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Buschle M, Hamerschmidt R, Matias JEF, Zanini OPL, Coelho LODM, Polanski JF. The Role of Computed Tomography in the Diagnosis of Congenital Sensorineural Hearing Loss. Int Arch Otorhinolaryngol 2024; 28:e387-e393. [PMID: 38974624 PMCID: PMC11226303 DOI: 10.1055/s-0044-1786827] [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: 01/25/2023] [Accepted: 07/30/2023] [Indexed: 07/09/2024] Open
Abstract
Introduction One of the paths in the investigation of congenital sensorineural hearing loss (CSNHL) is to try to characterize its etiology through the inner ear evaluation using high resolution computer tomography (CT) scans. With minor malformation, it is not always possible for a simple visual inspection to recognize if the structure in the inner ear is normal or not. Objective To verify if measurements of the inner ear are predictive of sensorineural hearing loss (SNHL) and suggest cutoff points of size limits. Methods Retrospective cross-sectional study of inner ear CT scan measurements of 214 patients, 50 with congenital SNHL (CSNHL) and 164 acquired SNHL (ASNHL) (control group). Results In the CSNHL group, central bony island (CBI) were 0.48 mm smaller ( p < 0.001), cochlear nerve aperture was (CNA) 0.10 mm smaller ( p < 0.001), and cochlea height was (CH) 0.15 mm smaller ( p < 0.001). Vestibular aqueduct (VA) and cochlea width (CW) were similar between groups (0.70 vs 0.72, p = 0.19, and 7.20 vs 7.15 p = 0.23). The predictive cutoff points for CSNHL were CBI = 3.6 mm, CAN = 1.4 mm, CH = 3.4 mm, CW = 7.0 mm, and VA = 0.9 mm. Conclusion Congenital sensorineural hearing loss determined a decrease in CBI, opening of the cochlear nerve (OCN), and CW. Thus, these measures, at the cutoff points indicated, should make us aware of the diagnosis of congenital hearing loss.
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Affiliation(s)
- Mauricio Buschle
- Universidade Federal do Paraná, Curitiba, PR, Brazil
- Hospital Iguaçu, Curitiba, PR, Brazil
| | | | | | | | | | - Jose Fernando Polanski
- Universidade Federal do Paraná, Curitiba, PR, Brazil
- Faculdade Evangélica Mackenzie do Paraná, Curitiba, PR, Brazil
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Yu FF, Feltrin FS, Bathla G, Raj K, Agarwal A, Lee WC, Booth T, Singh A. Imaging Guide to Inner Ear Malformations: An Illustrative Review. Curr Probl Diagn Radiol 2023; 52:576-585. [PMID: 37500297 DOI: 10.1067/j.cpradiol.2023.06.010] [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: 12/07/2022] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/29/2023]
Abstract
Inner ear malformation (IEM) with associated sensoryneural hearing loss (SNHL) is a major cause of childhood disability. Computed tomography (CT) and magnetic resonance imaging (MRI) imaging play important and often complementary roles in diagnosing underlying structural abnormalities and surgical planning allows for direct visualization of the cochlear nerve and is the preferred imaging modality prior to cochlear implantation. CT is helpful to assess osseous anatomy and when evaluating children with mixed hearing loss or syndromic associations. When reviewing these cases, it is important for the radiologist to be familiar with the key imaging features. In this article, we will present the imaging findings associated with different inner ear malformations associated with congenital sensorineural hearing loss.
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Affiliation(s)
- Fang Frank Yu
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | | | - Girish Bathla
- Department of Radiology, University of Iowa Hospital and Clinics, Iowa City, IA
| | - Karuna Raj
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | - Amit Agarwal
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | - Wan-Ching Lee
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, TX
| | - Timothy Booth
- Department of Radiology, Children's Hospital, University of Texas Southwestern, Dallas, TX
| | - Achint Singh
- Department of Radiology, University of Texas Health Science Center at San Antonio, Dallas, TX
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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.
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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'
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Sadeghinasab S, Eftekhari Moghadam AR, Saki N, Bayat A, Saki G. Alterations in Diffusion Tensor Imaging-derived Indices of Auditory Pathway-related Fiber Tracts in Children With Sensorineural Hearing Loss. Basic Clin Neurosci 2023; 14:857-865. [PMID: 39070202 PMCID: PMC11273202 DOI: 10.32598/bcn.2023.3593.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/29/2023] [Accepted: 09/18/2023] [Indexed: 07/30/2024] Open
Abstract
Introduction Hearing loss is the most common sensory-neurological defect in humans. The most common hearing impairment is sensorineural hearing loss (SNHL) caused by the inner ear and related nerves. Diffusion tensor imaging (DTI) is an advanced MRI technique that can provide valuable information about auditory neural pathways and their microstructural changes. The present study was designed to investigate the microstructural changes in auditory pathways-related fiber tracts in children with SNHL. Methods Twenty-two children including 11 subjects with SNHL aged 1-4 years and 11 healthy children were examined as controls. Then, DTI-derived parameters, such as fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AxD), and radial diffusivity (RD), and volume of fiber tracts were extracted from the inferior longitudinal fasciculus, acoustic radiation, and uncinate fasciculus. Results The results showed an increase in MD, RD, and AxD as well as a decrease in FA, volume, and diameter of auditory-pathway-related fiber tracts. Interestingly, there was an increase in the FA of acoustic radiation. Conclusion White matter connections in the auditory canal decrease and AR integrity increases due to compensatory effects. These probably reflect atrophy or degradation as well as compensatory cross-modal reorganization in the absence of auditory input and the use of sign language. Highlights Diffusion tensor imaging (DTI) plays an important role in preoperative planning.Anatomical knowledge of the auditory tract is essential for lacrimal drainage surgeries, such as cochlear implantation.DTI-based biomarkers for brain changes and allows us to better understand the pathophysiological changes of auditory tract.Microstructural changes in the fiber tracts associated with the auditory pathway can distinguish sensorineural hearing loss (SNHL) from healthy subjects. Plain Language Summary Sensorineural hearing loss (SNHL) is the most common type and accounts for the majority of all hearing loss. SNHL is a congenital deficit and refers to any cause of hearing loss due to a pathology of the cochlea, auditory nerve, or central nervous system. One of the chief treatment planning is cochlear implant for these patients. So, it is necessary to evaluate the auditory system by imaging devices such as MRI (magnetic resonance imaging) before treatment. Diffusion tensor imaging tractography, or diffusion tensor imaging (DTI) tractography, is an MRI technique that measures the rate of water diffusion between cells to understand and create a map of the body's internal structures; it is most commonly used to provide imaging of the brain. The purpose of the present research was to assess the auditory system and its nerve routs in children before cochlear implant. This study showed that DT imaging is a novel approach for assessment of children with SNHL before and treatment.
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Affiliation(s)
- Samira Sadeghinasab
- Department of Anatomical Sciences, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Reza Eftekhari Moghadam
- Department of Anatomical Sciences, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Nader Saki
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Bayat
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Audiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ghasem Saki
- Department of Anatomical Sciences, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Lovett A, Eastwood M, Metcalfe C, Muzaffar J, Monksfield P, Bance M. Outcomes of Cochlear implantation in early-deafened patients with Waardenburg syndrome: A systematic review and narrative synthesis. Laryngoscope Investig Otolaryngol 2023; 8:1094-1107. [PMID: 37621295 PMCID: PMC10446317 DOI: 10.1002/lio2.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/23/2023] [Accepted: 06/17/2023] [Indexed: 08/26/2023] Open
Abstract
Objective This systematic review aims to establish the expected hearing and speech outcomes following cochlear implantation (CI) in patients with profound congenital deafness secondary to Waardenburg syndrome (WS). Methods A systematic review of the literature and narrative synthesis was performed in accordance with the PRISMA statement. Databases searched: Medline, Pubmed, Embase, Web of Science, Cochrane Collection, and ClinicalTrials.gov. No limits were placed on language or year of publication. Results Searches identified 186 abstracts and full texts. Of these, 16 studies met inclusion criteria reporting outcomes in 179 patients and at least 194 implants. Hearing outcomes of those receiving cochlear implantation were generally good. Five studies included genetic analysis of one or more of the participants. A total of 11 peri/post-operative complications were reported. The methodological quality of included studies was modest, mainly comprising noncontrolled case series with small cohort size. All studies were OCEBM grade III-IV. Conclusion Cochlear implantation in congenitally deafened children with Waardenburg Syndrome is a well-established intervention as a method of auditory rehabilitation. Due to the uncommon nature of the condition, there is a lack of large-scale high-quality studies examining the use of cochlear implantation in this patient group. However, overall outcomes following implantation are positive with the majority of patients demonstrating improved audiometry, speech perception and speech intelligibility supporting its use in appropriately selected cases.
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Affiliation(s)
- Amy Lovett
- Royal Stoke University HospitalStoke on TrentUK
| | | | - Chris Metcalfe
- Royal Stoke University HospitalStoke on TrentUK
- University Hospitals Birmingham NHS Foundation TrustQueen Elizabeth Hospital BirminghamEdgbastonUK
| | - Jameel Muzaffar
- University Hospitals Birmingham NHS Foundation TrustQueen Elizabeth Hospital BirminghamEdgbastonUK
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
| | - Peter Monksfield
- University Hospitals Birmingham NHS Foundation TrustQueen Elizabeth Hospital BirminghamEdgbastonUK
| | - Manohar Bance
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
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6
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Vogl TJ, Helal R. [Radiologic Imaging of Pediatric Hearing Loss]. Laryngorhinootologie 2023; 102:222-234. [PMID: 36858062 DOI: 10.1055/a-1954-7750] [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: 03/03/2023]
Abstract
Hearing loss in childhood has serious consequences for the entire development of the child. It is very important to make an accurate early diagnosis. The assessment usually includes physical, genetic, and radiological examination. In imaging diagnostics, CT, Cone Beam CT and or MRI of the petrous bone are the usual imaging modalities for the assessment of diseases of mastoid air cells, middle ear, external ear, the cochlea, the vestibulocochlear nerve, and the brain.
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Muacevic A, Adler JR, Chu TSM, Chan J. The 100 Most-Cited Manuscripts in Hearing Implants: A Bibliometrics Analysis. Cureus 2023; 15:e33711. [PMID: 36793822 PMCID: PMC9925031 DOI: 10.7759/cureus.33711] [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] [Accepted: 01/12/2023] [Indexed: 01/13/2023] Open
Abstract
The aim of the study was to characterise the most frequently cited articles on the topic of hearing implants. A systematic search was carried out using the Thomson Reuters Web of Science Core Collection database. Eligibility criteria restricted the results to primary studies and reviews published from 1970 to 2022 in English dealing primarily with hearing implants. Data including the authors, year of publication, journal, country of origin, number of citations and average number of citations per year were extracted, as well as the impact factors and five-year impact factor of journals publishing the articles. The top 100 papers were published across 23 journals and were cited 23,139 times. The most-cited and influential article describes the first use of the continuous interleaved sampling (CIS) strategy utilised in all modern cochlear implants. More than half of the studies on the list were produced by authors from the United States, and the Ear and Hearing journal had both the greatest number of articles and the greatest number of total citations. To conclude, this research serves as a guide to the most influential articles on the topic of hearing implants, although bibliometric analyses mainly focus on citations. The most-cited article was an influential description of CIS.
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Deep NL, Carlson ML, Hoxworth JM, Driscoll CLW, Lohse CM, Lane JI, Ho ML. Classifying the Large Vestibular Aqueduct: Morphometry to Audiometry. Otol Neurotol 2023; 44:47-53. [PMID: 36509439 DOI: 10.1097/mao.0000000000003748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Large vestibular aqueduct (LVA) is the most common inner ear dysplasia identified in patients with hearing loss. Our objective was to systematically quantify LVA morphologies and correlate imaging findings with established audiometric outcomes. STUDY DESIGN Retrospective review. SETTING Tertiary referral center. PATIENTS Patients with large vestibular aqueduct identified radiographically, with or without hearing loss. INTERVENTIONS Diagnostic only. MAIN OUTCOME MEASURES Vestibular aqueduct (VA) width at midpoint, width at external aperture, and length were measured on cross-sectional imaging. Morphology was classified as type I (borderline), type II (tubular), or type III (funneled). Audiometric endpoints included air/bone conduction, pure tone averages, and air-bone gaps at 250 and 500 Hz. Statistical associations were evaluated using linear regression models, adjusted for age at first audiogram and sex. RESULTS One hundred seventeen patients (197 ears) were included, with mean age at first audiogram of 22.2 years (standard deviation, 21.7 yr). Imaging features associated with poor audiometric outcomes were increasing VA width at midpoint and external aperture, decreasing VA length, dilated extraosseous endolymphatic sac, cochleovestibular malformations, and increasing VA type (III > II > I). CONCLUSIONS Quantitative LVA measurements and a standardized morphologic classification system aid in prediction of early audiometric endpoints.
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Affiliation(s)
- Nicholas L Deep
- Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Phoenix, Arizona
| | - Matthew L Carlson
- Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Joseph M Hoxworth
- Neuroradiology Division, Department of Radiology, Mayo Clinic, Phoenix, Arizona
| | - Colin L W Driscoll
- Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - John I Lane
- Neuroradiology Division, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio
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Silva VAR, Pauna HF, Lavinsky J, Hyppolito MA, Vianna MF, Leal M, Massuda ET, Hamerschmidt R, Bahmad F, Cal RV, Sampaio ALL, Felix F, Chone CT, Castilho AM. Task force Guideline of Brazilian Society of Otology ‒ hearing loss in children - Part I ‒ Evaluation. Braz J Otorhinolaryngol 2022; 89:159-189. [PMID: 36529647 PMCID: PMC9874360 DOI: 10.1016/j.bjorl.2022.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To provide an overview of the main evidence-based recommendations for the diagnosis of hearing loss in children and adolescents aged 0 to 18 years. METHODS Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on childhood hearing loss were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. RESULTS The evaluation and diagnosis of hearing loss: universal newborn hearing screening, laboratory testing, congenital infections (especially cytomegalovirus), genetic testing and main syndromes, radiologic imaging studies, vestibular assessment of children with hearing loss, auditory neuropathy spectrum disorder, autism spectrum disorder, and noise-induced hearing loss. CONCLUSIONS Every child with suspected hearing loss has the right to diagnosis and appropriate treatment if necessary. This task force considers 5 essential rights: (1) Otolaryngologist consultation; (2) Speech assessment and therapy; (3) Diagnostic tests; (4) Treatment; (5) Ophthalmologist consultation.
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Affiliation(s)
- Vagner Antonio Rodrigues Silva
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil.
| | - Henrique Furlan Pauna
- Hospital Universitário Cajuru, Departamento de Otorrinolaringologia, Curitiba, PR, Brazil
| | - Joel Lavinsky
- Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Cirurgia, Porto Alegre, RS, Brazil
| | - Miguel Angelo Hyppolito
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Melissa Ferreira Vianna
- Irmandade Santa Casa de Misericórdia de São Paulo, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Mariana Leal
- Universidade Federal de Pernambuco (UFPE), Departamento de Cirurgia, Recife, PE, Brazil
| | - Eduardo Tanaka Massuda
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Rogério Hamerschmidt
- Universidade Federal do Paraná (UFPR), Hospital de Clínicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Curitiba, PR, Brazil
| | - Fayez Bahmad
- Universidade de Brasília (UnB), Programa de Pós-Graduação em Ciências da Saúde, Brasília, DF, Brazil; Instituto Brasiliense de Otorrinolaringologia (IBO), Brasília, DF, Brazil
| | - Renato Valério Cal
- Centro Universitário do Estado do Pará (CESUPA), Departamento de Otorrinolaringologia, Belém, PA, Brazil
| | - André Luiz Lopes Sampaio
- Universidade de Brasília (UnB), Faculdade de Medicina, Laboratório de Ensino e Pesquisa em Otorrinolaringologia, Brasília, DF, Brazil
| | - Felippe Felix
- Universidade Federal do Rio de Janeiro (UFRJ), Hospital Universitário Clementino Fraga Filho (HUCFF), Departamento de Otorrinolaringologia, Rio de Janeiro, RJ, Brazil
| | - Carlos Takahiro Chone
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
| | - Arthur Menino Castilho
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Campinas, SP, Brazil
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Coutinho-Nogueira D, Coqueugniot H, Dutour O, Ben-Ncer A, Hublin JJ. Inner ear modifications in Dar-es-Soltane II H5 (Morocco): A case of labyrinthitis ossificans. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2022; 38:41-44. [PMID: 35809435 DOI: 10.1016/j.ijpp.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This paper presents the inner ear modifications in Dar-es-Soltane II H5, an Aterian fossil possibly dated to 100 ka. MATERIAL The remains consist of a large portion of the cranium including the face, the left frontal and temporal bones, part of the left parietal bone and greater wing of the sphenoid. METHODS The bony labyrinth anatomy was investigated on existing micro-CT data acquired by the MPI-EVA. RESULTS The observation of micro-CT sections revealed a partial filling of the semi-circular canals that raises question about its origin. A careful examination of the micro-CT sections shows that the elements present in the semicircular canals were denser than the sediments observed in other regions and cavities of the temporal bone. CONCLUSIONS The current evidence suggests a pathological origin of this condition with partial ossification of the membranous labyrinth. The differential diagnosis indicates a case of labyrinthitis ossificans in its early stages. SIGNIFICANCE This pathological condition can be responsible for permanent hearing loss and is associated with dizziness and vertigo. Along with the Singa skull, Dar-es-Soltane II H5 represents one of the oldest known cases of labyrinthitis ossificans. LIMITATIONS The early stage of disease and the absence of the right temporal bone limit conclusions about the degree of disability of the individual and their dependence on the rest of the group. SUGGESTIONS FOR FURTHER RESEARCH To carry out a paleopathological study of all the fossils from Dar-es-Soltane II.
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Affiliation(s)
- Dany Coutinho-Nogueira
- Univ. Bordeaux, CNRS, MCC, PACEA, UMR, 5199 Pessac, France; EPHE, PSL University, Paris, France; University of Coimbra, CIAS - Research Centre for Anthropology and Health, Department of Life Science, Coimbra, Portugal.
| | - Hélène Coqueugniot
- Univ. Bordeaux, CNRS, MCC, PACEA, UMR, 5199 Pessac, France; EPHE, PSL University, Paris, France.
| | - Olivier Dutour
- Univ. Bordeaux, CNRS, MCC, PACEA, UMR, 5199 Pessac, France; EPHE, PSL University, Paris, France.
| | - Abdelouahed Ben-Ncer
- Institut National des Sciences de l'Archéologie et du Patrimoine, Rabat, Morocco.
| | - Jean-Jacques Hublin
- Collège de France, Paris, France; Dept. of Human Evolution, Max Planck Institute for Evolutionary Anthropology MPI-EVA), Leipzig, Germany.
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Biggs K, Crundwell G, Metcalfe C, Muzaffar J, Monksfield P, Bance M. Anatomical and audiological considerations in branchiootorenal syndrome: A systematic review. Laryngoscope Investig Otolaryngol 2022; 7:540-563. [PMID: 35434312 PMCID: PMC9008175 DOI: 10.1002/lio2.749] [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: 06/04/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Establish anatomical considerations, audiological outcomes, and optimal management in patients with branchiootic/branchiootorenal syndrome (BO/BOR). Methods Databases reviewed: Medline, Pubmed, Embase, Web of Science, Cochrane Collection, and ClinicalTrials.gov. Clinical or radiological studies of patients with BOR syndrome describing either the audiological profile or anatomical changes were included. Articles in which BOR syndrome was associated with other syndromes, and those that were focused only on general and genetic aspects of BOR syndrome were excluded. Articles were assessed using Oxford Centre for Evidence‐Based Medicine (OCEBM) grading system and the Brazzelli risk of bias tool for nonrandomized studies. Results Searches identified 379 articles. Of these, 64 studies met the inclusion criteria, reporting outcomes in 482 patients from at least 95 families. In 308 patients, hearing loss was categorized as sensorineural (29%), conductive (20%), and mixed (51%). Hearing outcomes were variable in terms of onset, pattern, and severity; ranging from mild to profound deafness. One hundred sixty‐nine patients presented with inner ear anomalies, 145 had middle, and 151 had external ear abnormalities. In 44 studies, 58 ear operations were described. Mixed outcomes were reported in patients managed with hearing aids or middle ear surgery; however, successful cochlear implantation was described in all five cases. Conclusion The anatomical and audiological profiles of patients with BO/BOR are variable. A range of surgical procedures were described, however lacked objective outcome measures. Given the range of anatomical variants, management decisions should be made on an individual basis including full audiological and radiological assessment. Level of evidence NA.
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Affiliation(s)
- Kirsty Biggs
- Royal Stoke University Hospital Stoke on Trent UK
- Wolfson Institute of Population Health Queen Mary University of London London UK
| | - Gemma Crundwell
- Cambridge University Hospitals NHS Foundation Trust Addenbrooke’s Health Campus Cambridge UK
| | - Christopher Metcalfe
- Royal Stoke University Hospital Stoke on Trent UK
- ENT Department, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - Jameel Muzaffar
- ENT Department, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK
- University of Cambridge Department of Clinical Neurosciences, Addenbrooke’s Health Campus Cambridge UK
| | - Peter Monksfield
- ENT Department, Queen Elizabeth Hospital Birmingham University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - Manohar Bance
- Cambridge University Hospitals NHS Foundation Trust Addenbrooke’s Health Campus Cambridge UK
- University of Cambridge Department of Clinical Neurosciences, Addenbrooke’s Health Campus Cambridge UK
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Yaprak N, Sayar E, Derin AT, Bostancı A, Turhan M, Yılmaz A. Hearing evaluation with ABR in pediatric patients with celiac disease. TURKISH JOURNAL OF GASTROENTEROLOGY 2021; 31:163-166. [PMID: 32141826 DOI: 10.5152/tjg.2020.19510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND/AIMS Celiac disease (CD) is an autoimmune and genetic disease that is triggered by gluten intolerance. We aimed to investigate whether Celiac disease have any effect on Auditory Brainstem Response (ABR) waves compare to a healthy control group, and present its association with sensorineural hearing loss (SNHL). MATERIALS AND METHODS Thirty-eight patients aged 2 to 16 years old were included in the study. The patients had confirmed diagnosis of Celiac disease through duodenal biopsies and transglutaminase Antibody (Ab) (+). The control group consisted of 18 children aged 3 to 17 years old who were all admitted to the pediatric gastroenterology department due to complaints of constipation and transglutaminase Ab (-).All children underwent Auditory-Brain-Stem-Evoked Responses (ABR). The data were gathered using click stimulus at 10/s frequency 90dB HL. RESULTS The results of ABR examination did not show any difference between the patient group and control group as regards the latency of the waves I, III, V. No difference was observed between the two groups in the interpeak latecies I-III, I-V and III-V. None of the patients was observed to have clinical hearing loss. DISCUSSION The exact pathogenesis of neurological damages observed in Celiac disease is still unknown. Humoral immune mechanisms are the most frequently attributed cause. CONCLUSION Although no significant difference was found in hearing values between the study group and healthy control group, there is a need for further research on this subject.
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Affiliation(s)
- Neslihan Yaprak
- Department of Otorhinolaryngology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ersin Sayar
- Department of Pediatric Gastroenterology, Alanya Alaaddin Keykubat University, Alanya Training and Research Hospital, Alanya, Turkey
| | - Alper Tunga Derin
- Department of Otorhinolaryngology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Aslı Bostancı
- Department of Otorhinolaryngology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Murat Turhan
- Department of Otorhinolaryngology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Aygen Yılmaz
- Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Antalya Turkey
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13
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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.
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14
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Whitehead MT, Guillot LM, Reilly BK. Cochlear signal alterations using pseudo-color perceptual enhancement for patients with sensorineural hearing loss. Pediatr Radiol 2021; 51:1448-1456. [PMID: 33687494 DOI: 10.1007/s00247-021-04987-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/12/2020] [Accepted: 01/26/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neuroimaging detection of sensorineural hearing loss (SNHL)-related temporal bone abnormalities is limited (20-50%). We hypothesize that cochlear signal differences in gray-scale data may exceed the threshold of human eye detection. Gray-scale images can be post-processed to enhance perception of tonal difference using "pseudo-color" schemes. OBJECTIVE To compare patients with unilateral SNHL to age-matched normal magnetic resonance imaging (MRI) exams for "labyrinthine color differences" employing pseudo-color post-processing. MATERIALS AND METHODS The MRI database at an academic children's hospital was queried for "hearing loss." Only unilateral SNHL cases were analyzed. Sixty-nine imaging exams were reviewed. Thirteen age-matched normal MR exams in children without hearing loss were chosen for comparison. Pseudo-color was applied with post-processing assignment of specific hues to each gray-scale intensity value. Gray-scale and pseudo-color images were qualitatively evaluated for signal asymmetries by a board-certified neuroradiologist blinded to the side of SNHL. RESULTS Twenty-six SNHL (mean: 7.6±3 years) and 13 normal control exams (mean: 7.3±4 years) were included. All patients had normal gray-scale cochlear signal and all controls had symmetrical pseudo-color signal. However, pseudo-color images revealed occult asymmetries localizing to the SNHL ear with lower values in 38%. Ninety-one percent of these cases showed concordance between the side of pseudo-color positivity and the side of hearing loss. CONCLUSION Pseudo-color perceptual image enhancement reveals intra-labyrinthine fluid alterations on MR exams in children with unilateral SNHL. Pseudo-color image enhancement techniques improve detection of cochlear pathology and could have therapeutic implications.
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Affiliation(s)
- Matthew T Whitehead
- Department of Radiology, Children's National Hospital, 111 Michigan Ave. NW, Washington, DC, 20010, USA. .,The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
| | - Lori M Guillot
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Department of Otolaryngology, Children's National Hospital, Washington, DC, USA.,Pediatric Ear, Nose and Throat of Atlanta, Atlanta, GA, USA
| | - Brian K Reilly
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Department of Otolaryngology, Children's National Hospital, Washington, DC, USA
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刘 梦, 张 天. [A review of diagnosis and treatment of syndromic hearing loss]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2021; 35:285-288. [PMID: 33794621 PMCID: PMC10128230 DOI: 10.13201/j.issn.2096-7993.2021.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Indexed: 06/08/2023]
Abstract
Hereditary deafness is divided into syndromic hearing loss and non-syndromic hearing loss according to whether it is accompanied by other system dysfunction. The early identification and diagnosis of syndromic hearing loss is very important, including clinical and molecular diagnosis. Early diagnosis can predict the progress of hearing loss, other systemic disorders and guide treatment. Thus otolaryngologists are likely to become the first doctors to treat children with syndromic hearing loss, it is more necessary to master the clinical and molecular diagnosis methods of common syndromic hearing loss, and cooperate with doctors of other relevant departments for early intervention and treatment. Therefore, this article reviewed the common features, molecular diagnostic methods and treatment strategies for syndromic hearing loss.
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Affiliation(s)
- 梦婷 刘
- 哈尔滨医科大学附属第一医院耳鼻咽喉头颈外科(哈尔滨,150001)
| | - 天虹 张
- 哈尔滨医科大学附属第一医院耳鼻咽喉头颈外科(哈尔滨,150001)
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16
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Benson JC, Carlson ML, Lane JI. MRI of the Internal Auditory Canal, Labyrinth, and Middle Ear: How We Do It. Radiology 2020; 297:252-265. [PMID: 32960730 DOI: 10.1148/radiol.2020201767] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
MRI is firmly established as an essential modality in the imaging of the temporal bone and lateral skull base. It is used to evaluate normal anatomic structures, evaluate for vestibular schwannomas, assess for inflammatory and/or infectious processes, and detect residual and/or recurrent cholesteatoma. It is also extensively used in pre- and postoperative evaluations, particularly in patients with vestibular schwannomas and candidates for cochlear implantation. Nevertheless, despite the widespread use of MRI for these purposes, many radiologists remain unfamiliar with the complex anatomy and expected imaging findings with such examinations. The purpose of this review is to provide an overview of the most useful MRI sequences for internal auditory canal and labyrinthine imaging, review the relevant anatomy, and discuss the expected appearances of the most commonly encountered pathologic entities. In addition, the features at pre- and postprocedural MRI will be discussed to help ensure that diagnostic radiologists may be of greatest use to the ordering physicians. © RSNA, 2020.
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Affiliation(s)
- John C Benson
- From the Departments of Radiology (J.C.B., J.I.L.) and Otolaryngology-Head and Neck Surgery (M.L.C.), Mayo Clinic, 200 1st St SW, Rochester, MN 55905
| | - Matthew L Carlson
- From the Departments of Radiology (J.C.B., J.I.L.) and Otolaryngology-Head and Neck Surgery (M.L.C.), Mayo Clinic, 200 1st St SW, Rochester, MN 55905
| | - John I Lane
- From the Departments of Radiology (J.C.B., J.I.L.) and Otolaryngology-Head and Neck Surgery (M.L.C.), Mayo Clinic, 200 1st St SW, Rochester, MN 55905
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17
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Ng MMY, D'Arco F, Chorbachi R, Nash R. Oval window perilymph fistula in child with recurrent meningitis and unilateral hearing loss. BMJ Case Rep 2020; 13:13/7/e234744. [PMID: 32713834 DOI: 10.1136/bcr-2020-234744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 2-year-old boy presented to Ears, Nose and Throat (ENT) surgeons with unilateral hearing loss. Following a prodrome of upper respiratory tract infection (URTI), he developed two episodes of pneumococcal meningitis in quick succession. This case demonstrates an unusual cause of perilymph fistula diagnosed on imaging and confirmed surgically. He had failed the Newborn Hearing Screening Programme and was therefore referred to audiology, who confirmed profound sensorineural hearing loss in the right ear. MRI showed incomplete partitioning (type 1) of the right cochlea, suggesting cerebrospinal fluid (CSF) leak from the region of the stapes. Exploratory tympanotomy confirmed this, and proceeded to CSF leak repair, obliteration of the Eustachian tube, subtotal petrosectomy, abdominal fat grafting and blind sac closure. Although middle ear effusions are common; particularly in children with recent URTI, the possibility of otogenic CSF leak needs to be considered, especially in cases of recurrent meningitis.
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Affiliation(s)
- Miane Min Yan Ng
- Ear, Nose and Throat Surgery Department, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Felice D'Arco
- Department of Radiology, NIHR GOSH BRC, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Raouf Chorbachi
- Department of Audiological Medicine/Audiology/Cochlear Implants, North Thames Cleft Service, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Robert Nash
- Department of Paediatric Otolaryngology, Cochlear Implants, Great Ormond Street Hospital for Children NHS Trust, London, UK.,University College London, London, UK
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18
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Moon PK, Qian JZ, McKenna E, Xi K, Rowe NC, Ng NN, Zheng J, Tam LT, MacEachern SJ, Ahmad I, Cheng AG, Forkert ND, Yeom KW. Cerebral volume and diffusion MRI changes in children with sensorineural hearing loss. NEUROIMAGE-CLINICAL 2020; 27:102328. [PMID: 32622314 PMCID: PMC7334366 DOI: 10.1016/j.nicl.2020.102328] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/19/2020] [Accepted: 06/20/2020] [Indexed: 12/11/2022]
Abstract
Microstructural and macrostructural changes in sensorineural hearing loss. Magnetic resonance imaging as tool to assess cerebral volume and diffusion. Greater diffusion in cortex, thalamus, caudate, brainstem with hearing loss. Smaller brainstem volume with hearing loss. Connexin 26, Pendrin mutations show diffusion changes in brainstem and thalamus.
Purpose Sensorineural hearing loss (SNHL) is the most prevalent congenital sensory deficit in children. Information regarding underlying brain microstructure could offer insight into neural development in deaf children and potentially guide therapies that optimize language development. We sought to quantitatively evaluate MRI-based cerebral volume and gray matter microstructure children with SNHL. Methods & Materials We conducted a retrospective study of children with SNHL who obtained brain MRI at 3 T. The study cohort comprised 63 children with congenital SNHL without known focal brain lesion or structural abnormality (33 males; mean age 5.3 years; age range 1 to 11.8 years) and 64 age-matched controls without neurological, developmental, or MRI-based brain macrostructure abnormality. An atlas-based analysis was used to extract quantitative volume and median diffusivity (ADC) in the following brain regions: cerebral cortex, thalamus, caudate, putamen, globus pallidus, hippocampus, amygdala, nucleus accumbens, brain stem, and cerebral white matter. SNHL patients were further stratified by severity scores and hearing loss etiology. Results Children with SNHL showed higher median ADC of the cortex (p = .019), thalamus (p < .001), caudate (p = .005), and brainstem (p = .003) and smaller brainstem volumes (p = .007) compared to controls. Patients with profound bilateral SNHL did not show any significant differences compared to patients with milder bilateral SNHL, but both cohorts independently had smaller brainstem volumes compared to controls. Children with unilateral SNHL showed greater amygdala volumes compared to controls (p = .021), but no differences were found comparing unilateral SNHL to bilateral SNHL. Based on etiology for SNHL, patients with Pendrin mutations showed higher ADC values in the brainstem (p = .029, respectively); patients with Connexin 26 showed higher ADC values in both the thalamus (p < .001) and brainstem (p < .001) compared to controls. Conclusion SNHL patients showed significant differences in diffusion and volume in brain subregions, with region-specific findings for patients with Connexin 26 and Pendrin mutations. Future longitudinal studies could examine macro- and microstructure changes in children with SNHL over development and potential predictive role for MRI after interventions including cochlear implant outcome.
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Affiliation(s)
- Peter K Moon
- Stanford University School of Medicine, Stanford, CA, USA
| | - Jason Z Qian
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | - Emily McKenna
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA
| | - Kevin Xi
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA
| | - Nathan C Rowe
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Nathan N Ng
- Stanford University School of Medicine, Stanford, CA, USA
| | - Jimmy Zheng
- Stanford University School of Medicine, Stanford, CA, USA
| | - Lydia T Tam
- Stanford University School of Medicine, Stanford, CA, USA
| | - Sarah J MacEachern
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Iram Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | - Alan G Cheng
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA
| | - Nils D Forkert
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - Kristen W Yeom
- Department of Radiology, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA.
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Prat Matifoll JA, Wilson M, Goetti R, Birman C, Bennett B, Peadon E, Prats-Uribe A, Prelog K. A Case Series of X-Linked Deafness-2 with Sensorineural Hearing Loss, Stapes Fixation, and Perilymphatic Gusher: MR Imaging and Clinical Features of Hypothalamic Malformations. AJNR Am J Neuroradiol 2020; 41:1087-1093. [PMID: 32409310 DOI: 10.3174/ajnr.a6541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/20/2020] [Indexed: 11/07/2022]
Abstract
X-linked deafness-2 (DFNX2) is an X-linked recessive disorder characterized by profound sensorineural hearing loss and a pathognomonic temporal bone deformity. Because hypothalamic malformations associated with DFNX2 have been rarely described, we aimed to further describe these lesions and compare them with features of a nonaffected population. All patients diagnosed with DFNX2 between 2006 and 2019 were included and compared with age-matched patients with normal MR imaging findings and without hypothalamic dysfunction. MR imaging features differing between groups were selected to help identify DFNX2. Sensitivity and specificity were calculated for these features. Agreement among 3 radiologists was quantified using the index κ. Information on the presence or absence of gelastic seizures, precocious puberty, or delayed puberty was also gathered. We selected distinctive MR imaging features of hypothalamic malformations in DFNX2. The feature selected on axial T2 images was the folded appearance of the ventromedial hypothalamus (sensitivity, 100%; specificity, 95.8%) characterized by an abnormal internal/external cleft (sensitivity, 100%; specificity, 95.7%). On coronal T2, the first distinctive feature was a concave morphology of the medial eminence (sensitivity, 100%; specificity, 97.1%), the second feature was at least 1 hypothalamic-septum angle ≥90° (sensitivity, 90%; specificity, 72.5%), and the third feature was a forebrain-hypothalamic craniocaudal length of ≥6 mm (sensitivity, 70%; specificity, 79.7%). Clinical features were also distinctive because 9 patients with DFNX2 did not present with gelastic seizures or precocious puberty. One patient had delayed puberty. The κ index and intraclass correlation coefficient ranged between 0.78 and 0.95. Imaging and clinical features of the hypothalamus suggest that there is a hypothalamic malformation associated with DFNX2. Early assessment for pubertal delay is proposed.
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Affiliation(s)
| | | | - R Goetti
- Radiology Department (R.G.), University of Sydney, Children's Hospital at Westmead (Sydney), Westmead, New South Wales, Australia
| | | | | | - E Peadon
- Deafness Centre (E.P.); Children's Hospital at Westmead (Sydney), Westmead, New South Wales, Australia
| | - A Prats-Uribe
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (A.P.-U.), Centre for Statistics in Medicine, Botnar Research Centre, University of Oxford, Oxford, UK
| | - K Prelog
- From the Departments of Radiology (J.-A.P.M., K.P.)
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20
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Sohal K, Moshy J, Owibingire S, Shuaibu I. Hearing loss in children: A review of literature. JOURNAL OF MEDICAL SCIENCES 2020. [DOI: 10.4103/jmedsci.jmedsci_166_19] [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] Open
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21
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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.
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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.
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22
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Abstract
OBJECTIVES Perilymphatic gusher (PLG) is an uncommon complication of stapedectomy and cochlear implant placement. Computerized tomography (CT) may reveal congenital dysplasia responsible for PLG but may also be (incorrectly) interpreted as normal. The aim of this study was to review CT findings in patients with PLG reported to have normal temporal bones. PATIENTS Patients in which a PLG was encountered and preoperative CT imaging had been interpreted as normal. INTERVENTION Collaborative review of temporal bone computed tomography by neurotologist and neuroradiologist. MAIN OUTCOME MEASURE Identification of undetected inner ear anomalies that may predispose to PLG. RESULTS Unanticipated PLG was encountered during stapes surgery in two patients and cochlear implantation in one. A focal bony dehiscence between the basal turn of the cochlea and internal auditory canal (IAC) was identified on a few oblique reformatted images in all patients. CONCLUSIONS High resolution CT with oblique image reformatting is essential to identify focal communication between the IAC and basal turn of the cochlea in ears with PLG.
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Roy CF, Yang L, Daniel SJ. A pediatric medulloblastoma presenting as isolated sensorineural hearing loss: Case report and review of the literature. Int J Pediatr Otorhinolaryngol 2019; 126:109640. [PMID: 31442874 DOI: 10.1016/j.ijporl.2019.109640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/08/2019] [Accepted: 08/09/2019] [Indexed: 10/26/2022]
Abstract
Medulloblastoma is the most common pediatric malignant brain tumor and carries a relatively grim prognosis despite recent advances in multimodality therapy. Delays in diagnosis and treatment initiation may contribute to worst outcomes. Signs of increased intracranial pressure and ataxia are known presentations of posterior fossa tumors, but sensorineural hearing loss (SNHL) is a seldom reported symptom. We report the case of a 2-year-old girl who had progressive unilateral SNHL since birth, which was later found to have a posterior fossa medulloblastoma when a head magnetic resonance imaging was ordered following subsequent progression to bilateral hearing impair. We further report our review of 17 additional cases of medulloblastoma presenting with SNHL and their associated head and neck findings. The present study provides insight into the current state of the literature on this rare symptom of a commonly encountered diagnosis, while highlighting the need to consider dedicated brain imaging in pediatric unilateral SNHL when a syndromic etiology or inner ear anomaly is not readily identified on initial investigations.
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Affiliation(s)
- Catherine F Roy
- Faculty of Medicine, McGill University, 3605 Rue de la Montagne, Montreal, Quebec, H3G 2M1, Canada.
| | - Luhe Yang
- Department of Diagnostic Imaging, University of Saskatchewan, 107 Administration Place, S7N 5A2, Saskatoon, Saskatchewan, Canada.
| | - Sam J Daniel
- Department of Pediatric Otolaryngology, Montreal Children's Hospital, McGill University Health Centre, 1001 Decarie, H4A 3J1, Montreal, Quebec, Canada.
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Buck L, Bailey KC, Carron JD. A Case of Childhood Hearing Loss. JAMA Otolaryngol Head Neck Surg 2019; 145:864-865. [DOI: 10.1001/jamaoto.2019.1701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lauren Buck
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson
| | - Kandice C. Bailey
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson
| | - Jeffery D. Carron
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson
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25
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Imaging of temporal bone inflammations in children: a pictorial review. Neuroradiology 2019; 61:959-970. [DOI: 10.1007/s00234-019-02258-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 07/02/2019] [Indexed: 02/04/2023]
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26
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Quirk B, Youssef A, Ganau M, D'Arco F. Radiological diagnosis of the inner ear malformations in children with sensorineural hearing loss. BJR Open 2019; 1:20180050. [PMID: 33178934 PMCID: PMC7592472 DOI: 10.1259/bjro.20180050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 11/24/2022] Open
Abstract
Malformations in either the inner ear, vestibulocochlear nerve (VIIIth) or auditory cortex of the brain can lead to congenital sensorineural hearing loss (SNHL). In most cases the underlying disorders involve the membranous labyrinth at a microscopic level and therefore radiological examinations are entirely normal. In a significant proportion however (up to 20%), there are abnormalities visualized in the inner ear and/or the VIIIth nerve; the type of abnormality is relevant for the surgical planning of a cochlear implant. Imaging and the accurate radiological identification of the affected inner ear structures therefore plays an integral role in the clinical evaluation of sensorineural hearing loss. In this pictorial review, we describe the main malformations of the inner ear in view of recent classifications and briefly explore the surgical implications.
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Affiliation(s)
- Bernadine Quirk
- Great Ormond Street Hospital for Children NHS Foundation Trust
| | - Adam Youssef
- Great Ormond Street Hospital for Children NHS Foundation Trust
| | - Mario Ganau
- Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust
| | - Felice D'Arco
- Great Ormond Street Hospital for Children NHS Foundation Trust
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27
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28
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Bunch PM, Kelly HR. Labyrinthitis. Neuroradiology 2019. [DOI: 10.1016/b978-0-323-44549-8.00043-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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29
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Abstract
Hearing loss is the most common congenital defect. With early diagnosis and intervention, we are able to improve speech and language outcomes in this population. In this article, we discuss the implications of the newborn hearing screen, as well as diagnostic interventions, management, and intervention, and the increasing role of congenital cytomegalovirus screening.
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Affiliation(s)
- Kavita Dedhia
- Department of Pediatric Otolaryngology, Emory University, 2015 Uppergate Drive, Atlanta, GA 30324, USA.
| | - Elise Graham
- Department of Pediatric Otolaryngology, University of Utah, 100 North Mario Capercchi Drive, Salt Lake City, UT 84113, USA
| | - Albert Park
- Department of Pediatric Otolaryngology, University of Utah, 100 North Mario Capercchi Drive, Salt Lake City, UT 84113, USA
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30
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Abstract
Temporal bone high-resolution computed tomography (HRCT) and magnetic resonance (MR) imaging are valuable tools in the evaluation of pediatric hearing loss. Computed tomography is important in the evaluation of pediatric conductive hearing loss and is the imaging modality of choice for evaluation of osseous abnormalities. MR imaging is the modality of choice for evaluation of sensorineural hearing loss. A broad spectrum of imaging findings can be seen with hearing loss in children. HRCT and MR imaging provide complementary information and are often used in conjunction in the preoperative evaluation of pediatric candidates for cochlear implantation.
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Hsu A, Desai N, Paldino MJ. The Unwound Cochlea: A Specific Imaging Marker of Branchio-Oto-Renal Syndrome. AJNR Am J Neuroradiol 2018; 39:2345-2349. [PMID: 30385470 DOI: 10.3174/ajnr.a5856] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/04/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Branchio-oto-renal syndrome is an important syndromic cause of hearing loss. Our aim was to determine the test characteristics of the unwound cochlea on temporal bone CT for the diagnosis of branchio-oto-renal syndrome in a cohort of children with hearing loss. MATERIALS AND METHODS Patients were identified retrospectively with a clinical diagnosis of branchio-oto-renal syndrome and CT imaging of the temporal bones. Age-matched controls were also identified with sensorineural hearing loss not related to a diagnosis of branchio-oto-renal syndrome and CT imaging of the temporal bones. All examinations were reviewed by 2 neuroradiologists blinded to the diagnosis of branchio-oto-renal syndrome versus controls for the absence/presence of an unwound cochlea defined as anteromedial rotation and displacement of the middle and apical turns away from the basal turn. RESULTS The final study group comprised 9 patients with branchio-oto-renal syndrome (age range, 1-14 years; mean age, 8.0 ± 4.3 years) and 50 control patients (age range, 1-16 years; mean age, 7.9 ± 4.1 years). The cochlea was subjectively abnormal in all 9 patients. In 8 patients (89%), imaging demonstrated a typical unwound cochlear morphology. By contrast, none of the control subjects demonstrated an unwound cochlea on either side. Statistically, the unwound cochlea was significantly more frequent in the branchio-oto-renal group compared with controls (P < .001). The unwound cochlea was 89% sensitive and 100% specific for the diagnosis of branchio-oto-renal syndrome. CONCLUSIONS The unwound cochlea is a specific imaging marker of branchio-oto-renal syndrome. These findings further support the diagnostic accuracy and therefore the utility of temporal bone imaging in the diagnosis of this disorder.
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Affiliation(s)
- A Hsu
- From the Department of Radiology, Texas Children's Hospital, Houston, Texas
| | - N Desai
- From the Department of Radiology, Texas Children's Hospital, Houston, Texas
| | - M J Paldino
- From the Department of Radiology, Texas Children's Hospital, Houston, Texas.
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Talenti G, Manara R, Brotto D, D'Arco F. High-resolution 3 T magnetic resonance findings in cochlear hypoplasias and incomplete partition anomalies: a pictorial essay. Br J Radiol 2018; 91:20180120. [PMID: 29688748 DOI: 10.1259/bjr.20180120] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Giacomo Talenti
- 1 Department of Diagnostics and Pathology, Neuroradiology Unit, Verona University Hospital , Verona , Italy
| | - Renzo Manara
- 2 Department of Medicine, Surgery and Dentistry, Unit of Neuroradiology, Section of Neuroscience, Scuola Medica Salernitana, University of Salerno , Baronissi , Italy
| | - Davide Brotto
- 3 Department of Neuroscience, ENT Unit, Università degli Studi di Padova , Padova , Italy
| | - Felice D'Arco
- 4 Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Trust , London , UK
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Abstract
PURPOSE OF REVIEW The purpose of this review is to review the evaluation and management of children with syndromic hearing loss. Specific syndromes and the impact of those syndromes on managing hearing loss will be discussed. RECENT FINDINGS Improved molecular testing has increased the ability to identify syndromes-associated hearing loss. Accurate diagnosis of syndromic hearing loss can guide discussions regarding prognosis and appropriate management options for the hearing impairment. SUMMARY A significant portion of childhood hearing loss is associated with a syndrome. Depending on the syndrome, surgical intervention including a bone-anchored hearing aid or cochlear implant may be helpful. In the future, targeted gene therapies may become a viable option for treating syndromic hearing loss.
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Al-Rawy AS, al-Shatouri M, El Tabbakh M, Gad AA. Systematic approach by computed tomography and magnetic resonance imaging in cochlear implantation candidates in Suez Canal University Hospital. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2017. [DOI: 10.1016/j.ejrnm.2017.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mazón M, Pont E, Montoya-Filardi A, Carreres-Polo J, Más-Estellés F. Inner ear malformations: A practical diagnostic approach. RADIOLOGIA 2017. [DOI: 10.1016/j.rxeng.2017.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sampson J, Thompson H. Youth hearing impairment: Early detection is key. Nursing 2017; 47:52-56. [PMID: 28328777 DOI: 10.1097/01.nurse.0000512877.14257.cb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Janice Sampson
- At California State University, Sacramento, Janice Sampson is an assistant professor in the School of Nursing and Heather Thompson is an assistant professor in the Department of Communication Sciences and Disorders
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Bilateral Labyrinthine and Internal Auditory Canal Enhancement in an Infant With Severe Labyrinthine Dysplasia: A Previously Unreported Phenomenon. Otol Neurotol 2017; 38:e21-e25. [PMID: 28346292 DOI: 10.1097/mao.0000000000001392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe a novel case of congenital profound bilateral sensorineural hearing loss in a patient with bilateral nodular internal auditory canal and labyrinthine enhancement and temporal bone dysplasia. PATIENTS A 76-day-old female was referred to the authors' center for evaluation of congenital deafness. Behavioral observations and objective audiometric evaluation demonstrated bilateral profound sensorineural hearing loss and a comprehensive multidisciplinary evaluation identified compound heterozygous pathogenic variants in MYO7A, a gene associated with Usher Syndrome Type 1B or DFNB2. Computed tomography and contrast-enhanced magnetic resonance imaging studies demonstrated bilateral temporal bone anomalies with unique middle and inner ear malformations, as well as unique contrast enhancement in the membranous labyrinth, internal auditory canals, and cranial nerves, which have not been previously described with MYO7A variants. INTERVENTIONS Given the potential risk for progressive bilateral labyrinthitis ossificans, bilateral simultaneous cochlear implantation was performed at 4 months of age. MAIN OUTCOME MEASURES Subsequent audiologic follow up after implantation shows significantly improved access to auditory information and increased vocalizations. At last testing, speech and language skills for both receptive and expressive language abilities were found to be commensurate with her chronological age. CONCLUSION We report a novel presentation and imaging findings of congenital bilateral profound sensorineural hearing loss in a patient with nodular internal auditory canal and labyrinthine enhancement and coexisting inner ear dysplasia. Despite the multiple radiologic abnormalities, the patient has demonstrated good benefit from cochlear implantation. Future study of rare variants of congenital deafness, such as this, is critical toward defining new disease processes and determining optimal treatment.
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Mazón M, Pont E, Montoya-Filardi A, Carreres-Polo J, Más-Estellés F. Inner ear malformations: a practical diagnostic approach. RADIOLOGIA 2017; 59:297-305. [PMID: 28040203 DOI: 10.1016/j.rx.2016.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 11/28/2022]
Abstract
Pediatric sensorineural hearing loss is a major cause of disability; although inner ear malformations account for only 20-40% of all cases, recognition and characterization will be vital for the proper management of these patients. In this article relevant anatomy and development of inner ear are surveyed. The role of neuroimaging in pediatric sensorineural hearing loss and cochlear preimplantation study are assessed. The need for a universal system of classification of inner ear malformations with therapeutic and prognostic implications is highlighted. And finally, the radiological findings of each type of malformation are concisely described and depicted. Computed tomography and magnetic resonance imaging play a crucial role in the characterization of inner ear malformations and allow the assessment of the anatomical structures that enable the selection of appropriate treatment and surgical approach.
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Affiliation(s)
- M Mazón
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, España.
| | - E Pont
- Servicio de Otorrinolaringología, Hospital General de Onteniente, Valencia, España
| | - A Montoya-Filardi
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - J Carreres-Polo
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - F Más-Estellés
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, España
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Ho ML, Moonis G, Halpin CF, Curtin HD. Spectrum of Third Window Abnormalities: Semicircular Canal Dehiscence and Beyond. AJNR Am J Neuroradiol 2016; 38:2-9. [PMID: 27561833 DOI: 10.3174/ajnr.a4922] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Third window abnormalities are defects in the integrity of the bony structure of the inner ear, classically producing sound-/pressure-induced vertigo (Tullio and Hennebert signs) and/or a low-frequency air-bone gap by audiometry. Specific anatomic defects include semicircular canal dehiscence, perilabyrinthine fistula, enlarged vestibular aqueduct, dehiscence of the scala vestibuli side of the cochlea, X-linked stapes gusher, and bone dyscrasias. We discuss these various entities and provide key examples from our institutional teaching file with a discussion of symptomatology, temporal bone CT, audiometry, and vestibular-evoked myogenic potentials.
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Affiliation(s)
- M-L Ho
- From the Department of Radiology (M.-L.H.), Mayo Clinic, Rochester, Minnesota
| | - G Moonis
- Department of Radiology (G.M.), Columbia University, New York, New York
| | | | - H D Curtin
- Radiology (H.D.C.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
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Saeed H, Powell HRF, Saeed SR. Cochlear implantation in X-linked deafness - How to manage the surgical challenges. Cochlear Implants Int 2016; 17:178-183. [PMID: 27142359 DOI: 10.1080/14670100.2016.1180018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE AND IMPORTANCE In children with X-linked deafness, cochlear malformations challenge the implant surgeon to avoid electrode insertion into the internal auditory meatus and prevent a continuous cerebrospinal fluid (CSF) leak. We describe our experience of cochlear implantation (CI) in two children with profound hearing loss secondary to X-linked deafness, highlighting safer operative techniques to avoid potential complications. CLINICAL PRESENTATION Descriptive cases of two children with X-linked deafness (patient 1 and patient 2) undergoing CI. Peri-operative imaging and work-up to surgery are discussed. Specific operative considerations, post-operative complications and subsequent audiological performance are highlighted. TECHNIQUE In each case, intra-operative fluoroscopic imaging ensured intra-cochlear insertion of electrodes. Expected CSF gusher was seen in each case which was initially controlled by packing around the cochleostomy and array with temporalis muscle and fascia. Patient 1 developed post-operative meningitis secondary to continuous CSF leak. We avoided further significant CSF leak by planning staged procedures for patient 2, with obliteration of the middle ear cleft and external ear canal (EAC) at the time of implantation. In both patients, bilateral implantation successfully provided hearing thresholds of less than 35 dB in both ears at routine follow up. CONCLUSIONS When planning for CI in children with radiological features of X-linked deafness, intra-operative imaging should be utilized to ensure correct electrode positioning. Traditional methods of stopping a CSF gusher may not suffice. We therefore encourage additional surgical obliteration of the middle ear space and EAC to avoid persistent CSF leak and its associated complications.
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Affiliation(s)
- Haroon Saeed
- a Department of Ear Nose and Throat Surgery , Tameside General Hospital , Fountain Street, Ashton-under-Lyne OL6 9RW , UK
| | - Harry R F Powell
- b Royal National Throat, Nose and Ear Hospital, University College London Hospitals , UK
| | - Shakeel R Saeed
- b Royal National Throat, Nose and Ear Hospital, University College London Hospitals , UK
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Vyas S, Bhatia V, Panda NK, Singh P, Khandelwal N. Labyrinthitis ossificans after meningitis: Superiority of high-resolution magnetic resonance imaging in demonstration of disease extent compared to high-resolution computed tomography. J Neurosci Rural Pract 2016; 7:327-9. [PMID: 27114680 PMCID: PMC4821957 DOI: 10.4103/0976-3147.176191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sameer Vyas
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Bhatia
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - N K Panda
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Paramjeet Singh
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Niranjan Khandelwal
- Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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DeMarcantonio M, Choo DI. Radiographic Evaluation of Children with Hearing Loss. Otolaryngol Clin North Am 2015; 48:913-32. [DOI: 10.1016/j.otc.2015.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Young JY, Ryan ME, Young NM. Preoperative imaging of sensorineural hearing loss in pediatric candidates for cochlear implantation. Radiographics 2015; 34:E133-49. [PMID: 25208295 DOI: 10.1148/rg.345130083] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cochlear implantation is the only U.S. Food and Drug Administration-approved treatment for children with marked bilateral sensorineural hearing loss. It provides auditory benefits that range from simple sound detection to substantial word understanding. Improved hearing through cochlear implantation has been demonstrated to enhance the rate of language acquisition, enable development of spoken language, and advance literacy in deaf children. Magnetic resonance imaging and computed tomography both have roles in the preoperative assessment of inner-ear abnormalities, cochlear nerve deficiency, and variant anatomy that may affect the decision to implant and the prognosis for auditory improvement and increase the risk for complications. Most cochlear abnormalities may be successfully treated with cochlear implantation, but the presence of a cochlear malformation may increase the risk for intraoperative cerebrospinal fluid leakage and postoperative bacterial meningitis. Eighth-nerve deficiency correlates with poor auditory outcomes and may affect eligibility for cochlear implantation. Another important consideration for implantation is the presence of labyrinthitis ossificans in some children with deafness resulting from bacterial meningitis, which may cause obstruction that limits electrode insertion. Anatomic variations of the facial nerve or middle-ear cavity, which are more common in syndromic patients, may also affect the surgical approach and make implantation difficult.
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Affiliation(s)
- Joseph Y Young
- From the Department of Radiology (J.Y.Y., M.E.R.) and Department of Otolaryngology- Head and Neck Surgery (N.M.Y.), Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Medical Imaging (J.Y.Y., M.E.R.) and Division of Pediatric Otolaryngology (N.M.Y.), Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL 60611; and Knowles Hearing Center, School of Communication, Northwestern University, Evanston, Ill (N.M.Y.)
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Kim L, Wisely CE, Lucius S, Weingarten J, Dodson EE. Positive Outcomes and Surgical Strategies for Bilateral Cochlear Implantation in a Child With X-Linked Deafness. Ann Otol Rhinol Laryngol 2015; 125:173-6. [PMID: 26346280 DOI: 10.1177/0003489415604167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To recognize that bilateral cochlear implantation (CI) in X-linked deafness is safe, describe techniques to maximize successful electrode placement and minimize surgical risks, and recognize that normalization of hearing as well as language acquisition is achievable. METHODS A 6-month-old male patient presented with bilateral profound sensorineural hearing loss and was confirmed to have X-linked deafness secondary to POU3F4 gene mutation. Due to lack of benefit from amplification, he underwent bilateral CI in a staged fashion at 12 (right) and 15 months (left) of age. A transmastoid-facial recess approach was used bilaterally utilizing perimodiolar electrodes. High-flow gushers were controlled with muscle plugs. C-arm fluoroscopy was used during insertion of electrodes. RESULTS Follow-up data are available for 12 months. No complications were encountered, including no postoperative cerebrospinal fluid (CSF) leakage or facial stimulation. Postoperative audiograms in aided conditions showed hearing thresholds <40 dB. At 11 months following activation of his second CI, he scored in the normal range for his chronological age on standardized language measures. CONCLUSION With careful preparation and the assistance of intraoperative fluoroscopy, CI in patients with congenital X-linked deafness can be done safely. Performing bilateral CI followed by dedicated auditory-verbal rehabilitation may allow patients to achieve normal language development.
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Affiliation(s)
- Leslie Kim
- The Ohio State University Wexner Medical Center, Columbus, Ohio, USA Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Shana Lucius
- Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Edward Eugene Dodson
- The Ohio State University, Columbus, Ohio, USA Nationwide Children's Hospital, Columbus, Ohio, USA
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Melzer JM, Eliason M, Conley GS. Congenital stapes malformation: Rare conductive hearing loss in a patient with Waardenburg syndrome. Laryngoscope 2015; 126:992-5. [DOI: 10.1002/lary.25443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Jonathan M. Melzer
- Department of Otolaryngology-Head and Neck Surgery; Naval Medical Center; Portsmouth Virginia U.S.A
| | - Michael Eliason
- Department of Otolaryngology-Head and Neck Surgery; Naval Medical Center; Portsmouth Virginia U.S.A
| | - George S. Conley
- Department of Otolaryngology-Head and Neck Surgery; Naval Medical Center; Portsmouth Virginia U.S.A
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Jiang Y, Shi X, Tang Y. Efficacy and safety of acupuncture therapy for nerve deafness: a meta-analysis of randomized controlled trials. Int J Clin Exp Med 2015; 8:2614-2620. [PMID: 25932209 PMCID: PMC4402856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/17/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Acupuncture is one of the important parts of therapeutic methods in traditional Chinese medicine, and has been widely used for the treatment of nerve deafness in recent years. The current study was to evaluate the efficacy and safety of acupuncture therapy for nerve deafness compared with conventional medicine therapy. METHODS PubMed, the Chinese National Knowledge Infrastructure Database, the Chinese Science and Technology Periodical Database, the Chinese Biomedical Database, the Wanfang Database were searched for articles published to identify randomized controlled trials evaluating efficacy and side effects between acupuncture and conventional medicine therapies up to 2013/06. RESULTS A total of 12 studies, including 527 patients assessed the efficacy and safety of acupuncture therapy for nerve deafness. Overall, the efficacy of acupuncture was significantly better than that of the conventional western medication (RR: 1.54, 95% CI: 1.36-1.74) or traditional Chinese medicines (RR: 1.51, 95% CI: 1.24-1.84), and the efficacy of acupuncture in combination with conventional western medication or traditional Chinese medicine was better than that of the conventional western medication alone (RR: 1.51, 95% CI: 1.29-1.77) or traditional Chinese medicine alone (RR: 1.59, 95% CI: 1.30-1.95). Based on the comparison of number of deafness patients who were completely cured, the efficacy of acupuncture in combination with traditional Chinese medicines was better than that of traditional Chinese medicine alone (RR: 4.62, 95% CI: 1.38-15.47). CONCLUSIONS Acupuncture therapy can significantly improve the hearing of patients with nerve deafness, and the efficacy of acupuncture in combination with medication is superior to medication alone.
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Affiliation(s)
- Yuebo Jiang
- Department of Internal Medicine Clinical, Acupuncture Division, Chinese PLA General HospitalBeijing, China
| | - Xian Shi
- Department of Internal Medicine Clinical, Acupuncture Division, Chinese PLA General HospitalBeijing, China
| | - Yan Tang
- Department of Internal Medicine, Daqing Hospital of Traditional Chinese MedicineDaqing City, Heilongjiang Province, China
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Willaredt MA, Ebbers L, Nothwang HG. Central auditory function of deafness genes. Hear Res 2014; 312:9-20. [DOI: 10.1016/j.heares.2014.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 01/31/2014] [Accepted: 02/10/2014] [Indexed: 01/11/2023]
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High-resolution 3-D T2-weighted imaging in the diagnosis of labyrinthitis ossificans: emphasis on subtle cochlear involvement. Pediatr Radiol 2013; 43:1584-90. [PMID: 23843131 DOI: 10.1007/s00247-013-2747-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/22/2013] [Accepted: 06/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Meningitis is the most common cause of acquired sensorineural hearing loss (SNHL) in children. Labyrinthitis ossificans develops in a significant number of patients with meningitis-related SNHL. Reduced T2 signal on MRI within the membranous labyrinth is often noted in the fibrous and ossifying stages of labyrinthitis ossificans. OBJECTIVE The purpose of this study is to demonstrate the distribution and extent of involvement of the cochlea in children being evaluated for labyrinthitis ossificans; using high-resolution 3-D T2-weighted imaging, and to evaluate for subtle involvement of the scala tympani within the basal turn of the cochlea. MATERIALS AND METHODS A retrospective review from 2002 to 2012 was performed using a cochlear implant database and PACS search function. Twenty-four patients were found to have MR findings consistent with labyrinthitis ossificans, 13 previously reported. Axial 3-D T2-weighted sequences were obtained in all patients. The presence of abnormal decreased T2 signal within the scala tympani and vestibuli of the cochlea was noted and graded according to the extent. The electronic medical record was reviewed for audiometry and risk factors as well as correlative operative findings. RESULTS The average age at imaging was 4.2 years. M:F ratio = 5:1. Eighty-eight percent (21/24) of patients had bilateral SNHL. The most common risk factor for labyrinthitis ossificans was meningitis (19/24 or 79%). Eighteen (75%) patients had a history of bacterial meningitis. The mean age for the onset of labyrinthitis was 1.2 years with an average of 2.2-year interval to imaging. Nineteen patients (79%) underwent placement of a cochlear implant. Cochlear obstruction was documented in 83% (40/48) of the ears. Lower grade (1) cochlear obstruction was present in 14 ears and limited to the scala tympani. Statistical analysis was performed correlating MRI imaging and surgical findings. CONCLUSION Subtle, isolated involvement of the scala tympani within the proximal basal turn is a common finding in labyrinthitis ossificans and history typical for meningitis is not uniformly present. The extent of cochlear obstruction is important and has surgical implications.
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Schmutzhard J, Aregger FC, Otieno A, Bunk S, Zorowka P, Schmutzhard E. Release of intracranial pressure leads to improvement of otoacoustic emissions--a case report of a Kenyan child with complicated tuberculous meningitis. J Trop Pediatr 2013; 59:326-9. [PMID: 23598892 DOI: 10.1093/tropej/fmt018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Intracranial pressure usually is measured with invasive techniques. The usability of transient evoked otoacoustic emissions as non-invasive approach has been evaluated only once by Frank et al. This article presents the case of a Kenyan boy with tuberculous meningitis and an active malresorptive hydrocephalus. At this stage, the otoacoustic emissions did show very low correlations. After releasing pressure, the otoacoustic emissions improved significantly. This case report points out the possible usability of otoacoustic emissions in intracranial pressure monitoring.
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Affiliation(s)
- Joachim Schmutzhard
- Department of Otorhinolaryngology, Medical University Innsbruck, 6020 Innsbruck, Austria.
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Abstract
PURPOSE OF REVIEW Over the last decade, the selection criteria for cochlear implantation have expanded to include children with special auditory, otologic, and medical problems. Included within this expanded group of candidates are those children with auditory neuropathy spectrum disorder, cochleovestibular malformations, cochlear nerve deficiency, associated syndromes, as well as multiple medical and developmental disorders. Definitive indications for cochlear implantation in these unique pediatric populations are in evolution. This review will provide an overview of managing and habilitating hearing loss within these populations with specific focus on cochlear implantation as a treatment option. RECENT FINDINGS Cochlear implants have been successfully implanted in children within unique populations with variable results. Evaluation for cochlear implant candidacy includes the core components of a full medical, audiologic, and speech and language evaluations. When considering candidacy in these children, additional aspects to consider include disorder-specific surgical considerations and child/caregiver counseling regarding reasonable postimplantation outcome expectations. SUMMARY Cochlear implants are accepted as the standard of care for improving hearing and speech development in children with severe-to-profound hearing loss. However, children with sensorineural hearing loss who meet established audiologic criteria for cochlear implantation may have unique audiologic, medical, and anatomic characteristics that necessitate special consideration regarding cochlear implantation candidacy and outcome. Individualized preoperative candidacy and counseling, surgical evaluation, and reasonable postoperative outcome expectations should be taken into account in the management of these children.
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