bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrocochleography in Round Window Vibrant Soundbridge Implantation
Authors: Colletti Vittorio , Colletti Liliana , Mandalà Marco 
Published: September 2011

ObjectiveDetermine the efficacy of electrocochleography (ECoG) monitoring to optimize the fitting of the floating mass transducer (FMT) of the Vibrant Soundbridge (VSB) on the round window membrane (RWm) niche in patients with conductive and mixed hearing loss.MethodIntraoperative ECoG monitoring in 41 patients with conductive and mixed hearing losses during surgery for VSB FMT RWm placement. Threshold and amplitude of click evoked compound action potentials (CAPs) were evaluated as a function of different middle ear locations and procedures for fitting the FMT on the RW niche.ResultsSuccessful FMT/RWm coupling with optimal CAPs responses requires: 1) removing part of the bony lip to obtain a complete view of the RWm, a full RWm/FMT contact; 2) drilling on the bony floor facing the RW to facilitate a perpendicular FMT/RWm; 3) interposing fascia between the FMT and RWm and all around the FMT to avoid contact with the surrounding bone; 4) locating the FMT approximately 1 mm inside the RW niche and placing a cartilage disk on the lateral face of the FMT to ensure stability of the coupling; 5) verifying that the footplate is not fixed.ConclusionIntraoperative ECoG monitoring verified that if the FMT is not in full close contact with the RWm and not free to vibrate without any contact with bone structures, the transfer of the FMT vibratory energy supplied to the cochlea will be incomplete and insufficient to fully compensate for sensorineural loss.
Endoscopic Dilatation of the Eustachian Tube
Authors: Dalchow Carsten , Muenscher Adrian , Knecht Rainald 
Published: September 2011

ObjectiveAn obstructive dysfunction of the Eustachian tube often leads to chronic otitis media, which must be treated with excessive surgery. The use of probes, tubes, or grommets are not always satisfying in the long term. With the use of modified balloon catheters, a safe and reliable treatment now becomes feasible.MethodA total of 107 patients with a history of tubal dysfunction were examined by otoscopy, pure‐tone‐audiometry, impedance audiometry, and tube manometry between July 2010 and January 2011. 20 patients were treated with endonasal endoscopic tube dilatation by inserting a ballon catheter into the Eustachian tube, which was then enlarged with 10 bar for 2 minutes.ResultsTwenty patients (14 male and 6 female; age 14‐71 years) were treated. All patients showed an obstructive dysfunction of the Eustachian tube in their preoperative diagnostics. A checkup one day and 3 months’ postdilatation verified an improved tube function in 14 patients, while all patients reported a subjective benefit after dilatation.ConclusionThe use of endonasal endoscopic tube dilatation provides otologists with a safe and reliable method to enlarge the cartilaginous part of the Eustachian tube. All patients benefited from treatment, while no complications such as total obstruction or open tube occurred.
Facial Nerve Decompression Surgery with Gelatin Containing bFGF
Authors: Hato Naohito , Nota Jumpei , Yamada Hiroyuki , Gyo Kiyofumi 
Published: September 2011

ObjectiveBasic fibroblast growth factor (bFGF) promotes the regeneration of denervated nerves. Our experimental study suggested that bFGF‐impregnated biodegradable gelatin hydrogel facilitates regeneration of the facial nerve in guinea pigs due to the sustained release of bFGF. Clinically, this therapeutic regimen may be useful for facial nerve decompression surgery.MethodTwenty‐five patients with severe facial paralysis were treated with the new procedure. The facial nerve was decompressed tympanic and mastoid portions via mastoid. A bFGF‐impregnated biodegradable gelatin hydrogel was placed around the exposed nerve. Regeneration of the facial nerve was evaluated once per month by observing the facial movement.ResultsPatients were followed until complete recovery occurred, or for more than 6 months in cases with a poor prognosis. All patients with severe Bell’s palsy and Ramsey Hunt syndrome showed early recuperation and milder sequelae compared to conventional decompression surgery. Recovery from the palsy was defined as House‐Brackmann grading 1 and 2. The rates of recovered patients with novel surgery and conventional surgery were 92.0% (n = 25) and 70.7% (n = 58), respectively; the former was significantly better than the latter (P <. 05).ConclusionThis is the first study to reveal the efficacy of a bFGF‐impregnated biodegradable gelatin hydrogel as a drug‐delivery medium in the paralyzed facial nerve surgery. Advantages of this decompression surgery are low risk of hearing impediment and long effective period after onset of paralysis.
Gentamicin Ototoxicity Requires Functional Mechanotransducer Channels
Authors: Huth Markus , Alharazneh Abdelrahman M. , Ricci Anthony , Luk Lauren , Cheng Alan G. 
Published: September 2011

ObjectiveTest the hypothesis that open mechanotransducer (MET) channels are required for aminoglycoside entry and toxicity in auditory hair cells.MethodCochlear cultures from postnatal 4‐day‐old rats were treated with gentamicin with and without MET channel blockers. The effects of MET channel blockers on hair cell survival were assessed by cell counts after immunohistochemistry. Two‐photon imaging was used to quantify uptake of Texas‐Red‐conjugated gentamicin (GTTR) into live hair cells.ResultsGentamicinalone (0.1mM) caused 76.5% hair cell loss in the basal cochlear turn. Cotreatment with MET channel blockers, 1.0 mM curare, and 0.5 mM quinine conferred protection (0.4% and 7.4% hair cell loss, both P <. 001); whereas treatment with endocytosis inhibitors, 2.6 μM conconavalin A and 80 µM dynosore, did not (63.7% and 76.0% hair cell loss). Two‐photon imaging showed that GTTR uptake (3 µM) into live hair cells was rapid and selective. Quinine and curare, but not concanavalin A, reduced GTTR uptake. Furthermore, as low calcium increases the open probability of MET channels, hypocalcemia showed facilitated GTTR uptake.ConclusionFunctional MET channels are required for aminoglycoside uptake into hair cells and its toxicity. Results suggest that limiting permeation of aminoglycosides through MET channels is a potential therapeutic target for preventing hair cell death.
Habituation following Tinnitus Retraining Therapy in Tinnitus Sufferers
Authors: Thong Jiun Fong , Wong Mei Ching , Junaidah S. , Chan Yew Meng 
Published: September 2011

ObjectiveEvaluate the efficacy of Tinnitus Retraining Therapy (TRT) in habituating patients with tinnitus.MethodProspective study of patients presenting to the tinnitus clinic at a tertiary referral otorhinolaryngology unit in Singapore over a 13‐year period (1997 to 2010). Patients who underwent Tinnitus Retraining therapy were followed up with structured interviews with the aid of questionnaire forms. Habituation following TRT was evaluated.ResultsA total of 702 patients were studied (55% male, 45% female). Average age was 51 years. Habituation of reaction to tinnitus and habituation of perception were analyzed. Average duration of follow‐up was 33 months (range, 0.25‐151 months). A total of 68% of patients described improvement in annoyance following TRT. Of these, 80% described habituation of perception as well. There was no statistical difference in gender and age between patients who did and did not respond to TRT. However, duration of treatment was significantly longer in patients who habituated.ConclusionThe goal of TRT is to achieve habituation of reaction to tinnitus. Habituation of perception is often a secondary result of sufficiently habituated response. From our study, more than two‐thirds of patients with tinnitus achieved habituation of reaction, and of these, the majority also habituated to awareness of the tinnitus.
Inner Ear Effects of Canal Wall Down Mastoidectomy: A Prospective Study
Authors: Benscoter Brent J. , Marmora Joseph , Leonetti John P. , Kircher Matthew L. , Jaber James J. , Feustel Paul J. 
Published: September 2011

ObjectiveEvaluate the inner ear effects of canal wall down (CWD) mastoidectomy in the treatment of chronic otitis media (COM) in regard to bone conduction hearing and reported tinnitus and dizziness related disability.MethodProspective study of 86 consecutive patients treated by CWD mastoidectomy for COM with or without cholesteatoma. Patients underwent preoperative audiogram and completion of 2 surveys: Dizziness Handicap Inventory (DHI) and Tinnitus Handicap Inventory (THI), which were repeated 4 to 6 months postoperatively.ResultsNo significant change in bone‐conduction hearing scores occurred postoperatively. DHI and THI scores improved in the vast majority of patients. Thirteen patients, 13 out of 34 (38%), had DHI improvement greater than 18 points, indicating a significant patient‐perceived improvement in dizziness‐related disability. Sixteen patients, 16 out of 43 (37%), had THI improvement greater than 20 points, indicating a significant patient‐perceived improvement in tinnitus‐related disability. Three patients developed new‐onset postoperative dizziness, and 5 patients developed new‐onset postoperative tinnitus. The odds ratio for improving DHI and THI scores relative to or worsening scores is 6.6 in DHI (95% CI: 1.8 to 25.0) and 4.2 in THI (95% CI: 1.45 to 12.2).ConclusionCanal wall down mastoidectomy did not result in new‐onset sensorineural hearing loss. In addition, using the Dizziness Handicap Inventory and Tinnitus Handicap Inventory measures, patient‐perceived disability from dizziness and tinnitus was shown to decrease after mastoid surgery.
Is There a “Biological Gear” in the Human Middle Ear?
Authors: Puria Sunil , Steele Charles , Cai Hongxue , Jackson Ryan 
Published: September 2011

ObjectiveA mammal’s ability to hear high‐frequency sound is due to unique structures such as 3 distinct middle‐ear (ME) ossicles. In larger mammals such as humans, the ME features a cylindrical malleus cross section, differing eardrum areas on each side of the malleus handle, and a mobile saddle‐shaped malleus‐incus joint (MIJ).MethodBased entirely on 3D reconstructions of micro‐CT images, a finite element biocomputation model was constructed, which includes the ear canal, eardrum, ossicles, suspensory soft tissue attachments, and ME joints modeled as mobile and fluid‐filled. Frequency responses of acoustics‐structure interactions were calculated using COMSOL Multiphysics solvers.ResultsResults indicate that at low frequencies, hinge‐like motion is dominant as expected, and that the orthotropy of the eardrum boosts the ME gain due to increased peak displacement. However, at high frequencies we observe multi‐resonance vibration modes at the eardrum and a bevel‐gear‐like motion at the MIJ, and the orthotropy of the eardrum makes the rotation axis of the malleus more coincident with its long axis. This supports the hypothesis that a “twisting” motion of the malleus and incus is required in larger mammals at high frequencies in order to compensate for larger moments‐of‐inertia of the larger ossicular masses.ConclusionWe argue that a new “twisting” gear‐like motion is necessary for efficient high‐frequency sound transmission in larger mammals, due to higher moments of inertia for hinge‐like motion in these species. These features favor the existence of the twisting motion of the malleus‐incus complex in addition to the classical hinge‐like motion.
Is There an Age Limit for Cochlear Impantation?
Authors: Sanchez‐Cuadrado Isabel , Perez‐Mora Rosa , Gavilan Javier , Lassaletta Luis , Zernotti Mario E. 
Published: September 2011

ObjectiveEvaluate quality of life following cochlear implantation in older postlocutive adults.MethodPostlingually deaf adults 60 years or older who underwent implantation in 3 institutions were included. Data concerning demographics and audiometric evaluation were collected and studied. Patients were divided in 2 groups (< 70 and ≥ 70 years). GBI was used to quantify quality of life.ResultsEighty‐one patients were included. The mean age at implantation was 68 years (range, 60‐82 years). A significant improvement in speech recognition after cochlear implantation was observed (P <. 01). The results of the GBI questionnaire showed an important benefit on the total scale (mean, 40) and on the 3 different subscales (53, 24, and 4, respectively). These results were similar to those of younger postlocutive candidates. However, particular cases with decreased quality of life were identified, in spite of acceptable audiologic results. The difference between the <70 and ≥70 years groups was not significant.ConclusionElderly CI users improve their quality of life, with similar outcomes to those achieved by younger adults. Because of particular conditions of this population, care must be taken when indicating a CI. Cochlear implantation should not be denied on the basis of age alone.
Meningitis Following Lateral Skull Base Surgery
Authors: Isaacson Brandon , Purcell Patricia L. , Roland Peter S. , Kutz J. Walter , Allen Kyle P. 
Published: September 2011

Objective1) Determine the clinical course of meningitis in the following lateral skull base surgery. 2) Examine risk factors leading to meningitis following lateral skull base surgery.MethodRetrospective review of patients undergoing lateral skull base surgery between February 1999 and March 2010. All subjects had culture‐proven meningitis in the postoperative period. Medical records were compared with the lateral skull base patients who did not develop meningitis.ResultsFourteen of 508 patients (2.8%) developed meningitis following lateral skull base surgery. The most common diagnosis was acoustic neuroma in 78.5%. A total of 64.3% of patients had a CSF leak prior to meningitis onset, and 42.9% received a lumbar drain. The mean time to onset of meningitis was 16.1 days. The most common pathogens were staphylococcus, streptococcus, and enterococcus species; each in 14.3% of cases. A total of 10.3% of patients with postoperative CSF leakage and 9.2% with lumbar drains developed meningitis. The odds ratio of developing meningitis in the setting of a postoperative CSF leak is 7.3. There were no meningitis associated mortalities.ConclusionPostoperative meningitis was seen in 2.8% of lateral skull base surgeries. As expected a CSF leak and placement of a lumbar subarachnoid drain are significant risk factors for developing meningitis. No mortality was associated with meningitis.
Occlusion of the Round Window: A Novel Way to Treat Hyperacusis Symptoms in Superior Semicircular Canal Dehiscence
Authors: Banerjee Anirvan , Nikkar‐Esfahani Ali 
Published: September 2011

ObjectiveConductive hyperacusis in SSCDS occurs because of presence of a “third window.” This can cause an increased imbalance in the impedances looking out of the cochlear windows. Reversible blocking of the round window can minimize symptoms of conductive hyperacusis.MethodThe tympanomeatal flap is elevated through a permeatal approach. The round window niche is identified, and the round window membrane is identified and occluded with bone wax and fascia in layers. Finally the tympanomeatal flap is reflected, and an ear wick is inserted.ResultsTwo patients who have undergone the above procedure have reported great reduction in symptoms. Importantly, no Tullio phenomenon has been noted postoperatively.ConclusionIn patients with SSCD syndrome who present with symptoms of conductive hyperacusis, blocking of the round window can be used to control symptoms. It provides an alternative to the plugging and resurfacing techniques. This procedure is simple to perform, is reversible, and can be undertaken as a day case.
Outcome of Intratympanic Gentamicin Injection for Ménière Disease
Authors: Huon Leh‐Kiong , Fang Te‐Yung , Wang Pa‐Chun 
Published: September 2011

ObjectiveIntratympanic genemicin (ITG) is an option for the treatment of intractable Ménière disease (MD). The aim of this study is to investigate the outcomes of ITG for MD using evidence‐based methodology.MethodThe MedLine database (1985~2010) was searched for original articles (level I or II in evidence strength) published in peer‐reviewed journals concerning ITG for MD. Data extracted from these articles were reviewed and analyzed using meta‐analysis technology.ResultsA total of 15 articles were clitically appraised; 2 prospective, double‐blinded randomized control trials (level I) and 13 prospective noncontrolled clinical trials (level II) were indentified. The pooled vertigo control rates (American Academy of Otolaryngology Head and Neck Surgery guidelines for Ménière disease) from 15 studies are: overall control rate 78% (class A, 95% CI 0.67‐0.85), substantial control rate 56 % to 98% (class A and B, 95% CI 0.25‐1.0) following ITG treatment (P =. 0001). Hearing is worse in 0% to 61% (95% CI 0.02‐0.83) after gentamicin treatment, which was neither clinically nor statistically significant (P = 1.000).ConclusionThe critical literature and meta‐analyses show that ITG can control vertigo for MD patients with limited injury to hearing. Quality of research has improved remarkably over the years. However, a large scale, randomized controlled trial is warranted to confirm the predicting factors for the true effectiveness of ITG in treating MD.
Relation between Serum Iron Level and Amikacin Ototoxicity
Authors: Shayaninasab Mohammad , Alizamir Azam , Behnoud Fatholah , Khoeinipourfar H. , Fatoloomi Mohammad Reza 
Published: September 2011

ObjectiveAminoglycosides are highly effective against bacteria but have serious side effects including ototoxicity and nephrotoxicity. Iron‐aminoglycoside complex causes ototoxicity by creating free radicals. We study the relation between serum iron level and amikacin ototoxicity to learn whether more iron results in more ototoxcity.MethodWe examined burned patients with amikacin prescription. Patients were divided into Group 1 (89 patients with serum ferritin above 150 ng/mL) and Group 2 (92 patients with serum ferritin below 150 ng/mL). Their hearing thresholds and red blood cell indices were compared using t and paired t test.ResultsIn comparing the 2 groups, thresholds of Group 1 were more than Group 2 at all frequencies, and the difference was statistically significant with P <. 001. Maximum threshold shift in Group 1 was greater than 20 dB and in Group 2 was less than 10 dB, at 8000Hz. Again, this result was statistically and clinically significant with a P <. 001. Finally, mean corpuscular volume was greater in Group 1 than Group 2, and the P‐value for the test was around. 001.ConclusionOur results suggest that iron level is related to aminoglycoside ototoxicity. More iron can create more ototoxicity, and iron deficiency may inhibit aminoglycoside ototoxicity. An increase in MCV may be due to higher serum ferritin and an indication of more ototoxicity.
Relationship between Audiogram and Pitch in Tonal Tinnitus
Authors: Kleinjung Tobias , Schecklmann Martin , Langguth Berthold , Landgrebe Michael , Vielsmeier Veronika , Steffens Thomas 
Published: September 2011

ObjectiveIt still remains a matter of debate whether the main responsible mechanism for tinnitus generation is reduced lateral inhibition or feed forward inhibition. On a perceptual level these different mechanisms should be reflected by the relation between the individual hearing curve and the perceived tinnitus frequency.MethodWe investigated in a large sample of 320 patients with unilateral (145 right, 175 left) tonal tinnitus the relationship between the perceived tinnitus pitch and the individual audiogram. The tinnitus frequency as determined by pitch matching was compared with an audiogram of the ear where the tinnitus was perceived.ResultsThe perceived tinnitus pitch depended to a greater extent on the frequency of maximum hearing loss than on the edge frequency.ConclusionResults of our study confirm the relevance of absolute hearing loss for tinnitus generation as compared with the edge frequency, suggesting that tinnitus is rather a fill‐in phenomenon, eg, generated by altered gain control, than the result of deficient lateral inhibition.
Role of Vestibular Function Tests in Cochlear Implantation
Authors: Hajioff Daniel , Wilkinson Andrew , Savage Julian , Robinson Philip J. , Parmar Amit , Nunez Desmond A. 
Published: September 2011

ObjectiveVestibular function tests are often undertaken before cochlear implantation, in part to help select the side of surgery. We aim to determine whether implantation on the side of better vestibular function leads to greater dizziness than implantation on the side of worse or similar function.MethodA total of 177 unilateral implant recipients were reviewed in 2 groups. A: Those implanted in the ear with worse or similar caloric function. B: Those implanted in the ear with greater (>20%) caloric function. All were assessed with the Dizziness Handicap Inventory and supplementary questions after a minimum 2 months.ResultsA total of 57% of both groups reported dizziness in the first 7 days postoperatively. At 2 months 20% of group A and 34% of group B experienced some dizziness. A total of 14% of group A and 10% of group B felt that cochlear implantation had resulted in impaired balance. The DHI scores of 86% of group A (median score 0) and 76% of group B (median score 10) corresponded with low handicap. None of these results differed significantly between groups A and B.ConclusionWhile cochlear implantation may result in dizziness it is almost always short‐lived and mild, even when the ear with a stronger caloric response is implanted.
Saccular Otoconia as a Cause of Ménière Disease
Authors: Yamane Hideo , Takayama Masahiro 
Published: September 2011

ObjectiveIdiopathic endolymphatic hydrops can be caused by disturbance of the longitudinal flow of the endolymph in Ménière disease. This study investigated a possibility that the dislodged otoconia from the saccule could be a cause of Ménière disease by occluding the pathway of the endolymph.MethodWe examined the ears of 65 patients with definitely diagnosed unilateral Ménière disease based on the criteria proposed by the AAO‐HNS and the ears of normal control subjects and cadavers using three‐dimensional (3D) cone beam CT by focusing on the vestibule.ResultsThe images of the reuniting duct and the saccular duct could be categorized by their patency. In the case of Ménière ears, both the reuniting duct and the saccular duct were occluded significantly compared with those of normal ears. The ears of the nonlesional side of Ménière patients also showed the occluded aspects of these ducts. The endolympatic sinus, which connects to the saccular duct, suggested relations with Ménière attack.ConclusionPatients with Ménière disease often show a significantly higher incidence of blockage of the reuniting duct and saccular duct. There is a big probability that radiodense substances such as saccular otoconia falling into these ducts may be one of the etiologies of Ménière disease.