bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bimodal Hearing on Music and Speech with FSP and HDCIS
Authors: Atwood Keenan , Runge Christina , Friedland David R. 
Published: February 2015

Objective1) Evaluate the effects of bimodal listening on performance for music and speech tasks when the implanted ear uses either fine structure processing (FSP) or high‐definition continuous interleaved sampling (HDCIS) strategies. 2) Understand whether the everyday listening condition of subjects affected their performance on these tasks.MethodA double‐blinded prospective study was performed on 10 adult subjects experienced with a cochlear implant (CI) and contralateral hearing aid (HA). Subjects were tested using FSP and HDCIS in bimodal and CI alone conditions. Musical instrument identification (timbre) and vowel recognition were tested. Outcomes were scored as percent correct.ResultsWith a CI alone, subjects scored higher using FSP than HDCIS on timbre (51.5% to 46.5%). The effect was opposite on vowel recognition (41.2% to 46.3%). However, when bimodal, FSP had a lower performance on timbre (52.6% to 55.1%) but higher on vowel recognition (72.7% to 70.8%). The bimodal condition provided larger benefit in timbre for HDCIS than FSP (8.6% to 1.1%). Further, the improvement in the bimodal condition was significantly higher for vowel tests than for timbre regardless of strategy. Subjects with FSP as their regular strategy outperformed subjects with HDCIS in every condition for both tests.ConclusionThe FSP processor may provide more information to users than HDCS, producing the better performance from FSP without an HA and the greater benefit for HDCIS with an HA. Using FSP regularly may improve central processing plasticity for users improving their performance with any processor.
Case‐Specific Simulation in Temporal Bone Surgery
Authors: Arora Asit , Swords Chloe , Khemani Sameer , Darzi Ara , Singh Arvind , Tolley Neil S. 
Published: February 2015

Objective1) To investigate the feasibility of performing case specific surgical rehearsal (CSSR) using a virtual reality (VR) temporal bone simulator. 2) To identify potential clinical applications in temporal bone surgery.MethodPreclinical study conducted in a London teaching hospital. Twenty‐four cadaver temporal bones were CT scanned and uploaded onto the Voxelman simulator. Sixteen participants (trainer and trainee group) performed 3 dissection tasks on VR and cadaver models. CSSR was assessed for feasibility and clinical applications using a 5‐point Likert scale.ResultsThe upload process required a semi‐automated system. The average time for each upload was 15 minutes. Suboptimal reconstruction occurred (n = 4) when the mastoid process and ossicular chain were not captured. CSSR rated highly among both groups (Likert score >4) for surgical anatomy (75%), facilitating surgical planning (75%), and training (94%). Both groups reported suboptimal realism compared to cadaver models due to poor depth perception. The most relevant clinical procedures for CSSR were ossicular chain surgery, pediatric cochlear implantation, and congenital anomalies. CSSR involving the facial nerve and cholesteatoma surgery were not feasible due to suboptimal soft tissue VR representation.ConclusionThe process of uploading CT data onto a temporal bone simulator to perform CSSR is feasible using a semi‐automated system. It represents a promising application for selected clinical procedures. Further clinical evaluation is warranted to assess the potential benefit.
Cerebellar Infarctions Mimicking Acute Peripheral Vertigo
Authors: Casani Augusto P. , Dallan Iacopo , Cerchiai Niccolò , Lenzi Riccardo , Franceschini Stefano Sellari 
Published: February 2015

Objective1) To determine the true incidence of cases of missed cerebellar stroke mimicking acute peripheral vertigo (APV), the so‐called pseudo‐APV without additional symptoms. 2) To identify the clinical indicators useful for differentiating APV from cerebellar infarction presenting isolated vertigo.MethodWe conducted a retrospective chart review of cases of missed cerebellar infarction over the past 3 years. All patients had first undergone a neurological evaluation and CT scan of the brain in the emergency unit, before performing a complete bedside examination in the Dizziness Unit of our tertiary referral center.ResultsWe identified 11 patients with cerebellar infarction mimicking APV (2.8% of all the cases presenting to the dizziness unit complaining of acute vertigo). Spontaneous horizontal nystagmus (of central type in 2 cases) was recorded in all patients. Head Impulse Test (HIT) was negative in 10 cases. MRI showed 9 cases of infarction in the posterior‐inferior cerebellar artery territory; in 2 patients an involvement of the anterior‐inferior cerebellar artery territory was recorded. The duration of vertigo lasted more than 72 hours in 8 patients. In 4 patients acute vertigo was followed by delayed neurological signs 2‐3 days after the onset.ConclusionPseudo‐APV is not an uncommon diagnosis in otoneurological practice. HIT, a careful evaluation of spontaneous nystagmus, persistence of vertigo, and imbalance more than 72 hours from the onset are useful clinical indicators for recognizing a cerebellar ischemic origin in cases of acute vertigo, especially in patients with vascular risk factors.
Clinical Features of Unilateral Cochlear Nerve Deficiency
Authors: Clemmens Clarice S. , Germiller John A. , Cohn Samuel 
Published: February 2015

ObjectiveCochlear nerve deficiency (CND) is increasingly recognized as a cause of sensorineural hearing loss. Our objectives were to 1) describe the clinical and genetic features of children with unilateral CND, 2) understand the relationships to other features on imaging, and 3) determine if either the IAC or bony cochlear nerve canal (BCNC) could predict CND.MethodClinical and genetic data were reviewed in 66 children with unilateral CND, defined either by our MRI criteria or by atresia of the BCNC. Temporal bone imaging was reviewed for any additional anomalies. BCNC and IAC diameters were compared with CN size by regression analysis.ResultsIn most patients, the cochlear division was the only branch involved (72%). Associated labyrinthine anomalies were uncommon (21%). Most children (71%) were non‐ syndromic. Of the 9 with syndromes, 2 each had 22q11.2 deletion, Down syndrome, and VACTERL, and 1 had a mild form of CHARGE syndrome. BCNC width correlated significantly with CN size (r2 0.50, P <. 0001). Though only 61% sensitive for CND, it was 100% specific. Size of the IAC was highly variable and showed no relationship to CN size.ConclusionMost cases of unilateral CND appear sporadic and non‐syndromic, with no other anomalies of the temporal bone. Nevertheless, it can occur as part of certain syndromes. CT is only useful in diagnosis if it shows a stenotic cochlear aperture, which strongly predicts CND. However, CT alone will miss the diagnosis in 39% of cases.
Cochlear Implants vs Hearing Aids in Auditory Neuropathy
Authors: Pelosi Stanley , Wanna George B. , Watkins Linsey , Hayes Cathrine , Bennett Marc L. , Haynes David S. , Rivas Alejandro 
Published: February 2015

ObjectivePatients with auditory neuropathy spectrum disorder (ANSD) exhibit altered neural synchrony in response to auditory stimuli. Cochlear implantation (CI) is thought to improve neural synchrony in response to auditory stimuli and improve speech perception relative to conventional hearing amplification (HA).MethodRetrospective review was performed of 40 patients with ANSD treated at Vanderbilt University in 1999‐2011. Twenty‐two patients underwent CI, 11 received HA only, and 7 were observed. Pretreatment performance was assessed through parent questionnaire (IT‐MAIS) and speech/language evaluation. Posttreatment outcomes were assessed using IT‐MAIS and closed/open‐set speech perception scores.ResultsAverage follow‐up for all patients was 36 months (range 0‐90). Two of 7 observed patients exhibited neuromaturation over time. Median available pretreatment IT‐MAIS scores were 13 and 34 for CI and HA groups, respectively (difference NS, rank sum test, P =. 06). All CI patients had a prior HA trial with failure of auditory skills development. Posttreatment, 15/20 CI patients and 5/11 HA patients with available data achieved closed/open‐set speech perception scores ≥60%. No differences between groups were found in post‐treatment IT‐MAIS scores (rank sum test, P =. 69) or the percentage of patients achieving the above levels of closed/open‐set speech perception (Fisher’s exact test, P =. 13).ConclusionIn our ANSD population, patients undergoing CI achieved at least comparable and possibly improved overall speech perception outcomes relative to HAs despite a greater initial level of auditory impairment as assessed by parent questionnaire. These findings further validate use of CIs in ANSD patients with failure of auditory skills development.
Comparison of Packing Material in Middle Ear Mucosal Trauma
Authors: Hachem Ralph Abi , Perez Enrique , Bueno Isabel , Van De Water Thomas R. , Angeli Simon I. 
Published: February 2015

ObjectiveTo compare absorbable gelatin sponge (AGS) with polyurethane foam (PUF) as middle ear packing material after mucosal trauma.MethodControlled animal experiment. Thirty‐six guinea pigs underwent middle ear surgery with mucosal trauma performed on both ears. One ear was packed with either PUF or AGS. Contralateral ears were used as nonpacked paired controls. Auditory brainstem response (ABR) thresholds were measured preoperatively and repeated at 1, 2, and 6 weeks postoperatively. Histological analysis was done by a pathologist blinded to the type of packing using hematoxylin and eosin staining to measure inflammatory reaction and trichome staining to measure fibrosis in each group.ResultsABR recordings demonstrates that threshold level changes from baseline were minor in the PUF and the control groups. Threshold levels were higher in the AGS group compared with both control groups and the PUF group for the 1 KHz and 0.5 KHz frequencies. Macoscopic analysis showed no tympanic membrane perforation and packing material was absorbed in all groups at 6 weeks postoperatiely. The histological analysis showed normal mucosal healing in the PUF and control groups. There was more packing retention, inflammation, and osteoneogenesis in the AGS group than the PUF or either control group.ConclusionFollowing surgical trauma, the middle ear mucosa healed well without packing or with PUF packing material, and hearing was not affected. In contrast AGS packing material showed hearing loss at low frequencies and osteogenesis.
Complications after Cochlear Implantation in Older Adults
Authors: Clarrett Danisa M. , Li Lingsheng , Lin Frank R. 
Published: February 2015

Objective1) Analyze the postoperative complications associated with cochlear implantation (CI) surgery in older adults. 2) Understand how the safety profile of CI in older adults compares with that in children and younger adults.MethodsWe conducted a retrospective chart review of all individuals aged 60 years or older who underwent a first CI from 1999‐2011 at Johns Hopkins to abstract data on postoperative follow‐up and complications. Statistical analyses comparing observed complication frequencies were performed using goodness‐of‐fit Fisher exact tests.ResultsFrom 1999‐2011, 445 individuals 60 years or older received a first cochlear implant at Johns Hopkins. The mean age at implantation was 72.7 years (range 60‐94.9 years) and the median duration of follow‐up was 4.8 years (range 0.1‐12.5 years). There were a total of 42 minor complications in 41 patients (9.2%) and 36 major complications in 21 patients (4.7%). There were no cases of meningitis or postoperative facial paralysis. Seventeen patients (3.8%) required surgical device removal. Complication rates did not differ between individuals 60‐75 years and those 75 years or older except for balance problems which were slightly more prevalent in the older cohort (9.5% vs 4.9%, P =. 05).ConclusionOur results demonstrate that CI in older adults has a safety profile comparable to CI in younger adults and children. We suggest that concerns for increased postoperative complications in patients of advanced age should not be considered when determining CI candidacy.
Facial Functioning following Split XI‐VII Anastomosis
Authors: Sappington Joshua M. , Leonetti John P. , Marzo Sam J. 
Published: February 2015

Objective1) Assess facial function in patients who underwent a split XII‐VII nerve anastomosis for facial reanimation. 2) Review our series of 4 patients. 3) Present a facial recovery grading system for patients who undergo a combination of static and mimetic procedures for facial reanimation.MethodPatients were included with facial paralysis who were treated with XII‐VII anastomosis at our institution between March of 2008 and December of 2011. Each patient’s facial function was evaluated using a new facial recovery grading scale that takes into account any method of static or mimetic facial reanimation techniques.ResultsAll 4 patients had complete facial paralysis prior to performing a split XII‐VII anastomosis. All of the patients demonstrated gains in facial functioning without compromising their oral competence. This proposed facial recovery grading scale provides a means by which clinicians can follow gains in facial function in patients who lack an anatomically intact facial nerve.ConclusionThe split XII‐VII nerve graft is a dynamic procedure that can assist in reanimating patients with facial nerve paralysis in whom the proximal facial nerve is not available. Patients in this group experienced minimal morbidity, maintained their oral competence, and demonstrated significant improvement in eye closure and midface animation.
Complications and Clinical Analysis of Cochlear Implatations
Authors: Qiu Jianhua 
Published: February 2015

ObjectiveTo investigate complications of cochlear implantation for prevention and therapy.MethodRetrospective study at a tertiary referral center. The patients (n = 673) who received cochlear implants in our department between 2000 and 2011 were followed up (range, 6 months to 10 years). All complications were systematically reviewed, and their causes were analyzed for prevention and therapy.ResultsThere were a total of 33 complications (4.9%). The minor were 26 cases (3.9%), including postoperative subcutaneous hematoma in 14 cases, acute otitis media in 2 cases, postoperative wound infection in 2 cases, delayed facial paralysis in 1 case, clonic facial spasm in 1 case, and severe dizziness in 6 cases. The major were 7 cases (1.1%), including cerebrospinal fluid leakage in 2 cases, implant‐related infection and extrusion in 2 cases, tympanic membrane perforation induced electrode exposed in 1 case, implantation failure due to cochlear ossification in 1 case, and magnet displacement in 1 case.ConclusionCochlear implantation is a safe and reliable operation, but it is still a serious problem to lower the incidence of complications.
Dizziness and Sleep Disorders
Authors: Duarte Juliana A. , Ganança Fernando F. , Chen Vitor G. , Bongiovanni Giuliano , Azevedo Lia R. , Gregorio Luis C. 
Published: February 2015

ObjectiveAssess the prevalence of the risk of sleep disorders in patients with dizziness and vestibular symptoms in patients with sleep disorders.MethodPerfoming a cross‐sectional study that included adult patients treated at the first consultation at the clinic of the Discipline of Otology and Neurotology (group 1) and Sleep Apnea ambulatory in the Department of Sleep Medicine (group 2) from UNIFESP and applying questionnaires about vestibular complaints and validated questionnaires on the risk of sleep disturbances.ResultsGroup 1 consisted of 24 patients, being 83.3% female, with mean age of 47.08 years. In assessing the risk for sleep disorders, 54.2% were at high risk according to the Berlin scale, 66.7% were at risk by the Pittsburgh scale, and 41.7% were at risk by the Epworth Sleepiness Scale. The second group was represented by 18 patients, being 77.8% male, with a mean age of 49.67 years. As for the vestibular symptoms, 44.4% reported dizziness, being vertigo in 22.2% of the cases and 22.2% with worsening at head movement.ConclusionThere is a high prevalence of the risk of sleep disorders in patients with dizziness and vestibular symptoms in patients with sleep disorders.
Electrical Stimulation Reduces Apoptotic Signaling in SGNs
Authors: Kopelovich Jonathan C. , Cagaanan Alain P. , Miller Charles A. , Abbas Paul J. , Green Steven H. 
Published: February 2015

ObjectiveTo establish the intracellular consequences of electrical stimulation (ES) to spiral ganglion neurons (SGNs) after deafferentation. SGNs die as a result of loss of hair cells, their sole afferent input. Some histologic animal studies of chronic ES after deafening show that ES alone may improve SGN survival. Here we use a rat model to determine the effect of both low and high pulse rate ES on activation of the pro‐apoptotic transcription factor Jun in deafferented SGNs in vivo.MethodsA single electrode was implanted through the round window of kanamycin‐deafened rats at either postnatal day 32 (P32) or P60 for 4 hours of ES (monopolar, biphasic pulses, amplitude twice eABR threshold) at either 100 or 5000 Hz. Jun phosphorylation, a proapoptotic signaling event known to occur in apoptotic SGNs after deafening, was assayed by immunofluorescence to quantitatively assess the effect of ES on proapoptotic signaling.ResultsJun phosphorylation was reliably suppressed by 100 Hz ES in deafened cochleae of P32 rats (P =. 045) but this effect was less robust when 5000 Hz ES was used. This effect was most significant in the cochlear turn just apical to the stimulating electrode and was not significant in P60 rats.ConclusionSuppression of phospho‐Jun occurs in deafferented SGNs after only 4 hours of ES, consistent with the hypothesis that ES provides trophic support to SGNs after deafferentation. Stimulation frequency may be consequential: 100 Hz ES was significantly more effective than 5000 Hz ES in suppressing phospho‐Jun.
Facial Nerve Findings in 210 Consecutive Atresia Repairs
Authors: Goldsztein Hernan , Roberson Joseph B. 
Published: February 2015

ObjectiveDescribe intraoperative facial nerve findings in 210 consecutive atresia cases. Identify preoperative and intraoperative anatomical variants that should alert the surgeon to potential high‐risk facial nerve anatomy.MethodRetrospective review of 210 consecutive atresia cases treated between 2007 and 2011 at a subspecialty private practice. Descriptive analysis of intraoperative findings.ResultsTwo hundred and ten consecutive patients (ages 2‐47) underwent atresia repair between 2007‐2011. Preoperative Jahrsdoerfer Scale was 9 (26%), 8 (47%), 7 (21%), 6 (3%), and 5 or less (4%). The facial nerve was found to have an abnormal course in 39% of the cases and not identified in 1%. It was congenitally dehiscent in 53% of cases and was surgically exposed in 10%. The most common site of congenital dehiscence was in the tympanic segment (57%). Facial‐stapes contact was found in 11% of cases. A single patient had a transient postoperative mild paresis (House‐Brackmann 2) as a consequence of surgery.ConclusionAtresia repair remains one of the most challenging procedures in otology. Despite modern preoperative imaging, the facial nerve remains at risk given the variable development of the first and second branchial arches. Thorough knowledge of anatomical variations and meticulous surgical technique are mandatory to safely perform these surgeries.
Hearing Improvement after CO2 Laser Myringoplasty
Authors: Ryan Marisa A. , Kaylie David 
Published: February 2015

Objective1) Report hearing improvement after CO2 laser myringoplasty using handheld fiber. 2) Describe method for CO2 laser myringoplasty.MethodRetrospective study of hearing over a 4‐year period of patients with atelectacic TM and hearing loss. CO2 laser myringoplasty performed using handheld fiber to contract TM at 2W 100‐msec pulse. Attempts to reinflate the retraction pocket were performed using Valsalva, hydrodissection, or manual dissection. Tympanostomy tubes were placed in all patients.ResultsLaser myringoplasty was performed on 60 ears of 43 patients. The average preoperative ABG was 15 dB. The average postoperative ABG was significantly improved at 7 dB (P <. 001). Hearing improvement remained significantly improved in 17 patients with greater than 2 years follow‐up with final ABG of 7 dB (P =. 007). The presence of effusion on hearing was assessed. Patients with effusion had worse preoperative ABG (19 dB) compared to dry ears (12 dB) (P =. 02), however, postoperative ABG and long‐term ABG was not significantly different in the 2 groups (P =. 3). Patients with myringostapediopexy that could not be elevated did not experience significant hearing improvement.ConclusionLaser myringoplasty for treatment of TM retraction using a CO2 laser with handheld flexible fiber significantly improves hearing immediately and in long term follow‐up. This system allows precise control of energy delivery to the TM. It also allows for laser delivery outside of direct line of sight. Patients with hearing loss and no effusion had significant immediate hearing improvement. Patients with effusions experience the greatest hearing improvement. Patients with TM adherence to ossicles that cannot be elevated with Valsalva are at greater risk for suboptimal hearing results.
INFα and Ototoxicity
Authors: Sharifian Shahriar M.R. , Bakhshaee Mehdi , Sima Hamid , Kamandi Shima , Afshari Reza , Tale Mohammad R. 
Published: February 2015

ObjectiveINFα is a common standard drug for the treatment of hepatitis B and C. Although a variety of related complications have been discussed, possible ototoxic effects of this mediation are not well described.MethodIn a descriptive cross‐sectional before and after study, 24 patients who received INFα for treatment of hepatitis B and C were included. Subjective and objective ototoxicity evaluations via questionnaire, high‐frequency audiometry, and measuring transiently evoked otoacoustic emissions (TEOAEs) were performed before, 1 week, and a month after starting the medication.ResultsEighteen patients (75%) were male with mean age of 40 ± 14.4 years. In the frequencies of 4000 and 8000 Hz before (9.38 ± 1.0 and 10.7 ± 1.2, respectively) and after (17.9 ± 2.6 and 17.6 ± 2.6, respectively) 1 month (but not 1 week) of treatment, a significant difference (P =. 001) was detected. A progressive decrease in amplitude of the OAE during TEOAE measurement in 1, 2, and 4 frequencies among 41.66%, 18.75%, and 43.75% were observed, respectively. Interestingly, all of the hearing impaired patients were males. Hearing impairment was statistically more common among older patients (51.6 ± 16 vs 33.1 ± 14; P =. 002).ConclusionINFα may cause some ototoxic effects. Baseline audiogram, close observation, and TEOAE monitoring during therapy are recommended.