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Wang B, Guo X, Wei C, Cao K. Preoperative EABR evaluation of auditory pathway integrity in patients with different etiology and postoperative effect estimation. Eur Arch Otorhinolaryngol 2024; 281:1185-1193. [PMID: 37615702 DOI: 10.1007/s00405-023-08198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES To evaluate the effect of electrical auditory brainstem response (EABR) on the integrity evaluation of auditory pathway and the prediction of postoperative effect of cochlear implantation in patients with different etiology of hearing loss. METHODS A total of 580 patients with neuropathic deafness who underwent cochlear implantation surgery from August 2011 to December 2020 were selected for EABR test. The preoperative EABR waveform was analyzed, and parameters such as V wave amplitude, threshold, latency and interval of each wave, and slope of V wave I/O curve were measured. Neural response telemetry (NRT) test was performed during MAP 1 month after operation, and C and T values of the machine were recorded. RESULTS The total EABR extraction rate was 98.45% among 580 patients, including 100% for the normal structure group and enlarged vestibular aqueduct group (LVAS), 92.44% for other malformed group. The average threshold of V wave in patients with normal cochlear structure was significantly better than the malformation groups (p < 0.05). The total extraction rate of NRT was 78.62%, including 99.72% in the group with normal structure, 95.65% in the LVAS group, 1.85-88.24% in the group with other malformations, and 0% in the cochlear ossification group. The correlation analysis showed a statistically significant correlation between the average preoperative EABR threshold and the C value of NRT. CONCLUSIONS Preoperative EABR could evaluate the integrity of auditory conduction pathway of patients with cochlear implantation and predict the postoperative hearing rehabilitation effect.
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Affiliation(s)
- Bin Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Xiaohui Guo
- Department of Ophthalmology, the Third Medical Center of PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Chaogang Wei
- Department of Otolaryngology-Head and Neck Surgery, Peking University First Hospital, No. 8 Xishku Street, Xicheng District, 100034, Beijing, China
| | - Keli Cao
- Department of Otolaryngology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China.
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Jafari Z, Fitzpatrick EM, Schramm DR, Rouillon I, Koravand A. An Umbrella Review of Cochlear Implant Outcomes in Children With Auditory Neuropathy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4160-4176. [PMID: 37647160 DOI: 10.1044/2023_jslhr-23-00128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PURPOSE The objective of this overview of systematic reviews (SRs; umbrella review) was to systematically summarize and critically appraise current evidence of cochlear implant (CI) outcomes in children with auditory neuropathy spectrum disorder (ANSD). METHOD This study was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. The methodological quality and the risk of bias in the included SRs were assessed using A MeaSurement Tool to Assess systematic Reviews 2 checklist and the Risk of Bias in Systematic Reviews tool, respectively. RESULTS According to eight included SRs, children with ANSD achieve CI outcomes (speech perception performance) similar to their peers with sensorineural hearing loss. In children with postsynaptic ANSD (cochlear nerve deficiency), cochlear nerve hypoplasia is associated with better speech recognition outcomes compared with cochlear nerve aplasia, especially in the absence of additional disabilities. Except for one study, the overall quality of the included SRs was critically low, and except for three studies, evidence of a high risk of bias was identified in other included SRs. CONCLUSIONS Current evidence supports CI benefits for children with ANSD. To improve the quality of evidence, well-designed, prospective studies with appropriate sample sizes, using valid outcome measures, clarifying matching criteria, and taking into account the role of confounding factors are essential.
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Affiliation(s)
- Zahra Jafari
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
| | - Elizabeth M Fitzpatrick
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
- Child Hearing Laboratory, CHEO Research Institute, Ottawa, Ontario, Canada
| | - David R Schramm
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ontario, Canada
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, Ontario, Canada
| | - Isabelle Rouillon
- Speech and Language Pathology, and Otolaryngology Department, Necker Hospital, Paris, France
| | - Amineh Koravand
- Audiology and Speech-Language Pathology Program, University of Ottawa, Ontario, Canada
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Evaluation of auditory pathway by EABR before cochlear implantation and the postoperative effect analysis. Eur Arch Otorhinolaryngol 2023; 280:105-114. [PMID: 35639140 DOI: 10.1007/s00405-022-07458-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 05/18/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To investigate the evaluation value of electrically evoked auditory brainstem response (EABR) monitoring before cochlear implantation in patients with cochlear nerve defects (CND). METHODS A total of 54 patients with cochlear nerve defects who underwent cochlear implantation in our hospital from 2011 to 2018 were selected as the CND group, and 20 patients with normal cochlear implantation were selected as the control group. The preoperative audiological characteristics, EABR characteristics and follow-up neural response telemetry results of the two groups were retrospectively analysed, and the preoperative EABR threshold and initiation C value were subjected to linear regression and correlation analysis. RESULTS The EABR waveform of the CND group was significantly different from the control group in terms of average wave V threshold, average dynamic range and V-wave I/O curve slope (P < 0.05). Average C value and dynamic range had a statistically significant difference from the control group (P < 0.05). Statistically significant positive correlations were found between the EABR threshold and C value, wave V I/O slope and postoperative category of auditory perception (P < 0.05). CONCLUSIONS The EABR test can be used to evaluate the auditory pathway function before cochlear implantation and its postoperative effect in patients with CND.
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Kuzovkov VE, Sugarova SB, Koroleva IV, Korneva YS, Lilenko AS, Tanaschishina VA. [Prospects for cochlear implantation in patients with auditory nerve dysplasia]. Vestn Otorinolaringol 2023; 88:66-72. [PMID: 37767593 DOI: 10.17116/otorino20228804166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Auditory nerve dysplasia (AND) can encompass various conditions of the auditory nerve (AN), ranging from true aplasia to hypoplasia. The purpose of this review is to discuss the prospect of cochlear implantation (CI) and subsequent auditory speech rehabilitation for AN abnormality. Studies of different authors when working with this category of children, possible results and methods of diagnostics of the AN condition are presented.
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Affiliation(s)
- V E Kuzovkov
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech the Ministry of Health Russian Federation, St. Petersburg, Russia
| | - S B Sugarova
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech the Ministry of Health Russian Federation, St. Petersburg, Russia
| | - I V Koroleva
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech the Ministry of Health Russian Federation, St. Petersburg, Russia
| | - Yu S Korneva
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech the Ministry of Health Russian Federation, St. Petersburg, Russia
| | - A S Lilenko
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech the Ministry of Health Russian Federation, St. Petersburg, Russia
| | - V A Tanaschishina
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech the Ministry of Health Russian Federation, St. Petersburg, Russia
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Electrically evoked auditory brainstem responses to electrical stimulation at round window membrane in congenitally deaf children at different ages. Int J Pediatr Otorhinolaryngol 2021; 148:110821. [PMID: 34225082 DOI: 10.1016/j.ijporl.2021.110821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To investigate the usefulness of measuring the electrically evoked auditory brainstem responses (eABRs) to electrical stimulation at the round window niche (RWN) and round window membrane (RWM) and the effect of deafness duration on functions of the auditory pathway to the level of the brainstem. METHODS According to the age at cochlear implantation (CI), 99 children with profound sensorineural hearing loss were divided into four groups: ≤12 months (group A), 13-36 months (group B), 37-60 months (group C) and >60 months (group D). The eABRs were evoked by electrical stimulation at RWN and RWM during the operation of CI. RESULTS The higher eABR extraction rate and lower threshold for RWM stimulation was found than those for RWN stimulation. The eⅢ latencies and eⅢ-eⅤ latency intervals for RWM stimulation were similar among four groups. However, children with earlier CI (group A) showed a significantly shorter eⅤ latency than others. CONCLUSION The eABR evoked by the electrical stimulation at RWM is more stable and sensitive compared with that at RWN for evaluating functions of the auditory conduction pathway. Development in the upper brainstem pathway may be more vulnerable to long-term deafness as revealed by the eⅤ latency.
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Zhang JG, Chen L, Li P, Sun JW, Guo XT, Sun JQ. Effect of unilateral cochlear implant use on contralateral electrically evoked auditory brainstem responses to round window membrane electrical stimulation. Acta Otolaryngol 2021; 141:588-593. [PMID: 33823755 DOI: 10.1080/00016489.2021.1906443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Long-term use of a unilateral cochlear implant (CI) may lead to abnormal development of contralateral auditory pathway. OBJECTIVES To investigate the usefulness of measuring the electrically evoked auditory brainstem response (eABR) with the electrical stimulation at the round window membrane and the effect of unilateral CI use on the contralateral auditory pathway functions. MATERIALS AND METHODS According to duration of unilateral CI use, 45 children with severe or profound sensorineural hearing loss were divided into sCI (≤12 months), lCI (≥24 months) and nCI (no CI use) groups. Intra-operative eABRs evoked by electrical stimulation at the round window membrane were recorded. RESULTS The latencies of eIII and eV were significantly longer in lCI group than in sCI group and in nCI group, respectively, but not significantly different between sCI group and nCI group. The eABR thresholds and eIII-eV latency intervals were not significantly different among three groups. CONCLUSIONS AND SIGNIFICANCE The eABR evoked by the electrical stimulation at the round window membrane is a reliable and effective way of evaluating functions of the auditory pathway in deaf children. Long-term use of a unilateral CI may promote the degenerative process of the contralateral auditory pathway to the level of the brainstem.
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Affiliation(s)
- Jun-Ge Zhang
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Wannan Medical College, Anhui Provincial Hospital, Hefei, Anhui, China
| | - Li Chen
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Wannan Medical College, Anhui Provincial Hospital, Hefei, Anhui, China
| | - Ping Li
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jing-Wu Sun
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xiao-Tao Guo
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jia-Qiang Sun
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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Audiologic Outcome of Cochlear Implantation in Children With Cochlear Nerve Deficiency. Otol Neurotol 2020; 42:38-46. [DOI: 10.1097/mao.0000000000002849] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cooper T, Melder KL, Hyre R, Hobson CE, McCall AA, Hirsch BE. Cochlear Implant Performance in Adult Patients with Absent Intraoperative Electrically Evoked Compound Action Potentials. Otolaryngol Head Neck Surg 2020; 162:725-730. [PMID: 32122228 DOI: 10.1177/0194599820907572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe cochlear implant performance outcomes in adult patients in whom no intraoperative electrically evoked compound action potential (ECAP) responses were able to be obtained despite intracochlear electrode placement. STUDY DESIGN Retrospective case review. SETTING Academic tertiary center. SUBJECTS AND METHODS Patients 18 years of age and older undergoing cochlear implantation between May 2010 and September 2018 with absent ECAP measurements intraoperatively with intracochlear electrode positioning were identified. Patient performance on sentence recognition testing using the Hearing in Noise Test (HINT) and AzBio at 6 to 12 months postoperatively was compared to preimplantation scores. Additional collected data included patient demographics, etiology of hearing loss, and preoperative pure-tone average (PTA) and word recognition scores (WRSs). RESULTS Intraoperative ECAP measurements were unable to be obtained in 15 cochlear implants performed on 14 patients out of 383 cochlear implant cases. Of the patients with absent ECAP measures, the mean ± SD age was 61.7 ± 15.7 years. Causes of hearing loss included congenital hearing loss, meningitis, autoimmune inner ear disease, otosclerosis, presbycusis, and Ménière's disease. The average preoperative PTA was 103.5 ± 17.0 dB. Twelve implanted ears had a WRS of 0% and 9 had a HINT score of 0% prior to surgery. The mean HINT score at 6 to 12 months postimplantation was 57.8% ± 37.8% and had improved by 42.6% ± 35.6% compared to the mean preimplantation HINT score (95% confidence interval, 22.0%-63.1%, P = .001, paired Student t test). CONCLUSION There is a wide range of cochlear implant performance in patients with absent intraoperative ECAP measures ranging from sound awareness to HINT scores of 100%.
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Affiliation(s)
- Timothy Cooper
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.,Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Katie L Melder
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Rick Hyre
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Candace E Hobson
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.,Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia, USA
| | - Andrew A McCall
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Barry E Hirsch
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
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Colletti L, Wilkinson EP, Colletti V. Auditory Brainstem Implantation after Unsuccessful Cochlear Implantation of Children with Clinical Diagnosis of Cochlear Nerve Deficiency. Ann Otol Rhinol Laryngol 2019. [DOI: 10.1177/000348941312201002] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Liliana Colletti
- Department of Otorhinolaryngology, University of Verona, Verona, Italy
| | | | - Vittorio Colletti
- Department of Otorhinolaryngology, University of Verona, Verona, Italy
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10
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Cinar BC, Yarali M, Atay G, Bajin MD, Sennaroglu G, Sennaroglu L. The role of eABR with intracochlear test electrode in decision making between cochlear and brainstem implants: preliminary results. Eur Arch Otorhinolaryngol 2017. [DOI: 10.1007/s00405-017-4643-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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van Eijl RHM, Buitenhuis PJ, Stegeman I, Klis SFL, Grolman W. Systematic review of compound action potentials as predictors for cochlear implant performance. Laryngoscope 2016; 127:476-487. [PMID: 27804133 DOI: 10.1002/lary.26154] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 05/07/2016] [Accepted: 05/31/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS The variability in speech perception between cochlear implant users is thought to result from the degeneration of the auditory nerve. Degeneration of the auditory nerve, histologically assessed, correlates with electrophysiologically acquired measures, such as electrically evoked compound action potentials (eCAPs) in experimental animals. To predict degeneration of the auditory nerve in humans, where histology is impossible, this paper reviews the correlation between speech perception and eCAP recordings in cochlear implant patients. DATA SOURCES PubMed and Embase. REVIEW METHODS We performed a systematic search for articles containing the following major themes: cochlear implants, evoked potentials, and speech perception. Two investigators independently conducted title-abstract screening, full-text screening, and critical appraisal. Data were extracted from the remaining articles. RESULTS Twenty-five of 1,429 identified articles described a correlation between speech perception and eCAP attributes. Due to study heterogeneity, a meta-analysis was not feasible, and studies were descriptively analyzed. Several studies investigating presence of the eCAP, recovery time constant, slope of the amplitude growth function, and spatial selectivity showed significant correlations with speech perception. In contrast, neural adaptation, eCAP threshold, and change with varying interphase gap did not significantly correlate with speech perception in any of the identified studies. CONCLUSIONS Significant correlations between speech perception and parameters obtained through eCAP recordings have been documented in literature; however, reporting was ambiguous. There is insufficient evidence for eCAPs as a predictive factor for speech perception. More research is needed to further investigate this relation. Laryngoscope, 2016 127:476-487, 2017.
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Affiliation(s)
- Ruben H M van Eijl
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Patrick J Buitenhuis
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sjaak F L Klis
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wilko Grolman
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
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Rah YC, Lee JY, Suh MW, Park MK, Lee JH, Chang SO, Oh SH. Cochlear Implantation in Patients With CHARGE Syndrome. Ann Otol Rhinol Laryngol 2016; 125:924-930. [PMID: 27557911 DOI: 10.1177/0003489416665190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the optimal surgical approach for cochlear implantation (CI) preoperatively based on the spatial relation of a displaced facial nerve (FN) and middle ear structures and to analyze clinical outcomes of CHARGE syndrome. METHODS Facial nerve displacement and associated deviation of inner ear structures were analyzed in 13 patients (17 ears) with CHARGE syndrome who underwent CI. Surgical accessibility through the facial recess was assessed based on anatomical landmarks. Postoperative speech performance and associated clinical characteristics were analyzed. RESULTS The most consistently identified ear anomalies were semicircular canal aplasia (100%), ossicular anomaly (100%), and vestibular hypoplasia (88%). Facial nerve displacement was found in 77% of cases (anteroinferior: 47%, anterior: 24%, inferior: 6%). The width of available surgical space around facial recess was significantly greater in cases of facial recess approach (2.85 ± 0.9 mm) than those of alternative approach (0.12 ± 0.29 mm, P = .02). Postoperatively, 53% achieved better than category 4 on the categories of auditory perception (CAP) scale. The CAP category was significantly correlated with internal auditory canal diameter (P = .025) and did not differ according to the applied surgical approach. CONCLUSION Preoperative determination of surgical accessibility through facial recess would be useful for safe surgical approach, and successful hearing rehabilitation was achievable by applying appropriate surgical approaches.
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Affiliation(s)
- Yoon Chan Rah
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea Department of Otorhinolaryngology, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea
| | - Ji Young Lee
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Myung-Whan Suh
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sun O Chang
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea Department of Otorhinolaryngology, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Seung-Ha Oh
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
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Wang Y, Pan T, Deshpande SB, Ma F. The Relationship Between EABR and Auditory Performance and Speech Intelligibility Outcomes in Pediatric Cochlear Implant Recipients. Am J Audiol 2015; 24:226-34. [PMID: 25677645 DOI: 10.1044/2015_aja-14-0023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 02/01/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The primary purpose of the present study was to investigate the relationship between postimplant electrically evoked auditory brainstem response (EABR) measures (wave V threshold, wave V latency, input-output functions) and auditory performance and speech intelligibility outcomes measured using parental rating scales, such as Categories of Auditory Performance (CAP; Archbold, Lutman, & Marshall, 1995) and the Speech Intelligibility Rating scale (SIR; Allen, Nikolopoulos, Dyar, & O'Donoghue, 2001), respectively. The secondary purpose was to evaluate the relationship between age at implantation and ratings on the CAP and SIR. METHOD Forty children with congenital sensorineural hearing loss participated. Preimplant parental ratings on the CAP and SIR were obtained, and all the children underwent cochlear implantation. Intracochlear EABRs were recorded postimplantation. Postimplant parental ratings on the CAP and SIR were obtained. The relationships between EABR parameters and auditory performance and speech intelligibility outcomes were studied. The effect of age at implantation on auditory performance and speech intelligibility outcomes was also investigated. RESULTS A significant negative correlation was found between EABR wave V thresholds and SIR growth (r = -.415, p = .016). Children with better CAP growths tended to have lower wave V thresholds than those with poorer CAP growths. Age at implantation had an effect on the auditory performance as measured using the CAP. CONCLUSIONS The present study provides evidence for the relationship between wave V thresholds of the intracochlear EABR and auditory performance and speech intelligibility outcomes measured using parental rating scales in pediatric cochlear implant recipients. Data also indicate that early intervention has a positive impact on auditory performance outcomes.
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Affiliation(s)
- Yu Wang
- Peking University Third Hospital, Beijing, China
| | - Tao Pan
- Peking University Third Hospital, Beijing, China
| | | | - Furong Ma
- Peking University Third Hospital, Beijing, China
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Colletti L, Colletti G, Mandalà M, Colletti V. The Therapeutic Dilemma of Cochlear Nerve Deficiency. Otolaryngol Head Neck Surg 2014; 151:308-14. [DOI: 10.1177/0194599814531913] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 03/26/2014] [Indexed: 11/17/2022]
Abstract
Objective To compare the outcomes between 2 age-matched cohorts of children with cochlear nerve deficiency: those receiving auditory brainstem implants (group A) or cochlear implants (group B). Study Design Retrospective cohort study. Setting Tertiary referral center. Subjects and Methods Subjects were selected from a pool of 537 children fitted with cochlear implants (n = 443) or auditory brainstem implants (n = 94) over the past 14 years. Performance, examined with the Category of Auditory Performance scale, and complications were compared with a mean follow-up of 5 years. Results All children had bilateral profound sensorineural hearing loss and cochlear nerve deficiency. Magnetic resonance imaging documented an absent cochlear nerve (n = 12) and a small cochlear nerve (n = 8) in group A and an absent cochlear nerve (n = 11) and a small cochlear nerve (n = 9) in group B ( P = 1.000). Children with cochlear implants had Category of Auditory Performance scores spanning from 0 to 3 levels of performance, and all required manual communication mode and visual supplementation. Children with auditory brainstem implants had Category of Auditory Performance scores spanning from 2 to 7, and most patients demonstrated behavioral responses irrespective of inner ear malformations and an absent cochlear nerve or small cochlear nerve ( P < .001). Conclusions In children with cochlear nerve deficiency, patients fitted with cochlear implants did not develop speech understanding and production. Those fitted with auditory brainstem implants had the opportunity to develop open-set speech perception, acquiring verbal language competence using oral communication exclusively and participating in mainstream education. The overall complication rate of auditory brainstem implants was not greater than that of cochlear implants.
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Affiliation(s)
| | - Giacomo Colletti
- Department of Maxillo-Facial Surgery, University of Milan, Italy
| | - Marco Mandalà
- Department of Maxillo-Facial Surgery, University of Milan, Italy
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Relationship between electrically evoked auditory brainstem response and auditory performance after cochlear implant in patients with auditory neuropathy spectrum disorder. Otol Neurotol 2014; 34:1261-6. [PMID: 23787967 DOI: 10.1097/mao.0b013e318291c632] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyze the pattern of electrically evoked auditory brainstem response (EABR) in auditory neuropathy spectrum disorder (ANSD) patients and to compare their performances with controls. STUDY DESIGN Retrospective analysis. SETTING Tertiary referral center. PATIENTS Eleven patients with ANSD and 9 control subjects with sensorineural hearing loss who did not have neural pathology. INTERVENTION Diagnostic. MAIN OUTCOME MEASURES Patients and control subjects each received a cochlear implant (CI) and underwent EABR. EABR threshold, wave V latency, and amplitude were measured as EABR parameters. The results of EABR were categorized as good response, variable response, or no response. Speech perception ability was assessed by the categories of auditory performance (CAP) score. RESULTS All controls responded to EABR, whereas 6 of the 11 ANSD patients did not respond to EABR. The EABR threshold of the ANSD patients was measured almost within the value of disease controls. However, the Wave V latency displayed variable lengths, and the amplitude showed a wider distribution compared with the value of the disease control. The EABR response group among the ANSD patients showed relatively good performance after CI. In contrast, the nonresponse group demonstrated variable outcomes, although all of them still benefited from CI. CONCLUSION The data suggested that all ANSD patients require CI and that EABR results can help establish realistic expectations about future performance. Even if electrical stimulation fails to generate sufficiently synchronized signal for eliciting EABR, CI provides at least partial, measurable auditory benefit in ANSD.
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Kontorinis G, Goetz F, Ruehl S, Buechner A, Lenarz T, Lesinski-Schiedat A. Options for hearing rehabilitation in children with cochleovestibular nerve dysplasia. Cochlear Implants Int 2013; 12 Suppl 1:S109-13. [DOI: 10.1179/146701011x13001035752813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
OBJECTIVE To report the results of cochlear implant-elicited cortical auditory evoked potentials (eCAEP) in children with cochlear nerve deficiency (CND). STUDY DESIGN Case control series. SETTING Tertiary academic referral center. PATIENTS Seven children with CND that have a cochlear implant in their affected ear. Four children without CND served as controls. INTERVENTION(S) eCAEPs were elicited by activation of individual cochlear implant electrodes. MAIN OUTCOME MEASURE(S) Onset responses (P1-N1-P2 complex). RESULTS Three of 7 CND children demonstrated eCAEP responses across a broad range of electrodes despite having limited or no open set speech perception abilities using their implants. Two of these children had eCAEPs that were characterized by substantial variability in latency, amplitude, and number of electrodes with identifiable responses. The remaining 4 ears with CND and poor speech perception had multiphasic responses that are inconsistent with eCAEPs. Non-CND ears with excellent speech perception abilities demonstrated robust responses on all electrodes stimulated. CONCLUSION Abent eCAEP responses were indicative of poor open-set speech perception skills in all cases. However, eCAEP onset responses were measurable in some children with imaging evidence of CND, indicating probable cochlear nerve hypoplasia rather than aplasia. That some children with CND and poor speech perception had robust eCAEPs in some instances makes this particular measure of limited use for predicting good speech perception outcomes after cochlear implantation in these children. The origin of multiphasic responses remains to be determined but may be of somatosensory origin in some instances.
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Deltenre P, Van Maldergem L. Hearing loss and deafness in the pediatric population. HANDBOOK OF CLINICAL NEUROLOGY 2013; 113:1527-38. [DOI: 10.1016/b978-0-444-59565-2.00023-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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MAP optimization as a predictor of cochlear implant outcomes in children with narrow internal auditory canal. Int J Pediatr Otorhinolaryngol 2012; 76:1591-7. [PMID: 22874590 DOI: 10.1016/j.ijporl.2012.07.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Revised: 07/13/2012] [Accepted: 07/14/2012] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purposes of this study were to investigate the auditory performance and MAP characteristics of implanted children with narrow internal auditory canal (IAC), and to examine the clinical usefulness of MAP optimization as a predictor of their cochlear implant (CI) outcomes by analyzing their auditory performance and habilitation methods in relation to MAP optimization. METHODS Eight children with narrow IAC who had used a CI over 3 years were included. We retrospectively examined their auditory performance and MAPs. Auditory performance was measured by the Categories of Auditory Performance (CAP) and monosyllabic word tests before and after implantation. The relationship between auditory performance and MAP parameters was explored, and their habilitation methods were analyzed. RESULTS Mean CAP scores improved from .25 preoperatively to 3.5 3 years postoperatively. Mean scores for monosyllabic word tests improved from 0% preoperatively to 27.8% 3 years postoperatively. The children used MAPs with a wider pulse width than the default setting. Four children using optimal MAPs achieved open-set speech perception, so were trained in the oral approach. The other four using suboptimal MAPs because of non-auditory stimulation achieved no open-set speech perception, so were trained in the total communication approach. CONCLUSIONS MAP optimization had a predictable value in determining the postoperative performance of children with narrow IAC who received a CI. The most suitable habilitation method can be determined early after implantation by identifying the presence of MAP optimization.
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Choi JY, Song MH, Jeon JH, Lee WS, Chang JW. Early surgical results of auditory brainstem implantation in nontumor patients. Laryngoscope 2012; 121:2610-8. [PMID: 22109761 DOI: 10.1002/lary.22137] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS An auditory brainstem implant (ABI) that stimulates the cochlear nucleus in the brainstem was initially designed for patients with neurofibromatosis type-2. Recently, promising surgical outcomes after ABI have been reported in nontumor patients with sensorineural hearing loss including those with cochlear nerve aplasia or ossified cochlea. We herein describe the surgical results and auditory outcomes of ABI in nontumor patients. STUDY DESIGN Retrospective case series at a tertiary hospital. METHODS Eleven deaf patients who received ABI from 2008 to 2010 were included in this study. The first group included eight patients with narrow internal auditory canals (IACs) and the second group consisted of three postlingually deaf adults with cochlear ossification. Pulsar CI100 ABI (Med-El Co., Innsbruck, Austria) was implanted via the suboccipital approach. RESULTS All eight patients with narrow IACs clearly demonstrated behavioral responses following initial stimulation using an ABI. The category of auditory performance (CAP) scores were progressively improved to reach auditory performances of CAP 4 in three patients, CAP 3 in two patients, CAP 2 in two patients, and CAP 1 in one patient. The three patients with ossified cochlea also reported auditory sensations when the ABI was activated. Two of them showed an auditory performance of CAP 4 or 5, but the third patient could not use the device due to nonauditory stimulation. CONCLUSIONS Based on our experience, ideal nontumor candidates for ABI include congenitally deaf children who experienced failure after cochlear implantation owing to cochlear nerve deficiency and postlingually deaf adults with severe cochlear ossification.
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Affiliation(s)
- Jae Young Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
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Electrophysiologic and Behavioral Outcomes of Cochlear Implantation in Children With Auditory Nerve Hypoplasia. Ear Hear 2012; 33:3-18. [DOI: 10.1097/aud.0b013e3182263460] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Song MH, Kim SC, Kim J, Chang JW, Lee WS, Choi JY. The cochleovestibular nerve identified during auditory brainstem implantation in patients with narrow internal auditory canals: can preoperative evaluation predict cochleovestibular nerve deficiency? Laryngoscope 2011; 121:1773-9. [PMID: 21792968 DOI: 10.1002/lary.21791] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS To analyze the value of preoperative diagnostic tools in predicting the status of the cochleovestibular nerve (CVN) in patients with narrow internal auditory canals (IAC). STUDY DESIGN Retrospective case series at a tertiary hospital. METHODS Eight profoundly deaf patients with narrow IACs who received auditory brainstem implantation were included in this study. The results of preoperative imaging, electrophysiologic, and auditory tests were correlated with the CVN status identified during auditory brainstem implantation. RESULTS Temporal bone computed tomography (CT) findings, including the patency of the bony cochlear nerve canal and the diameter of the IAC, were limited in accurately reflecting the status of the CVN. Magnetic resonance imaging (MRI) and preoperative auditory responses to either pure tone or environmental sounds were more accurate markers for detecting the presence of a CVN than CT; however, there were limitations in cases with a very thin CVN or combined severe mental retardation. Absence of promontory or intracochlear electrically evoked auditory brainstem responses were not always indicative of an absent CVN. CONCLUSIONS Visualization on MRI and detection of auditory responses suggested the presence of a CVN in patients with narrow IACs; however, the possibility of the presence of a CVN should be considered even when there is no clear evidence of a CVN on preoperative evaluations. Therefore, physicians should be prudent when determining candidacy for cochlear implantation or auditory brainstem implantation in patients with narrow IACs.
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Affiliation(s)
- Mee Hyun Song
- Department of Otorhinolaryngology, Kwandong University College of Medicine, Goyang, South Korea
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