bluuebunny/crossref_metadata_2025_split huggingface dataset:
Auditory Brainstem Implantation after Unsuccessful Cochlear Implantation in Children with Cochlear Nerve Deficiency
Authors: Colletti Vittorio , Mandala Marco , Colletti Liliana 
Published: August 2013

Objectives:To compare perceptual auditory abilities in 31 children with cochlear nerve deficiency (CND) and surgically verified absent cochlear nerve absence (ACN), receiving first a cochlear (CI) and subsequently an auditory brainstem implant (ABI).Methods:Thirty children initially received a CI at outside institutions and failed to progress in perceptual auditory abilities between 2000 and 2013. Explantation of the CI and ABI placement were performed on the same side. Revision of all surgical videos to determine presence or absence of the cochlear nerve. Perceptual auditory abilities obtained after the CI and after the ABI were converted to the Category of Auditory Performance (CAP) scale.Results:All children had severe to profound sensorineural hearing loss (SNHL) and CND. Magnetic resonance imaging documented ACN in 18 and small cochlear nerve (SCN) in 13 children. The internal auditory canal (IAC) was atretic in 8 and of reduced diameter in 12 children. At surgery, all patients demonstrated ACN. With cochlear implants, all patients had a CAP less than or equal to 2. With ABI, All patients had a CAP greater than or equal to 2. The complication rate was similar between CI and ABI patients.Conclusions:Children with a clinical diagnosis of CND and imaging of ACN and SCN, fitted with CIs have an extremely poor prognosis. In these children the opportunity for developing open set speech perception and acquiring speech may be better achieved with ABI placement. The overall complication rate of ABI is not greater than that of CI.
Blood Albumin and Alpha‐Fetoprotein Levels Play a Protective Role in Development of Age‐Related Hearing Impairment
Authors: Moon Il Joon , Cho Yang‐Sun , Byun Hayoung , Woo Sook‐Young , Chung Won‐Ho , Hong Sung Hwa 
Published: August 2013

Objectives:There are few epidemiological surveys that have examined risk factors longitudinally for age‐related hearing impairment (ARHI). This study aims to identify risk factors that predict the development of age‐related hearing impairment (ARHI), using survival analysis.Methods:This retrospective cohort study reviewed the records of the adult subjects (mean age = 55.6 years) who consecutively underwent health checkup including pure‐tone audiometry at the Health Promotion Center in Samsung Medical Center between 2001 and 2010. In this period, a total of 2,577 subjects (2,148 males and 429 females) underwent pure‐tone audiometry more than twice. A pure‐tone average (PTA: 0.5, 1, 2, 4 kHz) was calculated for each subject, and development of ARHI was defined as a PTA at follow‐up more than 5 dB greater than the baseline PTA. Kaplan‐Meier and Cox regression analysis were used to examine the effects of various factors, including laboratory profiles, in the development of ARHI. Multivariable analysis was performed with the variables that are associated with the outcome in the univariable analysis.Results:Kaplan‐Meier analysis reveals that ARHI occurs in 1,060 (41.1%) subjects at 6 years. Blood albumin (hazard ratio [HR] 0.341; confidence interval [CI] 0.245‐0.474) and alpha‐fetoprotein (HR 0.752; CI 0.705‐0.802) levels are the most potent protective factors for the development of ARHI in Cox regression analysis. In contrast, total bilirubin (HR 1.232; CI 1.091‐1.391) and glycated hemoglobin (HR 1.182; CI 1.092‐1.280) are potential risk factors.Conclusions:Worsening of hearing over time is common in the adult population. Results highlight the protective role of blood albumin and alpha‐fetoprotein levels in the development of ARHI.
Bone Conduction Hearing: Device Auditory Capability to Aid in Device Selection
Authors: Syms Mark J. , Hernandez Kelly E. 
Published: August 2013

Objectives:1) Obtain measures of six current bone conduction devices that use a surgically implanted osseointegrated post (Baha Intenso, Baha BP100, Baha BP110, Ponto, Ponto Pro) or a non‐surgical module on the teeth (SoundBite). 2) Describe how the measures relate to auditory performance.Methods:Compare measures of the six devices on the same laboratory system using identical standards (ANSI, IEC). Outcome Measurements: Maximum vibratory output, maximum gain, linear dynamic range, and frequency range. Independent Variables: Six devices.Results:Measures for all devices were highly repeatable (sd of test‐retest measures < 0.5 dB) and equivalent to available published results. Maximum output, gain, and linear dynamic range at full‐on gain settings were similar for all devices but differed by frequency region. For the frequency range necessary for processing speech (500‐2000 Hz), all of the devices have sufficient output, gain, and linear dynamic range. For the frequency range optimal for providing the spatial hearing benefits of understanding speech in noise and speech localization (1500‐8000 Hz), the dental device will have 10‐20 dB more gain and linear dynamic range than the implantable devices.Conclusions:All devices had sufficient output, gain, and linear dynamic range to reach a normal cochlea over a frequency range to provide benefit for processing speech. The dental device has a higher output and larger dynamic range (~20 dB) in the high frequency range (>2000 Hz) that relates to spatial hearing benefits.
Functional Outcome Predictors following Mandibular Reconstruction with Free Fibula Flap, Clinical and Videofluoroscopic Correlation
Authors: Hobbs Bradley A. , Balou Matina , McCullough Gary H. , Moreno Mauricio A 
Published: August 2013

Objectives:Identify outcome predictors by correlating clinical variables with postoperative videofluoroscopic swallow study (VFSS).Methods:Retrospective chart review of 36 patients treated at an academic tertiary center between September 2009 and November 2012.Results:Fifteen females and 21 males with a mean age of 54 years (range 7‐81); 17 cases were treated for malignancy. Tongue resection was grouped in 4 categories: no resection (n=6, 16.7%); 0‐25% (n=19, 52.8%); 25‐50% (n=7, 19.4%) and 50% or more (n=4, 11.1%). The mandibular defect was classified by HCL classification: H (n=6,16.7%); HC (n=2, 5.6%); L (n=8, 22.2%); LC (n=10, 27.8%); LCL (n=10, 27.8%). The size of the bony defect ranged from 3‐15cm (mean=9 cm). The flap was osseous only in 10 cases; the cutaneous paddle ranged from 10‐125 cm2 (mean=52). A gastrostomy tube was present preoperatively in 8 cases, and postoperatively at least transitorily in 14 cases; X‐ray tube (XRT) was used in 17 cases. Postoperative VFSS showed penetration in 13 cases and aspiration in 7. Overall, 29 patients (80.6%) achieved unrestricted diet and this was statistically correlated with: age (p=0.04); XRT (p=0.01); Preoperative G‐tube (p=0.12) and penetration or aspiration on VFSS (p=0.01).Conclusions:Age, radiation treatment, preoperative G‐tube dependency, and abnormal postoperative swallowing study are predictors for poor functional outcome in patients undergoing mandibular reconstruction with a free fibula flap. Skin paddle size and defect extension/location were not correlated with swallowing outcomes.
Complications of Vestibular Schwannoma Surgery
Authors: Ahmed Omar H. , Lin Jonathan K. , Mahboubi Hossein , Yaug Yuk Y.A. , Djalilian Hamid R. 
Published: August 2013

Objectives:1) Examine postoperative complications of patients who underwent vestibular schwannoma excision. 2) Determine significant clinical predictors of postoperative complications.Methods:Case data for vestibular schwannoma excisions performed in California from 1996‐2010 were examined using the California Hospital Inpatient Discharge Database (CHIDD). Cases were identified if they contained the principle procedure ICD‐9‐CM code 04.01. Postoperative complications were identified if cases contained ICD‐9‐CM codes for specific diagnoses and procedures.Results:Overall, 7,002 cases were examined. Most patients (76.2%) were 35‐64 years old, 40.5% had ≥ 1 comorbidity, and 86.5% were at high volume centers (≥ 100 excisions performed during 1996‐2010). Additionally, 24.4% had ≥ 1 of 34 pre‐defined postoperative complications and 0.2% died. Cerebrospinal fluid (CSF) leakage occurred in 2.8%, intracranial hemorrhage occurred in 0.4%, and ventriculostomy was required in 0.7%. Differences in complications between different volume centers (high, medium, and low) will be described. In 2006‐2010, there were significantly more postoperative complications compared to 1996‐2000. Presence of comorbidities was a significant predictor of having any postoperative complications (odds ratio [OR] 2.58, 95% confidence interval [CI]: 2.11‐3.17, P < 0.001).Conclusions:Postoperative complication rates increased over the study period, likely reflecting larger tumors that are not being treated with radiosurgery. Presence of comorbidities was a positive predictor of postoperative complications.
Detection Rates of the Labyrinthine Artery in Patients with ISSHL by 7‐T MRI
Authors: Sato Hiroaki , Kawagishi Kazuaki 
Published: August 2013

Objectives:Disturbance of inner ear blood flow has been considered to be one of the possible causes of idiopathic sudden sensorineural hearing loss (ISSNHL); however, imaging evaluation of the labyrinthine artery has not been reported to date. The aim of this study was to compare the detection rates of labyrinthine artery in subjects with and without ISSNHL using 7‐T magnetic resonance imaging (MRI).Methods:In 10 patients (5 males and 5 females) with ISSHL (ISSNHL group) and 14 volunteers (8 males and 5 females) with normal hearing (Control group), 7‐T MRI (Discovery MR950, GE Medical Systems) was performed with 3D time‐of‐flight spoiled gradient echo (3D TOF SPGR) sequence for the comparison of detection rates of the labyrinthine artery.Results:MRI scan was performed from 11 days to 49 days after onset. Among 10 patients with ISSNHL, 3 showed complete recovery and the rest showed partial recovery. The labyrinthine artery was depicted in 20 of 20 ears (100%) in the ISSHL group and 27 of 28 (96.4%) ears in the Control group. There was no significant difference in detection rates.Conclusions:The present study is the first to report depiction of the labyrinthine artery by 7‐T MRI. Our preliminary results indicate occlusion of the labyrinthine artery would be rare in the pathogenesis of ISSNHL and also demonstrate the labyrinthine artery could be detected by ultra‐high field MRI.
Device Failures, Complications, and Reoperation in a Cochlear Implant Program
Authors: Brill Kaitlin F. , Volsky Peter G. , Antonio Stephanie M. 
Published: August 2013

Objectives:1) Determine the incidence of complications of cochlear implants (CIs) in our small program; 2) Compare device failures and medical failures between types of implants; 3) Describe minor and major complications and patterns of CI device malfunction/failure.Methods:A chart review of CI patients in an academic medical center was performed in January 2013. Major complications included infections, tissue breakdown, or device failure requiring surgical management, including explantation. Device failure was determined by the CI surgeon, audiologist, or both. Minor complications included infections managed medically or with office procedures. Preliminary review included known patients with complications, device failures, and revision surgery and non‐users.Results:Between 1990 and 2012, 232 CI patients received care at our institution, including 16 implanted elsewhere. Nine patients (4%) experienced only minor complications, and 28 patients (12%) experienced a major complication. There were 20 cases of device failure in 19 patients (8%). Twenty‐three explants were performed in 22 patients (9%), indicated for device malfunction in 18 cases (17 patients, 7%); infection and extrusion in 2 patients (1%); headache in 2 patients (1%), and facial nerve stimulation in 1 patient. Magnet extrusion without acute infection occurred in 2 patients (1%), requiring 3 surgeries with the device in vivo. There were 3 non‐users (1%), one of whom was explanted for headache. Three patients (1%) had more than 1 revision surgery.Conclusions:Our complication rates are similar to those reported in the literature. Device testing post‐explantation is rarely received by the manufacturer; device failure appears to be a clinical diagnosis.
Direct‐Drive Acoustic Amplification Using a Tympanostomy Tube
Authors: Yau Yuk Y.A. , Mahboubi Hossein , Malley Melinda J.D. , Conderman Christian P. , Paulick Peyton , Bachman Mark , Djalilian Hamid R. 
Published: August 2013

Objectives:Determine whether a tympanostomy tube with a ferromagnetic cap can be actuated to deliver sound to the cochlea.Methods:A ferromagnetic mixture of nickel powder and epoxy was glued to the outer flange of an Armstrong V Grommet tympanostomy tube. The tube was then placed into the pars tensa portion of a cadaveric temporal bone. The Direct‐Drive Hearing Device (DHD), a completely‐in‐the‐canal hearing aid prototype developed in our lab, was coupled to the nickel‐epoxy flange and fixed inside the ear canal. The displacements of the posterior crus of the stapes were then measured using a Laser Doppler Vibrometer. The range of displacements induced by the device was compared to those of natural sound.Results:A 200 mV input to the device produced a range of displacements equivalent to those of sound at 70 dB sound pressure level (SPL; mean 0.44 nm; range 0.01‐2.80). A 400 mV input produced a range of displacements equivalent to those of sound at 80 dB SPL (mean 1.34 nm; range 0.02‐8.87).Conclusions:DHD, a small completely‐in‐the‐canal hearing aid prototype, is capable of actuating the TM through a ferromagnetic tympanostomy tube and producing range of displacements equivalent to moderate to severe levels of hearing loss.
Direct Monitoring of ABIs Evoked Potentials on the Cochlear Nuclei and Neighboring Cranial Nerves
Authors: Colletti Vittorio , Mandala Marco , Colletti Liliana 
Published: August 2013

Objectives:The potentials evoked with Auditory Brainstem Implant (ABI) on the cochlear nuclei (CN) and on the neighboring cranial nerves are traditionally evaluated with Electrical Auditory Brainstem Response (E‐ABR) and electromyography (EMG). To obtain a more precise evaluation of ABI insertion, a near field monitoring procedure that records electrical compound action potentials (E‐CNAPs) directly from the CN and from each individual cranial nerve is presented.Methods:Between January 1997 and September 2012, 184 patients were fitted with ABI by the Verona team, 155 in Verona and 29 (13 children and 16 adults) elsewhere. The E‐CNAPs utilizes a cotton‐wick recording electrode locate on different anatomical structures: CN, root entry zone of the cranial nerve VII, IX, X, XI, and V. All subjects were monitored with E‐ABR and 18 of them underwent also E‐CNAPs recording.Results:Systematic significant lower E‐CNAPs thresholds were observed compared with E‐ABRs. The evaluation of the threshold for inducing extra‐auditory effects with E‐CNAPs on the neighboring cranial nerves allowed a more precise selection of the active electrodes to be used in the fitting. For the same electrical intensity value utilized for obtaining ABI responses, E‐ABRs and E‐CNAPs showed potentials of neighboring cranial nerves respectively on 4 and 10 electrodes.Conclusions:The adoption of near‐field recordings offered the chance to improve the correct placement of the array and post‐operative outcomes. E‐CNAPs recorded on neighboring cranial nerves can replace EMG giving an on line demonstration of the effects on nerves on which electrodes induce myogenic responses.
Improved Resource Use following Vascularized Tissue Transfer: Mandatory Intensive Care Unit Stay Is Unnecessary
Authors: Panwar Aru , Militsakh Oleg N. , Lydiatt Daniel D. , Wieland Aaron M. , Lydiatt William M. 
Published: August 2013

Objectives:1) Analyze the impact of elimination of mandatory intensive care stay for patients following vascularized tissue transfer for reconstruction of defects following major head and neck surgical procedures. 2) Propose efficient, cost effective hospital pathways for care of patients following vascularized tissue transfer. 3) Demonstrate portability of such pathways between academic and community based practices.Methods:We performed a retrospective study involving two groups of adult patients who underwent vascularized free tissue transfer at a head and neck oncology practice at an academic and a community based hospital between July 2007 and June 2012. The first group of patients mandatorily received their immediate postoperative care in an intensive care unit. Following the institution of a specialized head and neck surgical unit, group 2 was cared for in a protocol driven, non intensive care unit setting. Outcomes and costs were compared between the two patient groups.Results:There was no adverse impact on rate of flap failure, inpatient mortality, and overall length of hospitalization. In contrast, a significant reduction in healthcare costs was observed when patients were routinely admitted to the head and neck surgery floor, instead of mandatory postoperative intensive care stay.Conclusions:1) Mandatory admission to intensive care following vascularized free tissue transfer for flap monitoring is unnecessary. 2) Results can be replicated in both an academic and community hospital setting.
Features of Music That Affect Its Enjoyment following Cochlear Implantation
Authors: Kohlberg Gavriel D. , Mancuso Dean , Chari Divya , Lalwani Anil K. 
Published: August 2013

Objectives:Enjoyment of music remains an elusive goal following cochlear implantation (CI). We assessed the hypothesis that reducing the complexity of music has the potential to enhance the listening experience for the cochlear implantee.Methods:Normal hearing adults (n = 17) were asked to evaluate an original and modified 20‐second piece of country music for its musicality, pleasantness, and naturalness before and after it was processed through CI simulation software. The music was modified by removing the vocals and/or changing the type of musical instruments playing (rhythmic only, melodic only, or combined rhythmic and melodic). Linear regression analysis with analysis of variance was used to assess the impact of music variation on music appreciation.Results:Without CI simulation, music segments that included the vocals, melodic instruments only, or combined rhythmic and melodic instruments sounded more pleasant, natural, and musical. In contrast, music segments processed through the CI simulation sounded more pleasant, natural, and musical when the vocals were removed and when only rhythmic instruments were included (all P values < 0.005).Conclusions:Musical enjoyment with or without CI is influenced by the complexity of the original music. Our study offers preliminary evidence that reduction of music complexity has the potential to make listening more enjoyable for the CI listener. Thus, in addition to improvement in software and hardware, engineering of music specifically for a CI listener may be an alternative means to enhance their listening experience.
Fibrous Incudostapedial Joint in Congenital Aural Atresia
Authors: Balaker Ashley E. , Roberson Joseph B. , Goldsztein Hernan 
Published: August 2013

Objectives:1) Determine the prevalence of a non‐bony or fibrous incudostapedial (IS) joint in the setting of congenital aural atresia. 2) Assess this anomaly's impact on surgical management and associated hearing outcomes.Methods:Operative reports and audiometric data of patients who underwent congenital aural atresia repair by a single surgeon from 2007‐2011 were reviewed for operative anatomic findings and audiometric outcomes.Results:Two hundred and twenty‐eight operations on 206 ears were performed. Median age was 5 years old. Fifty‐five (26.7%) of these ears had a fibrous IS joint. The severity of this anomaly was graded as mild in 23 ears, moderate in 20 ears, and severe in 12 ears. Average postoperative PTA2 in the severely fibrous group was 51 compared to 46 in the moderate group (P = 0.03) and 41 in the mild group (P = 0.006). Patients with a fibrous IS joint who underwent successful ossicular chain reconstruction (OCR) had an average postoperative PTA2 of 30, which was a significantly better outcome than in patients with moderately or severely fibrous IS joints who did not have OCR (P < 0.05).Conclusions:A fibrous IS joint was seen in 27% of patients undergoing repair of congenital aural atresia. The severity of this anomaly has important implications for postoperative hearing results. These findings suggest that ossicular chain reconstruction should be performed in moderately or severely fibrous cases.
First Clinical Results of the Dilatation of the Eustachian Tube in Patients with Tubal Dysfunction
Authors: Dalchow Carsten V. , Jowett Nathan , Kappo Nathalie , Boettcher Arne 
Published: August 2013

Objectives:One of the main causes for chronic otitis media is a tubal dysfunction which can now be treated with the endonasal dilatation of the Eustachian tube with the help of a novel balloon catheter.Methods:Since July 2010, we treated patients with a tubal dysfunction with a balloon dilatation of the Eustachian tube with the help of an endoscope through an endonasal approach. Such a dilatation was done in patients in whom we found a tubal dysfunction in the tube manometry and impedance audiometry. In 55 patients, a single‐sided and in 50 patients a bilateral treatment was performed by inserting a specially designed balloon catheter into the cartilage of the Eustachian tube and inflating it with 10 bar for 2 minutes.Results:Between July 2010 and November 2011, 105 patients (age 9‐71; 45 female, 60 male) were treated because of a tybal dysfunction. The dilatation was performed under general anesthesia using an endoscope and a specially designed applicator. The postoperative check‐up showed improved function in 69 patients, while 36 patients still showed a limitation of the tubal function. All patients reported a subjective improvement of middle ear pressure equalization.Conclusions:The endonasal dilatation of the Eustachian tube using the balloon catheter set to enlarge the cartilage is a safe and reliable method in patients with a tubal dysfunction. Our first clinical results confirm functional improvement after one year.