bluuebunny/crossref_metadata_2025_split huggingface dataset:
A RARE CASE OF VASCULAR ANOMALY OF THE
VERTEBROBASILAR SYSTEM IN A PATIENT WITH
MIXED TYPE VERTIGO
Authors: Jałocha-Kaczka Anna , Bielińska Marzena , Miłoński Jarosław , Kuśmierczyk Krzysztof , Polaczkiewicz Laura , Olszewski Jurek 
Published: May 2021

BackgroundThe aim of the study is to present a patient who suffered from severe vertigo with rare arterial vascular anomaly of the vertebrobasilar system.Case ReportA 56-year old female patient was urgently admitted due to dizziness, with a spinning motion toward the right, accompanied by nausea, vomiting, and diplopia which occurred on the morning of the day of admission and gradually intensified. The patient had laboratory tests,
VNG, functional imaging of the cervical spine, CT of the head, CTA of the cranial arteries, and neurological and ophthalmological consultations.
This demonstrated a vascular anomaly in which the basilar artery was an extension of the right vertebral artery, and the left atrophic vertebral
artery extended into the posterior inferior cerebellar artery. Conservative treatment and motor rehabilitation gave very good therapeutic effects.ConclusionIn the presented case, the basilar artery was found to be an extension of the right vertebral artery, while the left atrophic vertebral artery extended into the posterior inferior cerebellar artery. The vascular anomaly, osteochondrosis of the C4/C5 cervical spine, and hyperlipidemia resulted in mixed-type vertigo with decreased excitability of the labyrinth on the affected (anomalous) side due to insufficient
blood supply to the inner ear and lack of vascular compensation. The diagnosed anatomical anomaly of the vertebrobasilar system was not
an indication for surgical intervention; instead, conservative treatment was successful.
CORRELATION OF ASSR HEARING THRESHOLDS
WITH ABR HEARING THRESHOLDS IN CHILDREN
Authors: Vasileiou Alexandra , Pavlos Maragoudakis , Antonios Tzagaroulakis , Ioannis Xenellis , Vlastarakos Petros , Nikolopoulos Thomas 
Published: May 2021

BackgroundHearing assessment in neonates, or in older children/teenagers with special needs, is very challenging since a pure tone audiogram is not possible due to lack of co-operation and click-ABRs are not frequency specific.ObjectivesTo assess the value of auditory steady-state responses (ASSRs) in neonates or in uncooperative children/teenagers and correlate
the hearing thresholds derived from them with those derived from ABR.Subjects and MethodsUsing ABR and ASSR, the hearing thresholds of 119 children too young to perform behavioral audiometry, and older
children or teenagers with special needs (who were unable or unwilling to perform a pure tone audiogram), were assessed. The age range was
1 month to 18 years old with a mean age of 2.7 years and median of 2.3 years; the large majority (106 or 89%) were younger than 5 years.ResultsASSR was found to be a valuable and objective method for hearing assessment as a strong correlation between ABR-derived and ASSR-derived thresholds was found for all frequencies (500, 1000, 2000, and 4000 Hz) with Spearman rank correlation coefficients ranging from
0.83 to 0.87 and high statistical significance (p<0.0001).ConclusionThe reliability of ASSR is supported by the results of the present study which suggest that there is a strong correlation between
ASSR and ABR thresholds even at a frequency of 500 Hz
SOME REASONS FOR THE FAILURE OF SURGICAL
TREATMENT OF OTOSCLEROSIS: LESSONS FROM
A CASE STUDY
Authors: Skarzynski Henryk , Plichta Lukasz , Dziendziel Beata , Boruta Monika , Skarzynski Piotr 
Published: May 2021

IntroductionSurgical treatment of otosclerosis requires considerable experience of the otosurgeon, especially in advanced cases or in an ear
with an unusually narrow external auditory canal, a narrow niche of the round window, a significantly thickened stapes footplate, or an exposed or hanging facial nerve. Case involving subsequent reoperations by different surgeons can be particularly difficult. Collective knowledge of treatment failures during otosclerosis reoperation, as set out in the literature, does not list the difficulties encountered, fails to assess
most causes of failure, and does not describe remedies and corrective techniques.Material and MethodsThe course of treatment followed by a 55-year-old complaining of progressive, bilateral, mixed hearing loss due to
otosclerosis is described. The patient’s treatment consisted of stapes mobilization, followed by stapedotomy and restapedotomy of the right
ear, and stapetodomy of the left ear.ResultsThere was short-term improvement of hearing after mobilization of the stapes, but its subsequent deterioration, with elevation of
both the air- and bone-conduction thresholds in the right ear, were indications for reoperation and stapedotomy. Short-term improvement
in hearing was achieved after the operation, followed by rapid hearing loss. Due to this and growing balance disorders after nearly a year, a
restapedotomy was performed with complete closure of the air-bone gap. Then, due to hearing deterioration in the left ear, a successful stapedotomy was performed in this ear.ConclusionsRevision operations in otosclerosis require a lot of experience of the otosurgeon due to the many reasons for failure, particularly when the first surgery was performed elsewhere. An air-bone gap, severe tinnitus, and balance disorders are indications for reoperation by
an experienced otosurgeon, as common causes of failure are postoperative adhesions and subsequent stapes immobilization.
IMPLANT STABILITY IN ADULTS AND CHILDREN
IMPLANTED WITH NON-PIN OR PIN COCHLEAR
IMPLANT VARIANTS: SUCCESS WITH DIFFERENT
SURGICAL TECHNIQUES
Authors: Mlynski Robert , Magele Astrid , Baumgartner Wolf , Godey Benoit , Stark Thomas , Radelof Andreas , Hagen Rudolf , Brandstetter Markus , Jappel Alexandra , Sprinzl Georg 
Published: May 2021

BackgroundThe primary aim of this study was to collect information on the surgical procedures used to implant two cochlear implant variants
(non-pin and pin: Concerto and Concerto Pin from Med-El) in adults and children and to assess their medium-term stability. A secondary aim
was to assess the safety of these variants, both of which permit a minimally invasive surgical protocol to be used. The pin variant has greater flexibility in positioning and fixing of the implant, with the pins ensuring implant stability; also it requires less or no drilling and no tie-down sutures.Materials and MethodsNon-pin and pin cochlear implant variants (Concerto and Concerto Pin from Med-El) were implanted in adults
and children (n = 116) in 5 clinics. The different surgical techniques and methods of implant fixation were documented intraoperatively. Implant stability was subjectively assessed at first fitting and again approximately 3 and 6 months later. Safety was assessed based on the number and severity of adverse events.ResultsWith all non-pin variants suture fixation was always performed, but with the pin variant this was done for just 43% of adults and
49% of children (in the remainder, no additional fixation was performed). The study demonstrated the stability of both cochlear implant variants in children and adults, with no shifting or rocking observed. There were 33 adverse events reported during the study, 10 of which (9%)
were classified as related to the device or procedure.ConclusionsImplant stability and safety can be achieved through various surgical techniques and fixation methods when implanting either
the Concerto or Concerto Pin.
VARIABILITY OF HIGH-FREQUENCY
DISTORTION PRODUCT OTOACOUSTIC
EMISSIONS MEASURED BY THE SMARTOAE
DEVICE: PRELIMINARY STUDY
Authors: Pilka Edyta , Jedrzejczak W. , Kochanek Krzysztof , Skarzynski Henryk 
Published: May 2021

BackgroundDistortion product otoacoustic emissions (DPOAEs) are usually measured in a frequency range up to 8 kHz, although some
systems permit measurements up to 16 kHz. For any test to be reliable it is important to determine its repeatability. Therefore in the present
study DPOAE recordings were made using the SmartOAE system with a focus on the repeatability of high-frequency DPOAEs.Material and MethodsDPOAEs were measured in subjects with normal hearing from 0.25 to 16 kHz. Recordings were made at frequencies of 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12.5, 14, and 16 kHz. Each recording session consisted of three measurements: the first two
performed without removing the probe from the ear (single fit mode), and the third after removing and re-inserting it into the ear canal (multiple fit mode). Recordings from 15 ears were made.ResultsIn single fit mode, the biggest fluctuations were obtained at 0.75, 8, 11, 12.5, and 14 kHz – the largest was 2.8 dB. In the multiple fit
mode, greater variability was obtained compared to measurements made without removing the probe – the largest reached 3.4 dB.ConclusionsEven though the measured signals significantly exceeded the noise floor, differences between measurements for some frequencies still reached as high as 3.4 dB. Our work confirms the usefulness of testing very high DPOAE frequencies (>8 kHz), but at the same time
some caution is needed when interpreting the results.
CONNEXIN 43 EXPRESSION IN THE HUMAN COCHLEA:
AN IMMUNOHISTOCHEMISTRY STUDY
Authors: Liu Wei , Bostrom Marja , Kinnefors Anders , Edin Fredrik , Rask-Andersen Helge 
Published: May 2021

BackgroundMutations in the gene GJA1 which encodes gap junction protein connexin 43 (Cx43) have been linked to nonsyndromic prelingual deafness in humans. The protein forms gap junction channels (GJChs), creating intercellular pathways
for ions and small molecules – such as second messengers (IP3, cAMP, cGMP, and others), diverse metabolites (e.g. glucose,
amino acids, glutathione, ATP) and neuroprotectant (e.g. adenosine) – to reach neighboring cells. Cx43 in glial cells of the
central nervous system (CNS) and in satellite glial cells of the peripheral nociceptive sensory ganglia has been studied for its
structure as well as function in signal transduction and neuron protection. Distribution of Cx43 in the human cochlea is an
important unresolved issue.Material and MethodsFor the first time we analysed, using immunofluorescence and confocal immunofluorescence, the expression and distribution of Cx43 in 5 normal fresh human cochleae obtained at surgery for removal of giant posterior cranial fossa meningioma.ResultsIn the lateral wall of the cochlea, Cx43 was expressed mainly in the basal cell layer of the stria vascularis and the fibrocytes of the spiral ligament. In the organ of Corti, Cx43 antibody strongly stained both inner and outer pillar cells, the
covering layer cells of the basilar membrane and the supporting cells underneath outer hair cells. In the spiral ganglion, Cx43
expression was located in the satellite glial cells (SGCs) surrounding type I neurons.ConclusionsCx43 expression was found in human cochleae including the lateral wall, organ of Corti and spiral ganglion
satellite cells. Potential roles played by GJChs built up by Cx43 in maintaining homeostasis of the cochlea and protection of
neurons are speculated.
COMPUTERISED TURKISH VERSIONS OF TESTS FOR
CENTRAL AUDITORY PROCESSING DISORDER
Authors: Turkyilmaz Meral , Yilmaz Suna , Yagcioglu Suha , Yarali Mehmet , Celik Nagihan 
Published: May 2021

BackgroundTo detect central auditory processing disorder (CAPD), a test battery is needed that probes the integrity of the
central auditory nervous system and describes its response parameters. The audiologist needs to select a well-designed test
battery that examines a variety of auditory performance areas. Computer-controlled adaptive tests are recommended because
they maximise test efficiency and minimise floor and ceiling effects as well as minimising memory load. In order to increase
test efficiency and minimise difficulties and training, we adapted computerised versions of the Frequency Pattern test and the
Duration Pattern test.Material and MethodsThe present study was conducted at Hacettepe University, Turkey, in the Faculty of Medicine’s Otorhinolarnygology Department, Audiology and Speech Pathology Unit. In total, 80 children (43 girls, 37 boys) aged between 7 years
0 months and 11 years 11 months were recruited. Each participant completed an informed consent form and a biographical
survey prior to the tests. All tests were administered according to instructions at a comfortable listening level on a calibrated
laptop computer which delivered a ‘Frequency Pattern’ test and a ‘Duration Pattern’ test.ResultsNormative test results are presented. Scores obtained by both tests were evaluated as percent scores for clinical study.ConclusionsWe adapted the computerised versions of the Frequency Pattern and Duration Pattern tests. Norm percent scores
were obtained. We are continuing development of a computerised test battery that will include “gaps in noise” and “dichotic
digits” tests using touch-screen protocols.
LEVELS OF MONOCYTE CHEMOATTRACTANT PROTEIN-1
DIFFER FROM THE NORM IN PATIENTS WITH SUDDEN
SENSORINEURAL HEARING LOSS
Authors: Haubner Frank , Martin Ludwig , Steffens Thomas , Rohrmeier Christian , Strutz Juergen , Kleinjung Tobias 
Published: May 2021

BackgroundThe aim of this study was to evaluate the role of cytokines and soluble adhesion molecules in patients with sudden sensorineural hearing loss (SSNHL) with respect to their pure-tone audiometry values.Material and MethodsThis study analyses blood samples of 51 patients with SSNHL. Serum levels of ICAM-1, VCAM-1,
E-selectin, IL-6, IL-8, and MCP-1 were evaluated by ELISA. Pure-tone audiometry data were compared before and after a systemic steroid treatment regimen. The subjects with SSNHL were compared to a control group of 44 patients with normal hearing and matching age and gender. The data complete our previous data collection.ResultsThere is trend toward suppressed levels of MCP-1 in sera of SSNHL patients. There were no statistically significant
differences concerning ICAM-1, VCAM-1, E-selectin, IL-6, IL-8, and MCP-1 between SSNHL patients and controls. Puretone audiometry of the SSNHL group showed a significant improvement in hearing after systemic steroid therapy and a median follow-up of 4 months.ConclusionsFurther prospective studies are necessary to prove the role of MCP-1 and other cytokines in SSNHL in order
to develop adequate treatment regimens.
SINGLE TO MULTI-CHANNEL COCHLEAR REIMPLANTATION
AFTER 21 YEARS: CASE REPORT
Authors: Schnabl Johannes , Wolf-Magele Astrid , Koci Viktor , Schartinger Volker , Markl Andreas , Sprinzl Georg 
Published: May 2021

BackgroundIn the literature cochlear reimplantation is described as a possible surgical procedure and the change from a single to a multichannel device is associated with audiological improvement.Material and MethodsA 47 year old male caucasian patient presented after cochlear implantation 21 years ago. Lacking any
benefit from the old single-channel implant over the last few years, the patient no longer used the device. The old cochlear
implant was changed for a modern multichannel unit.ResultsThe patient showed a great improvement in hearing threshold and his quality of life with the new device.ConclusionsThis case justifies the reimplantation of patients who have been implanted more than 20 years ago.
PREPROCESSING STRATEGIES AND SPEECH PERCEPTION
IN COCHLEAR IMPLANT USERS
Authors: Yathiraj Asha , Rao Ashwini 
Published: May 2021

BackgroundThe aim of the study was to investigate whether noise reduction algorithms are beneficial for speech perception
in the presence of noise in children using cochlear implants. Further, the study also aimed to determine whether any difference in speech perception existed between different pre-processing strategies such as Adaptive Dynamic Range Optimization
(ADRO), Autosensitivity Control (ASC), and the two-stage adaptive beam-forming algorithm (Beam) in different signal-tonoise ratios (SNRs).Material and MethodSpeech identification scores of the participants were tested in quiet with the ‘Everyday’ default setting
activated. They were also tested using speech in noise at +5 dB and +10 dB SNR with ADRO, ASC, and Beam activated. Exactly 17 children using Nucleus cochlear implants for at least 1 year were tested.ResultsA significant difference was found between performance in quiet (in the ‘Everyday’ default setting) and in the presence of noise (with ADRO, ASC, and Beam). No significant difference was found between the 3 pre-processing strategies at
both SNRs and between the 2 SNRs for all 3 strategies.ConclusionsIn conditions where the signal and noise emerge from in front of the listener, no influence of the pre-processing strategies was seen.
SPEECH PERCEPTION ABILITIES IN INDIVIDUALS
WITH AUDITORY NEUROPATHY SPECTRUM DISORDER
WITH PRESERVED TEMPORAL SYNCHRONY
Authors: Chandan H. , Prabhu P. 
Published: May 2021

BackgroundThe auditory brainstem response (ABR) is usually abnormal in individuals with auditory neuropathy spectrum
disorder (ANSD). However, in some such individuals the ABR is preserved at low repetition rates. This study attempts to understand the speech perception abilities of ANSD individuals who have preserved temporal synchronicity.Material and MethodsThere were 149 individuals with ANSD in the study. They were classified into two groups based on
preserved or absent ABR. Speech identification scores (SISs) in these individuals in quiet and in the presence of noise were
compared.ResultsAt low repetition rates some 12.5% of subjects had preserved ABR with low amplitude wave V. Of these, 81% had an
SIS of more than 50% in quiet. However, in patients with absent ABR, only 27% of individuals had an SIS of more than 50%.
For subjects who had preserved ABR the mean SIS was 73.1% in quiet and 36.5% in noise compared to 35.9% in quiet and
20.2% in noise for individuals who had absent ABR.ConclusionsOne in eight of the patients with ANSD had preserved ABR. Speech understanding was also better in quiet and
in the presence of noise in individuals with preserved ABR. We conclude that speech reception abilities depend upon neural
synchronicity at the level of the auditory nerve.
Cervical and ocular vestibular evoked myogenic
potentials in individuals with severe to profound
hearing loss
Authors: Bansal Shalini , Sahni Shruti , Sinha Sujeet 
Published: May 2021

BackgroundVestibular evoked myogenic potential (VEMP) is a test to assess the functioning of otolith organs of the inner
ear. Cervical VEMPs (cVEMPs) assess the saccule and the inferior vestibular nerve, whereas ocular VEMPs (oVEMPs) assess the utricle and superior vestibular nerve. In individuals with sensorineural hearing loss, disturbances of cochlear function could accompany vestibular impairment since both these parts of the inner ear are anatomically related. The aim of the
present study was to find out the prevalence of cVEMPs and oVEMPs in individuals with congenital severe to profound sensorineural hearing loss.Material and MethodsThere were 46 participants in the present study: 23 with normal hearing and 23 with bilateral severe
to profound hearing loss, and cVEMPs and oVEMPs were recorded from all of them.ResultscVEMPs were present in 100% of subjects, both in the control and experimental groups; oVEMPs were present in
100% of the control and 66% of the experimental group. In hearing impaired individuals no correlation was found between
cVEMPs and oVEMPs, although a Mann-Whitney test revealed that the amplitude of cVEMPs and oVEMPs were significantly smaller in the hearing impaired group compared to normals.ConclusionsThe results indicate impairment of both utricular and saccular function in individuals with severe to profound
hearing loss. Also oVEMPs were absent in more individuals compared to cVEMPs, which suggests that utricular function is
more linked with the cochlea compared to that of the saccule.
Diagnostic Accuracy of High-Frequency DistortionProduct Otoacoustic Emission Screening of
Schoolchildren with Down Syndrome
Authors: Driscoll Carlie , Kei Joseph , Hearn Kate , Walsh Trina , Swann Sarah 
Published: May 2021

BackgroundIt has been suggested that children with Down syndrome (DS) may display high frequency hearing loss much
earlier than those in the general population. The purpose of this study was to investigate the diagnostic accuracy of high-frequency distortion-product otoacoustic emissions (HFDPOAEs) as a screening technique for schoolchildren with DS.Material and MethodsExactly 25 children with DS (15 males, 10 females, mean age =9.7 years, SD=2.6) were sampled from
six special education schools. HFDPOAE results were compared to the reference test results – high-frequency pure tone audiometry (HFPTA) at 8 and 10 kHz.ResultsTest performance was found to reach adequate levels (≥0.7) of accuracy for HFDPOAE SNR at 8 kHz and 10 kHz.
The hit rate at 8 kHz was average, but moderately high at 10 kHz. True negative rates and positive posterior probabilities for
the HFDPOAE test were high, and false alarm rates were acceptably low. However, the false negative rate was average at 8 kHz
and negative posterior probabilities were moderately high at both frequencies. Efficiency index values were high indicating
that a large proportion of HFDPOAE results were correct when compared with HFPTA results.ConclusionsInitial findings support the potential future use of HFDPOAE for screening children with DS for high-frequency hearing loss.
ATROPHY OF THE LONG CRUS OF INCUS OF UNCLEAR
ETIOLOGY: CASE REPORT
Authors: Skarzynski Henryk , Plichta Lukasz 
Published: May 2021

BackgroundStudy presents the case of a 27-year-old man admitted to our clinic with unilateral stable hearing loss in the
right ear which had been present for about 10 years. Patient’s medical history did not suggest inflammatory or trauma-related etiology of hearing loss.Material and MethodsPure tone audiometry tests showed conductive hearing loss of 40 dB in right ear and normal hearing
in left ear. Exploratory tympanotomy revealed atrophy of the distal 2/3 of the long process of the incus, with an extant thin
strand of connective tissue joining the remnant of the long process of the incus with the stapes head. During reconstruction, the
missing part of the incus was rebuilt using glass ionomer cement, with this strand serving as a core of the reconstructed part.ResultsThe missing part of the incus was successfully restored preserving the mobility of the ossicular chain. Pure tone audiometry performed at 1 and 12 months after surgery showed improved hearing in operated ear and closure of the air-bone gap.ConclusionsThere are rare cases presenting with ossicular damage without history of otitis media or head trauma in which
etiology is not possible to ascertain. Alloplastic reconstruction of atrophied elements using a glass ionomer cement is an effective treatment method producing lasting hearing improvement.