Ferraro, Tatiana; Samaha, Nadia L.; Tannan, Utkarsh; Sookram, Sebastian; Wong, Kevin; Hwa, Tiffany Peng
Publication date 05-08-2024
Objective Patients with concomitant limited English proficiency (LEP) and hearing loss may experience communication barriers, not fully mitigated by traditional interpreter services. Although there is no clear consensus on the most reliable and optimal resources for these patients, speech-to-text (STT) applications with translation capability may bridge these barriers. We review the existing literature applying STT translation programs in clinical settings and identify commercially available STT translation resources to evaluate their prospective application in the otology setting.
Databases Reviewed Pub Med MEDLINE, Embase, and Web of Science.
Methods A systematic review of English language peer-reviewed literature was conducted, examining STT translation in clinical settings. An additional search identifying STT software with translation capabilities was completed.
Results Seven out of 591 unique citations met the inclusion criteria, and 29 unique STT translation applications were identified, supporting up to 140 languages. Stakeholders endorse positive perceptions of STT translation programs. Facilitators to implementation included time and cost feasibility, whereas barriers included risk of mistranslation and inability to assess accuracy. Ongoing machine-learning efforts are underway for developing and improving STT translation technologies, but there is paucity of literature evaluating their application in patients with hearing loss.
Conclusions Small studies have suggested an acceptable level of accuracy for STT translation programs as adjunctive to standard of care services. Further work should proactively address implementation challenges with special attention to use of these technologies for patients with concomitant LEP and HL, while supporting additional technological advancement for application of these technologies in otology practice.
Maturi, Jay R.; Noij, Kimberley S.; Babu, Vidya; Creighton, Francis X. Jr; Galaiya, Deepa; Jenks, Carolyn M.
Publication date 01-10-2024
Objective To assess hearing and speech outcomes in pediatric patients with bilateral cochlear nerve deficiency (CND) who underwent cochlear implantation (CI) and to identify factors associated with improved outcomes.
Databases reviewed Pub Med, Embase, Web of Science, and Cochran databases were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Methods Studies that reported hearing and speech outcomes of pediatric patients with bilateral CND who underwent CI were included. Demographics, comorbidities, inner ear abnormalities, CND classification (aplasia or hypoplasia), details of diagnostic workup, and outcomes data were extracted. Outcomes were assessed using the four-level auditory performance level (APL) scale. Meta-analysis, using Cochran–Armitage tests, was performed on patients with individual data to assess factors associated with performance.
Results A total of 314 papers were screened, and 40 papers with 378 total patients met inclusion criteria. A total of 339 patients had patient-level data and were included in the meta-analysis. Of the 339 patients, 19% (n = 63) of patients had no measurable stimulation, 28% (n = 95) had improved detection, 22% (n = 76) achieved closed-set speech perception, and 31% (n = 105) achieved open-set speech perception. Patients with cochlear nerve aplasia (p = 0.016) and syndromes (p < 0.001) had significantly worse APL scores relative to patients with cochlear nerve hypoplasia and patients without syndromes, respectively.
Conclusions While most patients with bilateral CND benefit from CI and almost one-third of patients achieved open-set speech perception, outcomes were heterogenous and one-fifth of patients did not experience measurable benefit from CI.
Si, Yu; Shu, Fan; Liu, Wei; Jiang, Yusong; Xu, Yaodong; Ou, Yongkang; Yang, Haidi; Xiong, Hao; Liang, Maojin; Deng, Cuiping; Lu, Zhiyin; Luo, Yan; Shen, Jun; Zhang, Hongzheng; Zhang, Zhigang; Chen, Suijun
Publication date 29-08-2024
Background To prospectively evaluate the technical efficacy and safety of the double-lumen eustachian tube (ET) balloon catheter in patients with ET dysfunction.
Methods Patients who were diagnosed with ET dysfunction and needed balloon eustachian tuboplasty (BET) were prospectively enrolled. A double-lumen ET balloon catheter was used to dilate the ET and inject medicine. Efficacy results were assessed by the injection channel patency (ICP) rate, the injection reached the expected site (IRES) rate, and the improvement in eustachian tube function was evaluated by the seven-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) score. Safety results were assessed in terms of adverse events and device defects.
Results BET was successfully attempted in 87 patients from April 2022 to August 2022 at two academic medical centers in China (01, 02). The ICP rate was 100%, and the IRES rate was 88.51%. The overall ETDQ-7 score was significantly reduced (p < 0.001) postsurgically at both centers. There were no major complications or device defects.
Conclusion The double-lumen ET balloon catheter is technically effective and safe for the treatment of ET dysfunction.
Perez, Philip; Tsai, Tsung-Heng; Hawks, John; Barbone, Heather Malyuk; Pinkl, Joey; Thirumala, Partha; Bao, Jianxin
Publication date 29-08-2024
Objective To evaluate if permanent hearing loss occurred in the unoperated ear of patients undergoing otologic and skull base surgery with high-speed otologic drilling.
Study Design We retrospectively studied 250 patients (mean age 57.8 yr; 120 males, and 130 females) undergoing otologic or skull base surgery with high-speed drilling between 2013 and 2019.
Setting The University of Pittsburgh Medical Center.
Patients We evaluated preoperative and postoperative audiograms for patients undergoing surgery for cochlear implantation (95 patients, 38.0%), cholesteatoma or chronic ear disease (88 patients, 35.2%), repair of lateral skull base encephalocele (26 patients, 10.4%), resection of vestibular schwannoma or meningioma of the cerebellopontine angle (23 patients, 9.2%), lateral temporal bone resection (8 patients, 3.2%), microvascular decompression (7 patients, 2.8%), or other operations involving a high-speed otologic drill (3 patients, 1.2%).
Main Outcome Measures Hearing threshold shift, measured as the difference between postoperative threshold and preoperative threshold for each frequency. The association of age, gender, tested frequency, and surgery type with hearing threshold shift was investigated with analysis of covariance.
Results A total of 102 patients (40.8%) had a 10-dB or greater worsening of their hearing in at least one frequency on their postoperative audiogram in the contralateral, unoperated ear. One hundred six subjects (42.4%) had no change in hearing of 10 dB or greater at any frequency. Among patients with longitudinal postoperative audiograms, accelerated age-related hearing loss was observed in low frequencies.
Conclusions A significant number of patients demonstrated poorer hearing thresholds in the contralateral, unoperated ear after otologic and skull base surgery.
Pinto, João Viana; Almeida, Ana Isabel; Andrade, António; Vales, Fernando; Moura, Carla Pinto; Marques, Pedro
Publication date 01-10-2024
Objective To analyze the correlation between outcomes of stapes surgery and preoperative and postoperative audiometric results with different radiological staging classifications such as the Veillon classification (VC) and the Symons–Fanning classification (SFC).
Study Design Retrospective observational study.
Setting One tertiary hospital center.
Patients Adult patients submitted to stapes surgery due to otosclerosis from January 2017 to December 2022.
Intervention Evaluation of different radiological classifications such as the VC and SFC.
Main Outcome Measures Preoperative and postoperative pure-tone audiometric data, outcomes of stapes surgery success (closure of the ABG, rates of AC threshold less than or equal to 30 dB), and postoperative sensorineural hearing loss.
Results A total of 87 patients and 97 operated ears were included. The SFC was associated with preoperative BC (p = 0.041) and AC (p = 0.018) and postoperative BC (p = 0.026) with an increase in thresholds with higher radiological stages. The VC was associated with postoperative AC (p = 0.045) with an increase in AC thresholds with increasing radiological stages. Lastly, both the VC (p = 0.032) and the SFC (p = 0.023) were associated with a decrease in rates of postoperative AC thresholds ≤30 dB with higher radiological stages.
Conclusions The SFC seems to be more useful to predict preoperative AC and BC and postoperative BC. On the contrary, the VC was more useful to predict postoperative AC. Both scales were similarly associated with the rate of AC thresholds ≤30 dB.
Choi, Soo Jeong; Lee, Soo Jin; Lee, Dabin; Im, Gi Jung; Jung, Hak Hyun; Lee, Sun-Uk; Park, Euyhyun
Publication date 26-08-2024
Hypothesis Memantine, an N-methyl-d-aspartate receptor antagonist, is widely used to treat Alzheimers disease and has been found to have potential neuroprotective effects. In this study, we evaluated the protective effects of memantine against cisplatin-induced ototoxicity.
Background Cisplatin is a widely used anticancer drug for various cancers; however, its use is limited by its side effects, including ototoxicity. Several drugs have been developed to reduce cisplatin toxicity. In this study, we treated cisplatin-damaged cochlear hair cells with memantine and evaluated its protective effects.
Method House Ear Institute Organ of Corti 1 (HEI-OC1) cells and cochlear explants were treated with cisplatin or memantine. Cell viability, apoptotic patterns, reactive oxygen species (ROS) production, Bcl-2/caspase-3 activity, and cell numbers were measured to evaluate the anti-apoptotic and antioxidative effects of memantine.
Result Memantine treatment significantly improved cell viability and reduced cisplatin-induced apoptosis in auditory cells. Bcl-2/caspase-3 activity was also significantly increased, suggesting anti-apoptotic effects against cisplatin-induced ototoxicity.
Conclusion Our results suggest that memantine protects against cisplatin-induced ototoxicity in vitro, providing a potential new strategy for preventing hearing loss in patients undergoing cisplatin chemotherapy.
Matsui, Kosumo; Yoshida, Tadao; Sugimoto, Satofumi; Kobayashi, Masumi; Naganawa, Shinji; Sone, Michihiko
Publication date 01-10-2024
Objective Bilateral high signal intensity (SI) in the endolymphatic duct (ED) on magnetic resonance imaging (MRI) has been reported as a common characteristic in ears with large vestibular aqueduct syndrome (LVAS). However, the significance of bilateral high SI in the ED remains unknown. The present study aimed to compare the correlation between SI in the ED and the clinical manifestations in various otological disorders and consider the significance of the MRI findings.
Study Design Retrospective study.
Setting University hospital.
Patients The study included 2,450 ears from 1,225 patients with various otological disorders.
Intervention All ears underwent 3T enhanced MRI and were evaluated for the degree of endolymphatic hydrops (EH) and the SI ratios (SIRs; i.e., the calculation between SIs in the ED and those in the cerebellum).
Main Outcome Measure The imaging findings were compared with their clinical symptoms.
Results Ears with bilateral high SIRs in the ED tended to have considerably less occurrence of EH in both the cochlea and vestibule than those with bilateral low SIRs. Ears with SIR ≥8 showed significantly elevated hearing thresholds at lower frequencies on pure-tone audiometry, although they exhibited a markedly lower incidence of cochlear EH than those with SIR <8. Moreover, ears with vertigo exhibited notably higher SIRs than those without vertigo.
Conclusion Bilateral high SI in the ED on MRI may reflect pathophysiology underlying sensorineural hearing loss and vestibular symptoms, which are not associated with EH formation.
Dillon, Margaret T.; Buss, Emily; Thompson, Nicholas J.; Richter, Margaret E.; Davis, Amanda G.; Overton, Andrea B.; Rooth, Meredith A.; Canfarotta, Michael W.; Selleck, A. Morgan; Dedmon, Matthew M.; Brown, Kevin D.
Publication date 19-08-2024
Objective Some cochlear implant (CI) recipients with unilateral hearing loss (UHL) have functional acoustic hearing in the implanted ear, warranting the fitting of an ipsilateral electric–acoustic stimulation (EAS) device. The present study assessed speech recognition and subjective hearing abilities over time for EAS users with UHL.
Study Design Prospective, repeated-measures.
Setting Tertiary referral center.
Patients Adult CI recipients with normal-to-moderate low-frequency acoustic thresholds in the implanted ear and a contralateral pure-tone average (0.5, 1, and 2 k Hz) ≤25 dB HL.
Main Outcome Measures Participants were evaluated preoperatively and at 1, 3, and 6 months post-activation. Speech recognition for the affected ear was evaluated with CNC words in quiet. Masked speech recognition in the bilateral condition was evaluated with Az Bio sentences in a 10-talker masker (0 dB SNR) for three spatial configurations: target from the front and masker either colocated with the target or presented 90 degrees toward the affected or contralateral ear. Responses to the Speech, Spatial, and Qualities of Hearing Scale subscales were used to assess subjective hearing abilities.
Results Participants experienced significant improvements in CNC scores (F(3,13) = 14.90, p < 0.001), and masked speech recognition in the colocated (F(3,11) = 3.79, p = 0.043) and masker toward the contralateral ear (F(3,11) = 4.75, p = 0.023) configurations. They also reported significantly better abilities on the Speech Hearing (F(3,13) = 5.19, p = 0.014) and Spatial Hearing (F(3,13) = 10.22, p = 0.001) subscales.
Conclusions Adults with UHL and functional acoustic hearing in the implanted ear experience significant improvements in speech recognition and subjective hearing abilities within the initial months of EAS use as compared with preoperative performance and perceptions.
Siddiqui, Taimur; Lovin, Benjamin D.; Nguyen, Michelle T.; Marsh, Megan; Spiro, Jessica B.; Wickesberg-Summers, Jennifer; Cantu, Amy; Vilela, Ronald J.; Sweeney, Alex D.; Lindquist, Nathan R.
Publication date 27-08-2024
Objective The recent Field Corrective Action (FCA) for the Hi Res Ultra and Ultra 3D (V1) cochlear implants (CIs) triggered much research investigating clinical identification, failure rates, and postrevision outcomes. Pediatric data remain limited, especially with regards to speech outcomes. We aim to characterize the trajectory of children implanted with these devices with specific attention to speech outcomes.
Patients Retrospective cohort study of pediatric patients with FCA-affected CIs from March 2017 to January 2020 at a tertiary children’s hospital.
Interventions CI placement, device monitoring, audiologic evaluation, revision surgery.
Main Outcome Measures CI failure rates, revision surgery rate, speech recognition outcomes.
Results Forty-one devices were implanted in 27 pediatric patients. Average age at implantation was 4.01 years (range, 0.87–12.75). To date, 30 devices (73%) are known failures with 90% of these having undergone revision surgery. No statically significant difference was noted on open-set speech testing across best prerevision, immediate prerevision, and best postrevision time points. Best postrevision CNC scores had a mean score of 71% ± 26%, n = 16.
Conclusions Pediatric patients implanted with FCA-affected CI devices have a high risk of device failure. Open-set speech recognition was not significantly different from prerevision to postrevision testing, suggesting preserved speech outcomes. This may be partially attributable to limitations of cohort size and the pediatric population with open-set speech testing. However, we suspect that close follow-up with standardized testing and a low threshold for revision surgery provided by our multidisciplinary team may have mitigated these changes. Postrevision open-set speech testing remains positive for these patients.
Cottrell, Justin; Spitzer, Emily; Winchester, Arianna; Dunn-Johnson, Camille; Gantz, Bruce; Rathgeb, Susan; Shew, Matthew; Herzog, Jacques; Buchman, Craig; Friedmann, David; Jethanamest, Daniel; McMenomey, Sean; Waltzman, Susan; Thomas Roland, J. Jr
Publication date 01-10-2024
Objective To better understand cochlear implant (CI) performance after reimplantation with a different device manufacturer.
Study Design Multisite retrospective review.
Setting Tertiary referral centers.
Patients Patients older than 4 years who received a CI and subsequently underwent CI reimplantation with a different manufacturer over a 20-year period Intervention Reimplantation.
Main Outcome Measure The primary outcome was difference in the best CNC score obtained with the primary CI, compared with the most recent CNC score obtained after reimplantation.
Results Twenty-nine patients met the criteria at three centers. The best average CNC score achieved by adult patients after primary cochlear implantation was 46.2% (n = 16), measured an average of 14 months (range: 3–36 mo) postoperatively. When looking at the most recent CNC score of adult patients before undergoing reimplantation, the average CNC score dropped to 19.2% (n = 17). After reimplantation, the average 3- to 6-month CNC score was 48.3% (n = 12), with most recent average CNC score being 44.4% (n = 17) measured an average of 19 months (range: 3–46 mo) postoperatively. There was no statistically significant difference (p = 0.321; t11 = 0.48) identified in performance between the best CNC score achieved by adult patients after primary cochlear implantation, and the most recent score achieved after reimplantation (n = 12). Analysis of prerevision and postrevision speech performance was not possible in pediatric patients (<18 yr old) because of differences in tests administered.
Conclusion Patients undergoing reimplantation with a different manufacturer achieved CNC score performance comparable to their best performance with their original device.
Dornhoffer, James R.; Shannon, Christian; Hernandez-Herrara, Gabriel A.; Schvartz-Leyzac, Kara C.; Dubno, Judy R.; McRackan, Theodore R.
Publication date 01-10-2024
Objective Computer-based auditory training (CBAT) has been shown to improve outcomes in adult cochlear implant (CI) users. This study evaluates in new CI users whether starting CBAT within 3 months of activation or later impacts CI outcomes.
Study Design Prospective natural experiment.
Setting Tertiary academic medical center.
Patients Sixty-five new adult CI users.
Interventions CBAT use over the first-year postactivation.
Main Outcome Measures Speech recognition scores and CIQOL-35 Profile score improvements between CI recipients who started CBAT resources early (<3 mo) and late (3–12 mo) postactivation.
Results A total of 43 CI recipients started using CBAT within 3 months postactivation (early) and 22 after 3 months (late). Patients who used CBAT within 3 months postactivation showed significantly greater improvement in consonant-nucleus-consonant words (CNCw) (48.3 ± 24.2% vs 27.8 ± 24.9%; d = 0.84), Az Bio Sentences in quiet (55.1 ± 28.0% vs 35.7 ± 36.5%; d = 0.62), and CIQOL-35 listening domain scores (18.2 ± 16.3 vs 6.9 ± 12.9, d = 0.73 0.023, 1.43), at 3 months postactivation, compared to those who had not yet initiated CBAT. However, by 12 months postactivation, after which all CI recipients had started CBAT, there were no differences observed between patients who started CBAT early or late in speech recognition scores (CNCw: d = 0.26 −0.35, 0.88; Az Bio: d = 0.37 −0.23, 0.97) or in any CIQOL global or domain score (d-range = 0.014–0.47).
Conclusions Auditory training with self-directed computer software (CBAT) may yield speech recognition and quality-of-life benefits for new adult CI recipients. While early users showed greater improvement in outcomes at 3 months postactivation than users who started later, both groups achieved similar benefits by 12 months postactivation.
Cottrell, Justin; Winchester, Arianna; Friedmann, David; Jethanamest, Daniel; Spitzer, Emily; Svirsky, Mario; Waltzman, Susan B.; Shapiro, William H.; McMenomey, Sean; Roland, J. Thomas Jr
Publication date 27-08-2024
Objective To characterize transimpedance matrix (TIM) heatmap patterns in patients at risk of labyrinthine abnormality to better understand accuracy and possible TIM limitations.
Study Design Retrospective review of TIM patterns, preoperative, and postoperative imaging.
Setting Tertiary referral center.
Patients Patients undergoing cochlear implantation with risk of labyrinthine abnormality.
Intervention None.
Results Seventy-seven patients were evaluated. Twenty-five percent (n = 19) of patients had a TIM pattern variant identified. These variants were separated into 10 novel categories. Overall, 9% (n = 6) of electrodes were malpositioned on intraoperative x-ray, of which 50% (n = 3) were underinserted, 17% (n = 1) were overinserted, 17% (n = 1) had a tip foldover, and 17% (n = 1) had a coiled electrode. The number of patients with a variant TIM pattern and normal x-ray was 18% (n = 14), and the number of patients with normal TIM pattern and malposition noted on x-ray was 3% (n = 2; both were electrode underinsertions that were recognized due to open circuits and surgical visualization).
A newly defined skip heat pattern was identified in patients with IP2/Mondini malformation and interscalar septum width <0.5 mm at the cochlear pars ascendens of the basal turn.
Conclusions This study defines novel patterns for TIM heatmap characterization to facilitate collaborative and comparative research moving forward. In doing so, it highlights a new pattern termed skip heat, which corresponds with a deficient interscalar septum of the cochlea pars ascendens of the basal turn in patients with IP2 malformation. Overall, the data assist the surgeon in better understanding the implications and limitations of TIM patterns within groups of patients with risk of labyrinthine abnormalities.
"Patro, Ankita; Moberly, Aaron C.; Freeman, Michael H.; Perkins, Elizabeth L.; Jan, Taha A.; Tawfik, Kareem O.; OMalley, Matthew R.; Bennett, Marc L.; Gifford, René H.; Haynes, David S.; Chowdhury, Naweed I."
Publication date 01-10-2024
Objective To assess the minimal clinically important difference (MCID) values for cochlear implant-related speech recognition scores, which have not been previously reported.
Study Design Retrospective cohort.
Setting Tertiary referral center.
Patients Eight hundred sixty-three adult patients who underwent cochlear implantation between 2009 and 2022.
Main Outcome Measures MCID values for consonant-nucleus-consonant (CNC) word scores and Az Bio sentences in quiet and noise scores using distribution-based methods (half-standard deviation, standard error of measurement, Cohens d, and minimum detectable change).
Results In this cohort, the mean preoperative CNC word score was 13.9% (SD, 15.6). The mean preoperative Az Bio sentences in quiet score was 19.1% (SD, 22.1), and the mean preoperative Az Bio sentences in noise score was 13.0% (SD, 12.0). The average MCID values of several distribution-based methods for CNC, Az Bio in quiet, and Az Bio in noise were 7.4%, 9.0%, and 4.9%, respectively. Anchor-based approaches with the Speech, Spatial, and Qualities of hearing patient-reported measure did not have strong classification accuracy across CNC or Az Bio in quiet and noise scores (ROC areas under-the-curve ≤0.69), highlighting weak associations between improvements in speech recognition scores and subjective hearing-related abilities.
Conclusions Our estimation of MCID values for CNC and Az Bio in quiet and noise allows for enhanced patient counseling and clinical interpretation of past, current, and future research studies assessing cochlear implant outcomes.
Kanemaru, Shin-ichi; Kita, Shin-ichiro; Kanai, Rie; Yamaguchi, Tomoya; Kumazawa, Akiko; Yuki, Ryohei; Yoshida, Misaki; Miwa, Toru; Harada, Hiroyuki; Maetani, Toshiki
Publication date 19-08-2024
Objective To evaluate tympanic membrane regeneration therapy (TMRT) for pediatric tympanic membrane perforations (TMPs).
Study Design Intervention study.
Setting Research institute hospital.
Patients In this study, 20 patients with chronic TMP (M/F: 13/7, 13/8 ears, age 0–15 years) treated with TMRT were evaluated. As comparison, 20 pediatric patients with chronic TMP who underwent myringoplasty/tympanoplasty were included.
Interventions For the TM repair procedure, the edge of the TMP was disrupted mechanically, and gelatin sponge immersed in basic fibroblast growth factor was placed inside and outside the tympanic cavity and covered with fibrin glue. The TMP was examined 4 ± 1 weeks later. The protocol was repeated up to four times until closure was complete.
Main Outcome Measures Closure of the TMP and hearing improvement were evaluated at 16 weeks after the final regenerative procedure. Adverse events were monitored.
Results The mean follow-up period was 427.1 days. The TM regenerated in all cases, but pinhole reperforation occurred in two cases, and the final closure rate was 90.5% (19 of 21). Hearing improved to 24.9 ± 7.6 dB on average before surgery and to 13.8 ± 5.4 dB after surgery. The AB gap improved from 12.9 ± 8.0 to 5.2 ± 3.5 dB.
The myringoplasty/tympanoplasty group had significantly lower AB gap improvement compared with the TMRT group. There were no adverse events.
Conclusions TMRT can be expected to regenerate near-normal TMs with a high closure ratio, resulting in better-hearing improvement compared with the myringoplasty/tympanoplasty group, and is an effective treatment for children with long life expectancy.
Teunissen, Emma M.; Aukema, Tjerk W.; Banga, Rupan; Eeg-Olofsson, Måns; Hol, Myrthe K. S.; Hougaard, Dan D.; Tysome, James R.; Johansson, Martin L.; Svensson, Sara; Powell, Harry R. F.
Publication date 26-08-2024
Objective To investigate the clinical outcomes of bone-anchored hearing implant surgery using the MONO procedure.
Study Design Multicenter, multinational, single-arm, prospective trial with a 12-month follow-up.
Setting Seven European university hospitals from the United Kingdom, Sweden, Denmark, and The Netherlands.
Patients Fifty-one adult patients requiring surgical intervention for bone conduction hearing.
Intervention Bone-anchored hearing implant surgery using the MONO procedure.
Main Outcome Measures The primary endpoint assessed implant usability 3 months after surgery. Implant status, soft tissue reactions, pain and numbness, postoperative events, and sound processor usage were assessed at all follow-up visits. Hearing-related quality of life was evaluated using the Glasgow Benefit Inventory (GBI).
Results At 3 months, 94.2% of the implant/abutment complexes provided reliable anchorage for sound processor usage. No severe intraoperative complications occurred. Sixty-nine percent of surgeries were performed under local anesthesia, with surgery lasting 10 minutes on average. Four implants were lost due to trauma (n = 2), spontaneous loss of osseointegration (n = 1), or incomplete insertion (n = 1). Adverse soft tissue reactions occurred in 2.6% of visits, with a maximum Holgers grade of 3 (n = 1) and grade 2 (n = 5) across patients. Hearing-related quality of life at 3 months improved in 96% of patients.
Conclusion The MONO procedure provides a safe and efficient surgical technique for inserting bone-anchored hearing implants with few and minor intra- and postoperative complications.
Hoshino, Kimiko; Fujiwara, Keishi; Morita, Shinya; Fukuda, Atsushi; Takeda, Hideaki; Nakamaru, Yuji; Homma, Akihiro
Publication date 26-08-2024
Objective To evaluate semicircular canal function using video head impulse test (vHIT) in relapsing polychondritis (RP) patients presenting with dizziness and sensorineural hearing loss.
Study Design Retrospective case review.
Setting Tertiary referral center.
Patients Three patients with RP underwent vHIT and hearing tests.
Intervention Diagnostic.
Main Outcome Measures The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined, and the correlation between semicircular canal dysfunction and hearing loss was investigated.
Results Of the six ears, five exhibited semicircular canal dysfunction. Among these, one ear showed dysfunction in two semicircular canals, while the remaining four ears demonstrated dysfunction in all three semicircular canals. Sensorineural hearing loss, ranging from moderate to profound, was detected by pure-tone audiometry in all six ears. Furthermore, a significant correlation was observed between VOR gain in the horizontal semicircular canal (HSC) and hearing level.
Conclusions This study demonstrated semicircular canal dysfunction in RP patients presenting with dizziness and hearing loss using vHIT. Moreover, a significant correlation was found between HSC dysfunction and the severity of hearing loss. While inner ear involvement is a key clinical symptom included in the diagnostic criteria for RP, there have been few reports evaluating vestibular dysfunction, and this is the first report on the evaluation of several cases using vHIT. Accurate assessment of vestibular function by vHIT may facilitate early diagnosis and intervention in RP, potentially improving patient outcomes.
Nassiri, Ashley M.; Staricha, Kelly; Neff, Brian A.; Driscoll, Colin L. W.; Link, Michael J.; Carlson, Matthew L.
Publication date 05-08-2024
Objectives Describe a single institutions cochlear implant outcomes for patients with inner ear schwannomas (IES) in the setting of various tumor management strategies (observation, surgical resection, or stereotactic radiosurgery SRS).
Study Design Single-institution retrospective review.
Patients Patients diagnosed with isolated, sporadic IES who underwent cochlear implantation (CI).
Interventions CI with or without IES treatment.
Main Outcome Measures Speech perception outcomes, tumor status.
Results Twelve patients with IES underwent CI with a median audiologic and radiologic follow-up of 12 months. Six patients underwent complete resection of the tumor at the time of CI, four underwent tumor observation, and two underwent SRS before CI. At 1 year after CI for all patients, the median consonant–nucleus–consonant (CNC) word score was 55% (interquartile range, 44–73%), and the median Az Bio sentence in quiet score was 77% (interquartile range, 68–93%). Overall, those with surgical resection performed similarly to those with tumor observation (CNC 58 versus 61%; Az Bio in quiet 74 versus 91%, respectively). Patients who underwent tumor resection before implantation had a wider range of speech performance outcomes compared with patients who underwent tumor observation. Two patients had SRS treatment before CI (10 months previous and same-day as CI) with CNC word scores of 6 and 40%, respectively.
Conclusions Patients with IES who underwent CI demonstrated similar speech performance outcomes (CNC 56% and Az Bio 82%), when compared with the general cochlear implant population. Patients who underwent either tumor observation or surgical resection performed well after CI.
Abdul Halim, Riana Kipiani; Lapina, Gerard; Shin, Seung Ho; Jung, Youngrak; Lee, Jeong Gum; Moon, In Seok
Publication date 29-08-2024
Objective The management options for small acoustic tumors are still controversial, and surgery is indicated in a select number of patients only. This is to avoid unnecessary extensive operations and risk of complications. Endoscopic transcanal approach, which was recently introduced, can be an alternative option to overcome these challenges. We have developed a modified technique for endoscopic transcanal removal of small acoustic tumors with tympanoplasty using tragal cartilage and without the need to harvest abdominal fat for obliteration. There was also no need to do an ear cul-de-sac procedure compared with the previous method. We report the long-term outcomes of this approach.
Study Design Retrospective review.
Setting Tertiary hospital.
Patients Those who were diagnosed with small acoustic tumors between June 2016 and June 2022 were enrolled.
Interventions Tumor removal via a Modified Endoscopic Transcanal Transpromontorial Approach (mETTA).
Main Outcome Measure Tumor control rate, closure rate of tympanic membrane, and complications such as cerebrospinal fluid (CSF) leakage and facial palsy were analyzed. Operation time and hospital stay were also analyzed.
Results Twenty-two patients with a mean age of 55.5 ± 9.4 years were enrolled. Eighteen were vestibular schwannomas (VS), two were intracochlear schwannomas (ICS), and two were with intravestibulocochlear schwannomas (IVCS). Gross total removal was achieved in 21 cases. One had developed significant CSF leakage, and the other patient complicated with permanent facial palsy. The tympanic membrane healed well in all patients, but three patients showed delayed healing until several months and treated conservatively. Mean operation time was 149.6 ± 48.4 minutes, mean hospital stay was 8.9 ± 4.5 days, and mean postoperative follow-up period was 42.0 ± 15.7 months.
Conclusion Long-term results of modified endoscopic transcanal approach to small acoustic tumors are acceptable and comparable to classical treatments such as translabyrinthine approach or gamma knife radiation. This is an alternative option for smaller tumors warranting surgical removal and maintained cosmetic advantages.
Tan, Donald; Fujiwara, Rance J.T.; Tan, Christopher; Isaacson, Brandon; Hunter, Jacob B.
Publication date 21-08-2024
Objective To discuss the potential benefit of belzutifan therapy in a patient with von Hippel–Lindau (VHL) disease–associated endolymphatic sac tumor (ELST).
Patients Case report.
Interventions Clinical details of a patient with residual ELST after hearing preservation surgery who initiated belzutifan therapy postoperatively for concurrent renal cell carcinoma, as well as literature review of belzutifan and ELST.
Main Outcome Measures The patient remained without radiologic evidence of growth of her residual tumor at 17 months post-initiation of belzutifan. It is unknown whether this represents therapeutic drug effect, nonviability of residual tumor, or slow tumor growth not captured radiographically within the duration of follow-up.
Conclusions Belzutifan could have direct therapeutic benefit in patients with VHL-associated ELST.
"Epprecht, Lorenz; Zekelman, Leo; Reinshagen, Katherine L.; Xie, Guoqiang; Norton, Isaiah; Kikinis, Ron; Makris, Nikos; Piccirelli, Marco; Huber, Alexander; Lee, Daniel J.; Zhang, Fan; ODonnell, Lauren J."
Publication date 05-09-2024
Abstract: Hypothesis This study investigates the impact of different diffusion magnetic imaging (dMRI) acquisition settings and mathematical fiber models on tractography performance for depicting cranial nerve (CN) VII in healthy young adults.
Background The aim of this study is to optimize visualization of CN VII for preoperative assessment in surgeries near the nerve in the cerebellopontine angle, reducing surgery-associated complications. The study analyzes 100 CN VII in dMRI images from the Human Connectome Project, using three separate sets with different b values (b = 1,000 s/mm2, b =2,000 s/mm2, b =3,000 s/mm2) and four different tractography methods, resulting in 1,200 tractographies analyzed.
Results The results show that multifiber and free water (FW) compartment models produce significantly more streamlines than single-fiber tractography. The addition of an FW compartment significantly increases the mean streamline fractional anisotropy (FA). Expert quality ratings showed that the highest rated tractography was the 1 tensor (1T) method without FW at b values of 1,000 s/mm2.
Conclusions In this young and healthy cohort, best tractography results are obtained by using a 1T model without a FW compartment in b =1,000 diffusion MR images. The FW compartment increased the contrast between streamlines and cerebrospinal fluid (higher mean streamline FA). This finding may help ongoing research to improve CN VII tractography results in tumor cases where the nerve is often stretched and thinned by the tumor.
Jiang, Wen; Li, Feifan; Xu, Handong; Cao, Maorong; Xiao, Bin; Gong, Ke; Ma, Jingyu; Zhang, Weiguo; Tang, Xuxia; Liu, Fenye; Yu, Shudong
Publication date 01-10-2024
Purpose Gentamicin is a broad-spectrum antibiotic commonly used in clinical practice. However, the drug causes side effects of ototoxicity, leading to disruption in balance functionality. This study investigated the effect of gastrodin, a prominent compound present in Gastrodia, and the underlying mechanism on the development of gentamicin-induced vestibular dysfunction.
Methods Wild-type C57BL/6 mice were randomly assigned to three groups: control, gentamicin, and gentamicin + gastrodin groups. The extent of gentamicin-induced vestibular impairment was assessed through a series of tests including the swimming test, contact righting reflex test, and air-righting reflex. Alterations in vestibular hair cells were monitored through immunofluorescence assay, and cellular apoptosis was observed using TUNEL staining. The mRNA and protein expression of Notch1, Jagged1, and Hes1 was quantified through qRT-PCR, immunofluorescence, and western blot analyses.
Results Gentamicin treatment led to pronounced deficits in vestibular function and otolith organ hair cells in mice. Nevertheless, pretreatment with gastrodin significantly alleviated these impairments. Additionally, the Notch signaling pathway was activated by gentamicin in the utricle, contributing to a notable increase in the expression levels of apoptosis-associated proteins. By contrast, gastrodin treatment effectively suppressed the Notch signaling pathway, thereby mitigating the occurrence of apoptosis.
Conclusion Collectively, these findings underscore the crucial role of gastrodin in safeguarding against gentamicin-induced vestibular dysfunction through the modulation of the Notch signaling pathway. This study suggests the potential of gastrodin as a promising therapeutic agent for preventing vestibular injuries.
Feng, Sharon J.; Voruz, François; Leong, Stephen; Hammer, Daniella R.; Breil, Eugénie; Aksit, Aykut; Yu, Michelle; Chiriboga, Lauren; Olson, Elizabeth S.; Kysar, Jeffrey W.; Lalwani, Anil K.
Publication date 21-08-2024
Hypothesis Microneedle-mediated intracochlear injection of siRNA-Lipofectamine through the round window membrane (RWM) can be used to transfect cells within the cochlea.
Background Our laboratory has developed 100-μm diameter hollow microneedles for intracochlear injection through the guinea pig RWM. In this study, we test the feasibility of microneedle-mediated injection of siRNA and Lipofectamine, a commonly used reagent with known cellular toxicity, through the RWM for cochlear transfection.
Methods Fluorescently labeled scramble siRNA was diluted into Lipofectamine RNAi Max and OptiMEM. One microliter of 5 μM siRNA was injected through the RWM of Hartley guinea pigs at a rate of 1 μl/min (n = 22). In a control group, 1.0 μl of Lipofectamine, with no siRNA, was diluted into OptiMEM and injected in a similar fashion (n = 5). Hearing tests were performed before and either at 24 hours, 48 hours, or 5 days after injection. Afterward, animals were euthanized, and cochleae were harvested for imaging. Control cochleae were processed in parallel to untreated guinea pigs.
Results Fluorescence, indicating successful transfection, was observed within the basal and middle turns of the cochlea with limited distribution in the apex at 24 and 48 hours. Signal was most intense in the organ of Corti, spiral ligament, and spiral ganglion. Little to no fluorescence was observed at 5 days post-injection. No significant changes in auditory brainstem response (ABR) were noted post-perforation at 5 days, suggesting that siRNA-Lipofectamine at low doses does not cause cochlear toxicity.
Conclusions Small volumes of siRNA and Lipofectamine can be effectively delivered to cochlear structures using microneedles, paving the way for atraumatic cochlear gene therapy.
Urdang, Zachary D.; Jain, Amiti; Li, Marwin; Haupt, Thomas L.; Wilcox, Thomas O.; Chiffer, Rebecca C.; Gurgel, Richard K.
Publication date 21-08-2024
Objective To test the hypothesis that conductive hearing loss (CHL) is associated with dementia, and that middle ear reconstruction (MER) associates with improved outcomes for these measures in a multinational electronic health records database.
Study Design Retrospective cohort study with propensity-score matching (PSM).
Setting Tri NetX is a research database representing about 110 million patients from the United States, Taiwan, Brazil, and India.
Patients Subjects older than 50 years with no HL and any CHL (ICD-10: H90.0–2). Subjects of any age with and without any MER (CPT: 1010174).
Main Outcome Measures Odds ratios (ORs) and hazard ratios with 95% confidence intervals (95% CIs) for incident dementia (ICD-10: F01, F03, G30).
Results Of 103,609 patients older than 50 years experiencing any CHL, 2.74% developed dementia compared with 1.22% of 38,216,019 patients with no HL (OR, 95% CI: 2.29, 2.20–2.37). Of patients experiencing CHL, there were 39,850 who received MER. The average age was 31.3 years, with 51% female patients. A total of 343,876 control patients with CHL were identified; 39,900 patients remained in each cohort after 1:1 PSM for HL- and dementia-related risk factors. Matched risk for developing dementia among MER recipients was 0.33% compared with 0.58% in controls (OR: 0.58, 0.46–0.72).
Conclusions CHL increases the odds for dementia, and MER improves the odds for incident dementia. This study represents the first population study on the topic of CHL, MER, and dementia.
Yan, Jiangyu; Wu, Linrong; Zheng, Mengmeng; Lv, Yuan; Jiang, Feng; Gao, Weibo; Pan, Fangfang
Publication date 06-08-2024
Background Mitochondrial proteins assume a pivotal role in the onset and progression of diverse diseases. Nonetheless, the causal interconnections with sensorineural hearing loss (SNHL) demand meticulous exploration. Mendelian randomization analysis is a method used in observational epidemiological studies to predict the relationship between exposure factors and outcomes using genetic variants as instrumental variables. In this study, we applied this analytical approach to two distinct samples to predict the causal impact of mitochondrial proteins on SNHL.
Methods Two-sample Mendelian randomization analyses were executed to scrutinize the predicted associations between 63 mitochondrial proteins (nuclear-encoded) and SNHL, utilizing summary statistics derived from genome-wide association studies. Assessments of pleiotropy and heterogeneity were carried out to gauge the robustness of the obtained findings.
Results Four mitochondrial proteins exhibited a suggestive causal relationship with the susceptibility to SNHL. Dihydrolipoamide dehydrogenase (DLD; OR = 0.9706, 95% CI = 0.9382–0.9953, p = 0.0230) was linked to a diminished risk of SNHL. Conversely, elevated levels of mitochondrial ribosomal protein L34 (MRPL34; OR = 1.0458, 95% CI = 1.0029–1.0906, p = 0.0362), single-pass membrane protein with aspartate-rich tail 1 (SMDT1; OR = 1.0619, 95% CI = 1.0142–1.1119, p = 0.0104), and superoxide dismutase 2 (SOD2; OR = 1.0323, 95% CI = 1.0020–1.0634, p = 0.0364) were associated with an elevated risk of SNHL.
Conclusion This research utilized Mendelian randomization analysis to predict the relationship between mitochondrial proteins and SNHL. It provides a potential viewpoint on the etiology and diagnosis.
Scarpa, Alfonso; Carucci, Mario; Ralli, Massimo; De Luca, Pietro; Salzano, Giovanni; Viola, Pasquale; Chiarella, Giuseppe; Salzano Francesco, Antonio
Publication date 26-08-2024
No abstract available
Pubmed PDF WebBernkopf, Edoardo; Capriotti, Vincenzo; Bernkopf, Giulia; Fermi, Matteo; Cristalli, Giovanni
Publication date 27-08-2024
No abstract available
Pubmed PDF WebTawk, Karen; Vahidi, Ryka; Khoshsar, Avissa; Chao, Madeleine; Abouzari, Mehdi; Djalilian, Hamid R.
Publication date 26-08-2024
No abstract available
Pubmed PDF WebBernaerts, Anja; Van den Kerkhof, Frederik; Blaivie, Cathérine; Wuyts, Floris; van Dinther, Joost; Zarowski, Andrzej; Deckers, Filip; De Foer, Bert
Publication date 27-08-2024
No abstract available
Pubmed PDF WebRisoud, Michaël; Toulemonde, Philippine; Beck, Cyril; Schapira, Stéphane; Vincent, Christophe
Publication date 06-08-2024
No abstract available
Pubmed PDF WebFernandez, Ignacio Javier; Gozzi, Guglielmo; Molinari, Giulia; Barbazza, Alice
Publication date 27-08-2024
No abstract available
Pubmed PDF WebPublication date 01-10-2024
No abstract available
Pubmed PDF Web