation(s)
- Nithreen M Said
- Audiovestibular Medicine Unit, Otorhinolaryngology Department, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
- Audio-Vestibular Medicine Unit, Otorhinolaryngology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Lena S Telmesani
- Otorhinolaryngology Department, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Laila M Telmesani
- Otorhinolaryngology Department, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
6
|
Abstract
Pattern recognition of specific temporal bone radiological phenotypes, in association with abnormalities in other organ systems, is critical in the diagnosis and management of syndromic causes of hearing loss. Several recent publications have demonstrated the presence of specific radiological appearances, allowing precise genetic and/or syndromic diagnosis, in the right clinical context. This review article aims to provide an extensive but practical guide to the radiologist dealing with syndromic causes of hearing loss.
Collapse
Affiliation(s)
- Martin Lewis
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St. London, London, WC1N3JH, UK
| | - Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St. London, London, WC1N3JH, UK. felice.d'
| |
Collapse
|
7
|
Swords C, Geerardyn A, Zhu M, O'Malley JT, Wu P, Arenberg JG, Podury A, Brassett C, Bance M, Quesnel AM. Incomplete Partition Type II Cochlear Malformations: Delineating the Three-Dimensional Structure from Digitized Human Histopathological Specimens. Otol Neurotol 2023; 44:881-889. [PMID: 37621122 PMCID: PMC10803064 DOI: 10.1097/mao.0000000000003999] [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] [Indexed: 08/26/2023]
Abstract
HYPOTHESIS There are clinically relevant differences in scalae anatomy and spiral ganglion neuron (SGN) quantity between incomplete partition type II (IP-II) and normal cochleae. BACKGROUND IP-II is a commonly implanted cochlear malformation. Detailed knowledge of intracochlear three-dimensional (3D) morphology may assist with cochlear implant (CI) electrode selection/design and enable optimization of audiologic programming based on SGN maps. METHODS IP-II (n = 11) human temporal bone histological specimens were identified from the National Institute on Deafness and Other Communication Disorders National Temporal Bone Registry and digitized. The cochlear duct, scalae, and surgically relevant anatomy were reconstructed in 3D. A machine learning algorithm was applied to map the location and number of SGNs. RESULTS 3D scalae morphology of the basal turn was normal. Scala tympani (ST) remained isolated for 540 degrees before fusing with scala vestibuli. Mean ST volume reduced below 1 mm 2 after the first 340 degrees. Scala media was a distinct endolymphatic compartment throughout; mean ± standard deviation cochlear duct length was 28 ± 3 mm. SGNs were reduced compared with age-matched norms (mean, 48%; range, 5-90%). In some cases, SGNs failed to ascend Rosenthal's canal, remaining in an abnormal basalward modiolar location. Two forms of IP-II were seen: type A and type B. A majority (98-100%) of SGNs were located in the basal modiolus in type B IP-II, compared with 76 to 85% in type A. CONCLUSION Hallmark features of IP-II cochleae include the following: 1) fusion of the ST and scala vestibuli at a mean of 540 degrees, 2) highly variable and overall reduced SGN quantity compared with normative controls, and 3) abnormal SGN distribution with cell bodies failing to ascend Rosenthal's canal.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Cecilia Brassett
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Manohar Bance
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | |
Collapse
|
8
|
Curtis DP, Baumann AN, Jeyakumar A. Variation in cochlear size: A systematic review. Int J Pediatr Otorhinolaryngol 2023; 171:111659. [PMID: 37459768 DOI: 10.1016/j.ijporl.2023.111659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/22/2023] [Accepted: 07/09/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Advancements in imaging and implantation technology have invited reexamination of the classic teaching that the human cochlea maintains uniform size across demographics. Yet, studies yield conflicting results and relatively few broad systematic reviews have examined cochlear size variation. PURPOSE The purpose of this study is to quantify cochlear variability across eight different measurement categories and suggest normative values and ranges for each with consideration of disease state and gender where possible. METHODS A systematic search was conducted up to October 1, 2022, using the search terms "Cochlea/anatomy and histology"[Mesh]) AND 'size'" with filters "Humans" and "English" across three databases (PubMed, CINAHL, Medline). Further inclusion criteria involved reporting of numerical measurements in any of the eight included categories. RESULTS Of the 625 articles manually reviewed for relevance by title and abstract, 91 were selected for full-text review and 33 met all eligibility criteria. 5,791 cochleae were included and weighted means and ranges were calculated: "A" value (defined as the distance from the round window, through the modiolus, to the oppsite lateral wall) = 9.23 mm (8.43-10.4 mm, n = 2559); cochlear duct length (CDL) = 33.04 mm (range 28.2-36.4 mm, n = 2252); cochlear height = 5.14 mm (2.8-6.9 mm, n = 2098); the basal turn lumen diameter = 2.09 mm (1.7-2.2 mm, n = 617); "B" value (defined as perpendicular to "A" value and in the same plane) = 6.52 mm (5.73-6.9 mm, n = 908); width of the basal turn = 6.4 mm (6.22-6.86 mm, n = 356); height of the basal turn = 1.96 mm (1.77-2.56 mm, n = 204); length of the basal turn 21.87 mm (21.03-22.5 mm, n = 384). CONCLUSION A notable size range exists across the eight different cochlear parameters considered and we provide normative values for each measurement. Females tend to have smaller CDL and "A" value than males and the sensorineural hearing loss patients had smaller CDL and "A" value but larger cochlear height than the general population.
Collapse
Affiliation(s)
| | | | - Anita Jeyakumar
- Department of Otolaryngology, Mercy Bon Secours, Youngstown, OH, 44512, USA
| |
Collapse
|
9
|
Lewis MA, Juliano A, Robson C, Clement E, Nash R, Rajput K, D'Arco F. The spectrum of cochlear malformations in CHARGE syndrome and insights into the role of the CHD7 gene during embryogenesis of the inner ear. Neuroradiology 2023; 65:819-834. [PMID: 36715725 DOI: 10.1007/s00234-023-03118-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023]
Abstract
PURPOSE We reviewed the genotypes and the imaging appearances of cochleae in CHARGE patients from two large tertiary centres and analysed the observed cochlear anomalies, providing detailed anatomical description and a grading system. The goal was to gain insight into the spectrum of cochlear anomalies in CHARGE syndrome, and thus, in the role of the CHD7 gene in otic vesicle development. METHODS We retrospectively reviewed CT and/or MR imaging of CHARGE patients referred to our institutions between 2005 and 2022. Cochlear morphology was analysed and, when abnormal, divided into 3 groups in order of progressive severity. Other radiological findings in the temporal bone were also recorded. Comparison with the existing classification system of cochlear malformation was also attempted. RESULTS Cochlear morphology in our CHARGE cohort ranged from normal to extreme hypoplasia. The most common phenotype was cochlear hypoplasia in which the basal turn was relatively preserved, and the upper turns were underdeveloped. All patients in the cohort had absent or markedly hypoplastic semicircular canals and small, misshapen vestibules. Aside from a stenotic cochlear aperture (fossette) being associated with a hypoplastic or absent cochlear nerve, there was no consistent relationship between cochlear nerve status (normal, hypoplasia, or aplasia) and cochlear morphology. CONCLUSION Cochlear morphology in CHARGE syndrome is variable. Whenever the cochlea was abnormal, it was almost invariably hypoplastic. This may shed light on the role of CHD7 in cochlear development. Accurate morphological description of the cochlea contributes to proper clinical diagnosis and is important for planning surgical treatment options.
Collapse
Affiliation(s)
- Martin A Lewis
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St. London, London, WC1N3JH, UK
| | - Amy Juliano
- Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Caroline Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Emma Clement
- Department of Clinical Genetics, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Robert Nash
- Department of Audiological Medicine, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Kaukab Rajput
- Department of Audiological Medicine, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond St. London, London, WC1N3JH, UK. felice.d'
- Department of Radiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK. felice.d'
| |
Collapse
|
10
|
Timar M, Saki N, Bayat A, Hanafi M. Cochlear Implantation Outcomes in Pediatrics with Inner Ear Malformations in a Tertiary Care Hospital in Ahvaz. Indian J Otolaryngol Head Neck Surg 2023; 75:197-203. [PMID: 37206753 PMCID: PMC10188708 DOI: 10.1007/s12070-022-03339-z] [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: 07/07/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022] Open
Abstract
Cochlear implantation (CI) has been successful in individuals with sensorineural hearing loss (SNHL) over the last few years. This study assessed the auditory and speech performance results of pediatrics with inner ear malformations (IEMs) following cochlear implantation at the Ahvaz cochlear implantation center and compared the outcomes of various malformations. All pediatrics with IEMs undergoing CI were included in the study. This retrospective study was performed on pediatrics with congenital IEMs who underwent cochlear implantation in Ahvaz cochlear implantation center between 2014 and 2019. The Category of Auditory Performance (CAP) and the Speech Intelligibility Rating (SIR) scores are two of the most frequently administered tests. The CAP with ranging from 0 (displays no awareness of environmental sounds) to 7 (can use the telephone with a familiar talker), was used to measure the speech perception performance of the implanted children. Furthermore, SIR consists of five performance categories ranging from "prerecognizable words in spoken language" to "connected speech is intelligible to all listeners". Finally, the study included 22 patients. The evaluation of the CT-Scan revealed three types of inner ear malformation: Incomplete Partition (IP)-I in 2 (9.1%), IP-II in 12 (54.5%), and common cavity in 8 (36.4%) individuals. The results were shown that the median CAP score preoperative was 0.5 (interquartile range (IQR): 0-2) and postoperative was 3.5 (IQR: 3-7). There were statistically significant differences in CAP scores between preoperative and second-year follow-up postoperative (p value = 0.036). The results were shown that the median SIR score preoperative was 1 (IQR: 1-5) and postoperative was 2 (IQR: 1-5). There were statistically significant differences in SIR scores between preoperative and second-year follow-up postoperative (p value = 0.001). Following a thorough preoperative screening, patients with specific IEMs can be candidates for CI and not a contraindication. There were statistically significant differences in CAP and SIR scores between preoperative and second-year follow-up postoperative in the common cavity and IP-II groups.
Collapse
Affiliation(s)
- Mostafa Timar
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Radiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Saki
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Associate Professor of Otolaryngology, Head and Neck Surgery, Medicine of School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Bayat
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Associate Professor of Audiology, Department of Audiology, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadghasem Hanafi
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Radiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
11
|
Hiremath SB, Biswas A, Mndebele G, Schramm D, Ertl-Wagner BB, Blaser SI, Chakraborty S. Cochlear Implantation: Systematic Approach to Preoperative Radiologic Evaluation. Radiographics 2023; 43:e220102. [PMID: 36893052 DOI: 10.1148/rg.220102] [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: 03/10/2023]
Abstract
Sensorineural hearing loss results from abnormalities that affect the hair cells of the membranous labyrinth, inner ear malformations, and conditions affecting the auditory pathway from the cochlear nerve to the processing centers of the brain. Cochlear implantation is increasingly being performed for hearing rehabilitation owing to expanding indications and a growing number of children and adults with sensorineural hearing loss. An adequate understanding of the temporal bone anatomy and diseases that affect the inner ear is paramount for alerting the operating surgeon about variants and imaging findings that can influence the surgical technique, affect the choice of cochlear implant and electrode type, and help avoid inadvertent complications. In this article, imaging protocols for sensorineural hearing loss and the normal inner ear anatomy are reviewed, with a brief description of cochlear implant devices and surgical techniques. In addition, congenital inner ear malformations and acquired causes of sensorineural hearing loss are discussed, with a focus on imaging findings that may affect surgical planning and outcomes. The anatomic factors and variations that are associated with surgical challenges and may predispose patients to periprocedural complications also are highlighted. © RSNA, 2023 Quiz questions for this article are available through the Online Learning Center. Online supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article.
Collapse
Affiliation(s)
- Shivaprakash B Hiremath
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Asthik Biswas
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Gopolang Mndebele
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - David Schramm
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Birgit B Ertl-Wagner
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Susan I Blaser
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Santanu Chakraborty
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| |
Collapse
|
12
|
Luo Z, Cao P, Zhang C, Xu Z, Xu P, Liang T. Recurrent bacterial meningitis caused by incomplete Type I inner ear malformation: A case report. IBRAIN 2023; 10:231-237. [PMID: 38915941 PMCID: PMC11193859 DOI: 10.1002/ibra.12093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/19/2023] [Accepted: 01/30/2023] [Indexed: 06/26/2024]
Abstract
The incidence of incomplete partition Type I inner ear malformation is very low; therefore, bacterial meningitis caused by this malformation is also rare. Here, we report a case of such a patient. This case is a young female patient, who is 7 years old, began to have recurrent headaches, and after 5 years, also began to have chest and back pain. The doctor diagnosed meningitis, and the anti-infection treatment was effective. She was followed up annually and continued to have outbreaks repeatedly for 17 years, but the cause of repeated infection was not found. After a detailed diagnosis and treatment in our hospital, the patient was finally diagnosed with incomplete partition Type I inner ear malformation, resulting in repeated bacterial meningitis. The patient recovered well after surgical treatment, and the symptoms did not recur after 1-year follow-up.
Collapse
Affiliation(s)
- Zhong Luo
- Department of NeurologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Piao Cao
- Department of NeurologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Chun‐Lin Zhang
- Department of OtorhinolaryngologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Zu‐Cai Xu
- Department of NeurologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Ping Xu
- Department of NeurologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Tao Liang
- Department of NeurologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| |
Collapse
|
13
|
Niu Y, Chen W, Lin M, Sha Y. Vestibular hydrops in patients with semicircular canal malformation. Auris Nasus Larynx 2023:S0385-8146(23)00029-9. [PMID: 36740469 DOI: 10.1016/j.anl.2023.01.009] [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: 11/07/2022] [Revised: 12/22/2022] [Accepted: 01/24/2023] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the vestibular endolymphatic hydrops in patients with semicircular canal malformation. METHODS We searched 7864 patients who underwent MR Imaging after contrast injection and found 21 patients with semicircular canal malformations. Another 9 non-malformed patients with unilateral hearing loss were randomly included. We asked patients about their medical history and measured the volume of total vestibular fluid space and endolymphatic space. The vestibular volume ratio = endolymphatic space/total fluid space × 100. RESULTS Hearing loss was observed in 18 of 30 malformed ears and in 7 of 12 non-malformed ears. Statistical analysis showed no association between semicircular canal malformation and hearing loss. In the semicircular canal malformation group, the average vestibular volume ratio (22.6%) in the ears with hearing loss was higher than that in the ears without hearing loss (11.4%). There was no statistically significant difference in the average vestibular %EL in ears with hearing loss between the malformed inner ear group (22.6%) and non-malformed group (28.2%) (P>0.05). CONCLUSION There was no correlation between semicircular canal malformation and hearing loss. The mean vestibular hydrops volume ratio of the semicircular canal deformed ears with hearing loss was about 22.6%, which was not different from that of normal ears.
Collapse
Affiliation(s)
- Yue Niu
- Eye, Ear, Nose and Throat (EENT) Hospital of Fudan University, Shanghai, China, No. 83, Fenyang Road, Xuhui District, Shanghai, China
| | - Wei Chen
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China, No. 83, Fenyang Road, Xuhui District, Shanghai, China
| | - Mengyan Lin
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China, No. 83, Fenyang Road, Xuhui District, Shanghai, China
| | - Yan Sha
- Eye, Ear, Nose and Throat (EENT) Hospital of Fudan University, Shanghai, China, No. 83, Fenyang Road, Xuhui District, Shanghai, China.
| |
Collapse
|
14
|
Alahmadi A, Abdelsamad Y, Almuhawas F, Hamed N, Salamah M, Alsanosi A. Cochlear Implantation: The Volumetric Measurement of Vestibular Aqueduct and Gusher Prediction. J Pers Med 2023; 13:jpm13020171. [PMID: 36836405 PMCID: PMC9961179 DOI: 10.3390/jpm13020171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 01/20/2023] Open
Abstract
This study aimed to validate the role of 3D segmentation in measuring the volume of the vestibular aqueduct (VAD), and the inner ear, and to study the correlation between VAD volume and VAD linear measurements at the midpoint and operculum. The correlation with other cochlear metrics was also studied. We retrospectively recruited 21 children (42 ears) diagnosed with Mondini dysplasia (MD) plus enlarged vestibular aqueduct (EVA) from 2009 to 2021 and who underwent cochlear implantation (CI). Patients' sociodemographic data were collected, and linear cochlear metrics were measured using Otoplan. Vestibular aqueduct width and vestibular aqueduct and inner ear volumes were measured by two independent neuro-otologists using 3D segmentation software (version 4.11.20210226) and high-resolution CT. We also conducted a regression analysis to determine the association between these variables and CT VAD and inner ear volumes. Among the 33 cochlear implanted ears, 13 ears had a gusher (39.4%). Regarding CT inner ear volume, we found that gender, age, A-value, and VAD at the operculum were statistically significant (p-Value = 0.003, <0.001, 0.031, and 0.027, respectively) by regression analysis. Moreover, we found that Age, H value, VAD at the midpoint, and VAD at the operculum were significant predictors of CT VAD volume (p-Value < 0.04). Finally, gender (OR: 0.092; 95%CI: 0.009-0.982; p-Value = 0.048) and VAD at the midpoint (OR: 0.106; 95%CI: 0.015-0.735; p-Value = 0.023) were significant predictors of gusher risk. Patients' gusher risk was significantly differentiated by gender and VAD width at the midpoint.
Collapse
Affiliation(s)
- Asma Alahmadi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh 11411, Saudi Arabia
- Correspondence:
| | | | - Fida Almuhawas
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh 11411, Saudi Arabia
| | - Nezar Hamed
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh 11411, Saudi Arabia
| | - Marzouqi Salamah
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh 11411, Saudi Arabia
| | - Abdulrahman Alsanosi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, King Saud University Medical City (KSUMC), King Saud University, Riyadh 11411, Saudi Arabia
| |
Collapse
|
15
|
Method to estimate the basal turn length in inner ear malformation types. Sci Rep 2023; 13:66. [PMID: 36604454 PMCID: PMC9814883 DOI: 10.1038/s41598-022-23911-5] [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: 05/21/2022] [Accepted: 11/07/2022] [Indexed: 01/06/2023] Open
Abstract
The mathematical equations to estimate cochlear duct length (CDL) using cochlear parameters such as basal turn diameter (A-value) and width (B-value) are currently applied for cochleae with two and a half turns of normal development. Most of the inner ear malformation (IEM) types have either less than two and a half cochlear turns or have a cystic apex, making the current available CDL equations unsuitable for cochleae with abnormal anatomies. Therefore, this study aimed to estimate the basal turn length (BTL) from the cochlear parameters of different anatomical types, including normal anatomy; enlarged vestibular aqueduct; incomplete partition types I, II, and III; and cochlear hypoplasia. The lateral wall was manually tracked for 360° of the angular depth, along with the A and B values in the oblique coronal view for all anatomical types. A strong positive linear correlation was observed between BTL and the A- (r2 = 0.74) and B-values (r2 = 0.84). The multiple linear regression model to predict the BTL from the A-and B-values resulted in the following equation (estimated BTL = [A × 1.04] + [B × 1.89] - 0.92). The manually measured and estimated BTL differed by 1.12%. The proposed equation could be beneficial in adequately selecting an electrode that covers the basal turn in deformed cochleae.
Collapse
|
16
|
Brotto D, Ariano M, Sozzi M, Cenedese R, Muraro E, Sorrentino F, Trevisi P. Vestibular anomalies and dysfunctions in children with inner ear malformations: A narrative review. Front Pediatr 2023; 11:1027045. [PMID: 36923273 PMCID: PMC10008926 DOI: 10.3389/fped.2023.1027045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/06/2023] [Indexed: 03/02/2023] Open
Abstract
About 20% of children with congenital hearing loss present malformations of the inner ear. In the past few years much has been understood about the morphology and function of the anterior part of the labyrinth, since hearing loss may have a dramatic effect on the overall development of a child. Nowadays, for most of them, a chance for hearing rehabilitation is available, making hearing loss a treatable condition. The anomalies range from the lack of development of the whole inner ear to specific anomalies of isolated structures. Despite the frequent concomitant involvement of the posterior part of the labyrinth, this part of the inner ear is frequently neglected while discussing its morphology and dysfunction. Even though vestibular and balance function/dysfunction may have a significant impact on the global development of children, very little is known about these specific disorders in patients with inner ear malformations. The aim of this review is to summarize the available literature about vestibular anomalies and dysfunctions in children with inner ear malformations, discussing what is currently known about the topic.
Collapse
Affiliation(s)
- Davide Brotto
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Marzia Ariano
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Mosè Sozzi
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Roberta Cenedese
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Eva Muraro
- Department of Medicine, Camposampiero Hospital, Camposampiero, Italy
| | - Flavia Sorrentino
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| | - Patrizia Trevisi
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova, Italy
| |
Collapse
|
17
|
D'Arco F, Biswas A, Clement E, Rajput K, Juliano AF. Subtle Malformation of the Cochlear Apex and Genetic Abnormalities: Beyond the "Thorny" Cochlea. AJNR Am J Neuroradiol 2023; 44:79-81. [PMID: 36549853 PMCID: PMC9835904 DOI: 10.3174/ajnr.a7746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022]
Abstract
With the routine use of high-resolution heavily T2-weighted sequences to evaluate patients with hearing deficits, new, subtle phenotypes of cochlear malformations are being discovered and an increasing number of genotype-phenotype correlations are being found through a reverse phenotype approach, which can help guide geneticists. In this brief report, we present subtle malformations of the apical turn of the cochlea related to 3 genetic mutations, emphasizing the importance of a careful assessment of the cochlear apex.
Collapse
Affiliation(s)
- F D'Arco
- From the Department of Radiology (F.D., A.B.)
| | - A Biswas
- From the Department of Radiology (F.D., A.B.)
| | | | - K Rajput
- Audiological Medicine (K.R.), Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, UK
| | - A F Juliano
- Department of Radiology (A.F.J.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
18
|
Gupta AK, Grover M, Samdani S, Sushmitha N. CSF Otorhinorrhea Due to Inner Ear Malformation-A Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:3773-3775. [PMID: 36742932 PMCID: PMC9895462 DOI: 10.1007/s12070-021-02582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 04/17/2021] [Indexed: 02/07/2023] Open
Abstract
Inner ear malformations are an important cause of sensorineural hearing loss ranging from severe to profound and they also contribute to Cerebrospinal fluid leakage and recurrent meningitis. The most severe is the complete labyrinthine aplasia (Michel Deformity), then there is cochlear aplasia, cochlear hypoplasia, incomplete partition of the cochlea, enlarged vestibular acqueduct and cochlear aperture abnormality.
Collapse
Affiliation(s)
- Ashish Kumar Gupta
- Department of Otorhinolaryngology, Government Medical College, Bharatpur, Rajasthan India
| | - Mohnish Grover
- Department of Otorhinolaryngology, SMS Medical College and Hospitals, Jaipur, Rajasthan India
| | - Sunil Samdani
- Department of Otorhinolaryngology, SMS Medical College and Hospitals, Jaipur, Rajasthan India
| | - N. Sushmitha
- Department of Otorhinolaryngology, SMS Medical College and Hospitals, Jaipur, Rajasthan India
| |
Collapse
|
19
|
Juliano AF, D'Arco F, Pao J, Picariello S, Clement E, Moonis G, Robson CD. The Cochlea in Branchio-Oto-Renal Syndrome: An Objective Method for the Diagnosis of Offset Cochlear Turns. AJNR Am J Neuroradiol 2022; 43:1646-1652. [PMID: 36175083 PMCID: PMC9731253 DOI: 10.3174/ajnr.a7653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/19/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE An "unwound" or "offset" cochlea has been described as a characteristic imaging feature in patients with branchio-oto-renal syndrome, and recently recognized to be associated in particular to those with EYA1 gene mutations. Determination of this feature has traditionally relied on subjective visual assessment. Our aim was to establish an objective assessment method for cochlear offset (the cochlear turn alignment ratio) and determine an optimal cutoff turn alignment ratio value that separates individuals with EYA1-branchio-oto-renal syndrome from those with SIX1-branchio-oto-renal syndrome and healthy controls. MATERIALS AND METHODS Temporal bone CT or MR imaging from 40 individuals with branchio-oto-renal syndrome and 40 controls was retrospectively reviewed. Cochlear offset was determined visually by 2 independent blinded readers and then quantitatively via a standardized technique yielding the cochlear turn alignment ratio. The turn alignment ratio values were compared between cochleae qualitatively assessed as "not offset" and "offset." Receiver operating characteristic analysis was used to determine the ability of the turn alignment ratio to differentiate between these populations and an optimal cutoff turn alignment ratio value. Cochlear offset and turn alignment ratio values were analyzed for each branchio-oto-renal syndrome genotype subpopulation and for controls. RESULTS The turn alignment ratio can accurately differentiate between cochleae with and without an offset (P < .001). The optimal cutoff value separating these populations was 0.476 (sensitivity = 1, specificity = 0.986, J = 0.986). All except 1 cochlea among the EYA1-branchio-oto-renal syndrome subset and all with unknown genotype branchio-oto-renal syndrome had a cochlear offset and a turn alignment ratio of <0.476. All except 1 cochlea among the SIX1-branchio-oto-renal syndrome subset and all controls had no offset and a turn alignment ratio of >0.476. CONCLUSIONS There is a statistically significant difference in turn alignment ratios between offset and nonoffset cochleae, with an optimal cutoff of 0.476. This cutoff value allows excellent separation of EYA1-branchio-oto-renal syndrome from SIX1-branchio-oto-renal syndrome and from individuals without branchio-oto-renal syndrome or sensorineural hearing loss. The turn alignment ratio is a reliable and objective metric that can aid in the imaging evaluation of branchio-oto-renal syndrome.
Collapse
Affiliation(s)
- A F Juliano
- From the Department of Radiology (A.F.J.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - F D'Arco
- Department of Radiology (F.D.), Great Ormond Street Hospital for Children, London, UK
| | - J Pao
- Department of Radiology (J.P.), Orlando Health, Orlando Regional Medical Center, Orlando, Florida
| | - S Picariello
- Department of General and Specialized Surgery for Women and Children (S.P.), University of Campania "Luigi Vanvitelli," Naples, Italy
- Neuro-Oncology Unit (S.P.), Department of Paediatric Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - E Clement
- Department of Clinical Genetics (E.C.), Great Ormond Street Hospital for Children National Health Service Foundation Trust, London, UK
| | - G Moonis
- Department of Radiology (G.M.), NYU Langone Medical Center, New York, New York
| | - C D Robson
- Department of Radiology (C.D.R.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
20
|
Bächinger D, Breitsprecher TM, Pscheidl A, Dhanasingh A, Mlynski R, Dazert S, Langner S, Weiss NM. Internal auditory canal volume in normal and malformed inner ears. Eur Arch Otorhinolaryngol 2022; 280:2149-2154. [PMID: 36210370 PMCID: PMC10066105 DOI: 10.1007/s00405-022-07676-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/22/2022] [Indexed: 11/03/2022]
Abstract
Abstract
Purpose
A narrow bony internal auditory canal (IAC) may be associated with a hypoplastic cochlear nerve and poorer hearing performances after cochlear implantation. However, definitions for a narrow IAC vary widely and commonly, qualitative grading or two-dimensional measures are used to characterize a narrow IAC. We aimed to refine the definition of a narrow IAC by determining IAC volume in both control patients and patients with inner ear malformations (IEMs).
Methods
In this multicentric study, we included high-resolution CT (HRCT) scans of 128 temporal bones (85 with IEMs: cochlear aplasia, n = 11; common cavity, n = 2; cochlear hypoplasia type, n = 19; incomplete partition type I/III, n = 8/8; Mondini malformation, n = 16; enlarged vestibular aqueduct syndrome, n = 19; 45 controls). The IAC diameter was measured in the axial plane and the IAC volume was measured by semi-automatic segmentation and three-dimensional reconstruction.
Results
In controls, the mean IAC diameter was 5.5 mm (SD 1.1 mm) and the mean IAC volume was 175.3 mm3 (SD 52.6 mm3). Statistically significant differences in IAC volumes were found in cochlear aplasia (68.3 mm3, p < 0.0001), IPI (107.4 mm3, p = 0.04), and IPIII (277.5 mm3, p = 0.0004 mm3). Inter-rater reliability was higher in IAC volume than in IAC diameter (intraclass correlation coefficient 0.92 vs. 0.77).
Conclusions
Volumetric measurement of IAC in cases of IEMs reduces measurement variability and may add to classifying IEMs. Since a hypoplastic IAC can be associated with a hypoplastic cochlear nerve and sensorineural hearing loss, radiologic assessment of the IAC is crucial in patients with severe sensorineural hearing loss undergoing cochlear implantation.
Collapse
|
21
|
Kim J, Hong SH, Moon IJ. Effect of inner ear malformations on intraoperative
ECAP
thresholds and postoperative auditory performance. Laryngoscope Investig Otolaryngol 2022; 7:1098-1106. [PMID: 36000038 PMCID: PMC9392413 DOI: 10.1002/lio2.836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/30/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives This study sought to characterize the influence of inner ear malformations (IEMs) on intraoperative electrically evoked compound action potential (ECAP) and auditory performance to better understand the underlying pathophysiology related to variabilities in cochlear implant (CI) outcomes that individuals with malformed cochlea may present. Methods The medical records of 222 ears implanted with Cochlear Nucleus CI were reviewed. Of the total, 64 ears had radiologic evidence of IEMs, and 158 ears were normal. Individuals with IEMs were grouped based on the severity of anomalies; 38 had mild IEMs (e.g., enlarged vestibular aqueduct, incomplete partition type II, etc.) and 26 had severe IEMs (e.g., cochlear nerve hypoplasia, common cavity, etc.). Intraoperative ECAP thresholds obtained via neural response telemetry (NRT) and the categories of auditory performance (CAP) scores measured at 12 months postoperative were compared and correlated. Results Absent ECAP responses were more apparent in the IEM group. ECAP thresholds were significantly elevated in the severe IEM group, while the mild IEM group had ECAP thresholds comparable to the normal group. The mild IEM group achieved CAP scores similar to the normal control. Patients in the severe IEM group showed significantly lower CAP scores at 12 months postoperative. Significant negative relationships existed between ECAP thresholds and CAP scores obtained from all subjects. Conclusion Measurable ECAP responses and NRT thresholds varied across groups. The inverse relationship between NRT thresholds and CAP scores may suggest that electrophysiological responses measured during surgery may potentially be indicative of postoperative performance in our CI population. Level of Evidence 2b.
Collapse
Affiliation(s)
- Jeong‐Seo Kim
- Hearing Research Laboratory Samsung Medical Center Seoul South Korea
| | - Sung Hwa Hong
- Hearing Research Laboratory Samsung Medical Center Seoul South Korea
- Department of Otolaryngology – Head and Neck Surgery Samsung Changwon Hospital, Sungkyunkwan University School of Medicine Changwon South Korea
| | - Il Joon Moon
- Hearing Research Laboratory Samsung Medical Center Seoul South Korea
- Department of Otolaryngology – Head and Neck Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul South Korea
| |
Collapse
|
22
|
Zhu HY, Chen L, Hou XY, Tang ZQ, Sun JQ, Sun JW, Guo XT. Electrically evoked auditory brainstem responses in deaf patients with Mondini malformation during cochlear implantation. Eur Arch Otorhinolaryngol 2022; 279:4847-4852. [PMID: 35247096 DOI: 10.1007/s00405-022-07307-9] [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: 11/02/2021] [Accepted: 02/08/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the auditory pathway functions in deaf patients with Mondini malformation using the electrically evoked auditory brainstem response (EABR) during cochlear implantation (CI). METHODS A total of 58 patients with severe to profound sensorineural hearing loss (SNHL) were included in this study. Of these patients, 27 cases had Mondini malformation and 31 control cases had no inner ear malformations (IEMs). Intraoperative EABRs evoked by electrical stimulation at the round window niche (RWN) and round window membrane (RWM) were recorded. RESULTS Patients with Mondini malformation showed significantly lower EABR extraction rates than those with no IEMs did. However, for patients who showed EABRs, no significant difference in EABR thresholds, wave III (eIII) latencies, wave V (eV) latencies or eIII-eV latency intervals was found between two groups. CONCLUSION The physiological functions of the peripheral auditory system in patients with Mondini malformation may divide into opposite extremes, as revealed by a robust EABR and the absence of the EABR, respectively. The auditory conduction function should be objectively and individually evaluated for patients with Mondini malformation by the EABR.
Collapse
Affiliation(s)
- Han-Yu Zhu
- Department of Otolaryngology-Head and Neck Surgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Li Chen
- Department of Otolaryngology-Head and Neck Surgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Xiao-Yan Hou
- Department of Otolaryngology-Head and Neck Surgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Zheng-Quan Tang
- School of Life Sciences, Anhui University, Hefei, 230601, Anhui, China.,Key Laboratory of Human Microenvironment and Precision Medicine of Anhui Higher Education Institutes, Anhui University, Hefei, 230601, Anhui, China
| | - Jia-Qiang Sun
- Department of Otolaryngology-Head and Neck Surgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, China.
| | - Jing-Wu Sun
- Department of Otolaryngology-Head and Neck Surgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, China.
| | - Xiao-Tao Guo
- Department of Otolaryngology-Head and Neck Surgery, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001, Anhui, China. .,CAS Key Laboratory of Brain Function and Diseases, School of Life Sciences, University of Science and Technology of China, Hefei, 230027, Anhui, China.
| |
Collapse
|
23
|
Manara R, Avato I, Uberti A, Trevisi P, Bovo R, Martini A, Brotto D, Berettini S, Canzi P, Ciorba A, Cristofari E, Cuda D, Della Volpe A, Frau GN, Genovese E, Marsella P, Murri A, Sorrentino F, Vincenti V, Zanetti D. Bulging of the Oval Window in Common Cavity Deformity: A Possible Predictor of Meningitis. Otol Neurotol 2022; 43:101-104. [PMID: 34699400 DOI: 10.1097/mao.0000000000003394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the prevalence-rate of oval window bulging in the common cavity and its association with bacterial meningitis. PATIENTS CT and clinical files of 29 children with preliminary diagnosis of common cavity deformity were collected from 13 Italian centers. INTERVENTION A retrospective case review study was conducted with a centralized evaluation of the temporal bone CT imaging was performed at Azienda Ospedale - Università Padova, Padova, Italy. MAIN OUTCOME MEASURE Diagnosis of common cavity was reviewed; in addition, a fluid protrusion into the middle-ear cavity through the oval window at CT imaging was considered as oval window bulging. Its association with the history of bacterial meningitis was investigated. RESULTS Common cavity deformity was confirmed in 14/29 children (mean-age 11.4 ± 3.8; age-range 5-20; nine females) referred with this diagnosis. In 7/14 patients, the common cavity deformity was bilateral (i.e., 21 common cavities). Oval window bulging was found in 3/19 common cavities (concomitant middle-ear effusive otitis hampered the evaluation in two cases), while the internal acoustic meatus fundus was defective in 10/21 cases. History of bacterial meningitis was found in three children (21%) and two of them had oval window bulging at CT. In the case unrelated to oval window bulging, meningitis occurred late at the age of 12 during acute otitis contralateral to common cavity deformity (ipsilaterally to incomplete partition type 1). CONCLUSION Patients harboring common cavity deformity have a high risk of meningitis in their first years of life. Oval window bulging seems to be associated with a higher risk of meningitis. This information might be important for appropriate surgical planning.
Collapse
Affiliation(s)
- Renzo Manara
- Neuroradiology Unit, Department of Neurosciences, University of Padova, Padova
| | - Irene Avato
- Experimental Medicine, University of Pavia, Pavia, Italy
| | - Andrea Uberti
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova
| | - Patrizia Trevisi
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova
| | - Roberto Bovo
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova
| | - Alessandro Martini
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova
| | - Davide Brotto
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova
| | | | - Pietro Canzi
- Department of Otorhinolaryngology, University of Pavia, Pavia
| | - Andrea Ciorba
- ENT Department, University Hospital of Ferrara, Ferrara
| | | | | | | | | | - Elisabetta Genovese
- Department of Diagnostic, Clinical and Public Health, University of Modena and Reggio Emilia, Modena
| | - Pasquale Marsella
- Audiology and Otosurgery Unit, "Bambino Gesù" Pediatric Hospital, Rome
- University of Parma
| | | | - Flavia Sorrentino
- Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Padova
| | - Vincenzo Vincenti
- Otolaryngology-Head and Neck Surgery Department, University Hospital of Parma; and Unit of Surgical Pathology, University of Parma, Parma
| | - Diego Zanetti
- Audiology Unit, Dept of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| |
Collapse
|
24
|
Parlak S, Akgoz Karaosmanoglu A, Ozbal Batuk M, Sennaroglu L, Ozgen B. 3 Tesla MR imaging of the large endolymphatic duct and sac anomaly with audiological correlation. Eur J Radiol 2021; 145:110064. [PMID: 34839211 DOI: 10.1016/j.ejrad.2021.110064] [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: 07/29/2021] [Revised: 11/06/2021] [Accepted: 11/18/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Large endolymphatic duct and sac (LEDS) is one of the most common imaging abnormalities in congenital sensorineural hearing loss and is frequently seen with coexistent cochlear anomalies, especially incomplete partition type II. However, MRI findings of accompanying cochlear and especially modiolar dysplasias may be subtle. The purpose of this study is to evaluate the imaging findings of LEDS with high-resolution imaging at 3 T and correlate with the audiological data. METHODS 3 T temporal bone MRIs of 54 ears in 30 LEDS patients were retrospectively evaluated. The cochlear dysmorphism and modiolar deficiency were assessed qualitatively and quantitatively. The severity of LEDS anomaly, the signal changes within the LEDS and cochlea were also noted. The imaging findings were correlated to the audiological data. RESULTS The cochlea was abnormal in 77.8% of the ears with an isolated modiolar deficiency in 11.1%. Cochlea and modiolus were completely normal in 11.1% of the ears. In 63% of the ears X-distance was increased. T2 hypointensity within LEDS and cochlea were detected in 42.6%, and 7.4% of the ears, respectively. The median diameters of LEDS were higher in ears with severe to profound HL than ears with normal to moderate HL (p < 0.05). The X-distance, presence of T2 hypointensity within LEDS, and diameters of modiolus did not show statistical correlation with the audiographic data. CONCLUSION High-resolution 3 T imaging of patients with LEDS anomaly revealed a spectrum of cochlear anomalies, but up to 11.1% of the ears had no underlying anomaly despite severe (endolymphatic duct/sac) dilatation and/or profound HL.
Collapse
Affiliation(s)
- Safak Parlak
- Hacettepe University, Faculty of Medicine, Department of Radiology, Turkey.
| | | | - Merve Ozbal Batuk
- Hacettepe University, Faculty of Health Sciences, Department of Audiology, Turkey
| | - Levent Sennaroglu
- Hacettepe University, Faculty of Medicine, Department of Otorhinolaryngology, Turkey
| | - Burce Ozgen
- University of Illinois at Chicago, Department of Radiology, United States
| |
Collapse
|
25
|
Brotto D, Sorrentino F, Cenedese R, Avato I, Bovo R, Trevisi P, Manara R. Genetics of Inner Ear Malformations: A Review. Audiol Res 2021; 11:524-536. [PMID: 34698066 PMCID: PMC8544219 DOI: 10.3390/audiolres11040047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/04/2021] [Accepted: 10/08/2021] [Indexed: 12/02/2022] Open
Abstract
Inner ear malformations are present in 20% of patients with sensorineural hearing loss. Although the first descriptions date to the 18th century, in recent years the knowledge about these conditions has experienced terrific improvement. Currently, most of these conditions have a rehabilitative option. Much less is known about the etiology of these anomalies. In particular, the evolution of genetics has provided new data about the possible relationship between inner ear malformations and genetic anomalies. In addition, in syndromic condition, the well-known presence of sensorineural hearing loss can now be attributed to the presence of an inner ear anomaly. In some cases, the presence of these abnormalities should be considered as a characteristic feature of the syndrome. The present paper aims to summarize the available knowledge about the possible relationships between inner ear malformations and genetic mutations.
Collapse
Affiliation(s)
- Davide Brotto
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
- Correspondence:
| | - Flavia Sorrentino
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Roberta Cenedese
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Irene Avato
- Department of Diagnostic, Paediatric, Clinical and Surgical Science, University of Pavia, 35128 Pavia, Italy;
| | - Roberto Bovo
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Patrizia Trevisi
- Section of Otorhinolaryngology—Head and Neck Surgery, Department of Neurosciences, University of Padua, 35128 Padua, Italy; (F.S.); (R.C.); (R.B.); (P.T.)
| | - Renzo Manara
- Neuroradiology Unit, Department of Neurosciences, University of Padua, 35128 Padua, Italy;
| |
Collapse
|
26
|
Ito T, Fujikawa T, Honda K, Makabe A, Watanabe H, Bai J, Kawashima Y, Miwa T, Griffith AJ, Tsutsumi T. Cochlear Pathomorphogenesis of Incomplete Partition Type II in Slc26a4-Null Mice. J Assoc Res Otolaryngol 2021; 22:681-691. [PMID: 34622375 DOI: 10.1007/s10162-021-00812-4] [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: 11/03/2020] [Accepted: 08/09/2021] [Indexed: 11/24/2022] Open
Abstract
Incomplete partition type II (IP-II) is frequently identified in ears with SLC26A4 mutations. Cochleae with IP-II are generally observed to have 1½ turns; the basal turns are normally formed, and the apical turn is dilated or cystic. The objective of this study was to characterize the pathomorphogenesis of the IP-II cochlear anomaly in Slc26a4-null mice. Otic capsules were dissected from Slc26a4Δ/+ and Slc26a4Δ/Δ mice at 1 and 8 days of age and at 1 and 3 months of age. X-ray micro-computed tomography was used to image samples. We used a multiplanar view and three-dimensional reconstructed models to calculate the cochlear duct length, cochlear turn rotation angle, and modiolus tilt angle. The number of inner hair cells was counted, and the length of the cochlear duct was measured in a whole-mount preparation of the membranous labyrinth. X-ray micro-computed tomography mid-modiolar planar views demonstrated cystic apical turns in Slc26a4Δ/Δ mice resulting from the loss or deossification of the interscalar septum, which morphologically resembles IP-II in humans. Planes vertical to the modiolus showed a similar mean rotation angle between Slc26a4Δ/+ and Slc26a4Δ/Δ mice. In contrast, the mean cochlear duct length and mean number of inner hair cells in Slc26a4Δ/Δ mice were significantly smaller than in Slc26a4Δ/+ mice. In addition, there were significant differences in the mean tilt angle and mean width of the modiolus. Our analysis of Slc26a4-null mice suggests that IP-II in humans reflects loss or deossification of the interscalar septum but not a decreased number of cochlear turns.
Collapse
Affiliation(s)
- Taku Ito
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan.
| | - Taro Fujikawa
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan
| | - Keiji Honda
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan
| | - Ayane Makabe
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan
| | - Hiroki Watanabe
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan
| | - Jing Bai
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan
| | - Yoshiyuki Kawashima
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan
| | - Toru Miwa
- Department of Otolaryngology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, 2-4-20 Ogimachi, Kita-ku, Osaka, 530-8480, Japan
| | - Andrew J Griffith
- Molecular Biology and Genetics Section, National Institute On Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, 20892, USA.,Departments of Otolaryngology and Physiology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Takeshi Tsutsumi
- Department of Otorhinolaryngology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, 113-8519, Tokyo, Japan
| |
Collapse
|
27
|
Roesch S, Rasp G, Sarikas A, Dossena S. Genetic Determinants of Non-Syndromic Enlarged Vestibular Aqueduct: A Review. Audiol Res 2021; 11:423-442. [PMID: 34562878 PMCID: PMC8482117 DOI: 10.3390/audiolres11030040] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/02/2021] [Accepted: 08/24/2021] [Indexed: 12/13/2022] Open
Abstract
Hearing loss is the most common sensorial deficit in humans and one of the most common birth defects. In developed countries, at least 60% of cases of hearing loss are of genetic origin and may arise from pathogenic sequence alterations in one of more than 300 genes known to be involved in the hearing function. Hearing loss of genetic origin is frequently associated with inner ear malformations; of these, the most commonly detected is the enlarged vestibular aqueduct (EVA). EVA may be associated to other cochleovestibular malformations, such as cochlear incomplete partitions, and can be found in syndromic as well as non-syndromic forms of hearing loss. Genes that have been linked to non-syndromic EVA are SLC26A4, GJB2, FOXI1, KCNJ10, and POU3F4. SLC26A4 and FOXI1 are also involved in determining syndromic forms of hearing loss with EVA, which are Pendred syndrome and distal renal tubular acidosis with deafness, respectively. In Caucasian cohorts, approximately 50% of cases of non-syndromic EVA are linked to SLC26A4 and a large fraction of patients remain undiagnosed, thus providing a strong imperative to further explore the etiology of this condition.
Collapse
Affiliation(s)
- Sebastian Roesch
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, 5020 Salzburg, Austria; (S.R.); (G.R.)
| | - Gerd Rasp
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, 5020 Salzburg, Austria; (S.R.); (G.R.)
| | - Antonio Sarikas
- Institute of Pharmacology and Toxicology, Paracelsus Medical University, 5020 Salzburg, Austria;
| | - Silvia Dossena
- Institute of Pharmacology and Toxicology, Paracelsus Medical University, 5020 Salzburg, Austria;
- Correspondence: ; Tel.: +43-(0)662-2420-80564
| |
Collapse
|
28
|
Sennaroğlu L. Radiological Features and Pathognomonic Sign of Stapes Footplate Fistula in Inner Ear Malformations. Turk Arch Otorhinolaryngol 2021; 59:95-102. [PMID: 34386795 PMCID: PMC8329392 DOI: 10.4274/tao.2021.6180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/22/2021] [Indexed: 12/01/2022] Open
Abstract
Objective Some inner ear malformations may cause recurrent meningitis, which may be fatal. The etiology is usually a stapes footplate fistula which enables microorganisms to pass into the inner ear containing cerebrospinal fluid (CSF), causing repeated attacks of meningitis. Radiological signs of the fistula are not obvious and are not reported in detail in the literature. The aim of the study is to investigate the radiological features of stapes footplate fistula in inner ear malformations. Methods Radiological findings were analyzed for seventeen patients with inner ear malformations (IEMs) operated on because of recurrent meningitis. Using this information, images of 1,010 patients with IEMs were retrospectively reviewed to investigate the radiological findings of stapes footplate fistula and their relationship to IEMs. They were classified according to the Sennaroglu classification system, and according to different stages of stapes footplate fistula. Results In the case of a stapes footplate cyst, computerized tomography shows an opacity at the oval window. On magnetic resonance imaging, a fluid filled cystic structure continuous with and having similar signal characteristics to the CSF in the inner ear is a pathognomonic finding of a stapes footplate cyst. It is most commonly found in common cavity anomaly (18.2%); the second most frequent finding is incomplete partition type I (15%). And it can even be seen in cases of cochlear aplasia where only the vestibule is present. Conclusion If the history reveals recurrent meningitis, particular attention should be given to the oval window area, where an opacity, cyst or a leaking lesion should be looked for on the imaging. It is the responsibility of the otolaryngologist to notice these findings, and to operate on the patient to prevent further attacks of meningitis.
Collapse
Affiliation(s)
- Levent Sennaroğlu
- Department of Otolaryngology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
29
|
Imaging of inner ear malformations: a primer for radiologists. Radiol Med 2021; 126:1282-1295. [PMID: 34196909 PMCID: PMC8520521 DOI: 10.1007/s11547-021-01387-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/15/2021] [Indexed: 01/19/2023]
Abstract
In the multidisciplinary management of patients with inner ear malformations (IEMs), the correct diagnosis makes the differences in terms of clinical and surgical treatment. The complex anatomical landscape of the inner ear, comprising several small structures, makes imaging of this region particularly challenging for general radiologists. Imaging techniques are important for identifying the presence and defining the type of IEM and the cochlear nerve condition. High-resolution magnetic resonance imaging (MRI) sequences and high-resolution computed tomography (HRCT) are the mainstay imaging techniques in this area. Dedicated MRI and HRCT protocols play an important role in the diagnosis and treatment of patients with inner ear disease. The most suitable technique should be selected depending on the clinical setting. However, in cases of congenital malformation of the inner ear, these techniques should be considered complementary. Since prompt intervention has a positive impact on the treatment outcomes, early diagnosis of IEMs is very important in the management of deaf patients. This article reviews the key concepts of IEMs for clinical radiologists by focusing on recent literature updates, discusses the principal imaging findings and clinical implications for every IEM subgroup, thus providing a practical diagnostic approach.
Collapse
|
30
|
Lee SY, Choi BY. Potential Implications of Slim Modiolar Electrodes for Severely Malformed Cochleae: A Comparison With the Straight Array With Circumferential Electrodes. Clin Exp Otorhinolaryngol 2021; 14:287-294. [PMID: 34098628 PMCID: PMC8373838 DOI: 10.21053/ceo.2021.00752] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/06/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives Malformations of the inner ear account for approximately 20% of cases of congenital deafness. In current practice, straight arrays with circumferential electrodes (i.e., full-banded electrodes) are widely used in severely malformed cochleae. However, the unpredictability of the location of residual spiral ganglion neurons in such malformations argues against obligatorily using full-banded electrodes in all cases. Here, we present our experience of electrically evoked compound action potential (ECAP) and radiography-based selection of an appropriate electrode for severely malformed cochleae. Methods Three patients with severely malformed cochleae, showing cochlear hypoplasia type II (CH-II), incomplete partition type I (IP-I), and cochlear aplasia with a dilated vestibule (CADV), respectively, were included, and the cochlear nerve deficiency (CND) was evaluated. A full-banded electrode (CI24RE(ST)) and slim modiolar electrode (CI632) were alternately inserted to compare ECAP responses and electrode position. Results In patient 1 (CH-II with CND), who had initially undergone cochlear implantation (CI) using a lateral wall electrode (CI422), revision CI was performed due to incomplete insertion of CI422 and resultant unsatisfactory performance by explanting the CI422 and re-inserting the CI24RE(ST) and CI632 sequentially. Although both electrodes elicited reliable ECAP responses with correct positioning, CI24RE(ST) showed overall lower ECAP thresholds compared to CI632; thus, CI24RE(ST) was selected. In patient 2 (IP-I with CND), CI632 elicited superior ECAP responses relative to CI24RE(ST), with correct positioning of the electrode; CI632 was chosen. In patient 3 (CADV), CI632 did not elicit an ECAP response, while meaningful ECAP responses were obtained with the CI24RE(ST) array once correct positioning was achieved. All patients’ auditory performance markedly improved postoperatively. Conclusion The ECAP and radiography-based strategy to identify an appropriate electrode may be useful for severely malformed cochleae, leading to enhanced functional outcomes. The practice of sticking to full-banded straight electrodes may not always be optimal for IP-I and CH-II.
Collapse
Affiliation(s)
- Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
31
|
Ertugrul G, Sennaroglu G, Sennaroglu L. Postural Control in Subjects with Incomplete Partition Inner Ear Malformations: A Comparison of Incomplete Partition Types. ORL J Otorhinolaryngol Relat Spec 2021; 84:47-54. [PMID: 34098563 DOI: 10.1159/000515873] [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] [Received: 01/05/2021] [Accepted: 03/13/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Children with inner ear malformation (IEM) are at risk of vestibular loss as well as hearing loss. Incomplete partition (IP) anomalies constitute about 41% of all IEMs. This study aimed to investigate the postural control in subjects with the same type of IP on both sides and to compare their results with cochlear implant (CI) users without IEM and healthy peers. METHODS The study group consists of 17 subjects with the same IP types on both sides and using auditory implants on at least one side, with the following 3 groups: 6 IP-I subjects (mean age 12.28 ± 6.25), 6 IP-II subjects (mean age 12.90 ± 3.23), and 5 IP-III subjects (mean age 6.98 ± 3.10). Six unilateral CI users (mean age 11.38 ± 3.57) with normal inner ear structures were included in the CI control group, and 6 healthy peers (10.20 ± 4.79) were included in the healthy control group. The postural control was measured using the Bruininks-Oseretsky Test of Motor Proficiency Second Edition (BOT-2) balance subtest. All devices were turned off during the balance test. RESULTS The BOT-2 balance scale scores were observed to be significantly different between the IP-I and healthy control group (medians of balance scores being 3.00 and 16.00, respectively, p < 0.001) and the IP-III and healthy control group (medians of balance scores being 6.60 and 16.00, respectively, p = 0.04). The IP-II group had better balance scores (median = 8.00) than those of the other IP groups, although there were no significant differences between the IP-II and other groups (p > 0.05). CONCLUSION This study demonstrated that subjects with the same IP type on both sides and with early implantation may differ in terms of their postural control abilities depending on their IP type. Subjects with IP should be regularly followed up by the vestibular assessment and supported by their postural control ability by vestibular rehabilitation.
Collapse
Affiliation(s)
- Gorkem Ertugrul
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Gonca Sennaroglu
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Levent Sennaroglu
- Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
32
|
Halawani RT, Dhanasingh A. New Classification of Cochlear Hypoplasia Type Malformation: Relevance in Cochlear Implantation. J Int Adv Otol 2021; 16:153-157. [PMID: 32784151 DOI: 10.5152/iao.2020.7690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES This paper attempts to create a new classification type of cochlear hypoplasia (CH)-type malformation taking into consideration of vestibular section and internal auditory canal (IAC). MATERIALS AND METHODS Preoperative computed-tomography (CT) scans of cochlear implant (CI) candidates (N=31) from various clinics across the world with CH type malformation were taken for analysis. CT dataset were loaded into 3D-slicer freeware for three-dimensional (3D) segmentation of the inner-ear by capturing complete inner-ear structures from the entire dataset. Cochlear size in terms of diameter of available cochlear basal turn and length of cochlear lumen was measured from the dataset. In addition, structural connection between IAC and cochlear portions was scrutinized, which is highly relevant to the proposed CH classification in this study. RESULTS CH group-I has the normal presence of IAC leading to cochlear and vestibular portions, whereas CH group-II is like CH group-I but with some degree of disruption in vestibular portion. In CH group-III, a disconnection between IAC and the cochlear portion irrespective of other features. Within all these three CH groups, the basal turn diameter varied between 3.1 mm and 9.6 mm, and the corresponding cochlear lumen length varied between 3 mm and 21 mm for the CI electrode array placement. CONCLUSION A new classification of CH mainly based on the IAC connecting the cochlear and vestibular portions is presented in this study. CI electrode array length could be selected based on the length of the cochlear lumen, which can be observed from the 3D image.
Collapse
Affiliation(s)
- Roa Talal Halawani
- Ohud General Hospital, Ministry of Health, AL Medina, Kingdom of Saudi Arabia
| | | |
Collapse
|
33
|
da Costa Monsanto R, Knoll RM, de Oliveira Penido N, Song G, Santos F, Paparella MM, Cureoglu S. Otopathologic Abnormalities in CHARGE Syndrome. Otolaryngol Head Neck Surg 2021; 166:363-372. [PMID: 33874787 DOI: 10.1177/01945998211008911] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To perform an otopathologic analysis of temporal bones (TBs) with CHARGE syndrome. STUDY DESIGN Otopathologic study of human TB specimens. SETTING Otopathology laboratories. METHODS From the otopathology laboratories at the University of Minnesota and Massachusetts Eye and Ear Infirmary, we selected TBs from donors with CHARGE syndrome. These TBs were serially sectioned at a thickness of 20 µm, and every 10th section was stained with hematoxylin and eosin. We performed otopathologic analyses of the external ear, middle ear (middle ear cleft, mucosal lining, ossicles, mastoid, and facial nerve), and inner ear (cochlea, vestibule, internal auditory canal, and cochlear and vestibular nerves). The gathered data were statistically analyzed. RESULTS Our study included 12 TBs from 6 donors. We found a high prevalence of abnormalities affecting the ears. The most frequent findings were stapes malformation (100%), aberrant course of the facial nerve (100%) with narrow facial recess (50%), sclerotic and hypodeveloped mastoids (50%), cochlear (100%) and vestibular (83.3%) hypoplasia with aplasia of the semicircular canals, hypoplasia and aplasia of the cochlear (66.6%) and vestibular (91.6%) nerves, and narrowing of the bony canal of the cochlear nerve (66.6%). The number of spiral ganglion and Scarpa's ganglion neurons were decreased in all specimens (versus normative data). CONCLUSIONS In our study, CHARGE syndrome was associated with multiple TB abnormalities that may severely affect audiovestibular function and rehabilitation.
Collapse
Affiliation(s)
- Rafael da Costa Monsanto
- Department of Otolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil.,Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Renata Malimpensa Knoll
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary / Harvard Medical School, Boston, Massachusetts, USA
| | - Norma de Oliveira Penido
- Department of Otolaryngology-Head and Neck Surgery, Universidade Federal de São Paulo / Escola Paulista de Medicina, São Paulo, Brazil
| | - Grace Song
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Felipe Santos
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary / Harvard Medical School, Boston, Massachusetts, USA
| | - Michael Mauro Paparella
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sebahattin Cureoglu
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
34
|
Radiological measurement of cochlear dimensions in cochlear hypoplasia and its effect on cochlear implant selection. The Journal of Laryngology & Otology 2021; 135:501-507. [PMID: 33843508 DOI: 10.1017/s0022215121000979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine the effect of cochlear dimensions on cochlear implant selection in cochlear hypoplasia patients. METHODS Temporal bone computed tomography images of 36 patients diagnosed with cochlear hypoplasia between 2010 and 2016 were retrospectively reviewed and compared with those of 40 controls without sensorineural hearing loss. RESULTS Basal turn length and mid-modiolar height were significantly lower in the cochlear hypoplasia patients with subtypes I, II and III than in the control group (p < 0.001). Mid-scalar length was significantly shorter in subtype I-III patients as compared with the control group (p < 0.001). In addition, cochlear canal length (measured along the lateral wall) was significantly shorter in subtype I-IV patients than in the control group (subtypes I-III, p < 0.001; subtype IV, p = 0.002). CONCLUSION Cochlear hypoplasia should be considered if basal turn length is less than 7.5 mm and mid-modiolar height is less than 3.42 mm. The cochlear implant should be selected according to cochlear hypoplasia subgroup. It is critically important to differentiate subtype II from incomplete partition type I and subtype III from a normal cochlea, to ensure the most appropriate implant electrode selection so as to optimise cochlear implantation outcomes.
Collapse
|
35
|
Sennaroglu L. Response to letter regarding 'Another evidence for pressure transfer mechanism in incomplete partition two anomaly via enlarged vestibular aqueduct'. Cochlear Implants Int 2021; 22:183-185. [PMID: 33722176 DOI: 10.1080/14670100.2020.1834231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Levent Sennaroglu
- Department of Otolaryngology, Hacettepe University Medical Faculty, Ankara, Turkey
| |
Collapse
|
36
|
Cochlear implantation in children with Mondini dysplasia: our experience. The Journal of Laryngology & Otology 2021; 135:125-129. [PMID: 33568241 DOI: 10.1017/s0022215121000372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study details the intra-operative complications, and compares auditory scales post-implantation of either profoundly deaf young children with radiologically normal inner ears (group A) or children with Mondini dysplasia (group B). METHODS A retrospective survey was carried out of 338 patients with severe to profound sensorineural hearing loss who underwent cochlear implant surgery from February 2015 to May 2017. Patients were divided into 2 groups of 27 patients each. Both groups were followed up to three years post-implantation. RESULTS Cerebrospinal fluid ooze developed in 12 patients, and 2 patients had a cerebrospinal fluid 'gusher', one of which had to be explored within 24 hours. After implant use for one year, both groups had similar speech perception scores. CONCLUSION The cerebrospinal fluid gusher in Mondini dysplasia should be anticipated and adequately managed intra-operatively. This study highlights the tailoring of a post-implantation rehabilitation programme according to individual needs.
Collapse
|
37
|
Sennaroglu L, Bajin MD. Management of stapes footplate fistula in inner ear malformations. Int J Pediatr Otorhinolaryngol 2021; 140:110525. [PMID: 33264678 DOI: 10.1016/j.ijporl.2020.110525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Certain inner ear malformations have stapes footplate fistula which may cause meningitis during otitis media. This may result in fatality. It is the responsibility of the otolaryngologist to diagnose and treat the condition to prevent further attacks of meningitis. MATERIALS AND METHODS Surgical findings of the 17 patients who have inner ear malformations with oval window fistula were retrospectively analyzed. Inner ear malformations were classified according to Sennaroglu classification. Different stages of stapes footplate fistula are classified. FINDINGS Seventeen patients had spontaneous stapes footplate fistula at the oval window. No patient had spontaneous leakage at the round window site. Proper sealing of the leakage area with fascia in a dumbbell fashion is mandatory. Keeping the stapes in place and lumbar drainage are the two most important factors in the successful management of fistula. Particularly important is the simultaneous fistula repair and cochlear implantation where combined postauricular-transcanal approach provides the best method. Vaccination is important but not sufficient to prevent meningitis in inner ear malformations unless repair of the fistula is performed. CONCLUSION If the patient has a history of meningitis in the presence of inner ear malformation, particular attention should be given to oval window area to look for an opacity, cyst or a leaking lesion at the stapes footplate. Immediate surgical exploration and repair of the leak is mandatory to prevent further attacks of meningitis. Surgeon should not leave the operation without fully controlling the leak.
Collapse
Affiliation(s)
- Levent Sennaroglu
- Department of Otolaryngology, Hacettepe University Medical Faculty, Turkey.
| | - Munir Demir Bajin
- Department of Otolaryngology, Hacettepe University Medical Faculty, Turkey
| |
Collapse
|
38
|
Tran L, Duong V, Lokman S. Inner ear malformations in cochlear implant recipients. INDIAN JOURNAL OF OTOLOGY 2021. [DOI: 10.4103/indianjotol.indianjotol_194_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
39
|
Talenti G, Robson C, Severino MS, Alves CA, Chitayat D, Dahmoush H, Smith L, Muntoni F, Blaser SI, D'Arco F. Characteristic Cochlear Hypoplasia in Patients with Walker-Warburg Syndrome: A Radiologic Study of the Inner Ear in α-Dystroglycan-Related Muscular Disorders. AJNR Am J Neuroradiol 2021; 42:167-172. [PMID: 33122211 PMCID: PMC7814787 DOI: 10.3174/ajnr.a6858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/16/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Walker-Warburg syndrome, muscle-eye-brain disease, and Fukuyama congenital muscular dystrophy are α-dystroglycan-related muscular disorders associated with brain malformations and eye abnormalities in which no structural inner ear abnormality has been described radiologically. We collected patients from 6 tertiary pediatric hospitals and reported the radiologic features and frequency of inner ear dysplasias. MATERIALS AND METHODS Patients previously diagnosed clinicoradiologically with Walker-Warburg syndrome, muscle-eye-brain disease, or Fukuyama congenital muscular dystrophy were included. We recorded the pathogenic variant, when available. Brain MR imaging and/or CT findings were reviewed in consensus, and inner ear anomalies were classified according to previous description in the literature. We then correlated the clinicoradiologic phenotype with the inner ear phenotype. RESULTS Thirteen patients fulfilled the criteria for the Walker-Warburg syndrome phenotype, 8 for muscle-eye-brain disease, and 3 for Fukuyama congenital muscular dystrophy. A dysplastic cochlea was demonstrated in 17/24. The most frequent finding was a pronounced cochlear hypoplasia type 4 with a very small anteriorly offset turn beyond the normal-appearing basal turn (12/13 patients with Walker-Warburg syndrome and 1/11 with muscle-eye-brain disease or Fukuyama congenital muscular dystophy). Two of 8 patients with muscle-eye-brain disease, 1/3 with Fukuyama congenital muscular dystrophy, and 1/13 with Walker-Warburg syndrome showed a less severe cochlear hypoplasia type 4. The remaining patients without Walker-Warburg syndrome were healthy. The vestibule and lateral semicircular canals of all patients were normal. Cranial nerve VIII was present in all patients with diagnostic MR imaging. CONCLUSIONS Most patients with the severe α-dystroglycanopathy Walker-Warburg syndrome phenotype have a highly characteristic cochlear hypoplasia type 4. Patients with the milder variants, muscle-eye-brain disease and Fukuyama congenital muscular dystrophy, more frequently have a normal cochlea or milder forms of hypoplasia.
Collapse
Affiliation(s)
- G Talenti
- From the Department of Diagnostics and Pathology (G.T.), Neuroradiology Unit, Verona University Hospital, Verona, Italy
| | - C Robson
- Division of Neuroradiology (C.R.), Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - M S Severino
- Neuroradiology Unit (M.S.S.), Istituti di Ricovero e Cura a Carattere Scientifico, Istituto Giannina Gaslini, Genova, Italy
| | - C A Alves
- Departments of Radiology and Division of Neuroradiology (C.A.A.), Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - D Chitayat
- The Prenatal Diagnosis and Medical Genetics Program (D.C.), Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - H Dahmoush
- Department of Radiology (H.D.), Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California
| | - L Smith
- Dental and Maxillofacial Surgery Department (L.S.), Great Ormond Street Hospital, London, UK
| | - F Muntoni
- Dubowitz Neuromuscular Centre (F.M.), UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - S I Blaser
- Division of Neuroradiology (S.I.B.), Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - F D'Arco
- Neuroradiology Unit (F.D.), Department of Radiology, Great Ormond Street Hospital for Children, National Health Service Trust, London, UK felice.d'
| |
Collapse
|
40
|
Ertugrul G, Sennaroglu G, Karakaya J, Sennaroglu L. Postural instability in children with severe inner ear malformations: Characteristics of vestibular and balance function. Int J Audiol 2020; 60:115-122. [PMID: 32885696 DOI: 10.1080/14992027.2020.1808250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the postural instability and vestibular functions in children with severe inner ear malformations (IEMs). DESIGN A prospective case-control study. STUDY SAMPLE The study group consisted of 10 children using unilateral auditory brainstem implant (ABI) with labyrinthine aplasia or rudimentary otocyst. The age-matched control groups consisted of 10 unilateral cochlear implant (CI) users with normal inner ear structures and 10 healthy peers. All tests were performed to implant users when the implants were off. RESULTS All median VOR gains in the ABI group (median anterior, lateral, and posterior canal 0.15, 0.05, and 0.05, respectively, for the non-implanted sides) were significantly lower than those of the control groups (median VOR gains ≥ 0.90 in both control groups). There were no oVEMP and cVEMP responses in the study group. The mean BOT-2 balance scores of the ABI (3.70 ± 1.34) group was dramatically lower than those of the CI (9.40 ± 2.88) and healthy control (16.20 ± 4.16, p < 0.001). CONCLUSIONS The postural instability in children with severe IEMs was higher than those in CI users with normal inner ear structures and healthy peers. The level of deficiency in the labyrinthine was more important for postural stability in children.
Collapse
Affiliation(s)
- Gorkem Ertugrul
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Gonca Sennaroglu
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Levent Sennaroglu
- Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
41
|
Hong R, Du Q, Pan Y. New Imaging Findings of Incomplete Partition Type III Inner Ear Malformation and Literature Review. AJNR Am J Neuroradiol 2020; 41:1076-1080. [PMID: 32467182 DOI: 10.3174/ajnr.a6576] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 04/04/2020] [Indexed: 11/07/2022]
Abstract
Incomplete partition type III, also referred to as X-linked deafness, is a rare genetic inner ear malformation. Its characteristic CT findings, including bulbous dilation of the internal auditory canal and absence of the modiolus with the interscalar septa present, have been well-recognized. In this series of 19 cases, we report the abnormalities of the vestibule and semicircular canals and provide a comprehensive description of their CT and MR imaging findings. The inner ear malformations in incomplete partition type III were bilateral and basically symmetric, with involvement of the internal auditory canal, nerve canals in the fundus, cochlea, vestibule, semicircular canals, vestibular aqueduct, otic capsule, round window, oval window, and stapes. An irregular vestibule with a cystic appearance is also a distinctive imaging feature, which could be seen in about 90% of our patients, with a cystic appearance of the semicircular canals present in nearly half of the cases.
Collapse
Affiliation(s)
- R Hong
- From the Departments of Radiology (R.H., Y.P.)
| | - Q Du
- Otolaryngology-Head and Neck Surgery (Q.D.), Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China
| | - Y Pan
- From the Departments of Radiology (R.H., Y.P.)
| |
Collapse
|
42
|
Irregular Contour of Inner Ear Structures and Hypomineralized Areas at Otic Capsule: Are They Other Additional Imaging Findings of Incomplete Partition-III? J Comput Assist Tomogr 2020; 44:386-388. [PMID: 32168082 DOI: 10.1097/rct.0000000000000991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Incomplete partition III (IP-III) characterized by congenital mixed or sensorineural hearing loss is a rare genetic disease transmitted through X-linked inheritance. Incomplete partition III can be easily achieved based on pathognomonic computed tomography findings. The aims of this study were to investigate the otic capsule abnormalities in IP-III and to report irregular contour of membranous labyrinth and hypomineralized areas at otic capsule, which have not previously been described. MATERIALS AND METHODS The otic capsule features of 10 subjects (8 affected patients, 1 of whom is a female; 2 carrier mothers), who were diagnosed on clinical and typical radiologic findings, were analyzed. RESULTS All patients had typical IP-III as described in the literature. Seven of 10 patients had irregular contour. Seven of 10 patients demonstrated hypomineralized areas, which were very hypodense to normally develop otic capsule areas. One affected patients and 2 carrier mothers had a normal-looking membranous labyrinth contour and normal mineralization at otic capsule. CONCLUSIONS We report for the first time the irregular contour of inner ear structures and hypodense otic capsule areas in patients with IP-III. We think that though speculative, abnormal development of the inner endosteal layer results in irregular contour of inner ear structures. Hypomineralized areas at otic capsule could be explained by abnormal development of middle enchondral layer due to reduced or absent vascular supply from middle ear mucosa during fetal life. These findings may be accepted as additional criteria of IP-III.
Collapse
|
43
|
Sennaroğlu L, Tahir E. A Novel Classification: Anomalous Routes of the Facial Nerve in Relation to Inner Ear Malformations. Laryngoscope 2020; 130:E696-E703. [PMID: 32134124 DOI: 10.1002/lary.28596] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES/HYPOTHESIS The objective of this study was to classify anomalous facial nerve (FN) routes and to determine their association with inner ear malformations (IEMs). STUDY DESIGN Retrospective cross sectional study. METHODS The computed tomography images of 519 patients (796 ears) with IEMs were retrospectively evaluated, and the abnormal routes of the FN were classified as: Meatal segment: type 1, normal internal auditory canal (IAC); type 2, narrow IAC; type 3, facial canal (FC) only; type 4: separate FC/duplicated IAC. Labyrinthine segment (LS): type 1, normal; type 2a/b/c, mild/moderate/severe anterior displacement; type 3, superior displacement; type 4: straight LS. Tympanic segment (TS): type 1, normal; type 2, superiorly displaced TS; type 3, TS at the oval window; type 4: TS inferior to the oval window; type 5: unclassified. Mastoid segment: type 1, normal facial recess (FR)/normal mastoid segment; type 2: narrow FR; type 3, unclassified. RESULTS In meatal segment classification, a narrow IAC was common in ears with cochlear hypoplasia (CH) (76.1%), and only FC was common in ears with severe IEMs (62.7%) such as Michel deformity, common cavity, and cochlear aplasia. Incomplete partition-III has its unique superiorly displaced LS (100%). CH-IV also has its unique mild anterosuperior displacement. Ears with a superiorly displaced TS usually (93.1%) had aplastic or hypoplastic semicircular canals. The FR is likely to be narrow in CH and severe IEMs. CONCLUSIONS The FN route is affected in IEMs, which must be kept in mind when operating on ears with IEMs. Especially in CH cases, all segments of the FN can be abnormal. LEVEL OF EVIDENCE 4 Laryngoscope, 130:E696-E703, 2020.
Collapse
Affiliation(s)
- Levent Sennaroğlu
- Department of Otolaryngology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Emel Tahir
- Department of Otolaryngology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| |
Collapse
|
44
|
D'Arco F, Sanverdi E, O'Brien WT, Taranath A, Talenti G, Blaser SI. The link between inner ear malformations and the rest of the body: what we know so far about genetic, imaging and histology. Neuroradiology 2020; 62:539-544. [PMID: 32125475 DOI: 10.1007/s00234-020-02382-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/17/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK.
| | - Eser Sanverdi
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - William T O'Brien
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Ajay Taranath
- Department of Radiology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Giacomo Talenti
- Department of Diagnostics and Pathology, Neuroradiology Unit, Verona University Hospital, Verona, Italy
| | - Susan I Blaser
- Division of Neuroradiology, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
45
|
The Natural History of Hearing Loss in Pendred Syndrome and Non-Syndromic Enlarged Vestibular Aqueduct. Otol Neurotol 2020; 40:e178-e185. [PMID: 30741891 DOI: 10.1097/mao.0000000000002140] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The aim was to investigate the progress of hearing loss over time in a cohort of pendred syndrome and non-syndromic enlarged vestibular aqueduct (PS/NSEVA) with one or two confirmed pathogenic variations in SLC26A4. STUDY DESIGN Retrospective cohort study. SUBJECTS AND METHODS At our tertiary referral center, a retrospective search of all patients with enlarged vestibular aqueduct, hearing loss and SLC26A4 mutations yielded 103 individuals by March 2017, 96 of whom had records of hearing levels; both an early audiometry and the latest between 3 and 668 months follow-up. Pure-tone average (PTA; average of thresholds at 0.5, 1, 2 and 4 kHz) was calculated for both ears at time 1 and time 2. Neonatal screening results were retrieved. RESULTS Eighty-seven (87) individuals had biallelic (M2) and 16 had monoallelic alterations (M1) in their SLC26A4. On average, the PTA progressed to 80 dB HL by the age of 6 years for the entire cohort, and 3.2 years for the biallelic (M2) affected individuals. 25% of the cohort was screened in the neonatal screening program; of these 42% had "passed" at least monaurally. Audiometric profiles related to age show faster deterioration in high frequencies than in low frequencies. CONCLUSION In patients with PS/NSEVA and SLC26A4 mutations, the average hearing loss progresses to 80 dB HL by the age of 6 years. For biallelic (M2) affected individuals it was 3.2 years. Although hearing levels reached severe to profound during childhood, almost 1/2 had passed neonatal hearing screening, at least monaurally, emphasizing the need for close follow-up.
Collapse
|
46
|
Vaid S, Vaid N, Kiran AS. Deossification of the Otic Bone in High Pressure CSF Otorhinorrhea: A New Radiological Finding. Indian J Otolaryngol Head Neck Surg 2020; 72:385-391. [PMID: 32728551 DOI: 10.1007/s12070-019-01777-w] [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] [Received: 11/22/2019] [Accepted: 12/24/2019] [Indexed: 10/25/2022] Open
Abstract
To highlight a new radiological feature in a patient with labyrinthine malformation presenting with bilateral spontaneous high pressure cerebrospinal fluid (CSF) otorhinorrhea. Study design-retrospective case review. Setting-academic, tertiary cochlear implant center. A cochlear implantee with Incomplete Partition Defect (Type 1) presented with meningitis and CSF otorhinorrhea for which she initially underwent medical treatment. High resolution computed tomography (HRCT) of the temporal bone with CT cisternography was performed for identifying the site of the CSF leak. HRCT and CT cisternography revealed a defect in the region of the stapes foot plate and marked thinning/deossification of the cochlear promontory. These two findings were absent in the pre-implant imaging of the patient done 3 years ago. Surgery by endaural approach was undertaken to close the site of CSF leak. Intraoperatively, marked thinning of the cochlear promontory was observed, corresponding to 'blue lining' of the labyrinth in otologic surgery. This intraoperative finding indicating high intralabyrinthine CSF pressure correlated well with the imaging findings. Primary surgical repair resulted in successful CSF leak closure followed by theco-peritoneal shunting to prevent recurrence of the leak. The patient is using her cochlear implant and doing well with auditory verbal therapy. She is asymptomatic till date. Thinning and deossification of the otic capsule on HRCT is an important indicator of high CSF pressure in patients with labyrinthine malformations. Our case study highlights the need for heightened radiological and clinical vigilance in this subgroup of patients to predict complications and ensure prompt intervention.
Collapse
Affiliation(s)
- Sanjay Vaid
- Division of Head and Neck Imaging, Star Imaging and Research Centre, Pune, India.,Pune, Maharashtra 411007 India
| | - Neelam Vaid
- Department of Otorhinolaryngology, K.E.M. Hospital, Pune, India
| | | |
Collapse
|
47
|
Kaga K, Minami S, Enomoto C. Electrically evoked ABR during cochlear implantation and postoperative development of speech and hearing abilities in infants with common cavity deformity as a type of inner ear malformation. Acta Otolaryngol 2020; 140:14-21. [PMID: 31762359 DOI: 10.1080/00016489.2019.1692147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: The electrically evoked auditory brainstem response (eABR) during cochlear implantation in common cavity (CC) deformity has not been clinically well studied.Aim/Objective: To investigate the eABR wave configuration during cochlear implantation, the postoperative development of hearing, and educational settings in infants with CC deformity.Materials and Methods: Nine infants who were congenitally deaf and found to have CC deformity and suspected cochlear nerve deficiency by temporal bone CT and MRI were studied. All of them underwent sequential and unilateral cochlear implantation and their eABRs were recorded during the surgery. The postoperative development was followed up.Results: eABRs of all the nine infants with CC deformity showed that the mean peak of the evoked wave V (eV) was the same as that in controls at latencies but was twofold higher than that in controls at thresholds and their postoperative hearing thresholds improved markedly.Conclusion and Significance: The brainstem auditory pathways of the infants were considered intact on the basis of the eV peak latencies in the eABRs. The postoperative development of their speech and hearing abilities and their educational settings varied, probably because of the twofold higher thresholds of their eABRs and limited number of auditory neural units.
Collapse
Affiliation(s)
- Kimitaka Kaga
- National Tokyo Medical Center, National Institute of Sensory Organs, Tokyo, Japan
- Kamio Memorial Hospital, Tokyo, Japan
| | - Shujiro Minami
- Department of Otolaryngology, National Tokyo Medical Center, Tokyo, Japan
| | - Chieko Enomoto
- Department of Otolaryngology, National Tokyo Medical Center, Tokyo, Japan
| |
Collapse
|
48
|
Zhang L, Wang J, Zhao F, Li Y. Inner ear pressure evaluation using wideband tympanometry in children with Large Vestibular Aqueduct Syndrome (LVAS): A pilot study. Int J Pediatr Otorhinolaryngol 2020; 128:109690. [PMID: 31678622 DOI: 10.1016/j.ijporl.2019.109690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 09/14/2019] [Accepted: 09/18/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate middle ear function in children with Large Vestibular Aqueduct Syndrome (LVAS) to explore the feasibility of measuring inner ear pressure using Wideband tympanometry (WBT). METHODS 13 young children with LVAS were recruited. WBT and other audiological measurements i.e., Auditory Steady State Response (ASSR), Auditory Brain Stem Response (ABR), and Distorted Product Otoacoustic Emissions (DPOAE) were performed. Absorbance under ambient and peak pressure were compared with normative data, and analyzed using a one sample t-test. RESULTS Average absorbance in children with LVAS was significantly lower than normative data under ambient pressure at 1000, 1189, 1296, 2000 Hz and 4000 Hz. Absorbance under peak pressure was also significantly lower at 707, 794, 917, 1000, 1189, 1297, 1498 and 2000 Hz. However, absorbance was higher than standard values above 4000 Hz under ambient and peak pressure. It was also higher under ambient pressure at frequencies below 500 Hz. CONCLUSION The special characteristics of middle ear function found in children with Large Vestibular Aqueduct Syndrome (LVAS) indicate that WBT offers a sensitive and non-invasive method to evaluate inner ear pressure indirectly.
Collapse
Affiliation(s)
- Lifang Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Jie Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China; Beijing Engineering Research Center of Audiology Technology, Beijing, 100730, China
| | - Fei Zhao
- Centre for SLT and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, CF5 2YB, Wales, UK; Department of Hearing-Speech Sciences, Sun Yat-sen University, Guangzhou, 510520, China
| | - Yongxin Li
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
| |
Collapse
|
49
|
D'Arco F, Youssef A, Ioannidou E, Bisdas S, Pinelli L, Caro-Dominguez P, Nash R, Siddiqui A, Talenti G. Temporal bone and intracranial abnormalities in syndromic causes of hearing loss: an updated guide. Eur J Radiol 2019; 123:108803. [PMID: 31891841 DOI: 10.1016/j.ejrad.2019.108803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/11/2019] [Accepted: 12/15/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe in detail the temporal bone and brain findings in both common and rare syndromic causes of hearing loss, with the purpose of broadening among radiologists and enhance the current understanding of distinct imaging features in paediatric patients with syndromic hearing loss. METHODS A detailed search of electronic databases has been conducted, including PubMed, Ovid Medline, Scopus, Cochrane Library, Google Scholar, National Institute for Health and Care Excellence (NICE), Embase, and PsycINFO. RESULTS Syndromic causes of hearing loss are characterised by different and sometimes specific abnormalities in the temporal bone. CONCLUSION A complete knowledge of the image findings in the temporal bones, brain, skull and other body regions is critical for the optimal assessment and management of these patients.
Collapse
Affiliation(s)
- Felice D'Arco
- Department of Neuroradiology, Great Ormond Street Hospital for Children, London, UK
| | - Adam Youssef
- Department of Neuroradiology, Great Ormond Street Hospital for Children, London, UK
| | | | - Sotirios Bisdas
- Department of Neuroradiology, University College of London, London, UK
| | - Lorenzo Pinelli
- Neuroradiology Unit, Spedali Civili Di Brescia, Brescia, Italy
| | | | - Robert Nash
- Ear, Nose and Throat Surgery Department, Great Ormond Street Hospital for Children, London, UK
| | - Ata Siddiqui
- Department of Neuroradiology,Guy's and St.Thomas Hospital, London, UK
| | - Giacomo Talenti
- Neuroradiology Unit, Department of Diagnostics and Pathology, Verona University Hospital, Verona, Italy.
| |
Collapse
|
50
|
Mey K, Muhamad AA, Tranebjaerg L, Rendtorff ND, Rasmussen SH, Bille M, Cayé-Thomasen P. Association of SLC26A4 mutations, morphology, and hearing in pendred syndrome and NSEVA. Laryngoscope 2019; 129:2574-2579. [PMID: 31633822 DOI: 10.1002/lary.27319] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/07/2018] [Accepted: 05/03/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate the relations of monoallelic (M1), biallelic (M2), or the absence of mutations (M0) in SLC26A4 to inner ear morphology and hearing levels in individuals with Pendred syndrome (PS) or nonsyndromic enlarged vestibular aqueduct (NSEVA) associated with hearing loss. METHODS In a cohort of 139 PS/NSEVA individuals, 115 persons from 95 unrelated families had full genetic sequencing of SLC26A4, and 113 had retrievable images for re-assessment of inner ear morphology. The association between the number of mutant alleles in SLC26A4, inner ear morphology (including endolymphatic sac size and protein content on magnetic resonance imaging), and hearing level (pure tone average) was explored. RESULTS Biallelic SLC26A4 mutations (M2) occurred in three-quarters of the cohort and was invariably associated with poor hearing; in 87%, it was associated with incomplete partition type II of the cochlea as well as enlarged endolymphatic sac and vestibular aqueduct. M1 or M0 individuals exhibited a greater variability in inner ear morphology. Endolymphatic sac size and presence of "high-protein" sac contents were significantly higher in M2 individuals compared to M1 and M0 individuals. CONCLUSION The number of SLC26A4 mutations is associated with severity and variability of inner ear morphology and hearing level in individuals with PS or NSEVA. M2 individuals have poorer hearing and present largely incomplete partition type II of the cochleas with enlarged endolymphatic sacs, whereas individuals with M1 and no detectable SLC26A4 mutations have less severe hearing loss and more diverse inner ear morphology. LEVEL OF EVIDENCE 4. Laryngoscope, 129:2574-2579, 2019.
Collapse
Affiliation(s)
- Kristianna Mey
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology Rigshospitalet/Gentofte, Hellerup
| | | | - Lisbeth Tranebjaerg
- the Department of Clinical Genetics, Rigshospitalet/The Kennedy Center.,the Institute of Clinical Medicine
| | - Nanna D Rendtorff
- the Department of Clinical Genetics, Rigshospitalet/The Kennedy Center
| | | | - Michael Bille
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology Rigshospitalet/Gentofte, Hellerup
| | - Per Cayé-Thomasen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology Rigshospitalet/Gentofte, Hellerup.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|