bluuebunny/crossref_metadata_2025 huggingface dataset:
Catabolism of Mannosidase and Fucosidase in Cholesteatoma
Authors: Olszewska Ewa , Jakimowicz‐Rudy Joanna , Rogowski Marek
Published: February 2015

Objective

To determine the level of glycoconjugates catabolism by marking α‐mannosidase (MAN) and α‐fucosidase (FUC) activity in cholesteatoma and serum.

Method

Middle ear cholesteatomas (Chol), normal skin specimens (C) and serum of cholesteatoma patients and serum from healthy volunteers were included in the study. The concentration of lysosomal exoglycosidases activity was assessed on the basis of p‐nitrophenol release from the derivatives of the substrate (MAN from mannose and FUC from fucose).

Results

Mean concentration of MAN activity in Chol was 8.31112 pKat/mL in comparison with C (2.621048 pKat/mL). Pearson correlation (MAN activity) was r = 0.26321. Mean activity concentration of FUC in Chol was 10.03288 pKat/mL in comparison with C: 2.723152 pKat/mL. The average concentration of MAN activity in serum from cholesteatoma patients was 3.05712 pKat/mL, compared to the concentration of MAN activity in the control serum 2.73244 pKat/mL. The average concentration of FUC activity in serum of cholesteatoma patients was 5.40336 pKat/mL and significantly higher in comparison with the FUC activity concentrations in C 3.51976 pKat/mL.

Conclusion

There is an increase of glycocojugates catabolism due to the significantly higher concentration of MAN and FUC activity in cholesteatoma. The increased concentration of MAN and FUC activity in serum of cholesteatoma patients might suggest the role of those enzymes in the pathogenesis of chronic otitis media with cholesteatoma.
Central Obesity Is Related to Age‐Related Hearing Loss
Authors: Kim Tae Su , Chung Jong Woo , Kim Do Yeon , Kim Eon Bin
Published: February 2015

Objective

1) Test the the hypothesis that central adiposity measured by computed tomography is a better predictor of the risk of age‐related hearing loss (ARHL) than is body mass index (BMI), or waist circumference (WC). 2) Determine whether the visceral/subcutaneous fat ratio (VSR) is a significant risk factor for age‐related hearing loss.

Method

We performed a retrospective review of medical records from 235 adult subjects, either normal or symmetric sensorineural hearing loss, who visited the ASAN Health Promotion Center between July 2010 and June 2011. All subjects underwent fat measurement abdominal CT. The mean individual subject thresholds of 500 Hz, 1 kHz, 2 kHz. and 4 kHz were averaged to obtain the average pure tone hearing level (PTA). Glucose, lipid profile, BMI, and WC were measured after an overnight fast.

Results

VSR, WC, and age were positively associated with PTA score. But in men, VSR showed a positive association with borderline significance with PTA score. With backward stepwise multivariate linear regression analysis, VSR, but not WC, showed significant positive association with PTA score in females. When age, systemic disease, and other variables were adjusted using logistic regression analysis, WC and VSR showed significant positive correlation with hearing loss in males. However in women, VSR, but not WC, showed a significant positive correlation with hearing loss.

Conclusion

The VSR is an independent risk factor for ARHL. The VSR which is measured by CT is a better predictor of the risk of ARHI than is BMI or WC, especially for women.
Cholesteatoma: Long‐term Follow‐up in Romanian Patients
Authors: Cosgarea Marcel , Necula Violeta , Maniu Alma
Published: February 2015

Objective

Cholesteatoma is an abnormal destructive growth of squamous epithelium in middle ear and mastoid. The presence of cholesteatoma requires surgical intervention and the main goal is to achieve a safe, dry ear and to improve hearing. The extension of surgery depends on the size of the cholesteatoma.

Method

A total of 875 patients were treated for cholesteatoma in our department between 2001 and 2010, 213 pediatric patients. We performed both open and closed and technique, depending on disease extension, bone erosion, and complications, followed by second‐look surgery in most of the closed‐technique cases.

Results

The closed technique was the treatment of choice in 69.2% cases, most of them uncomplicated cholesteatomas. In 30.6% we performed open technique for different reasons. Second look surgery was done in 57.3% of cases after 1.5 or 2 years. A total of 27.1% of patients were lost to the follow‐up program after the first years. Residual cholesteatomas were noticed in 17% of the cases and the recurrent cholesteatomas were operated in 32% of the cases. After surgery the air‐bone gape improved in 67.1% of the cases because of tympanoplasty with autologous graft or different types of prosthesis. In some cases we used the BAHA prosthesis.

Conclusion

Cholesteatoma is a serious condition which needs surgical treatment. Second‐look control in closed technique should be done after one‐one and a half year. Closed technique is recommended in order to restore the function of the ear which is very important for a proper development and a good quality of life.
Clinical Analysis of 22 Cases of Automastoidectomy
Authors: Lee Sun Kyu , Jeung JiHyeon , Byun Jae Yong , Yeo Seung‐Geun , Park Moon‐Suh
Published: February 2015

Objective

Automastoidectomy is a destructive condition of the mastoid and middle ear cavity about which very little has been reported. 1) Know the clinical features and severities of automastoidectomy caused by chronic otitis media. 2) Evaluate the results of its surgical outcomes.

Method

Retrospective study. Patients who visited outpatient clinic and were diagnosed with COM with automastoidectomy state by temporal bone CT from January 2003 to December 2011 were included in this study. All patients underwent surgery. Their postoperative states were evaluated at the outpatient clinic at least 6 months after surgery.

Results

Two patients complained of facial palsy, 7 hearing disturbance, 10 otorrhea, and 3 otalgia. At physical examination, attic destruction and retracted tympanic membrane (TM) were observed in 12 patients, EAC destruction in 8, TM perforation in 4, and 1 had intact TM. All pathologic results were cholesteatoma. A total of 19 had canal wall down mastoidectomy, 2 had canal wall‐up mastoidectomy, and 1 had subtotal petrosectomy. One had tympanoplasty type 1, 3 had columella over stapes head, 10 had interposition or columella over stapedial footplate and, 1 had tympanoplasty type 3. Overall hearing improvement rate was 9.0%. There was no recurrence.

Conclusion

Automastoidectomy is a relatively rare condition of middle ear diseases. It could be caused by cholesteatomatous COM and non‐cholesteatomatous COM. Hearing reconstructive procedures are generally not effective compared with other conditions. This study may be helpful to know the clinical features and surgical outcomes of this condition.
Clinical Value of VEMP in Ménière’s Disease
Authors: Youm Hye‐Youn , Kim Min Beom , Choi Jeesun , Byun Ha‐Young , Park Ga‐Young , Chung Won‐Ho
Published: February 2015

Objective

1) To find clinical value of cervical vestibular evoked myogenic potential (VEMP) in Ménière’s disease (MD). 2) To evaluate whether the VEMP results can be useful in assessing the stage of MD. 3) To evaluate the clinical effectiveness of VEMP in predicting hearing outcome.

Method

The amplitude, peak latency and interaural amplitude difference ratio (IAD ratio) was obtained using cervical VEMP. The VEMP results of MD were compared with normal subjects and MD stages were compared with IAD ratio. Finally, the hearing changes were analyzed according to their VEMP results.

Results

In clinically definite unilateral MD (n = 41), the prevalence of cervical VEMP abnormality in IAD ratio was 34.1%. Compared with healthy subjects (n = 33), the VEMP profile showed low amplitude and similar latency. The mean IAD ratio in MD was 23%, and was significantly different from healthy subjects (P =. 01). As the stage increased, IAD ratio was significantly increased (P =. 078). After stratification by initial hearing level, stage I and II subjects (hearing threshold, 0‐40 dB) with abnormal IAD ratio showed a decrease in hearing over time compared to those with normal IAD ratio (P =. 065).

Conclusion

VEMP parameters have an important clinical role in MD. Especially, IAD ratio can be used to assess the stage of MD. An abnormal IAD ratio may be used as a predictor of poor hearing outcomes in subjects with early stage MD.
Cochlear Implant in Far Advanced Otosclerosis
Authors: Ruiz Hector E. , Curet Carlos , Salvadores Maria I. , Romani Carolina , Rubiño Luis , Queirolo Adriana , Dotto Gabriela
Published: February 2015

Objective

To evaluate clinical characteristics of these patients, with otosclerosis, complications,and observations of the benefits of implants to medium and long term.

Method

Thirty two adult patients, age 50 years old, 22 women and 10 men, with profound sensorineural hearing loss, and otosclerosis far advanced, were treated with multi‐channel cochlear implants. All had otological examination, psychological, audiometry, and 0% of speech discriminations with‐well‐fitted hearing aid, CTS (4 with RMI) to determine hypodensity or morphologic changes.

Results

CTS with morphologic changes in the cochlea in 24/32 patients (Rottevel’s grading): 9 had type 2 (localized retrofenestral disease), 6 type 3 (retrofenestral diffuse). Full insertion inside the cochlea in 28/32 cases, where in 6 patients it was necessary to drill the bone in 4 to 6 mm in the tympanic basal turn. four patients had partial insertion of electrodes, 1 of them with 2 electrodes in IAC and leakage of CSF, 1 with stimulation of the facial nerve (type 3). Three patients were reinplanted. Tinnitus with sensation of resounds was observed in 5 patients. Good discriminations in speech was evidenced in 26/32 patients.

Conclusion

Patients with far advanced otosclerosis demonstrated good performance with CI in 26/32 cases. In otosclerosis type 3, 5 out of 6 patients had more difficulty in the insertion of electrodes, 1 of them with 2 electrodes within the IAC and leakage of LCR, and 5 of them with tinnitus and smaller auditory outcome.
Cochlear Implant Performance after Round Window Insertion
Authors: Kang Bryan J. , Petti Derek , Kim Ana H.
Published: February 2015

Objective

To compare speech performance after undergoing round window (RW) electrode insertion with those who underwent traditional cochleostomy (C) cochlear implant (CI) surgery.

Method

Study design: Prospective study. Setting: Academic cochlear implant center. Patients who met CI criteria with favorable intraoperative RW anatomy who underwent RW CI electrode insertion were included. Patients meeting CI criteria who underwent traditional cochleostomy surgery were matched for age, duration of deafness, and preoperative hearing to serve as the comparison group. Intervention: RW versus traditional C electrode insertion. Main outcome measures: Postoperative speech performance using the consonant‐nucleus‐consonant (CNC) speech perception tested between 3 to 24 months after CI implantation.

Results

Eighty‐seven patients underwent RW insertion between 2007 to 2011. Thirty‐two patients had pre‐ and postoperative speech perception data for analysis. Age ranged from 9.7 to 79.4 years (mean, 53.9 ± 16.1 years). A total of 18 patients who underwent C insertion were identified, ranging in age from 37.8 to 68.3 years (mean, 51.4 ± 16.1 years). No significant differences in postoperative CI speech perception scores were noted between the RW and C group at 1 year post‐CI (RW group 53.6 ± 23.2% versus C group 56.2 ± 21.4%; P =. 73).

Conclusion

Our study suggests that in patients with favorable RW anatomy, RW cochlear implant electrode insertion demonstrated comparable speech performance compared to the traditional cochleostomy insertion.
Cochlear Implantation: Role of Language, Income, and Ethnicity
Authors: Willis Elena , Bent John P. , Masur Jonathan
Published: February 2015

Objective

To compare postcochlear implantation (CI) speech perception (SP) outcomes between a non‐English speaking ethnic minority study group and an English speaking ethnic majority control group.

Method

We performed a retrospective case‐control study at an academic tertiary care children’s hospital. Records were reviewed of 49 children who underwent CI from February 2005 to September 2011. Children with abnormal cognitive function (n = 12), postsurgical complications (n = 1), or incomplete SP testing (n = 24) were excluded. The remaining 12 cases (implantation age 1‐10 years; mean, 4.3 years) were reviewed for language, income, ethnicity, and SP scores. Their scores were compared to those from the Childhood Development after Cochlear Implantation (CDaCI) study. The CDaCI is a demographically balanced and multicenter‐based pediatric cohort from which publications are beginning to define normative post‐CI SP outcomes. Both groups had equivalent neurological status and age.

Results

Of our 12 children, 7 were Hispanic, 2 white, 2 multi‐ethnicity, and 1 Russian. Four were non‐English speaking, 5 spoke English as a second language, and 7 were bilingual. Three received bilateral CI. Early Speech Perception (ESP) scores were collected at 6 and 12 months. At both follow‐up intervals the study group performed significantly worse than the control group. (6‐month P =.048, 12‐month P =. 01)

Conclusions

This study suggests that among pediatric CI recipients, those from predominantly non‐English speaking, socioeconomically disadvantaged backgrounds develop SP at slower than normal rates. Future interventions should be directed at overcoming these obstacles.
Dextran Therapy in Sudden Deafness: A Quasi Study
Authors: Cheng Po‐Wen , Wang Chi‐Te , Chou Hsu‐Wen , Fang Kai‐Min , Lai Mei‐Shu
Published: February 2015

Objective

To evaluate the treatment outcome of low‐molecular‐weight dextran in the management of idiopathic sudden sensorineural hearing loss (ISSHL), we conducted this quasi‐experimental study to investigate whether subjects receiving additional dextran therapy demonstrated better hearing outcomes than patients receiving corticosteroid alone.

Method

Clinical records of 169 patients of ISSHL were reviewed from 2002 to 2010. Gathered information included age, gender, pretreatment hearing, delay of treatment, presence of vertigo and DM. Treatment methods include 1) oral prednisolone (1 mg/kg/d for 7 days) and 2) oral prednisolone plus dextran infusion (500 mL, twice daily).

Results

Initial analysis revealed that patients who received dextran therapy tended to have more severe hearing loss and shorter delay of treatment than the steroid group (P <. 01). Therefore, we applied propensity score to control for selection bias. Subjects with the same propensity score represented the same chance of receiving specific treatment. As a result, we re‐identified 50 pairs of propensity‐score‐matched subjects (N = 100) with a homogenous distribution of all clinical factors (P >. 05). Average hearing gain in subjects receiving dextran therapy (plus steroid) were 36.9 ± 20.1 dB, which does not differ from 34.7 ± 22.3 dB for subjects receiving steroid only (P =. 60).

Conclusion

Matching of propensity score successfully balanced the heterogeneity between the dextran and steroid group. Analytical result demonstrated that the addition of low‐molecular‐weight dextran to steroid therapy does not increase therapeutic effectiveness in managing ISSHL. Therefore, routine dextran administration in treating ISSHL should be carefully weighed against its potential hazards.
Differences in Quality of Life for Acoustic Neuroma Patients
Authors: McLaughlin Eamon J. , Bigelow Douglas C. , Lee John Y. K. , Ruckenstein Michael J.
Published: February 2015

Objective

Using the disease‐specific, validated Penn Acoustic Neuroma Quality of Life (PANQOL) survey we proposed the following study objectives: 1) Understand the demographics for patients with acoustic neuromas undergoing conservative management verses stereotactic radiosurgery (gamma knife). 2) Determine if there is a difference in quality of life for these patient groups.

Method

A retrospective chart review of acoustic neuroma patients who completed a PANQOL survey between the dates of October 1, 2010 and January 1, 2012 was performed. A total of 76 patients (38 conservative, 38 gamma knife) were included. Patient demographics, tumor characteristics, and PANQOL data for the 2 groups were statistically analyzed.

Results

Patient age, sex, percentage of extracanalicular tumors, and time elapsed from diagnosis to the PANQOL survey were not significantly different for the 2 groups. There was a statistically significant difference in tumor size between the 2 groups (CON 8.59 mm vs GK 16.45 mm, P ≤. 001). The differences in PANQOL composite scores for hearing, balance, facial nerve symptoms, pain, anxiety, and energy were not statistically significant. However, there was a statistically significant difference in the general composite score (CON 5.97 vs GK 5.32, P =. 015).

Conclusion

Despite significantly larger tumors, patients undergoing gamma knife experience a similar quality of life when compared to patients who are being conservatively managed. The use of disease‐specific quality of life measures, such as the PANQOL, will contribute to the development of “best evidence” treatment strategies for patients with acoustic neuromas.
Diffusion Tensor Tractography of the Facial Nerve
Authors: Escada Pedro A. , Pereira Pedro M. , De Almeida Gonçalo Neto , Taoka Rui Manaças; Toshiaki
Published: February 2015

Objective

1) Demonstrate that preoperative diffusion tensor (DT) tractography can predict the displacement of the facial nerve in the vicinity of vestibular schwannomas. 2) Demonstrate that the course of the constructed tract consistently agreed with the surgical findings in most of the cases.

Method

Prospective study of 15 patients undergoing surgical removal of vestibular schwannomas. The course of the facial nerve, determined preoperatively by diffusion tensor tractography using the method of Taoka et al was compared with the course of the nerve determined intraoperatively by microscopic inspection and using facial nerve monitoring equipment.

Results

The displaced facial nerve was identified in 14 patients by diffusion tensor tractography in axial and coronal T1 post‐gadolinium and equivalent tractography images. In 13 patients there was a precise correspondence between the course of the nerve determined preoperatively by diffusion tensor tractography and the course of the nerve found at surgery. In 1 patient the facial nerve was found anterior/cranial to the tumor while tractography seemed to depict an anterior/caudal course.

Conclusion

Diffusion tension tractography of the facial nerve is a feasible technique that can consistently predict the displacement of the facial nerve in the vicinity of vestibular schwannomas. The technique can be used preoperatively to lower the risk of facial nerve injury during acoustic neuroma surgery.
Effect of Creatine on Rat Inner Ear Stem Cell Culture
Authors: El Garem Hani F. , Mina Amir , El Sallam Sedik Abd , Di Santo Stefano , Ducray Angelique , Widmer Rudolph , Senn Pascal
Published: February 2015

Objective

Investigate whether creatine might enhance the long lasting propagation and differentiation of inner ear stem cells.

Method

Rat inner ear stem cells were propagated in basal medium. Creatine supplementation was at third passage. Self‐renewal capacity initiated measured by the spheres number in each passage. Cultures was grown for 2 weeks in creatine absence or presence, and neuronal and hair cell numbers were analyzed by beta‐III‐ tubulin and myosin VIIa immunohistochemistry, respectively.

Results

Stem cells were propagated for 11 passages for utricle and organ of Corti and 6 for spiral ganglion derived spheres. Creatine significantly enhanced the number of propagated spheres from P3 onward. Creatine promoted the spiral ganglia– derived spheres number and significantly increased the yield of neuronal cells of differentiated progenitors by 40%. It had no effect on differentiation in cultures derived from utricle and organ of Corti.

Conclusion

Creatine supplementation promoted both the propagation of rat spiral ganglia, utricle, and organ of Corti, as well as neural differentiation of spiral ganglia stem cells.
Effect of Using Earphones for Music‐Induced Hearing Impairment
Authors: Chang Yu‐Tuan , Lin Cheng‐Yu , Kuo Yu‐Liang , Kuo Nai‐Wen , Chao Chun Chih , Wu Jiunn‐Liang
Published: February 2015

Objective

Noise‐induced hearing losses (NIHL) have become more common among adolescents because of increased exposure to personal music players. Many adolescents used to listen to music by headphone. We aimed to assess whether the use of earphones has a significant effect on music‐induced hearing impairment in teenage students.

Method

This cross‐sectional study recruited students who habitually listen to music in quiet environments. Listeners with use of earphone and desktop speaker were included. Pure tone audiometry (PTA), distortion product otoacoustic emission (DPOAE), and completed questionnaire were obtained. Cumulative noise exposure (CNE) was calculated by listening time and volume of using players.

Results

A total of 105 subjects were analyzed. Mean age was 17.03 years. Sixty‐eight subjects (67.76%) used earphones, and the others used desktop speakers. Mean of PTA at high frequency (average of 3000, 4000, and 6000 Hz) was 8.97 dBHL (SD = 5.71). DPOAE amplitude level at high frequency was 19.87 dBSPL (SD = 5.11). Mean of CNE was 86.66 dB‐year (SD = 12.14). There was a good dose‐response relationship between CNE and DPOAE amplitude levels at high frequency (P <. 01). Under the similar CNE status, subjects with earphones had worse DPOAE amplitude levels than those with desktop speakers (P <. 05).

Conclusion

This study identified that the use of earphones may affect the relationship between music exposure dose and NIHL at high frequency. To preserve hearing, teenage students should avoid using earphones to listen to music for long periods of time.
Contrast‐Enhanced Ultrasound for Monitoring Parotid Tumors
Authors: Klotz Laura , Clevert Dirk , Gurkov Robert
Published: February 2015

Objective

Contrast‐enhanced ultrasound (CE‐US) can be used for noninvasive analysis of functional vascularization. Lesions of the parotid gland are associated with different vascularity compared to the normal gland. The aim of the clinical trial was to evaluate CE‐US as a diagnostic tool for parotid lesion.

Method

For CE‐US measurements, following intravenous SonoVue injection, the intensity‐time curve gradients were calculated from CE‐US data.

Results

The intensity‐time gradients derived from CE‐US measurements revealed significantly higher perfusion in the malign lesions group than the benign lesions group. Area under curve was significantly higher for malign lesions.

Conclusion

CE‐US–derived area under curve parameters appear as an independent and quantitative marker for the monitoring of parotid lesions. Clinical experience and further studies will have to validate this method as a reliable diagnostic tool to decide especially whether to proceed with surgery.
Epidemiological Study of Hearing Loss
Authors: Zanoni Alessandra , Cruz Oswaldo Laercio
Published: February 2015

Objective

To identify the most frequently observed characteristics among patients with hearing impairment in a Brazilian tertiary referral center, the Center of Hearing Impairment at UNIFESP.

Method

Patients assisted during the period from 2005 to 2009 with primary complaint of hearing difficulty had their charts reviewed. This study gathered 4467 patients, which underwent an ENT assessment by history taking, physical examination, audiological testing, and, when indicated, imaging examinations as well as other specialties evaluation in order to contribute to a precise diagnosis and treatment definition. A database was developed specifically for registration of patients in this study.

Results

Average age was about 47 years, with a balanced distribution regarding gender. Mean time between onset of hearing loss and the demand for medical care was approximately 12 years. Hypertension, with or without comorbidities, was most frequently observed in association with hearing loss, reported by 28% of all patients. Presbycusis was the most common etiological diagnosis, followed by unclear sensorineural hearing impairment. Fitting of hearing aids was indicated in almost 70% of all cases.

Conclusion

Results indicate that there is an excessive delay between the onset of the hearing difficulty and an access to specialized care. Age‐related hearing loss deserves special attention from public and private health systems for its high incidence, and a significant number of patients who need and would benefit from hearing rehabilitation through electronic aids, especially hearing aids. The high prevalence of comorbidities, particularly hypertension, suggests that these diseases may play an important role in the manifestation and evolution of sensorineural hearing loss.
Epidemiology and Complications of Acoustic Neuroma Excision
Authors: Mahboubi Hossein , Ahmed Omar , Oliaei Sepehr , Kiumehr Saman , Djalilian Hamid R.
Published: February 2015

Objective

1) To examine surgical outcomes, charges, and demographics information for patients who have undergone an acoustic neuroma excision. 2) To determine if outcome measures and charges are significantly different between high‐volume and low‐volume centers.

Method

Case data for acoustic neuroma excisions performed in California from 2008 to 2010 were examined using California Hospital Discharge Data (CHDD). Cases were identified if they contained the principal procedure ICD‐9‐CM code 04.01. Postoperative complications were identified if cases contained ICD‐9‐CM codes for specific diagnoses and procedures (ie, meningitis, ventriculostomy, etc).

Results

There were 1158 cases. Most patients were between the ages of 35 and 64 years (72.8%), women (54%), and white (76.0%). The median total charge was $103,485, the average hospital stay was 5.1 days, 90.3% of patients were discharged routinely (ie, home), and 7.3% of patients endured postoperative complications. High‐volume centers (10 ≤ surgeries per year average) had less complications (5.7% of patients had complication(s) vs 13%; P <. 001), shorter hospital stays (4.7 days vs 6.6 days; P <. 001), higher rates of routine discharges (94.8% vs 73.6%; P <. 001), and lower average charges per day and total charges (P <. 001).

Conclusion

Compared with lower volume centers, high‐volume centers had fewer complications, shorter hospital stays, higher rates of routine discharges, and lower total charges for all services rendered and average charges per day. Interestingly, CHDD demonstrates that median total charges have risen dramatically from data reported in 1996 to 1998 ($103,485 vs $26,862).
Extra‐tympanic Electrocochleography in Auditory Neuropathy Spectrum Disorder
Authors: Hang Anna X. , He Shuman , Buchman Craig A.
Published: February 2015

Objective

Compare electrocochleography (ECochG) recordings obtained simultaneously at the round window (RW) and tympanic membrane (TM) in patients with auditory neuropathy spectrum disorder (ANSD) in order to validate a noninvasive method for assessing site of lesion in these patients. Better understanding of site of lesion may help optimize intervention strategy and ultimately, performance among ANSD children.

Method

ECochG responses were recorded simultaneously at the TM and RW using single pulse and trains of clicks and tone‐burst stimuli during cochlear implantation in ANSD children. Recorded potentials included the cochlear microphonic (CM) and nerve compound action potential (CAP). Correlation between RW and TM ECochG recordings were analyzed using Pearson correlation test.

Results

ECochG responses were successfully recorded at both the TM and RW simultaneously from 7 ANSD patients using all 4 paradigms. Both sites (TM and RW) revealed similar response patterns although RW responses were at least 1 order of magnitude greater than the TM responses. For all patients and conditions tested, the TM and RW ECochG recordings were significantly correlated in 88% of cases. A clear CAP was recorded from a subset of patients. Also, in the click train condition, in patients with a CAP response, the amplitude was noted to rapidly decrease following the first 3 to 4 stimuli.

Conclusion

RW ECochG recordings have larger amplitudes and better morphology than TM recordings, but still showed positive correlation in most cases. The CAP morphology recorded from a subset of our subjects is consistent with previous literature. CAP amplitude decrement in the click train condition indicates neural adaptation in ANSD.
Hearing Results of Titanium Ossiculoplasty in Taiwan
Authors: Huang Chang‐Wei
Published: February 2015

Objective

The choice of ossicular prosthesis depends on middle ear condition, including ossicle autograft, polycel, and titanium materials. We applied titanium ossicular prosthesis since 2008. The objective of this study was to evaluate the hearing results of ossicloplasty using titanium prosthesis. This is the first report in Asian people.

Method

Between October 2008 and March 2011, we included 76 chronic ear patients with similar hearing levels and pathogens who had undergone ossiculoplasty by the same surgeon with titanium prosthesis. The hearing evaluation was completed at least 6 months postoperatively. Hearing was evaluated by the average of 0.5K, 1K, and 2K.

Results

Among 76 patients, there were 58 with the postoperative air‐bone gap below 20 dB, accounting for 76%. We divided patients into 2 groups, the traumatic ossicular destruction and chronic ear groups. In the traumatic group, the postoperative air‐bone gap was below 20 dB for 8 out of 9 patients, accounting for 88%, and in the chronic ear group, 49 out of 67 patients, or 73%. Furthermore, the overall extrusion rate is 4%, 3 in 76 patients. The frequently used functional length is 2.0 mm and accounts for 90%.

Conclusion

We share our preliminary hearing results using titanium ossicular prosthesis in recent 3 years in Taiwan. The overall results are excellent, about 3 out of 4 patients have air‐bone gap below 20 dB postoperatively, especially in traumatic cases, up to 88%. The extrusion rate is rather low as 4%.
Intratympanic Steroid for Sudden Sensorineural Hearing Loss
Authors: Sichel Jean‐Yves , Muhanna Nidal , Shwartz Yehuda , Peleg Uri , Rodriguez Mercedes , Shaul Hanan , Perez Ronen
Published: February 2015

Objective

Intratympanic (IT) steroids are increasingly used in the treatment of sudden sensorineural hearing loss (SSNHL). The aim of this study is to investigate the effectiveness of IT administration of dexamethasone treatment for SSNHL.

Method

We retrospectively reviewed medical records of SSNHL patients who were treated with IT dexamethasone in our hospital from January 2004 to October 2010. Indications for IT treatment: 1) Failure of systemic therapy; 2) Contraindications for systemic therapy; 3) Patients who presented more than 2 weeks after the onset of hearing loss.

Results

A total of 117 patients were reviewed. The mean age of the patients was 51.2 years, ranging from 18 to 81 years. Patients were divided into 2 groups: I) Patients who were treated with IT dexamethasone after the failure of initial systemic treatment: n = 80 (68.3%). II) Patients who were treated only with IT dexamethasone: n = 37 (31.6%). Thirty‐nine patients (48%) from group I showed improvement of more than 20 dB in SRT while 14 patients (38%) from group II showed similar improvement. Overall, 87 patients (74.35%) showed some improvement in speech reception threshold (SRT). The presence of vertigo had negative effect on the hearing outcome.

Conclusion

This study shows that IT prednisone therapy may be beneficial in the treatment of sudden SNHL. Although the results of this study and other similar ones are convincing, a prospective randomized controlled study is warranted.
Laser Stapedotomy Using SMART Piston: 5‐Year Results
Authors: Khalil Sherif , Lavy Jeremy
Published: February 2015

Objective

The SMART piston is composed of a nitinol‐based hook and a Teflon‐based piston. Nitinol is a metal alloy of nickel and titanium that allows self‐crimping by heat activation. The aim of this study is to evaluate the long‐term (5 years) auditory results after the use of the SMART piston in primary laser stapedotomy.

Method

This is a retrospective review of prospectively collected data. The 5‐year postoperative follow‐up data for 32 patients is presented. Preoperative pure tone audiograms recording air and bone conduction thresholds at 0.5, 1, 2, 3, and 4 kHz were recorded. Postoperative pure tone audiograms at the same frequencies were recorded after 6 weeks, 6 months, 1, 2, 3, 4, and 5 years. Air‐bone gaps and pure tone averages at 0.5, 1, 2, and 3 kHz were calculated.

Results

The 4‐frequency pure tone average of 0.5, 1, 2, and 3 kHz had a mean preoperative value of 58.4dB (SD ± 14.3dB) in air‐conduction thresholds. This has shown a drop in mean thresholds to 28.7 dB (SD ± 11.0 dB) in the 5‐year follow‐up. The air‐bone gap also decreased from 30.1 dB (SD ± 9.6 dB) to 1.5 dB (SD ± 3.8 dB), which was statistically significant (P =. 001). There was no significant change in the pure tone average bone conduction threshold when comparing the preoperative thresholds (28.3 dB, SD ± 12.5dB) and postoperative thresholds (23.9dB, SD ± 11.1 dB; P =. 551).

Conclusion

Results demonstrate that the SMART piston provides excellent long‐term auditory outcome. The ease of the self‐crimping and the tightness of the crimp provide the advantage of long‐term results.
Lateral External Auditory Canal to Mastoid Fistulas
Authors: Agan Ashley D. , Isaacson Brandon , Kutz Joe W.
Published: February 2015

Objective

1) Describe computed tomography (CT), tympanogram and examination findings seen in patients with lateral external auditory canal (EAC) to mastoid fistulas. 2) Discuss treatment of patients with lateral EAC to mastoid fistulas.

Method

Retrospective chart review of patients diagnosed with lateral EAC to mastoid fistulas from January 2006 through January 2012. Data collected included computed tomography (CT) scans, audiograms, and examination and operative findings.

Results

Seventeen patients were identified. A total of 82% (n = 14) had CT scans, all of which demonstrated a fistula between the mastoid and EAC. Examination findings demonstrated 53% (n = 9) with an intact tympanic membrane, 29% (n = 5) with a perforation, and 18% (n = 3) that could not be assessed. In all, 82% (n = 14) had tympanograms, and of those, 86% (n = 12) had type B and 14% (n = 2) had type C. A total of 88% (n = 15) of patients had a history of surgery in the affected ear. Of those, 87% (n = 13) had history of canal wall‐up mastoidotympanoplasty. A total of 65% (n = 11) of patients required a canal wall‐down mastoidectomy.

Conclusion

External auditory canal to mastoid fistula is a potential complication of otologic surgery. This entity can sometimes be identified on examination, but CT is highly sensitive in confirming the diagnosis. Most patients require a canal wall down procedure but the canal wall can be reconstructed in select cases.
Long‐term Surgical Results of Semicircular Canal Fistulae
Authors: Katsura Hirokazu , Mishiro Yasuo , Adachi Osamu , Sakagami Masafumi
Published: February 2015

Objective

Although many studies report short‐term hearing results after surgically managing semicircular canal fistulae, long‐term results are still unknown. In the present study, long‐term postoperative hearing outcomes were reviewed in 14 ears of patients with cholesteatoma and semicircular canal fistulae.

Method

Between 1996 and 2010, 84 patients with cholesteatoma and semicircular canal fistulae underwent tympanoplasty at Hyogo College of Medicine Hospital. The location of the fistula was the lateral semicircular canal in all cases and superior semicircular canal in 5 cases. Fourteen patients were followed up for more than 5 years.

Results

Postoperative air‐bone gap was ≤10 dB in 1 case, between 11 and 20 dB in 7 cases, between 21 and 30 dB in 4 cases, and ≥31 dB in 2 cases. Mean bone‐conduction hearing levels on the operated side had deteriorated by 3 dB in 1 kHz, by −1 dB in 2 kHz, and −2 dB in 4 kHz at 1 year postoperatively and by 8 dB, 6 dB, and 2 dB at 5 years postoperatively, respectively. Bone‐conduction hearing levels in 1 and 2 kHz were significantly deteriorated at 5 years postoperatively, compared with baseline and 1‐year (P <. 05).

Conclusion

Even if the semicircular canal fistula is surgically managed, bone‐conduction hearing level gradually deteriorates in the 1‐ and 2‐ kHz ranges over the long time.
Low‐Cost System for Auditory Brainstem Evoked Response
Authors: Ercolino Jose M. , Chiossone‐Kerdel Juan A. , Hernandez Jorge , Goncalves Stefania
Published: February 2015

Objective

1) Be able to design‐low‐cost ABR equipment. 2) Learn the possibility of mainstream technology applied for laboratory equipment use and be able to standardize the results with commercially available ABR equipment. 3) Apply this technology for research and neurophysiology laboratories.

Method

Animal experimentation study. This system comprises a differential amplifier, high‐pass and low‐pass filters, a main rejection notch filter, an analog to digital converter, and software programs for data acquisition and processing automation. Amplifier and filters were designed using low‐cost and readily available commercial components. Auditory stimuli were reproduced by a portable music player and a miniature rechargeable speaker. The stimuli comprising auditory clicks, tone pips and tone bursts, were generated numerically by the software and transferred digitally to the music player. 25 female and male Sprague‐Dawley rats were tested with amplitude and threshold protocols.

Results

Results demonstrate a linear correlation and morphology with ABR previously recorded by other teams. Amplitude in the response was little affected by the hardware but strongly modified by electrode position. A regression analysis demonstrated a coincidence r = 0.92 with the physiological measured threshold using RMS analysis. Ketamine affects the first 20 minutes of recordings by delaying latency in all waves, the effect fades away after that. Morphological changes were observed by blocking the ear canal in accordance with previous studies.

Conclusion

The ABRs obtained compare favorably with other published results in similar conditions. Clear amplification with subdermal electrodes are seen consistently and very little EEG noise is obtain with the recordings, with no significant difference between individuals and results from other studies. The system will rapid determine auditory threshold with good accuracy. We are confident that this approach will make hardware more accessible for low budget research facilities.
Lumbar Puncture Opening Pressure in Spontaneous CSF Otorrhea
Authors: Allen Kyle P. , Isaacson Brandon , Kutz Joe W. , Gerecci Deniz , Roland Peter S.
Published: February 2015

Objective

Determine the incidence of increased intracranial pressure, measured by lumbar puncture opening pressure, in patients with spontaneous cerebrospinal fluid (CSF) otorrhea.

Method

Retrospective case review at a tertiary care referral center. Patients included underwent repair of spontaneous CSF otorrhea between January 2007 and December 2011. These patients have subsequently undergone postoperative lumbar puncture with measurement of the opening pressure to determine the presence of increased intracranial pressure. The main outcome measure is the lumbar puncture opening pressure.

Results

Nineteen ears in 17 patients underwent surgical repair for spontaneous CSF otorrhea via a transmastoid or middle fossa craniotomy. The average age at the time of repair was 58.9 years, 82.4% of patients were women, and 94.1% of patients were obese (BMI >30). The left ear was more commonly involved in 68.4% of cases. An encephalocele was observed in 63.2% of ears. Elevated opening pressure (greater than 20 cm/H2O) was noted in 41.2% of patients, and the median opening pressure was 19 cm/H2O. Of patients with elevated intracranial pressure, 55.6% were treated either medically or surgically to reduce ICP. Two patients underwent placement of ventriculoperitoneal shunts and 3 were treated with acetazolamide.

Conclusion

As has been reported in the literature regarding spontaneous CSF rhinorrhea, elevated intracranial pressure is common in patients with spontaneous CSF otorrhea with 41.2% of patients affected in this series. These patients frequently require intervention in the postoperative setting to reduce ICP.
Management of Venous Pulsatile Tinnitus
Authors: Wang Yu‐cheng , Jin Lei
Published: February 2015

Objective

To discuss the therapeutic effect of ligation of the internal jugular vein and how to deal with pulsatile tinnitus of venous origin.

Method

A retrospective study was conducted on 12 patients who were diagnosed with venous hum and treated with ligation of the jugular vein. They all had normal otoscopy findings.

Results

These 12 patients were all women, ranging in age from 27 to 61 years. Seven patients got relief of tinnitus right after the surgery, among which 5 patient’s symptoms recurred within 2 years. The rest got no relief and 1 of them aggravated into intolerable roaring.

Conclusion

Diagnosis of venous hum should be made only after careful elimination of other disorders, such as BIH, ACAD, HJB, and other rare vascular anomalies. Ligation of IJV should be avoided even for the treatment of venous hum because of the poor effect and unpredictable complications.
Mastoid Obliteration with Autologous Costal Cartilage
Authors: Cho Yong Beom , Lee Chang Joon , Jo Si Young , Cho Sung Woo , Choi Jung Uk , Seo Kyung Sun , Jang Chul Ho
Published: February 2015

Objective

Autologous cartilage such as conchal cartilage has been commonly used as an obliteration material of the mastoid, however sufficient amount could not be harvested. We evaluate the use of autologous costal cartilage for obliteration of mastoid cavity after canal wall down mastoidectomy.

Method

Retrospective review of the patients who underwent mastoid obliteration with autologous costal cartilage after CWD was performed. Costal cartilage was harvested at 7th or 8th rib with middle ear surgery. Pre‐ and postoperative audiometry, neodrum findings, temporal bone CT and complications including wound infection and canal wall displacements were evaluated.

Results

A total of 39 patients (29 women, 10 men) with a mean age of 52.5 years underwent the procedure. The follow‐up period ranged from 9 months to 14 months (mean period, 11.4 months). For all cases in the study, complications such as postoperative wound infection, perforation, and canal wall destruction did not develop. Small skin dehiscence at the rib harvest site occurred in one case and healed up with reapproximation of the wound. All except 2 patients showed successful postoperative air‐bone gap within 20 dB. Mastoidectomized cavities of all cases were well obliterated in follow‐up temporal bone CT.

Conclusion

Adequate amount of cartilage could be harvested from the costal cartilage and mastoid obliteration could be successfully performed with normal‐shaped canal and hearing improvement. We propose the autologous costal cartilage for an obliteration material of the mastoid cavity after canal wall down procedure.
Modified Surgical Approach in Facial Palsy: It’s Worth a Try
Authors: Panda Naresh K. , Kaushal Darwin , Verma Roshan
Published: February 2015

Objective

To evaluate effectiveness of a modified technique of facial nerve decompression with respect to improvement in facial function and hearing preservation.

Method

Retrospective analysis conducted between 2002 and 2005 of 15 cases of posttraumatic facial nerve paralysis. A modified posterior tympanotomy approach was used in these patients. There were 13 males and 2 females aged between 12 and 43 years (mean age, 23.6 years). All the cases were operated by the senior author. Only patients with immediate onset facial paralysis were included in the analysis. These patients had received a full course of corticosteroids as conservative treatment before the surgical exploration. Intervention: Transmastoid facial nerve decompression using the modified technique. Outcome measurement: The clinical, audiometric, and radiologic evaluation was done for all patients. Analysis: Recovery of facial function and hearing status.

Results

Eleven out of 15 patients had recovery of facial function to House Brackmann I‐II. Two cases had HB III function. Two patients with bilateral paralysis had HB IV function. Only 1 case reported hearing deterioration. The rest of the patients maintained their preoperative hearing status.

Conclusion

This technique provides insight into a favorable way of doing facial nerve decompression with an aim to considerably preserve the hearing.
MRI Safety of Otologic Implants in the United States
Authors: Azadarmaki Roya , Tubbs Rhonda , Chen Douglas , Hillman Todd
Published: February 2015

Objective

To review information on MRI safety for commonly used otologic implants including cochlear implants, middle ear implantable hearing devices, osseointegrated cochlear stimulators, and middle ear prosthetic devices.

Method

A literature review of the National Library of Medicine’s online database was performed with focus on MRI safety of routinely used implanted hearing devices. Manufacturing companies were contacted for devices with no information on MRI safety in the literature.

Results

The Baha system and Ponto Pro osseointegrated implants’ abutment and fixture, middle ear ossicular reconstruction prosthetic devices, and all stapes prosthetic devices except for the 1987 McGee prosthesis are safe to use in standard MRI fields. Cochlear implants with removable magnets such as the newer Cochlear Americas Implants and the HiResolution Bionic Ear System’s HiRes 90K can be used in standard MRI fields. MED‐EL cochlear implants can be used in low MRI magnetic fields up to 0.2T. All other cochlear implants, middle ear implantable hearing devices, and the Sophono device are not approved for MRI use.

Conclusion

MRI safety status of otologic implants depends on their magnetic potential. Knowledge of the MRI safety guidelines for the commonly used otologic implants is important. United States guidelines on MRI safety and compatibility are not always the same as in Europe and other parts of the world.
Neuroplastic Surgery of Facial Palsy
Authors: Cosgarea Marcel , Maniu Alma , Pop Sever , Chirila Magdalena , Necula Violeta
Published: February 2015

Objective

The facial nerve is the most susceptible to injury of all the cranial nerves because of its complex course through the temporal bone confined within a prolonged bony canal. Facial nerve palsy produces important changes in facial aspect with devastating social consequences for the patient.

Method

A retrospective study of 10 years of material (2000‐2009) was done on 21 patients. After a thorough evaluation, surgical treatment was decided which comprised nerve decompression, or anastomosis between the end of intratympanic segment and the distal segment of facial nerve by interposing sural or auricularis magnus nerve graft.

Results

The interposition of the graft in facial nerve was carried out in the mastoid, in 11 cases in the 72 hours after trauma, in 5 cases 3 months later and in 1 case twelve months later. Nerve decompression was performed in 4 cases. The nerve graft and the nervous ends were prepared beforehand by cutting a few millimeters of the epineural sheet. Then the graft was positioned in the bone canal, the ends were put together and the anastomosis was made with autologous fibrin adhesive.

Conclusion

Surgical therapy in peripheral traumatic facial palsy gives good functional results. Nerve decompression has statistically better results compared to anastomosis and nerve transplant. The choice of surgical technique and results directly depend on location and intensity of the lesion and the treatment time.