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Hiss MM, Kaul VF, Riggs WJ, Chawla M, Munjal V, Varadarajan VV, Adunka OF. Noise-induced hearing loss in the contralateral ear during otologic and neurotologic surgeries. Am J Otolaryngol 2024; 45:104049. [PMID: 37738880 DOI: 10.1016/j.amjoto.2023.104049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE Noise-induced hearing loss in the non-surgical ear during otologic/neurotologic surgery has not been well studied. The purpose of this study was to evaluate changes in hearing that may occur in the contralateral (i.e., non-surgical) ear after various otologic/neurotologic surgeries due to noise generated by drills. We hypothesized that otologic/neurotologic surgeries, longer in duration, would suggest longer drilling times and result in decreased hearing in the contralateral ear as evidenced by a change post-operative pure tone air conduction thresholds when compared to pre-operative thresholds. METHODS A retrospective chart review at a tertiary referral center. Adult patients (18-75 years old) who underwent otologic/neurotologic surgeries from May 1, 2016 through May 1, 2021 were considered for inclusion. Surgeries included vestibular schwannoma resection (translabyrinthine, middle cranial fossa, or retrosigmoid approaches), endolymphatic sac/shunt and labyrinthectomy for Meniere's disease, and tympanomastoid surgery for middle ear pathology (e.g., cholesteatoma). Patient characteristics obtained through record review included age, sex, surgical procedure, pre-operative and post-operative audiometric thresholds and word recognition scores (WRS) for the contralateral ear, and duration of surgery. RESULTS No significant differences were observed for change in audiometric thresholds in the contralateral ear for any surgery when considering individual frequencies. Additionally, no significant change in WRS was observed for any surgical approach. CONCLUSIONS The risk of hearing loss in the non-surgical ear during various otologic/neurotologic surgeries appears to be minimal when measured via routine clinical tests.
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Affiliation(s)
- Meghan M Hiss
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA.
| | - Vivian F Kaul
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA
| | - William J Riggs
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA
| | - Mehak Chawla
- The Ohio State University College of Medicine; Columbus, OH, USA
| | - Vikas Munjal
- The Ohio State University College of Medicine; Columbus, OH, USA
| | - Varun V Varadarajan
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA
| | - Oliver F Adunka
- The Ohio State University Wexner Medical Center; Department of Otolaryngology - Head and Neck Surgery; Columbus, OH, USA
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Riggs WJ, Fontenot TE, Hiss MM, Varadarajan V, Moberly AC, Adunka OF, Fitzpatrick DC. Lack of neural contributions to the summating potential in humans with Meniere's disease. Front Neurosci 2022; 16:1039986. [PMID: 36570833 PMCID: PMC9768452 DOI: 10.3389/fnins.2022.1039986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/10/2022] [Indexed: 12/12/2022] Open
Abstract
Objective To investigate the electrophysiology of the cochlear summating potential (SP) in patients with Meniere's disease (MD). Although long considered a purely hair cell potential, recent studies show a neural contribution to the SP. Patients with MD have an enhanced SP compared to those without the disease. Consequently, this study was to determine if the enhancement of the SP was in whole or part due to neural dysfunction. Design Study participants included 41 adults with MD and 53 subjects with auditory neuropathy spectrum disorder (ANSD), undergoing surgery where the round window was accessible. ANSD is a condition with known neural dysfunction, and thus represents a control group for the study. The ANSD subjects and 17 of the MD subjects were undergoing cochlear implantation (CI) surgery; the remaining MD subjects were undergoing either endolymphatic sac decompression or labyrinthectomy to alleviate the symptoms of MD. Electrocochleography was recorded from the round window using high intensity (90 dB nHL) tone bursts. The SP and compound action potential (CAP) were measured to high frequencies (> = 2 kHz) and the SP, cochlear microphonic (CM) and auditory nerve neurophonic (ANN) to low frequencies. Linear mixed models were used to assess differences between MD and ANSD subjects. Results Across frequencies, the MD subjects had smaller alternating current (AC) response than the ANSD subjects (F = 31.61,534, p < 0.001), but the SP magnitudes were larger (F = 94.31,534, p < 0.001). For frequencies less than 4 kHz the SP magnitude in the MD group was significantly correlated with the magnitude of the CM (p's < 0.001) but not in the ANSD group (p's > 0.05). Finally, the relative proportions of both ANN and CAP were greater in MD compared to ANSD subjects. The shapes of the waveforms in the MD subjects showed the presence of multiple components contributing to the SP, including outer and inner hair cells and neural activity. Conclusion The results support the view that the increased negative polarity SP in MD subjects is due to a change in the operating point of hair cells rather than a loss of neural contribution. The steady-state SP to tones in human subjects is a mixture of different sources with different polarities.
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Affiliation(s)
- William J. Riggs
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH, United States
- Department of Audiology, Nationwide Children’s Hospital, Columbus, OH, United States
| | - Tatyana E. Fontenot
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Meghan M. Hiss
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH, United States
| | - Varun Varadarajan
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH, United States
| | - Aaron C. Moberly
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH, United States
| | - Oliver F. Adunka
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH, United States
- Department of Audiology, Nationwide Children’s Hospital, Columbus, OH, United States
| | - Douglas C. Fitzpatrick
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Trecca EMC, Adunka OF, Mattingly JK, Hiss MM, Cassano M, Malhotra PS, Riggs WJ. Electrocochleography Observations in a Series of Cochlear Implant Electrode Tip Fold-Overs. Otol Neurotol 2021; 42:e433-e437. [PMID: 33196531 DOI: 10.1097/mao.0000000000003008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Tip fold-over is a rare but serious complication of cochlear implant (CI) surgery. The purpose of this study was to present intraoperative electrocochleography (ECochG) observations in a series of CI electrode tip fold-overs. PATIENTS Five pediatric subjects undergoing CI surgery through a round window (RW) approach with a perimodiolar electrode array, who were diagnosed with either auditory neuropathy spectrum disorder or enlarged vestibular aqueduct. INTERVENTIONS Intraoperative RW ECochG during CI surgery: tone burst stimuli were presented from 95 to 110 dB SPL. MAIN OUTCOME MEASURES Magnitude and phase characteristics of ECochG responses obtained intraoperatively before and immediately after electrode insertion were examined for patients with and without tip fold-over. RESULTS Three subjects presented with tip fold-over and two formed the control group. Among fold-over cases, one participant exhibited an inversion in the starting phase of the cochlear microphonic response and a decrease in spectral magnitude from pre- to postinsertion. Both subjects who did not exhibit a change in phase had an increase in the ECochG-total response (ECochG-TR) magnitude. No case in the control group exhibited a change in starting phase. In regard to the ECochG-TR, all controls showed a decrease in the magnitude. CONCLUSIONS Despite the small number of patients, heterogeneous ECochG response patterns were observed within the fold-over group. Though these results are not conclusive, they can serve as a framework to begin to understand ECochG's utility in detecting intraoperative tip fold-over.
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Affiliation(s)
- Eleonora M C Trecca
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.,Department of Otolaryngology - Head and Neck Surgery, University Hospital of Foggia, Foggia, Italy
| | - Oliver F Adunka
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Jameson K Mattingly
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Meghan M Hiss
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Michele Cassano
- Department of Otolaryngology - Head and Neck Surgery, University Hospital of Foggia, Foggia, Italy
| | - Prashant S Malhotra
- Department of Otolaryngology - Head and Neck Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - William J Riggs
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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Riggs WJ, Hiss MM, Varadarajan VV, Mattingly JK, Adunka OF. Enlarged vestibular aqueduct: Intraoperative electrocochleography findings during cochlear implantation. Int J Pediatr Otorhinolaryngol 2020; 134:110065. [PMID: 32361253 DOI: 10.1016/j.ijporl.2020.110065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022]
Abstract
Enlarged vestibular aqueduct (EVA) is the most frequent inner ear abnormality found on computed tomography in children with sensorineural hearing loss. The effects EVA abnormalities have on electrocochleography (ECochG) are unknown. Positive deflections in summation potential evoked by tone bursts were observed in 3/5 subjects, while a large negative deflection, similar to endolymphatic hydrops (EH), was observed for 2/5 subjects. The presence of an enlarged summation potential, with and without a compound action potential, was observed in response to a broadband click stimulus. Results suggest likely effects of a third window on ECochG responses and presence of EH in EVA.
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Affiliation(s)
- William J Riggs
- The Ohio State University, College of Medicine, Department of Otolaryngology- Head and Neck Surgery, Columbus, OH, USA; Nationwide Children's Hospital, Department of Audiology, Columbus, OH, USA.
| | - Meghan M Hiss
- The Ohio State University, College of Medicine, Department of Otolaryngology- Head and Neck Surgery, Columbus, OH, USA
| | - Varun V Varadarajan
- The Ohio State University, College of Medicine, Department of Otolaryngology- Head and Neck Surgery, Columbus, OH, USA
| | - Jameson K Mattingly
- The Ohio State University, College of Medicine, Department of Otolaryngology- Head and Neck Surgery, Columbus, OH, USA
| | - Oliver F Adunka
- The Ohio State University, College of Medicine, Department of Otolaryngology- Head and Neck Surgery, Columbus, OH, USA; Nationwide Children's Hospital, Department of Otolaryngology-Head and Neck Surgery, Columbus, OH, USA
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Sanders MC, Chang NYN, Hiss MM, Uchanski RM, Hullar TE. Temporal binding of auditory and rotational stimuli. Exp Brain Res 2011; 210:539-47. [PMID: 21287154 DOI: 10.1007/s00221-011-2554-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 01/06/2011] [Indexed: 11/24/2022]
Abstract
Integration of cues from multiple sensory channels improves our ability to sense and respond to stimuli. Cues arising from a single event may arrive at the brain asynchronously, requiring them to be "bound" in time. The perceptual asynchrony between vestibular and auditory stimuli has been reported to be several times greater than other stimulus pairs. However, these data were collected using electrically evoked vestibular stimuli, which may not provide similar results to those obtained using actual head rotations. Here, we tested whether auditory stimuli and vestibular stimuli consisting of physiologically relevant mechanical rotations are perceived with asynchronies consistent with other sensory systems. We rotated 14 normal subjects about the earth-vertical axis over a raised-cosine trajectory (0.5 Hz, peak velocity 10 deg/s) while isolated from external noise and light. This trajectory minimized any input from extravestibular sources such as proprioception. An 800-Hz, 10-ms auditory tone was presented at stimulus onset asynchronies ranging from 200 ms before to 700 ms after the onset of motion. After each trial, subjects reported whether the stimuli were "simultaneous" or "not simultaneous." The experiment was repeated, with subjects reporting whether the tone or rotation came first. After correction for the time the rotational stimulus took to reach vestibular perceptual threshold, asynchronies spanned from -41 ms (auditory stimulus leading vestibular) to 91 ms (vestibular stimulus leading auditory). These values are significantly lower than those previously reported for stimulus pairs involving electrically evoked vestibular stimuli and are more consistent with timing relationships between pairs of non-vestibular stimuli.
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Affiliation(s)
- Mark C Sanders
- Speech and Hearing Science, Arizona State University, Tempe, AZ, USA
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