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Zhuo S, Li Y, Cui B, Liu Y, Deng J, Lou J, Yuan J, Si Y, Zhang Z. Round Window Niche Veil is Visible on High-Resolution Computed Tomography and a Predictor of Local Drug Efficacy to Inner Ear. Laryngoscope 2024; 134:1396-1402. [PMID: 37638702 DOI: 10.1002/lary.31006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/29/2023] [Accepted: 08/16/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES To determine the morphologies and effect of the round window niche veil (RWNV) on local drug delivery efficacy and develop diagnostic criteria on high-resolution computed tomography (HRCT). METHODS Patients diagnosed with otosclerosis, bilateral profound sensorineural hearing loss or vestibular schwannoma were enrolled from 2019 to 2022, receiving temporal bone HRCT scanning, and anatomic variations of RWMV were summarized intraoperative. For patients with vestibular schwannoma, 1 mL of dexamethasone solution (4 mg/mL) was administered via facial recess during operation, and samples of perilymph were collected to analyze. The diagnostic criteria of RWNV on HRCT were developed and verified. RESULTS A total of 85 patients were enrolled. RWNV was observed in 54 cases intraoperatively with an incidence of 63.5% (95% CI, 52.9%-73.0%). The median perilymph concentrations were 4.86-fold higher in the group without RWNV than with RWNV (p < 0.0001). RWNV could be visualized on HRCT with a window width of 3500-4500 HU and a window level of 300-500 HU. The characteristic features were as follows: (1) a thin soft tissue shadow could be seen at the entrance of the round window niche (RWN); (2) it was visible in at least 2 consecutive layers along the upper margin of RWN from top to bottom; (3) it was discontinuous with the adjacent bone margin. The sensitivity and specificity of the diagnostic criteria were 77.8% and 93.6%, respectively. CONCLUSION RWNV could reduce local dexamethasone diffusion efficacy to the inner ear, which could be diagnosed on HRCT and used as a predictor of local drug delivery efficacy to the inner ear. LEVEL OF EVIDENCE 3 Laryngoscope, 134:1396-1402, 2024.
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Affiliation(s)
- Shipei Zhuo
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech, Sun Yat-sen University, Guangzhou, China
| | - Yong Li
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bozhen Cui
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech, Sun Yat-sen University, Guangzhou, China
| | - Yuxiang Liu
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingman Deng
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech, Sun Yat-sen University, Guangzhou, China
| | - Jintao Lou
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech, Sun Yat-sen University, Guangzhou, China
| | - Jianpeng Yuan
- Department of Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Yu Si
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech, Sun Yat-sen University, Guangzhou, China
| | - Zhigang Zhang
- Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech, Sun Yat-sen University, Guangzhou, China
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Moon PK, Ward KM, Din TF, Saki S, Cheng AG, Yeom KW, Ahmad IN. Microstructural Changes in the Brainstem Auditory Pathway in Children With Hearing Loss. Otol Neurotol 2024; 45:e170-e176. [PMID: 38361295 PMCID: PMC10919892 DOI: 10.1097/mao.0000000000004129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To assess the utility of diffusion tensor imaging of the auditory pathway in children with sensorineural hearing loss (SNHL). STUDY DESIGN Retrospective cohort study. SETTING A single academic tertiary children's hospital. PATIENTS Sixteen pediatric patients with bilateral SNHL of at least moderate severity in the poorer ear (eight male; mean age, 5.3 ± 4.9 yrs). Controls consisted of age- and sex-matched children with normal hearing who were imaged for nonotologic, non-neurologic medical concerns and found to have normal magnetic resonance imaging (MRI). INTERVENTIONS Three Tesla MRI scanners were used for diffusion tensor imaging. MAIN OUTCOME MEASURES Quantitative diffusion tensor metrics were extracted from the superior olivary nucleus (SON), inferior colliculus (IC), and ipsilateral fiber tracts between the SON and IC delineated by tractography. RESULTS We identified differences in fractional anisotropy of the SON between the SNHL cohort and controls (0.377 ± 0.056 vs. 0.422 ± 0.052; p = 0.009), but not in the IC. There were no differences in the mean diffusivity (MD) values in the IC and SON. Among younger children (≤5 yrs), MD was decreased in the SNHL cohort compared with controls in the IC (0.918 ± 0.051 vs. 1.120 ± 0.142; p < 0.001). However, among older children (>5 yrs), there were no differences in MD (1.124 ± 0.198 vs. 0.997 ± 0.103; p = 0.119). There were no differences in MD or fractional anisotropy in the white matter fibers of the IC-SON tract. CONCLUSIONS Our results suggest abnormal neural tracts along the central auditory pathway among children with SNHL. Longitudinal studies should assess the prognostic value of these MRI-based findings for assessing long-term outcomes and determining intervention efficacy.
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Affiliation(s)
- Peter K. Moon
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kristina M. Ward
- Pediatric Audiology, Lucile Packard Children’s Hospital, Stanford, CA 94305, USA
| | - Taseer F. Din
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Sara Saki
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Alan G. Cheng
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Kristen W. Yeom
- Department of Radiology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Iram N. Ahmad
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
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Liu X, Shi L, Li E, Jia S. Associations of hearing loss and structural changes in specific cortical regions: a Mendelian randomization study. Cereb Cortex 2024; 34:bhae084. [PMID: 38494888 DOI: 10.1093/cercor/bhae084] [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: 12/04/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 03/19/2024] Open
Abstract
INTRODUCTION Previous studies have suggested a correlation between hearing loss (HL) and cortical alterations, but the specific brain regions that may be affected are unknown. METHODS Genome-wide association study (GWAS) data for 3 subtypes of HL phenotypes, sensorineural hearing loss (SNHL), conductive hearing loss, and mixed hearing loss, were selected as exposures, and GWAS data for brain structure-related traits were selected as outcomes. The inverse variance weighted method was used as the main estimation method. RESULTS Negative associations were identified between genetically predicted SNHL and brain morphometric indicators (cortical surface area, cortical thickness, or volume of subcortical structures) in specific brain regions, including the bankssts (β = -0.006 mm, P = 0.016), entorhinal cortex (β = -4.856 mm2, P = 0.029), and hippocampus (β = -24.819 cm3, P = 0.045), as well as in brain regions functionally associated with visual perception, including the pericalcarine (β = -10.009 cm3, P = 0.013). CONCLUSION Adaptive changes and functional remodeling of brain structures occur in patients with genetically predicted HL. Brain regions functionally associated with auditory perception, visual perception, and memory function are the main brain regions vulnerable in HL.
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Affiliation(s)
- Xiaoduo Liu
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, 45 Changchun Street, Xicheng District, Beijing, 100053, China
| | - Lubo Shi
- Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing Digestive Disease Center, 95 Yong'an Road, Xicheng District, Beijing, 100050, China
| | - Enze Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
| | - Shuo Jia
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, 2 Anzhen Road, Chaoyang District, Beijing, 100029, China
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Szleper A, Lachowska M, Wojciechowski T, Pronicka-Iwanicka K. Detailed analysis of inner ear malformations in CHARGE syndrome patients - correlation with audiological results and proposal for computed tomography scans evaluation methodology. Braz J Otorhinolaryngol 2024; 90:101383. [PMID: 38219448 PMCID: PMC10826126 DOI: 10.1016/j.bjorl.2023.101383] [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: 09/02/2023] [Revised: 11/12/2023] [Accepted: 12/13/2023] [Indexed: 01/16/2024] Open
Abstract
OBJECTIVES The aim was to describe the spectrum of inner ear malformations in CHARGE syndrome and propose a Computed Tomography (CT) detailed scan evaluation methodology. The secondary aim was to correlate the CT findings with hearing thresholds. METHODS Twenty ears of ten patients diagnosed with CHARGE syndrome were subjected to CT analysis focusing on the inner ear and internal acoustic canal. The protocol used is presented in detail. ASSR results were analyzed and correlated with inner ear malformations. RESULTS Cochlear hypoplasia type III was the most common malformation found in 12 ears (60%). Cochlear hypoplasia type II, aplasia with a dilated vestibule, and rudimentary otocyst were also identified. In 20%, no cochlear anomaly was found. The lateral Semicircular Canal (SCC) absence affected 100% of ears, the absence of the posterior SCC 95%, and the superior SCC 65%. Better development of cochlea structures and IAC correlated significantly with the lower hearing thresholds. CONCLUSION This study demonstrated that rudimentary SCC or a complete absence of these SCCs was universally observed in all patients diagnosed with CHARGE syndrome. This finding supports the idea that inner ear anomalies are a hallmark feature of the CHARGE, contributing to its distinct clinical profile. The presence of inner ear malformations has substantial clinical implications. Audiological assessments are crucial for CHARGE syndrome, as hearing loss is common. Early detection of these malformations can guide appropriate interventions, such as hearing aids or cochlear implants, which may significantly improve developmental outcomes and communication for affected individuals. Recognizing inner ear malformations as a diagnostic criterion presents implications beyond clinical diagnosis. A better understanding of these malformations can advance the knowledge of CHARGE pathophysiology. It may also help guide future research into targeted therapies to mitigate the impact of inner ear anomalies on hearing and balance function. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Agata Szleper
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland
| | - Magdalena Lachowska
- Department of Otolaryngology, Audiology and Phoniatrics, Children's Memorial Health Institute, Warsaw, Poland.
| | - Tomasz Wojciechowski
- Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Poland
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Cai H, Xiao H, Lin J, Lin C, Guo X, Huang G, Ye S. The value of gadolinium-enhanced MRI in predicting the development of sudden hearing loss into Ménière's disease. Clin Otolaryngol 2024; 49:117-123. [PMID: 37864503 DOI: 10.1111/coa.14116] [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: 12/19/2022] [Revised: 08/08/2023] [Accepted: 10/07/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To compare the clinical features of sudden hearing loss (SHL) in patients with and without endolymphatic hydrops (EH), and to investigate the association between SHL with EH and Ménière's disease (MD). METHODS The clinical data of 63 SHL patients with first symptoms were evaluated retrospectively. Patients were separated into two groups based on the results of gadolinium-enhanced magnetic resonance imaging: EH and non-EH groups. Independent sample t-test and U-test were used to compare groups for continuous variables, and the chi-squared test, corrected chi-squared test and Bonferroni correction test were used to compare groups for binary and ordinal variables. The binary logistic regression model was utilised for univariate and multivariate analysis of follow-up patient prognosis. RESULTS The EH and non-EH groups contained 32 and 31 patients, respectively. The EH group had a higher prevalence of low-tone descending hearing loss. Fifty-one patients were followed for more than 2 years. In the EH group, 11 and 15 patients were diagnosed with sudden sensorineural hearing loss (SSNHL) and MD, respectively, while in the non-EH group, 24 patients were diagnosed with SSNHL and only one with MD. EH, low-tone descending hearing loss and vertigo were risk factors for the diagnosis of MD in a subgroup univariate regression analysis of patients experiencing SHL. EH was found to be a risk factor for the progression of SHL into MD in a multifactor regression analysis. CONCLUSIONS Patients with SHL who have EH are more likely to present with low-tone descending hearing loss. EH is a risk factor for the subsequent development of MD.
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Affiliation(s)
- Huimin Cai
- Department of Otorhinolaryngology-Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Otorhinolaryngology-Head and Neck Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Institute of Otorhinolaryngology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Heng Xiao
- Department of Otorhinolaryngology-Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Otorhinolaryngology-Head and Neck Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Institute of Otorhinolaryngology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jianwei Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Chenxin Lin
- Department of Otorhinolaryngology-Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Xiaojing Guo
- Department of Otorhinolaryngology-Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Gengliang Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Shengnan Ye
- Department of Otorhinolaryngology-Head and Neck Surgery, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Department of Otorhinolaryngology-Head and Neck Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Fujian Institute of Otorhinolaryngology, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Maeda Y, Kojima K, Omichi R. 15-year follow-up for steroid-responsive, fluctuating hearing loss in the ear with endolymphatic hydrops confirmed by magnetic resonance imaging. Auris Nasus Larynx 2023; 50:964-967. [PMID: 37045639 DOI: 10.1016/j.anl.2023.03.009] [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: 01/07/2023] [Revised: 03/03/2023] [Accepted: 03/31/2023] [Indexed: 04/14/2023]
Abstract
Autoimmune mechanisms may play crucial roles in the etiology of endolymphatic hydrops (ELH), which was previously regarded as a postmortem finding in the temporal bone. Recently, ELH has been visualized using 3-T MR imaging in living patients. A 47-year-old woman with deafness in the left ear since adolescence developed right-sided steroid-responsive sensorineural hearing loss in the low frequencies. During over 15 years of follow-up at our otolaryngology clinic, acute deteriorations of hearing in the only hearing ear repeatedly recovered with administration of intravenous and oral steroids. Hearing in the only hearing ear at 62 years old was preserved and comparable to that at 47 years old. At 61 years old, cochlear ELH was documented bilaterally on MR imaging, appearing more severe in the deafened ear than in the hearing ear. This case provides new evidence of the potential steroid-responsiveness of hearing loss due to contralateral-type delayed ELH distinctly visualized on MR imaging.
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Affiliation(s)
- Yukihide Maeda
- Department of Otolaryngology- Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata, Kita-Ku, Okayama 700-8558, Japan.
| | - Katsuhide Kojima
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata, Kita-Ku, Okayama 700-8558, Japan
| | - Ryotaro Omichi
- Department of Otolaryngology- Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata, Kita-Ku, Okayama 700-8558, Japan
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Li YT, Bai K, Li GZ, Hu B, Chen JW, Shang YX, Yu Y, Chen ZH, Zhang C, Yan LF, Cui GB, Lu LJ, Wang W. Functional to structural plasticity in unilateral sudden sensorineural hearing loss: neuroimaging evidence. Neuroimage 2023; 283:120437. [PMID: 37924896 DOI: 10.1016/j.neuroimage.2023.120437] [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: 07/28/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023] Open
Abstract
A cortical plasticity after long-duration single side deafness (SSD) is advocated with neuroimaging evidence while little is known about the short-duration SSDs. In this case-cohort study, we recruited unilateral sudden sensorineural hearing loss (SSNHL) patients and age-, gender-matched health controls (HC), followed by comprehensive neuroimaging analyses. The primary outcome measures were temporal alterations of varied dynamic functional network connectivity (dFNC) states, neurovascular coupling (NVC) and brain region volume at different stages of SSNHL. The secondary outcome measures were pure-tone audiograms of SSNHL patients before and after treatment. A total of 38 SSNHL patients (21 [55%] male; mean [standard deviation] age, 45.05 [15.83] years) and 44 HC (28 [64%] male; mean [standard deviation] age, 43.55 [12.80] years) were enrolled. SSNHL patients were categorized into subgroups based on the time from disease onset to the initial magnetic resonance imaging scan: early- (n = 16; 1-6 days), intermediate- (n = 9; 7-13 days), and late- stage (n = 13; 14-30 days) groups. We first identified slow state transitions between varied dFNC states at early-stage SSNHL, then revealed the decreased NVC restricted to the auditory cortex at the intermediate- and late-stage SSNHL. Finally, a significantly decreased volume of the left medial superior frontal gyrus (SFGmed) was observed only in the late-stage SSNHL cohort. Furthermore, the volume of the left SFGmed is robustly correlated with both disease duration and patient prognosis. Our study offered neuroimaging evidence for the evolvement from functional to structural brain alterations of SSNHL patients with disease duration less than 1 month, which may explain, from a neuroimaging perspective, why early-stage SSNHL patients have better therapeutic responses and hearing recovery.
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Affiliation(s)
- Yu-Ting Li
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Ke Bai
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Gan-Ze Li
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Bo Hu
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Jia-Wei Chen
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.
| | - Yu-Xuan Shang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Ying Yu
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Zhu-Hong Chen
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Chi Zhang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Lin-Feng Yan
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Guang-Bin Cui
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Lian-Jun Lu
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, China.
| | - Wen Wang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
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Yu FF, Feltrin FS, Bathla G, Raj K, Agarwal A, Lee WC, Booth T, Singh A. Imaging Guide to Inner Ear Malformations: An Illustrative Review. Curr Probl Diagn Radiol 2023; 52:576-585. [PMID: 37500297 DOI: 10.1067/j.cpradiol.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/29/2023]
Abstract
Inner ear malformation (IEM) with associated sensoryneural hearing loss (SNHL) is a major cause of childhood disability. Computed tomography (CT) and magnetic resonance imaging (MRI) imaging play important and often complementary roles in diagnosing underlying structural abnormalities and surgical planning allows for direct visualization of the cochlear nerve and is the preferred imaging modality prior to cochlear implantation. CT is helpful to assess osseous anatomy and when evaluating children with mixed hearing loss or syndromic associations. When reviewing these cases, it is important for the radiologist to be familiar with the key imaging features. In this article, we will present the imaging findings associated with different inner ear malformations associated with congenital sensorineural hearing loss.
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Affiliation(s)
- Fang Frank Yu
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | | | - Girish Bathla
- Department of Radiology, University of Iowa Hospital and Clinics, Iowa City, IA
| | - Karuna Raj
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | - Amit Agarwal
- Department of Radiology, University of Texas Southwestern, Dallas, TX
| | - Wan-Ching Lee
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, TX
| | - Timothy Booth
- Department of Radiology, Children's Hospital, University of Texas Southwestern, Dallas, TX
| | - Achint Singh
- Department of Radiology, University of Texas Health Science Center at San Antonio, Dallas, TX
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Robson CD, Lewis M, D'Arco F. Non-Syndromic Sensorineural Hearing Loss in Children. Neuroimaging Clin N Am 2023; 33:531-542. [PMID: 37741656 DOI: 10.1016/j.nic.2023.05.005] [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] [Indexed: 09/25/2023]
Abstract
Pediatric hearing loss is common with significant consequences in terms of language, communication, social and emotional development, and academic advancement. Radiological imaging provides useful information regarding hearing loss etiology, prognosis, therapeutic options, and potential surgical pitfalls. This review provides an overview of temporal bone imaging protocols, an outline of the classification of inner ear anomalies associated with sensorineural hearing loss and illustrates some of the more frequently encountered and/or important causes of non-syndromic hearing loss.
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Affiliation(s)
- Caroline D Robson
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, USA.
| | - Martin Lewis
- Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK
| | - Felice D'Arco
- Department of Radiology, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK
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Zhang Y, Liu J, Wang Y. Gray matter density changes in children with congenital severe sensorineural deafness: a voxel-based morphometric study. Neuroreport 2023; 34:728-733. [PMID: 37556586 DOI: 10.1097/wnr.0000000000001948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Early hearing loss could cause abnormal brain development, which has been linked to the complex process known as cross-modal neuroplasticity. However, previous studies investigating the brain structure of infants with congenital severe sensorineural hearing loss (CSSHL) are scarce and have yielded inconsistent results. This study aimed to further explore the gray matter (GM) density changes in children with CSSHL. Fifteen children aged 0-5 years with CSSHL and 11 healthy children as controls (aged 0-5 years) were recruited. Each participant underwent a structural MRI scan. The voxel-based morphometry method was performed to evaluate GM density for each participant and analyze their characteristics. It was discovered that: (1) GM density of the right superior temporal gyrus and caudate in the CSSHL group was smaller than that of healthy controls (HC). However, GM density was larger in the left posterior central gyrus, superior frontal gyrus, inferior parietal lobule and right cerebellum in the CSSHL group compared with HC. (2) The GM density value of the left superior frontal gyrus and inferior parietal lobule was negatively correlated with age. However, the GM density value of the right superior temporal gyrus in the CSSHL group was positively correlated with age. Compared with HC, the GM density of CSSHL children was larger in somatosensory areas (including left superior frontal gyrus, posterior central gyrus, inferior parietal lobule and right cerebellum), whereas GM density was smaller in auditory-related areas (such as the right superior temporal gyrus and caudate). Moreover, GM density change was influenced by the duration of hearing deprivation.
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Affiliation(s)
- Yingxing Zhang
- Child Healthcare Department, Anhui Hospital Affiliated to Children's Hospital of Fudan University/Anhui Provincial Children's Hospital, Hefei
| | - Jie Liu
- Department of Radiology, The First Affiliated Hospital of the University of Science and Technology of China, Anhui Province, P. R. China
| | - Ya Wang
- Child Healthcare Department, Anhui Hospital Affiliated to Children's Hospital of Fudan University/Anhui Provincial Children's Hospital, Hefei
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Sorge I, Hirsch FW, Fuchs M, Gräfe D, Dietz A, Sorge M. Imaging in children with hearing loss. ROFO-FORTSCHR RONTG 2023; 195:896-904. [PMID: 37348530 DOI: 10.1055/a-2081-4119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
BACKGROUND Since the introduction of hearing screening in Germany in 2009, pediatric hearing disorders are detected at an early stage. Early therapy is essential for language development. Imaging plays a central role in diagnosis and therapy planning. METHOD Imaging findings of the most relevant causes of pediatric hearing disorders are presented. Specific attention is given to the method used in each case - CT or MRI. RESULTS AND CONCLUSIONS While CT is the method of choice for conductive hearing loss, a combination of CT and MRI with high-resolution T2-3D sequences has been established as the best diagnostic method for sensorineural hearing loss. The most common causes of conductive hearing loss in childhood are chronic inflammation and cholesteatoma. Congenital malformations of the outer or middle ear are less frequent. In the case of sensorineural hearing loss, the cause is located in the inner ear and/or the cochlear nerve or the cerebrum. In these cases, congenital malformations are the most common cause. KEY POINTS · CT and MRI are necessary to identify morphological causes of hearing disorders and to clarify the possibility of hearing-improving ear surgery or cochlear implantation.. · Contraindications for surgical procedures must be excluded.. · Anatomical variants that may be risk factors for surgery must be described.. CITATION FORMAT · Sorge I, Hirsch F, Fuchs M et al. Imaging diagnostics for childhood hearing loss. Fortschr Röntgenstr 2023; 195: 896 - 904.
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Affiliation(s)
- Ina Sorge
- Department of Pediatric Radiology, University Hospital Leipzig, Germany
| | | | - Michael Fuchs
- Department of Phoniatrics and Audiology, University Hospital Leipzig, Germany
| | - Daniel Gräfe
- Department of Pediatric Radiology, University Hospital Leipzig, Germany
| | - Andreas Dietz
- Department of Otolaryngology, University Hospital Leipzig, Germany
| | - Martin Sorge
- Department of Otolaryngology, University Hospital Leipzig, Germany
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Blanco Pareja M, Liaño Esteso G, Suárez-Vega V, Manrique-Huarte R, Dominguez P, Pérez-Fernández N. Congruence and incongruence on the radiological and functional examination of inner ear hemorrhage. Acta Otolaryngol 2023; 143:845-848. [PMID: 38059470 DOI: 10.1080/00016489.2023.2286494] [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: 09/26/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Inner ear hemorrhage (IEH) is an increasingly recognized cochlear lesion that can cause sensorineural hearing loss (SNHL). Magnetic resonance imaging (MRI) is known to be the best imaging modality for clarifying the causes of SNHL and providing images that point to those causes. AIMS Evaluate the lesional patterns in patients with presumed Inner ear hemorrhage (IEH) from radiological and functional aspects. MATERIAL AND METHODS We retrospectively reviewed 10 patients performed in our institution from 2014 to 2020, with suspected labyrinthine hemorrhage based on radiological and functional examination. RESULTS We included 8 patients with IEH and sensorineural hearing loss (SNHL). The median age was 55 years (range: 3 months - 78 years). The results from the MRI and functional tests were compared for each end-organ. Only three cases (37.5%) showed a correlation between signal abnormalities and dysfunction in the labyrinthine apparatus. CONCLUSIONS In patients with SNHL inner ear hemorrhage needs to be ruled out in the differential diagnosis, so specific MRI sequences should be requested. It represents a way to a better understanding of the disorder and the variety of findings claim for a complete auditory and vestibular testing.
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Affiliation(s)
| | | | | | | | - Pablo Dominguez
- Department of Radiology, Clinica Universidad de Navarra, Pamplona, Spain
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13
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Wang Y, Jiang M, Zhu Y, Xue L, Shu W, Li X, Chen H, Li Y, Chen Y, Chai Y, Zhang Y, Chu Y, Song Y, Tao X, Wang Z, Wu H. Impact of inner ear malformation and cochlear nerve deficiency on the development of auditory-language network in children with profound sensorineural hearing loss. eLife 2023; 12:e85983. [PMID: 37697742 PMCID: PMC10497283 DOI: 10.7554/elife.85983] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/09/2023] [Indexed: 09/13/2023] Open
Abstract
Profound congenital sensorineural hearing loss (SNHL) prevents children from developing spoken language. Cochlear implantation and auditory brainstem implantation can provide partial hearing sensation, but language development outcomes can vary, particularly for patients with inner ear malformations and/or cochlear nerve deficiency (IEM&CND). Currently, the peripheral auditory structure is evaluated through visual inspection of clinical imaging, but this method is insufficient for surgical planning and prognosis. The central auditory pathway is also challenging to examine in vivo due to its delicate subcortical structures. Previous attempts to locate subcortical auditory nuclei using fMRI responses to sounds are not applicable to patients with profound hearing loss as no auditory brainstem responses can be detected in these individuals, making it impossible to capture corresponding blood oxygen signals in fMRI. In this study, we developed a new pipeline for mapping the auditory pathway using structural and diffusional MRI. We used a fixel-based approach to investigate the structural development of the auditory-language network for profound SNHL children with normal peripheral structure and those with IEM&CND under 6 years old. Our findings indicate that the language pathway is more sensitive to peripheral auditory condition than the central auditory pathway, highlighting the importance of early intervention for profound SNHL children to provide timely speech inputs. We also propose a comprehensive pre-surgical evaluation extending from the cochlea to the auditory-language network, showing significant correlations between age, gender, Cn.VIII median contrast value, and the language network with post-implant qualitative outcomes.
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Affiliation(s)
- Yaoxuan Wang
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Mengda Jiang
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yuting Zhu
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Lu Xue
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Wenying Shu
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Xiang Li
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Hongsai Chen
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Yun Li
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Ying Chen
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Yongchuan Chai
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Yu Zhang
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Yinghua Chu
- MR Collaboration, Siemens Healthineers LtdShanghaiChina
| | - Yang Song
- MR Scientific Marketing, Siemens Healthineers LtdShanghaiChina
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Zhaoyan Wang
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
| | - Hao Wu
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Ear Institute, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseasesShanghaiChina
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Buciuc M, Ali H, Gonzalez P, Nankee CL, Holmstedt CA. Teaching NeuroImage: Sudden Bilateral Sensorineural Hearing Loss Due to Vertebrobasilar Ischemia. Neurology 2023; 101:454-455. [PMID: 37277201 PMCID: PMC10491444 DOI: 10.1212/wnl.0000000000207444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 04/07/2023] [Indexed: 06/07/2023] Open
Affiliation(s)
- Marina Buciuc
- From the Medical University of South Carolina, Charleston.
| | - Hamid Ali
- From the Medical University of South Carolina, Charleston
| | - Paulo Gonzalez
- From the Medical University of South Carolina, Charleston
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Jia G, Song Z, Wu L, Sun Q, Sheng Y, Ni Y, Li H, Li W. An Accurate and Individualized Preoperative Estimation Method for the Linear Insertion Depth of Cochlear Implant Electrode Arrays Based on Computed Tomography. Ear Hear 2023; 44:1036-1042. [PMID: 36864593 DOI: 10.1097/aud.0000000000001346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
OBJECTIVES Cochlear implantation or auditory brainstem implantation is currently the only accepted method for improving severe or profound sensorineural hearing loss. The length of the electrodes implanted during cochlear implantation is closely related to the degree of hearing improvement of hearing after the surgery. We aimed to explore new methods to accurately estimate the electrode array (EA) linear insertion depth based on computed tomography (CT) images prior surgery, which could help surgeons select the appropriate EA length for each patient. DESIGN Previous studies estimated the linear insertion depth by measuring the length of the lateral wall of the cochlea rather than the electrode's path in the cochlea duct. Here, we determined the actual position of the EA on the CT image after cochlear surgery in order to predict the path of the EA, and the length of the predicted EA path was measured by the contouring technique (CoT) to estimate the linear insertion depth of the EA. Because CoT can only measure the length of the estimated EA path on a two-dimensional plane, we further modified the measurement by weighting the height of the cochlea and the length of the EA tail (the length of the last stimulating electrode to the end, which cannot be displayed on the CT image), which we termed the modified CoT + height + tail (MCHT) measurement. RESULTS Based on our established method, MCHT could reduce the error to the submillimeter range (0.67 ± 0.37 mm) when estimating the linear insertion depth of various kinds of EAs compared with the actual implant length. The correlation coefficient between the linear insertion depth as predicted by MCHT and the actual was 0.958. The linear insertion depth estimated by this method was more accurate than that estimated using the classical CoT technique ( R = 0.442) and using the modified Escudé's method ( R = 0.585). CONCLUSIONS MCHT is a method based on CT images that can accurately predict the linear insertion depth of cochlear implants preoperatively. This is the first report that we are aware of a method for predicting linear insertion depth before cochlear implantation with only submillimeter errors and that is tailored to different types of EAs.
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Affiliation(s)
- Gaogan Jia
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, People's Republic of China
- These authors contributed equally to this work
| | - Zijun Song
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, People's Republic of China
- These authors contributed equally to this work
| | - Lingjie Wu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, People's Republic of China
| | - Qiushi Sun
- College of Information Science and Electronic Engineering, Zhejiang University, Hangzhou, People's Republic of China
| | - Yaru Sheng
- Radiology Department of Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yusu Ni
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, People's Republic of China
| | - Huawei Li
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, People's Republic of China
- Institutes of Biomedical Sciences, Fudan University, Shanghai, People's Republic of China
- The Institutes of Brain Science and the Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, People's Republic of China
| | - Wenyan Li
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, People's Republic of China
- NHC Key Laboratory of Hearing Medicine (Fudan University), Shanghai, People's Republic of China
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Joo HA, Lee DK, Lee YJ, Alrehaili BM, AlMutawah AA, Kang WS, Ahn JH, Chung JW, Park HJ. Anatomical Features of Children With Mondini Dysplasia: Influence on Cochlear Implantation Performance. Otol Neurotol 2023; 44:e379-e386. [PMID: 37231535 DOI: 10.1097/mao.0000000000003911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To analyze the long-term auditory performance after cochlear implantation (CI) and identify anatomical features of Mondini dysplasia associated with post-CI outcomes. STUDY DESIGN Retrospective study. SETTING Tertiary care academic center. PATIENTS We enrolled 49 ears with Mondini dysplasia who underwent CI with more than 7 years of follow-up and age at CI- and sex-matched control group with radiologically normal inner ears. MAIN OUTCOMES AND MEASURES The development of auditory skills after CI was evaluated using word recognition scores (WRSs). The anatomical features were measured based on temporal bone computed tomography and magnetic resonance imaging, involving the width of the bony cochlear nerve canal (BCNC), cochlear basal turn, enlarged vestibular aqueduct, cochlear height, and diameter of the cochlear nerve (CN). RESULTS CI in ears with Mondini dysplasia showed comparable benefits and improvement of auditory performance to controls during the 7 years of follow-up. In Mondini dysplasia, four (8.2%) ears showed narrow BCNC (<1.4 mm) with poorer WRS (58 ± 17%) than those with normal-sized BCNC, which had WRS (79 ± 10%) comparable to that of the control group (77 ± 14%). In Mondini dysplasia, the maximum ( r = 0.513, p < 0.001) and minimum ( r = 0.328, p = 0.021) CN diameters had positive correlations with post-CI WRS. The maximum CN diameter ( β = 48.347, p < 0.001) and BCNC width ( β = 12.411, p = 0.041) were significant factors that influence the post-CI WRS in multiple regression analysis. CONCLUSIONS Preoperative anatomical evaluation, especially BCNC status and CN integrity, may serve as predictive markers for post-CI performance.
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Affiliation(s)
- Hye Ah Joo
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Kyu Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Ji Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bassim Mallith Alrehaili
- Otolaryngology-Head and Neck Surgery, Ohud Hospital, Al Madinah Al Munawwarah, Kingdom of Saudi Arabia
| | - Abdullah Ali AlMutawah
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Seok Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joong Ho Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Woo Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hong Ju Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Hiremath SB, Biswas A, Mndebele G, Schramm D, Ertl-Wagner BB, Blaser SI, Chakraborty S. Cochlear Implantation: Systematic Approach to Preoperative Radiologic Evaluation. Radiographics 2023; 43:e220102. [PMID: 36893052 DOI: 10.1148/rg.220102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Sensorineural hearing loss results from abnormalities that affect the hair cells of the membranous labyrinth, inner ear malformations, and conditions affecting the auditory pathway from the cochlear nerve to the processing centers of the brain. Cochlear implantation is increasingly being performed for hearing rehabilitation owing to expanding indications and a growing number of children and adults with sensorineural hearing loss. An adequate understanding of the temporal bone anatomy and diseases that affect the inner ear is paramount for alerting the operating surgeon about variants and imaging findings that can influence the surgical technique, affect the choice of cochlear implant and electrode type, and help avoid inadvertent complications. In this article, imaging protocols for sensorineural hearing loss and the normal inner ear anatomy are reviewed, with a brief description of cochlear implant devices and surgical techniques. In addition, congenital inner ear malformations and acquired causes of sensorineural hearing loss are discussed, with a focus on imaging findings that may affect surgical planning and outcomes. The anatomic factors and variations that are associated with surgical challenges and may predispose patients to periprocedural complications also are highlighted. © RSNA, 2023 Quiz questions for this article are available through the Online Learning Center. Online supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article.
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Affiliation(s)
- Shivaprakash B Hiremath
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Asthik Biswas
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Gopolang Mndebele
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - David Schramm
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Birgit B Ertl-Wagner
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Susan I Blaser
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
| | - Santanu Chakraborty
- From the Department of Radiology, Division of Neuroradiology (S.B.H., S.C.), and Department of Otolaryngology-Head and Neck Surgery (D.S.), University of Ottawa, The Ottawa Hospital, 1053 Carling Ave, Ottawa, ON, Canada K1Y 4E9; Division of Neuroradiology, Great Ormond Street Hospital for Children, London, England (A.B.); Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada (G.M., B.B.E.W., S.I.B.); and Department of Medical Imaging, University of Toronto, Toronto, ON, Canada (S.B.H., G.M., B.B.E.W., S.I.B.)
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18
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Deep NL, Carlson ML, Hoxworth JM, Driscoll CLW, Lohse CM, Lane JI, Ho ML. Classifying the Large Vestibular Aqueduct: Morphometry to Audiometry. Otol Neurotol 2023; 44:47-53. [PMID: 36509439 DOI: 10.1097/mao.0000000000003748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Large vestibular aqueduct (LVA) is the most common inner ear dysplasia identified in patients with hearing loss. Our objective was to systematically quantify LVA morphologies and correlate imaging findings with established audiometric outcomes. STUDY DESIGN Retrospective review. SETTING Tertiary referral center. PATIENTS Patients with large vestibular aqueduct identified radiographically, with or without hearing loss. INTERVENTIONS Diagnostic only. MAIN OUTCOME MEASURES Vestibular aqueduct (VA) width at midpoint, width at external aperture, and length were measured on cross-sectional imaging. Morphology was classified as type I (borderline), type II (tubular), or type III (funneled). Audiometric endpoints included air/bone conduction, pure tone averages, and air-bone gaps at 250 and 500 Hz. Statistical associations were evaluated using linear regression models, adjusted for age at first audiogram and sex. RESULTS One hundred seventeen patients (197 ears) were included, with mean age at first audiogram of 22.2 years (standard deviation, 21.7 yr). Imaging features associated with poor audiometric outcomes were increasing VA width at midpoint and external aperture, decreasing VA length, dilated extraosseous endolymphatic sac, cochleovestibular malformations, and increasing VA type (III > II > I). CONCLUSIONS Quantitative LVA measurements and a standardized morphologic classification system aid in prediction of early audiometric endpoints.
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Affiliation(s)
- Nicholas L Deep
- Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Phoenix, Arizona
| | - Matthew L Carlson
- Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Joseph M Hoxworth
- Neuroradiology Division, Department of Radiology, Mayo Clinic, Phoenix, Arizona
| | - Colin L W Driscoll
- Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | | | - John I Lane
- Neuroradiology Division, Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Mai-Lan Ho
- Department of Radiology, Nationwide Children's Hospital, Columbus, Ohio
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19
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赵 质, 祝 园, 符 一, 姜 鸿. [Correlation of temporal bone HRCT, SLC26A4 gene and hearing loss in enlarged vestibular aqueduct]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 36:736-740. [PMID: 36217650 PMCID: PMC10128559 DOI: 10.13201/j.issn.2096-7993.2022.10.002] [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] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Indexed: 06/16/2023]
Abstract
Objective:To explore the correlation between high-resolution computed tomography(HRCT) of temporal bones, SLC26A4 gene mutation and hearing loss in patients with enlarged vestibular aqueduct(EVA). Methods:The medical records of 257 subjects hospitalized for moderate to severe sensorineural hearing loss in the Department of Otolaryngology Head and Neck Surgery, Hainan General Hospital between May 2018 to 2021 were retrospectively reviewed. All included cases received audiological examination, HRCT scanning of temporal bones and SLC26A4 gene sequencing. According to the Valvassori standard, cases with the diameter from the common peduncle of the semicircular canal to the midpoint of the outer orifice of the vestibular aqueduct(MP) over 1.5 mm, or the diameter of the outer orifice of the vestibular aqueduct(OP) more than 2.0 mm were diagnosed as EVA. There were 22 cases(44 ears) of EVA in the study, aged between 6 months to 17 years old. Based on the hearing changes at birth and during growth, 18 ears of which were classified into the stable hearing group, while the other 26 ears in the unstable group. Moreover, all involved cases were grouped by MP(1.5 to <3.0 mm and ≥3.0 mm) and OP(2.0 to <4.0 mm and ≥4.0 mm). SPSS 25.0 software was applied in the study. The correlation between hearing loss and MP and OP was analyzed. The results of HRCT of temporal bones and SLC26A4 gene sequencing were compared as well. Results:Though the size of MP and OP was not statistically different between the stable and hearing groups in EVA ears(P>0.05), it was significantly correlated with the severity of hearing loss(P<0.05). Of the 22 EVA patients diagnosed by HRCT, 21 were positive for SLC26A4 gene mutation. The positive rate of EVA by SLC26A4 gene sequencing was highly consistent with HRCT(Kappa=0.975). Conclusion:The size of MP and OP in EVA patients was related to the degree of hearing loss, but not to the stable nature of hearing loss. Temporal bone HRCT scanning and SLC26A4 gene sequencing are highly consistent in the diagnosis of EVA. The latter has no radiation and can be combined with hearing screening for early diagnosis of EVA.
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Affiliation(s)
- 质彬 赵
- 海南医学院附属海南医院 海南省人民医院耳鼻咽喉头颈外科(海口,570311)Department of Otolaryngology Headand Neck Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311 , China
| | - 园平 祝
- 海南医学院附属海南医院 海南省人民医院耳鼻咽喉头颈外科(海口,570311)Department of Otolaryngology Headand Neck Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311 , China
| | - 一飞 符
- 海南医学院附属海南医院 海南省人民医院耳鼻咽喉头颈外科(海口,570311)Department of Otolaryngology Headand Neck Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311 , China
| | - 鸿彦 姜
- 海南医学院附属海南医院 海南省人民医院耳鼻咽喉头颈外科(海口,570311)Department of Otolaryngology Headand Neck Surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311 , China
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Cui W, Wang S, Chen B, Fan G. White matter structural network alterations in congenital bilateral profound sensorineural hearing loss children: A graph theory analysis. Hear Res 2022; 422:108521. [PMID: 35660126 DOI: 10.1016/j.heares.2022.108521] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 03/22/2022] [Accepted: 05/14/2022] [Indexed: 11/25/2022]
Abstract
Functional magnetic resonance imaging (fMRI) studies have revealed a functional reorganization in patients with sensorineural hearing loss (SNHL). The structural basement of functional changes has also been investigated recently. Graph theory analysis brings a new understanding of the structural connectome and topological features in central neural system diseases. However, little is known about the structural network connectome changes in SNHL patients, especially in children. We explored the differences in topologic organization, rich-club organization, and structural connection between children with congenital bilateral profound SNHL and normal hearing under the age of three using graph theory analysis and probabilistic tractography. Compared with the normal-hearing (NH) group, the SNHL group showed no difference in global and nodal topological parameters. Increased structural connection strength were found in the right cortico-striatal-thalamus-cortical circuity. Decreased cross-hemisphere connections were found between the right precuneus and the left auditory cortex as well as the left subcortical regions. Rich-club organization analysis found increased local connection in the SNHL group. These results revealed structural organizations after hearing deprivation in congenital bilateral profound SNHL children.
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Affiliation(s)
- Wenzhuo Cui
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, LN, China
| | - Shanshan Wang
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, LN, China
| | - Boyu Chen
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, LN, China
| | - Guoguang Fan
- Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, LN, China.
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21
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李 智, 吕 佳, 陈 纲, 陈 志, 张 鹏, 钟 翠. [Relationship between sudden sensorineural hearing loss and facial auditory nerve and anterior inferior cerebellar artery vascular loop in the internal auditory tract MRI]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 36:435-440. [PMID: 35822361 PMCID: PMC10128497 DOI: 10.13201/j.issn.2096-7993.2022.06.006] [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] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Indexed: 06/15/2023]
Abstract
Objective:To investigate the correlation between the facial auditory nerve and anterior inferior cerebellar artery vascular loop in MRI of the internal auditory meatus and idiopathic sudden sensorineural hearing loss. Methods:This retrospective study enrolled 144 patients with idiopathic sudden sensorineural hearing loss(SSNHL)(experimental group) and 36 healthy subjects with 72 ears(control group), who attended the Department of Otolaryngology Head and Neck Surgery, the 940th Hospital of the Joint Logistics Support Unit of the Chinese PLA from January, 2019 to January, 2021. The magnetic resonance imaging(MRI) data of the internal auditory meatus and clinical data were collected and compared between the two groups. Results:The distance between the auditory nerve and the peripheral vessels in the unilateral SSNHL-affected ear was significantly different from that in the contralateral ears and that in the healthy ears of the control group (P<0.05). The distance between the auditory nerve and the peripheral vessels in both ear affected by bilateral SSNHL was significantly different from that in the healthy ears of the control group (P<0.05). There was no significant difference in radiological grading of vascular loops between the ears affected by unilateral SSNHL and the contralateral ears and the healthy ear of the control group (P>0.05). No statistically significant differences in radiological grading of vascular loops were found between both ears with bilateral SSNHL and the healthy ears in the control group(P>0.05). The severity of hearing loss, audiometric configuration, radiological grading of vascular loops and the distance between the facial auditory nerve and peripheral vessels were not significantly different between the affected ears in unilateral SSNHL and both ears in bilateral SSNHL (P>0.05). Conclusion:SSNHL is associated with the distance between the auditory nerve and the nearest peripheral vessel. SSNHL may occur when the vessel compresses the auditory nerve.
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Affiliation(s)
- 智慧 李
- 中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州,730050)Department of Otolaryngology Head and Neck Surgery, the 940th Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
| | - 佳蕙 吕
- 中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州,730050)Department of Otolaryngology Head and Neck Surgery, the 940th Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
| | - 纲 陈
- 中国人民解放军联勤保障部队第九四〇医院影像科Department of Imaging, the 940th Hospital of the Joint Logistics Support Unit of the Chinese PLA
| | - 志峰 陈
- 中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州,730050)Department of Otolaryngology Head and Neck Surgery, the 940th Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
| | - 鹏志 张
- 中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州,730050)Department of Otolaryngology Head and Neck Surgery, the 940th Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
| | - 翠萍 钟
- 中国人民解放军联勤保障部队第九四〇医院耳鼻咽喉头颈外科(兰州,730050)Department of Otolaryngology Head and Neck Surgery, the 940th Hospital of the Joint Logistics Support Unit of the Chinese PLA, Lanzhou, 730050, China
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Li YT, Chen JW, Yan LF, Hu B, Chen TQ, Chen ZH, Sun JT, Shang YX, Lu LJ, Cui GB, Wang W. Dynamic Alterations of Functional Connectivity and Amplitude of Low-Frequency Fluctuations in Patients with Unilateral Sudden Sensorineural Hearing Loss. Neurosci Lett 2022; 772:136470. [PMID: 35066092 DOI: 10.1016/j.neulet.2022.136470] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/24/2021] [Revised: 12/26/2021] [Accepted: 01/17/2022] [Indexed: 02/05/2023]
Abstract
Unilateral sudden sensorineural hearing loss (SSNHL) adversely affects the quality of life, leading to increased risk of depression and cognitive decline. Our previous studies have mainly focused on the static brain function abnormalities in SSNHL patients. However, the dynamic features of brain activity in SSNHL patients are not elucidated. To explore the dynamic brain functional alterations in SSNHL patients, age- and sex- matched SSNHL patients (n=38) and healthy controls (HC, n=44) were enrolled. The dynamic functional connectivity (dFC) and dynamic amplitude of low-frequency fluctuation (dALFF) methods were used to compare the temporal features and dynamic neural activity between the two groups. In dFC analyses, the multiple functional connectivities (FCs) were clustered into 2 different states; a greater proportion of FCs in SSNHL patients showed sparse state compared with HC. In dALFF analyses, SSNHL individuals exhibited decreased dALFF variability in bilateral inferior occipital gyrus, middle occipital gyrus, calcarine, right lingual gyrus, and right fusiform gyrus. dALFF variability showed a negative correlation with activated partial thromboplatin time. The dynamic characteristics of SSNHL patients were different from static functional connectivity and static amplitude of low-frequency fluctuation, especially within the visual cortices. These findings suggest that SSNHL patients experience cross-modal plasticity and visual compensation, which may be closely related to the pathophysiology of SSNHL.
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Affiliation(s)
- Yu-Ting Li
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China
| | - Jia-Wei Chen
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
| | - Lin-Feng Yan
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China
| | - Bo Hu
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China
| | - Tian-Qi Chen
- Institution of Basic Medicine, Fourth Military Medical University, 169 Changle Road, Xi'an 710032, Shaanxi, China
| | - Zhu-Hong Chen
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China
| | - Jing-Ting Sun
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China; Shaanxi University of Chinese Medicine, Middle Section of Century Avenue, Xianyang 712046, Shaanxi, China
| | - Yu-Xuan Shang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China
| | - Lian-Jun Lu
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China.
| | - Guang-Bin Cui
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
| | - Wen Wang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi'an 710038, Shaanxi, China.
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Matsuura K, Yoshimura H, Shinagawa J, Kurozumi M, Takumi Y. Audiological Features in 63 Patients With Cochlear Nerve Deficiency. Otol Neurotol 2022; 43:23-28. [PMID: 34538855 DOI: 10.1097/mao.0000000000003365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We aimed to investigate the clinical features of cochlear nerve deficiency (CND), and in particular, the long-term course of hearing disability and audiogram shapes. STUDY DESIGN Retrospective observational nonrandomized group study. SETTING Academic medical center. PATIENTS/INTERVENTIONS The subjects were 63 children with congenital hearing loss who visited our hospital between 2009 and 2019 and underwent MRI, based on which they were diagnosed with CND. There were 61 cases of unilateral CND and two cases of bilateral CND. MAIN OUTCOME MEASURES Imaging tests by MRI and CT and audiometric assessments by pure-tone audiometry and distortion product otoacoustic emission were performed. RESULTS Among the cases of CND diagnosed by assessing the cochlear nerve on MRI, approximately 20% of the bony cochlear nerve canals that could be assessed on CT were normal. Of the 61 cases diagnosed with unilateral CND, 55 cases had cochlear nerve aplasia (90.2%), and six had cochlear nerve hypoplasia (9.8%), with a mean hearing ability of 92.2 and 94.6 dB HL, respectively. Thus, the majority of cases had severe-to-profound hearing loss. The overall audiometric patterns were 78.7% flat, 9.8% cookie-bite, and 9.8% high-frequency. Six of 61 cases (9.8%) had a distortion product otoacoustic emission (DPOAE) response based on the affected side, and none of the cases lost the response during follow-up. CONCLUSIONS Herein, we report the largest study on CND and performed CND image and audiometric assessments. Accurately in diagnosing CND requires not only CT but also MRI assessment. Hearing loss is often severe to profound; however, various audiometric patterns have been observed. CND includes a small number of cases that respond to DPOAE, indicating that some CND cases are clinically diagnosed with auditory neuropathy spectrum disorder (ANSD). A sustained DPOAE response might help in differentiating CND from other ANSDs. Children with congenital deafness who have passed the newborn hearing screening by DPOAE should be examined by MRI to rule out CND.
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Affiliation(s)
| | | | | | - Masahiro Kurozumi
- Department of Radiology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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Nakano A, Arimoto Y, Mutai H, Nara K, Inoue S, Matsunaga T. Clinical and genetic analysis of children with hearing loss and bilateral enlarged vestibular aqueducts. Int J Pediatr Otorhinolaryngol 2022; 152:110975. [PMID: 34801268 DOI: 10.1016/j.ijporl.2021.110975] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 08/28/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the clinical and genetic features of children with hearing loss associated with one of the most common malformations of the inner ear: bilateral enlargement of vestibular aqueducts (EVA). METHODS Clinical and genetic features were investigated in 28 children with hearing loss diagnosed with bilateral EVA by computed tomography from January 2008 to September 2019. RESULTS Fourteen subjects had undergone newborn hearing screening (NHS). Nine subjects (64.3%) were referred in both ears, 4 subjects (28.6%) were referred in one ear, and one subject (7.1%) passed in both ears. Nineteen of 26 subjects (73.1%) who were followed for more than 3 years had hearing fluctuations, while 17 (65.4%) had hearing loss progression. Eleven of 28 subjects (39.2%) had vertigo attacks. Pathogenic variants were identified in two alleles of the SLC26A4 gene in 24 of 27 subjects (88.9%) by sequencing of all exons and flanking introns, leading to genetic diagnosis of Pendred syndrome/DFNB4. Our results indicate that genetic screening for specific SLC26A4 variants using a commercial clinical laboratory test in Japan would have achieved genetic diagnoses in 13 of the 27 subjects (54.2%). Although there was no statistically significance in the frequency of hearing fluctuation or progression depending on the presence or absence of the gene variant, mean hearing level was severe in subjects with two pathogenic variants in SLC26A4 gene. The most common variant detected in our subjects was p.His723Arg (13 alleles, 27.1%), followed by c. 919-2A > G (four alleles, 8.3%). Two novel variants were detected in this study: c.1544+1G > T and c.1614+5G > A. CONCLUSIONS Our data suggest that some subjects may present with bilateral EVA that cannot be detected by NHS. We estimated that genetic diagnosis for SLC264 gene would not have been made in almost half subjects with the commercial genetic screening approach used in the present study in Japan. Although there were some limitations in this study, the subjects with pathogenic variants in two alleles of the SLC26A4 gene could have more severe hearing loss.
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Affiliation(s)
- Atsuko Nakano
- Division of Otorhinolaryngology, Chiba Children's Hospital, 579-1 Heta-cho, Chiba-shi, Chiba, 266-0007, Japan.
| | - Yukiko Arimoto
- Division of Otorhinolaryngology, Chiba Children's Hospital, 579-1 Heta-cho, Chiba-shi, Chiba, 266-0007, Japan
| | - Hideki Mutai
- Division of Hearing and Balance Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Kiyomitsu Nara
- Division of Hearing and Balance Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Satomi Inoue
- Medical Genetics Center, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Tatsuo Matsunaga
- Division of Hearing and Balance Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan; Medical Genetics Center, National Hospital Organization Tokyo Medical Center, 2-5-1 Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
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Bouhadjer K, Tissera K, Farris CW, Juliano AF, Cunnane ME, Curtin HD, Mankarious LA, Reinshagen KL. Retrospective Review of Midpoint Vestibular Aqueduct Size in the 45° Oblique (Pöschl) Plane and Correlation with Hearing Loss in Patients with Enlarged Vestibular Aqueduct. AJNR Am J Neuroradiol 2021; 42:2215-2221. [PMID: 34737185 DOI: 10.3174/ajnr.a7339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/17/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Vestibular aqueduct measurements in the 45° oblique (Pöschl) plane provide a reliable depiction of the vestibular aqueduct; however, adoption among clinicians attempting to counsel patients has been limited due to the lack of correlation with audiologic measures. This study aimed to determine the correlation between midpoint vestibular aqueduct measurements in the Pöschl plane in patients with an enlarged vestibular aqueduct with repeat audiologic measures. MATERIALS AND METHODS Two radiologists independently measured the midpoint vestibular aqueduct diameter in the Pöschl plane reformatted from CT images in 54 pediatric patients (77 ears; mean age at first audiogram, 5 years) with an enlarged vestibular aqueduct. Four hundred nineteen audiograms were reviewed, with a median of 6 audiograms per patient (range, 3-17; mean time between first and last audiograms, 97.4 months). The correlation between midpoint vestibular aqueduct size and repeat audiologic measures (pure tone average, speech-reception threshold, and word recognition score) using a linear mixed-effects model was determined. RESULTS The mean midpoint vestibular aqueduct size was 1.78 mm (range, 0.81-3.46 mm). There was excellent interobserver reliability with intraclass correlation coefficients for the 2 readers measuring 0.92 (P < .001). Each millimeter increase in vestibular aqueduct size was associated with an increase of 10.5 dB (P = .006) in the pure tone average, an increase of 14.0 dB (P = .002) in the speech-reception threshold, and a decrease in the word recognition score by 10.5% (P = .05). CONCLUSIONS Midpoint vestibular aqueduct measurements in the Pöschl plane are highly reproducible and demonstrate a significant correlation with audiologic data in this longitudinal study with repeat measures. These data may be helpful for clinicians who are counseling patients with an enlarged vestibular aqueduct using measurements obtained in the Pöschl plane.
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Affiliation(s)
- K Bouhadjer
- From the Departments of Radiology (K.B., A.F.J., M.E.C., H.D.C., K.L.R.)
| | - K Tissera
- Otolaryngology (K.T., L.A.M.), Massachusetts Eye and Ear, Boston, Massachusetts
| | - C W Farris
- Department of Radiology (C.W.F.), Massachusetts General Hospital, Boston, Massachusetts
| | - A F Juliano
- From the Departments of Radiology (K.B., A.F.J., M.E.C., H.D.C., K.L.R.)
| | - M E Cunnane
- From the Departments of Radiology (K.B., A.F.J., M.E.C., H.D.C., K.L.R.)
| | - H D Curtin
- From the Departments of Radiology (K.B., A.F.J., M.E.C., H.D.C., K.L.R.)
| | - L A Mankarious
- Otolaryngology (K.T., L.A.M.), Massachusetts Eye and Ear, Boston, Massachusetts
| | - K L Reinshagen
- From the Departments of Radiology (K.B., A.F.J., M.E.C., H.D.C., K.L.R.)
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王 林, 夏 贵, 陈 旭. [The value of quantitative measurement of key structures of inner ear by HRCT in hearing evaluation of patients with congenital severe sensorineural deafness]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 35:880-885. [PMID: 34628808 PMCID: PMC10127707 DOI: 10.13201/j.issn.2096-7993.2021.10.004] [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] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Indexed: 06/13/2023]
Abstract
Objective:Study on the value of quantitative measurement of key structures of inner ear by high resolution computer tomography(HRCT) in hearing evaluation of patients with congenital severe sensorineural hearing loss(SNHL). Methods:A total of 90 children with extremely severe SNHL diagnosed and treated in Beilun District People's Hospital from January 2018 to February 2021 were collected as the experimental group. In the same period, 90 children(180 ears) with normal inner ear structure and hearing were scanned because of head trauma and suspected temporal bone fracture. Logistic univariate and multivariate regression analysis were used to analyze the factors affecting the occurrence of extremely severe SNHL. Based on the results of multivariate analysis, a Nomogram prediction model was established. The model before and after internal correction was evaluated by the receiver working characteristic curve. Results:Inner ear malformation, SSCC bone island width, LSCC bone island width and cochlear height were independent risk factors for extremely severe SNHL. The results of Nomogram predictive model showed that cochlear height 34 points, LSCC bone island width 19 points, SSCC bone island width 22 points, inner ear malformation 37 points, the total score(112 points) corresponding to the incidence of extremely severe SNHL(0.3%). The actual C-index value of Nomogram prediction model is 0.858, the C-index of internal verification is 0.851, and the C-index of external verification is 0.847. The coincidence of the model is good. It is suggested that the model can effectively predict the risk factors of congenital extremely severe SNHL and has high prediction accuracy. Conclusion:The standardized measurement of SSCC bone island width, LSCC bone island width and cochlear height by HRCT is of great value in the diagnosis of microinner ear malformation in children with extremely severe SNHL.
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Affiliation(s)
- 林 王
- 宁波市北仑区人民医院(浙大一院北仑分院)耳鼻咽喉科(浙江宁波, 315800)Department of Otorhinolaryngology, Beilun District People's Hospital[Beilun Branch of the First Hospital of Zhejiang University], Ningbo, 315800, China
| | - 贵华 夏
- 宁波市北仑区人民医院(浙大一院北仑分院)耳鼻咽喉科(浙江宁波, 315800)Department of Otorhinolaryngology, Beilun District People's Hospital[Beilun Branch of the First Hospital of Zhejiang University], Ningbo, 315800, China
| | - 旭东 陈
- 宁波市北仑区人民医院(浙大一院北仑分院)放射科Department of Radiology, Beilun District People's Hospital[Beilun Branch of the First Hospital of Zhejiang University]
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Wenger TL, Perkins J, Parish-Morris J, Hing AV, Chen ML, Cielo CM, Li D, Bhoj EJ, Hakonarson H, Zackai E, McDonald-McGinn DM, Taylor JA, Jackson O, Sie K, Bly R, Dahl J, Evans KN. Cleft palate morphology, genetic etiology, and risk of mortality in infants with Robin sequence. Am J Med Genet A 2021; 185:3694-3700. [PMID: 34291880 DOI: 10.1002/ajmg.a.62430] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/26/2021] [Accepted: 07/03/2021] [Indexed: 11/07/2022]
Abstract
Robin sequence (RS) has many genetic and nongenetic causes, including isolated Robin sequence (iRS), Stickler syndrome (SS), and other syndromes (SyndRS). The purpose of this study was to determine if the presence and type of cleft palate varies between etiologic groups. A secondary endpoint was to determine the relationship of etiologic group, cleft type, and mortality. Retrospective chart review of patients with RS at two high-volume craniofacial centers. 295 patients with RS identified. CP was identified in 97% with iRS, 95% with SS, and 70% of those with SyndRS (p < .0001). U-shaped CP was seen in 86% of iRS, 82% with SS, but only 27% with SyndRS (p < .0001). At one institution, 12 children (6%) with RS died, all from the SyndRS group (p < .0001). All died due to medical comorbidities related to their syndrome. Only 25% of children who died had a U-shaped CP. The most common palatal morphology among those who died was an intact palate. U-shaped CP was most strongly associated with iRS and SS, and with a lower risk of mortality. RS with submucous CP, cleft lip and palate or intact palate was strongly suggestive of an underlying genetic syndrome and higher risk of mortality.
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Affiliation(s)
- Tara L Wenger
- Division of Genetic Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Jonathan Perkins
- Division of Otolaryngology, Seattle Children's Hospital, Seattle, WA, USA
| | - Julia Parish-Morris
- Division of Psychiatry, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Anne V Hing
- Division of Craniofacial Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Maida L Chen
- Division of Pulmonary Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Christopher M Cielo
- Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Dong Li
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elizabeth J Bhoj
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Hakon Hakonarson
- Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Elaine Zackai
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Donna M McDonald-McGinn
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jesse A Taylor
- Division of Plastic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Oksana Jackson
- Division of Plastic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kathleen Sie
- Division of Otolaryngology, Seattle Children's Hospital, Seattle, WA, USA
| | - Randall Bly
- Division of Otolaryngology, Seattle Children's Hospital, Seattle, WA, USA
| | - John Dahl
- Division of Otolaryngology, Seattle Children's Hospital, Seattle, WA, USA
| | - Kelly N Evans
- Division of Craniofacial Medicine, Seattle Children's Hospital, Seattle, WA, USA
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黄 健, 夏 巍, 唐 翔, 谭 颂, 唐 安. [Progress of research on cone beam CT in cochlear implantation]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 35:567-572. [PMID: 34304522 PMCID: PMC10128610 DOI: 10.13201/j.issn.2096-7993.2021.06.019] [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] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 03/22/2021] [Indexed: 11/12/2022]
Abstract
Cochlear implant, as the most successful artificial auditory implant, brings tens of thousands of patients with severe or profound sensorineural hearing loss back to the world of sound every year. With the expansion of surgical indications, a large number of difficult cases bring new challenges for cochlear implantation. As a new technology, cone beam CT has the double advantages of high spatial resolution and low radiation. It is considered as the second revolution of CT technology, which shows unique value in the application of cochlear implantation. This article reviews the basic principles of cone beam CT and its application and research progress in cochlear implantation.
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Affiliation(s)
- 健健 黄
- 广西医科大学第一附属医院耳鼻咽喉头颈外科(南宁,530021)
| | - 巍 夏
- 广西医科大学第一附属医院耳鼻咽喉头颈外科(南宁,530021)
| | - 翔龙 唐
- 广西医科大学第一附属医院耳鼻咽喉头颈外科(南宁,530021)
| | - 颂华 谭
- 广西医科大学第一附属医院耳鼻咽喉头颈外科(南宁,530021)
| | - 安洲 唐
- 广西医科大学第一附属医院耳鼻咽喉头颈外科(南宁,530021)
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Burd C, Pai I, Pinto M, Dudau C, Connor S. Morphological comparison of internal auditory canal diverticula in the presence and absence of otospongiosis on computed tomography and their impact on patterns of hearing loss. Neuroradiology 2021; 63:431-437. [PMID: 33210164 PMCID: PMC7880953 DOI: 10.1007/s00234-020-02606-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/12/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE The association of internal auditory canal (IAC) fundal diverticula with otospongiosis (OS) and their clinical significance remain unclear. We explored whether isolated IAC diverticula were morphologically different from those with additional CT features of OS, and whether IAC diverticula morphology influenced patterns of hearing loss. METHODS Consecutive temporal bone CT studies with (n = 978) and without (n = 306) features of OS were retrospectively assessed. Two independent observers evaluated the presence of IAC diverticula morphological features (depth, neck:depth ratio, definition of contour and angulation of shape), and these were correlated with the presence of fenestral and pericochlear OS. Audiometric profiles were analysed for the isolated IAC diverticula and those with fenestral OS alone. Continuous data was compared using Wilcoxon rank sum tests and categorical data with chi-squared and Fisher's exact tests. RESULTS Ninety-five isolated IAC diverticula were demonstrated in 54/978 patients (5.5%) without CT evidence of OS (31M, 23F, mean age 46), and 119 IAC diverticula were demonstrated in 71/306 patients (23%) with CT evidence of OS (23M, 48F, mean age 55). Reduced neck:depth ratio, ill definition and angulation were all significantly associated with the presence of pericochlear OS (p < 0.001), whilst only ill definition was associated with the presence of fenestral OS alone (p < 0.05). No morphological feature was associated with conductive hearing loss in isolated diverticula or with sensorineural hearing loss in diverticula with fenestral OS alone. CONCLUSION IAC diverticula associated with pericochlear OS demonstrate different morphological features from isolated IAC diverticula. There are no clear audiometric implications of these morphological features.
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Affiliation(s)
- Christian Burd
- Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Irumee Pai
- Department of Otolaryngology, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK
- School of Biomedical Engineering & Imaging Sciences Clinical Academic Group, King's College London, London, SE1 9RT, UK
| | - Melisha Pinto
- Department of Oral Medicine and Radiology, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
| | - Cristina Dudau
- Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK
| | - Steve Connor
- Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
- School of Biomedical Engineering & Imaging Sciences Clinical Academic Group, King's College London, London, SE1 9RT, UK.
- Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK.
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Prat Matifoll JA, Wilson M, Goetti R, Birman C, Bennett B, Peadon E, Prats-Uribe A, Prelog K. A Case Series of X-Linked Deafness-2 with Sensorineural Hearing Loss, Stapes Fixation, and Perilymphatic Gusher: MR Imaging and Clinical Features of Hypothalamic Malformations. AJNR Am J Neuroradiol 2020; 41:1087-1093. [PMID: 32409310 DOI: 10.3174/ajnr.a6541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/20/2020] [Indexed: 11/07/2022]
Abstract
X-linked deafness-2 (DFNX2) is an X-linked recessive disorder characterized by profound sensorineural hearing loss and a pathognomonic temporal bone deformity. Because hypothalamic malformations associated with DFNX2 have been rarely described, we aimed to further describe these lesions and compare them with features of a nonaffected population. All patients diagnosed with DFNX2 between 2006 and 2019 were included and compared with age-matched patients with normal MR imaging findings and without hypothalamic dysfunction. MR imaging features differing between groups were selected to help identify DFNX2. Sensitivity and specificity were calculated for these features. Agreement among 3 radiologists was quantified using the index κ. Information on the presence or absence of gelastic seizures, precocious puberty, or delayed puberty was also gathered. We selected distinctive MR imaging features of hypothalamic malformations in DFNX2. The feature selected on axial T2 images was the folded appearance of the ventromedial hypothalamus (sensitivity, 100%; specificity, 95.8%) characterized by an abnormal internal/external cleft (sensitivity, 100%; specificity, 95.7%). On coronal T2, the first distinctive feature was a concave morphology of the medial eminence (sensitivity, 100%; specificity, 97.1%), the second feature was at least 1 hypothalamic-septum angle ≥90° (sensitivity, 90%; specificity, 72.5%), and the third feature was a forebrain-hypothalamic craniocaudal length of ≥6 mm (sensitivity, 70%; specificity, 79.7%). Clinical features were also distinctive because 9 patients with DFNX2 did not present with gelastic seizures or precocious puberty. One patient had delayed puberty. The κ index and intraclass correlation coefficient ranged between 0.78 and 0.95. Imaging and clinical features of the hypothalamus suggest that there is a hypothalamic malformation associated with DFNX2. Early assessment for pubertal delay is proposed.
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Affiliation(s)
| | | | - R Goetti
- Radiology Department (R.G.), University of Sydney, Children's Hospital at Westmead (Sydney), Westmead, New South Wales, Australia
| | | | | | - E Peadon
- Deafness Centre (E.P.); Children's Hospital at Westmead (Sydney), Westmead, New South Wales, Australia
| | - A Prats-Uribe
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (A.P.-U.), Centre for Statistics in Medicine, Botnar Research Centre, University of Oxford, Oxford, UK
| | - K Prelog
- From the Departments of Radiology (J.-A.P.M., K.P.)
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Orman G, Kukreja MK, Vallejo JG, Desai N, Huisman TAGM, Kralik SF. Accuracy of MR Imaging for Detection of Sensorineural Hearing Loss in Infants with Bacterial Meningitis. AJNR Am J Neuroradiol 2020; 41:1081-1086. [PMID: 32439638 DOI: 10.3174/ajnr.a6539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/21/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Bacterial meningitis most commonly affects young children and can result in critical adverse outcomes, including sensorineural hearing loss (SNHL). The purpose of this study is to determine the diagnostic accuracy of MR imaging for predicting the development of SNHL among infants with bacterial meningitis. MATERIALS AND METHODS A retrospective review was performed among infants (age <365 days) with bacterial meningitis (n = 115). Independent and consensus blinded review of brain MRIs (n = 239) performed less than 90 days from presentation were conducted. Abnormal appearance of the inner ear was defined as enhancement on postcontrast T1-weighted (T1-weighted+C) sequence and FLAIR hyperintensity. The consensus MR imaging appearance of the inner ear on FLAIR, T1-weighted+C, and combined evaluation was compared with criterion standard audiometric testing to determine the sensitivity and specificity of MR imaging for detecting SNHL. RESULTS The mean age at diagnosis of bacterial meningitis was 50.6 days (range, 0-338 days) and 24.3% had SNHL. Sensitivity and specificity was 0.61/0.96, 0.50/0.94, and 0.61/0.94 for T1-weighted+C, FLAIR hyperintensity, and combined evaluation, respectively, for prediction of SNHL. There was excellent interobserver agreement for both the T1-weighted+C and FLAIR sequences and combined evaluation for presence of abnormal enhancement and hyperintense signal, respectively. Factors associated with abnormal MR imaging findings on T1-weighted+C and/or FLAIR in patients with SNHL included low CSF glucose (P = .04, .02) and high CSF protein (P = .04, .03). CONCLUSIONS Abnormal enhancement and/or FLAIR hyperintensity of the inner ear demonstrate high specificity and average sensitivity for prediction of SNHL among infants with bacterial meningitis.
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Affiliation(s)
- G Orman
- From the Edward B. Singleton Department of Radiology (G.O., M.K.K., N.D., T.A.G.M.H., S.F.K.)
| | - M K Kukreja
- From the Edward B. Singleton Department of Radiology (G.O., M.K.K., N.D., T.A.G.M.H., S.F.K.)
| | - J G Vallejo
- Department of Pediatrics, Section of Infectious Diseases (J.G.V.), Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - N Desai
- From the Edward B. Singleton Department of Radiology (G.O., M.K.K., N.D., T.A.G.M.H., S.F.K.)
| | - T A G M Huisman
- From the Edward B. Singleton Department of Radiology (G.O., M.K.K., N.D., T.A.G.M.H., S.F.K.)
| | - S F Kralik
- From the Edward B. Singleton Department of Radiology (G.O., M.K.K., N.D., T.A.G.M.H., S.F.K.)
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Touska P, Connor SEJ. Recent advances in MRI of the head and neck, skull base and cranial nerves: new and evolving sequences, analyses and clinical applications. Br J Radiol 2019; 92:20190513. [PMID: 31529977 PMCID: PMC6913354 DOI: 10.1259/bjr.20190513] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 12/14/2022] Open
Abstract
MRI is an invaluable diagnostic tool in the investigation and management of patients with pathology of the head and neck. However, numerous technical challenges exist, owing to a combination of fine anatomical detail, complex geometry (that is subject to frequent motion) and susceptibility effects from both endogenous structures and exogenous implants. Over recent years, there have been rapid developments in several aspects of head and neck imaging including higher resolution, isotropic 3D sequences, diffusion-weighted and diffusion-tensor imaging as well as permeability and perfusion imaging. These have led to improvements in anatomic, dynamic and functional imaging. Further developments using contrast-enhanced 3D FLAIR for the delineation of endolymphatic structures and black bone imaging for osseous structures are opening new diagnostic avenues. Furthermore, technical advances in compressed sensing and metal artefact reduction have the capacity to improve imaging speed and quality, respectively. This review explores novel and evolving MRI sequences that can be employed to evaluate diseases of the head and neck, including the skull base.
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Affiliation(s)
- Philip Touska
- Department of Radiology, Guy’s and St. Thomas’ NHS Foundation Trust, Guy’s Hospital, Great Maze Pond, London, SE1 9RT, United Kingdom
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Gueneuc A, Spaggiari E, Millischer AE, Michot C, O'Gorman N, Ville Y. Contribution of three-dimensional ultrasound and three-dimensional helical computed tomography to prenatal diagnosis of Stickler syndrome. Ultrasound Obstet Gynecol 2019; 54:279-280. [PMID: 30251283 DOI: 10.1002/uog.20127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 06/08/2023]
Affiliation(s)
- A Gueneuc
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes, Sorbonne Paris-Cité, Paris, France
| | - E Spaggiari
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - A E Millischer
- Department of Pediatrics Radiology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - C Michot
- University Paris Descartes, Sorbonne Paris-Cité, Paris, France
- Department of Medical Genetics, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - N O'Gorman
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes, Sorbonne Paris-Cité, Paris, France
| | - Y Ville
- Department of Obstetrics and Maternal-Fetal Medicine, Necker-Enfants Malades Hospital, AP-HP, Paris, France
- University Paris Descartes, Sorbonne Paris-Cité, Paris, France
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Behringer J, Ryan M, Miller M, Jaju A. Magnetic resonance imaging findings in a patient with cryopyrin-associated periodic syndrome: A rare hereditary multi-system inflammatory disorder. Neuroradiol J 2019; 32:420-425. [PMID: 31337256 DOI: 10.1177/1971400919863712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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] [Indexed: 12/16/2022] Open
Abstract
Cryopyrin-associated periodic syndrome is a hereditary inflammatory disorder encompassing a wide spectrum of clinical phenotypes. This disorder has been associated with mutation of the NLRP3 gene coding for cryopyrin, which leads to overproduction of interleukin-1. The condition causes relapsing bouts of inflammation involving multiple organ systems, including the central nervous system, and, if untreated, can lead to long-term debilitating effects. A literature review revealed only a few brief descriptions of magnetic resonance imaging findings in cryopyrin-associated periodic syndrome patients. We describe serial magnetic resonance imaging findings in an 11-year-old female with clinically diagnosed cryopyrin-associated periodic syndrome who presented with intermittent headaches, progressive sensorineural hearing loss, fevers, and abdominal pain. The magnetic resonance imaging showed progressively worsening low T2 signal in the cochlea, cochlear enhancement, and leptomeningeal enhancement. We also describe some previously unreported findings in this syndrome, including cranial nerve and cauda equina enhancement.
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Affiliation(s)
| | - Maura Ryan
- Ann and Robert H. Lurie Children's Hospital of Chicago, USA
| | - Michael Miller
- Ann and Robert H. Lurie Children's Hospital of Chicago, USA
| | - Alok Jaju
- Ann and Robert H. Lurie Children's Hospital of Chicago, USA
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King KA, Ansari G, Panackal AA, Zalewski C, Anjum S, Bennett JE, Beri A, Kim HJ, Hammoud D, Brewer CC, Williamson PR. Audiologic and Otologic Complications of Cryptococcal Meningoencephalitis in Non-HIV Previously Healthy Patients. Otol Neurotol 2019; 40:e657-e664. [PMID: 31157723 PMCID: PMC6565454 DOI: 10.1097/mao.0000000000002242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To identify audiologic and otologic outcomes in previously healthy non-HIV patients with cryptococcal meningoencephalitis (CM). STUDY DESIGN Retrospective case review of a subset of patients recruited in a prospective observational study following previously healthy individuals who developed CM. SETTING Tertiary referral center, National Institutes of Health Clinical Center. PATIENTS Previously healthy adult patients with CM without immune suppressive therapy before disease onset. INTERVENTIONS Diagnostic evaluations included audiometry, acoustic immittance, otoacoustic emissions, and auditory brainstem response studies, in addition to neurotologic assessment. RESULTS Twenty-nine patients (58 years) underwent audiologic evaluation between 6 months and 3.5 years after CM diagnosis; 21 patients were seen for longitudinal assessment with an average duration of follow up of 20.3 months. Nearly three-quarters (73%) of the cohort presented with hearing loss, most commonly (90%) sensorineural in origin. The most frequent degree of loss was mild and then moderate, although some patients had severe or profound impairment. Hearing loss improved (43%) or remained stable (38%) in most cases. Ears with internal auditory canal enhancement on magnetic resonance imaging (MRI) had significantly more hearing loss than those without enhancement, although a similar finding was not observed with gyral enhancement or the presence of ependymitis or ventricular volume expansion. Hearing loss was not associated with reduced cerebrospinal fluid (CSF) glucose, CSF total protein, cryptococcal antigen, or total cell count. CONCLUSIONS Hearing loss is a common manifestation of cryptococcal meningitis in previously healthy patients and may involve a cochlear or neural site of lesion, or both. Routine surveillance of hearing in patients is recommended, regardless of symptomatology, to ensure early and appropriate intervention and care.
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Affiliation(s)
- Kelly A King
- National Institute on Deafness and Other Communication Disorders
| | | | - Anil A Panackal
- Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health
| | - Chris Zalewski
- National Institute on Deafness and Other Communication Disorders
| | - Seher Anjum
- Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health
| | - John E Bennett
- Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health
| | - Andrea Beri
- Biomedical Translational Research Information System
| | - Hung Jeff Kim
- National Institute on Deafness and Other Communication Disorders
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University Hospital, Washington, DC
| | - Dima Hammoud
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Carmen C Brewer
- National Institute on Deafness and Other Communication Disorders
| | - Peter R Williamson
- Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health
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Kang TK, Ha R, Oh JH, Sunwoo W. The potential protective effects of temporal bone pneumatization: A shock absorber in temporal bone fracture. PLoS One 2019; 14:e0217682. [PMID: 31150482 PMCID: PMC6544272 DOI: 10.1371/journal.pone.0217682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/17/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives We hypothesize that when temporal bone fractures occur, the pneumatic cells in the temporal bone are able to absorb most of the impact force during a traumatic event. This study aims to correlate the degree of pneumatization of the temporal bone with the severity of temporal bone fracture (TBF). Methods Charts and computed tomography scans representing 54 TBFs, diagnosed from 2012 to 2017 at a single tertiary hospital, were retrospectively reviewed. Temporal bone pneumatization (TBP) in the petrous apex and mastoid region was evaluated using previously published classification systems. TBP classifications and fracture types were correlated with TBF complications such as sensorineural hearing loss (SNHL), facial nerve palsy (FNP), and vestibular dysfunction. Results Patients with increased pneumatization of the temporal bone had significantly fewer and less severe SNHL. SNHL more strongly correlated with the degree of pneumatization in the mastoid (P = 0.005) than that in the petrous apex (P = 0.024). On the other hand, the degree of TBP correlated poorly with FNP and vestibular dysfunction. However, the mastoid hypopneumatization demonstrated significant correlation with otic-capsule violations (P = 0.002). Fractures with otic-capsule violation were 4 times more likely to have vestibular dysfunction (P = 0.043) and 3 times more likely to have SNHL (P = 0.006). FNP was not associated with otic-capsule violating fractures but was 3.5 times more common in comminuted fractures (P = 0.025). Conclusions The degree of temporal bone pneumatization was negatively correlated to the incidence of otic-capsule violation and the severity of hearing impairment in patients with temporal bone fracture. This study substantiated the potential protective effect of temporal bone pneumatization in TBFs.
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Affiliation(s)
- Tae Kyu Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Ryun Ha
- Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Jae Hwan Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea
| | - Woongsang Sunwoo
- Department of Otorhinolaryngology-Head and Neck Surgery, Gachon University Gil Medical Center, Incheon, Korea
- * E-mail:
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Dateki S, Watanabe S, Mishima H, Shirakawa T, Morikawa M, Kinoshita E, Yoshiura KI, Moriuchi H. A homozygous splice site ROBO1 mutation in a patient with a novel syndrome with combined pituitary hormone deficiency. J Hum Genet 2019; 64:341-346. [PMID: 30692597 DOI: 10.1038/s10038-019-0566-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 01/06/2019] [Accepted: 01/09/2019] [Indexed: 01/02/2023]
Abstract
The genetic causes of combined pituitary hormone deficiency remain elusive in most patients. Recently, incompletely penetrant heterozygous mutations in ROBO1 have been described in patients with pituitary stalk interruption syndrome. Herein, we identified a novel homozygous slice site mutation in ROBO1 (c.1342+1G>A) using a trio whole-exome sequencing strategy in a 5-year-old Japanese boy who had combined pituitary hormone deficiency, psychomotor developmental delay, severe intellectual disability, sensorineural hearing loss, strabismus, and characteristic facial features, including a broad forehead, micrognathia, and arched eyebrows. Magnetic resonance imaging delineated anterior pituitary hypoplasia, ectopic posterior pituitary, invisible pituitary stalk, thinning of the corpus callosum, and hypoplasia of the pons and midbrain. The phenotypically normal parents (first cousins) were heterozygous for the mutation. The results provide further evidence of ROBO1 being involved in the development of the pituitary gland. A recessive mutation of ROBO1 is a potential novel cause of a syndromic disorder associated with combined pituitary hormone deficiency.
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Affiliation(s)
- Sumito Dateki
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan.
| | - Satoshi Watanabe
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan
| | - Hiroyuki Mishima
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8102, Japan
| | - Toshihiko Shirakawa
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan
| | - Minoru Morikawa
- Department of Radiology, Nagasaki University Hospital, Nagasaki, 852-8501, Japan
| | | | - Koh-Ichiro Yoshiura
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8102, Japan
| | - Hiroyuki Moriuchi
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501, Japan
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Eliezer M, Poillon G, Maquet C, Gillibert A, Horion J, Marie JP, Guichard JP, Magne N, Attyé A. Sensorineural hearing loss in patients with vestibular schwannoma correlates with the presence of utricular hydrops as diagnosed on heavily T2-weighted MRI. Diagn Interv Imaging 2019; 100:259-268. [PMID: 30773403 DOI: 10.1016/j.diii.2019.01.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [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: 11/09/2018] [Revised: 01/08/2019] [Accepted: 01/13/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE The purpose of this study was to assess whether the volume of the vestibular endolymphatic space correlates with the degree of hearing loss using heavily T2-weighted fast imaging employing steady-state acquisition with cycle phase (FIESTA-C) MRI. MATERIALS AND METHODS A total of 23 patients with vestibular schwannoma, as diagnosed on typical image findings, who underwent FIESTA-C MRI were included. There were 13 women and 10 men with a mean age of 63.5±9.3 (SD) years (range: 49-88years). Two radiologists independently evaluated the volume of the utricle and saccule. Correlation between tumor volume, vestibular endolymphatic space volume and degree of hearing loss - as evaluated with the levels of pure-tone average and speech recognition threshold - were searched for. RESULTS The mean saccular, utricular and tumor volumes were 3.17±1.1 (SD) mm3 (range: 1.45-5.7mm3), 14.55±5 (SD) mm3; (range: 6.6-23.9mm3) and 17.4±5.5 (SD) mm3; (range: 8.3-25.4mm3), respectively. There was a moderate correlation between the volume of the utricle and the degree of hearing loss as evaluated with the levels of pure-tone average (rho=0.5; P=0.015) and speech recognition threshold (rho=0.58; P=0.004). There were no significant correlations between saccular and tumor volumes and the degree of hearing loss. CONCLUSION The volume of the utricle in patients with obstructive vestibular schwannoma moderately correlates with the degree of hearing loss.
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Affiliation(s)
- M Eliezer
- Department of Neuroradiology, Rouen University Hospital, 76000 Rouen, France; Department of Neuroradiology, Hôpital Lariboisière, 75010 Paris, France.
| | - G Poillon
- Department of Neuroradiology, Rouen University Hospital, 76000 Rouen, France
| | - C Maquet
- Department of Head And Neck Surgery, Rouen University Hospital, 76000 Rouen, France
| | - A Gillibert
- Department of Biostatistics, Rouen University Hospital, 76000 Rouen, France
| | - J Horion
- Department of Neuroradiology, Rouen University Hospital, 76000 Rouen, France
| | - J-P Marie
- Department of Head And Neck Surgery, Rouen University Hospital, 76000 Rouen, France
| | - J-P Guichard
- Department of Neuroradiology, Hôpital Lariboisière, 75010 Paris, France
| | - N Magne
- Department of Neuroradiology, Rouen University Hospital, 76000 Rouen, France
| | - A Attyé
- Department of Neuroradiology, Rouen University Hospital, 76000 Rouen, France; Department of Neuroradiology and MRI, Grenoble Alpes University Hospital, SFR RMN neurosciences, 38000 Grenoble, France
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Wang J, Ren T, Sun W, Liang Q, Wang W. Post-contrast 3D-FLAIR in idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol 2019; 276:1291-1299. [PMID: 30747317 DOI: 10.1007/s00405-019-05285-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/20/2018] [Accepted: 01/07/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE Our study investigated correlations between clinical characteristics, particularly hearing recovery, interval time between onset and three-dimensional fluid attenuation inversion recovery magnetic resonance imaging (3D-FLAIR MRI), and the signal intensity of post-contrast 3D-FLAIR MRI in patients with idiopathic sudden sensorineural hearing loss (SSNHL). METHODS The study enrolled 100 SSNHL patients. The signal intensities and asymmetry ratios of the inner ear structures, including the cochleae, vestibules and vestibulocochlear nerve, were evaluated and calculated. The relationships between the clinical characteristics and MRI findings were assessed. RESULTS After intravenous gadolinium (Gd) injection, 3D-FLAIR revealed high signal intensities in 65 patients. The corrected asymmetry ratios of cochlea correlated closely with interval time between onset and MRI. The asymmetry ratios of the inner ear structures were significantly lower in patients with final complete to partial hearing recovery. The corrected asymmetry ratios of the inner ear structures correlated with initial/final pure tone audiometry (PTA) and hearing recovery in the affected ear. Notably, it was shown that the corrected asymmetry ratios identified a poor prognosis for hearing recovery, with a sensitivity and specificity of 67.9% and 75.0% in the cochlea, 83.3% and 75.0% in the vestibule, and 52.4% and 81.2% in the vestibulocochlear nerve, respectively. CONCLUSIONS Post-contrast 3D-FLAIR after intravenous Gd injection in SSNHL can be used to assess the permeability of the blood-labyrinth and blood-nerve barriers. The asymmetry ratios of the inner ear structures may identify patients with poor prognosis for hearing recovery. Signal characteristics are closely related to interval time between onset and MRI.
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Affiliation(s)
- Jiali Wang
- NHC Key Laboratory of Hearing Medicine (Fudan University), Fudan University, No. 83 Fenyang Road, Xuhui District, Shanghai, 200031, People's Republic of China
- Department of Otolaryngology of the Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, 200031, People's Republic of China
| | - Tongli Ren
- NHC Key Laboratory of Hearing Medicine (Fudan University), Fudan University, No. 83 Fenyang Road, Xuhui District, Shanghai, 200031, People's Republic of China
- Department of Otolaryngology of the Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, 200031, People's Republic of China
| | - Wenfang Sun
- Department of Otolaryngology, Chongqing General Hospital, Chongqing, 400000, People's Republic of China
| | - Qiong Liang
- NHC Key Laboratory of Hearing Medicine (Fudan University), Fudan University, No. 83 Fenyang Road, Xuhui District, Shanghai, 200031, People's Republic of China
- Department of Otolaryngology of the Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, 200031, People's Republic of China
| | - Wuqing Wang
- NHC Key Laboratory of Hearing Medicine (Fudan University), Fudan University, No. 83 Fenyang Road, Xuhui District, Shanghai, 200031, People's Republic of China.
- Department of Otolaryngology of the Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, 200031, People's Republic of China.
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Inui H, Sakamoto T, Ito T, Kitahara T. Magnetic resonance-based volumetric measurement of the endolymphatic space in patients with Meniere's disease and other endolymphatic hydrops-related diseases. Auris Nasus Larynx 2018; 46:493-497. [PMID: 30503567 DOI: 10.1016/j.anl.2018.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 09/26/2018] [Revised: 10/29/2018] [Accepted: 11/15/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis. METHODS Forty-one patients with ALHL, 82 with SD, 48 with cMD, 72 with uMD, and 47 CS participated in the study. With the exception of all uMD patients, none of the subjects had vertigo. Images of the inner ear fluid space, positive perilymph signal, and positive endolymph signal were acquired using a 3-T MRI scanner. Three-dimensional images were reconstructed semi-automatically by using anatomical and tissue information to fuse the inner ear fluid space images and the ELS images. RESULTS The cochlear ELS/total fluid space (TFS) volume ratio was 10.2±6.7% (mean±standard deviation) in the CS group, 12.1±5.7% in ALHL patients, 15.2±8.7% in SD patients, 18.1±8.2% in cMD patients, and 21.9±16.4% in uMD patients. The vestibular ELS/TFS volume ratio was 17.7±10.2% in the CS group, 18.9±8.3% in ALHL patients, 19.9±11.3% in SD patients, 22.5±13.7% in cMD patients, and 35.7±24.1% in uMD patients. The cochlear ELS/TFS volume ratio in patients with uMD was similar to that in the cMD group and significantly higher than that in the CS, ALHL, and SD groups (CS=ALHL<SD<cMD=uMD: p<0.05 for CS vs. SD and p<0.01 for CS vs. cMD). The vestibular ELS/TFS volume ratio in patients with uMD was significantly higher than that in the CS and all other patient groups (CS=ALHL=SD=cMD<uMD: p<0.01 for uMD vs. all other groups). CONCLUSION The cochlear ELS volume of patients with MD and other endolymphatic hydrops-related diseases differed from that of CS. Our results suggest that ALHL may not be caused by endolymphatic hydrops. We confirmed the presence of extended ELS in patients with SD.
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Affiliation(s)
- Hiroshi Inui
- Inui ENT Clinic, 47-1 Miwa, Sakurai-city, Nara, 6330001, Japan.
| | - Tsuyoshi Sakamoto
- PixSpace Ltd., 3-8-1 Asano, Kokurakita-ku, Kitakyusyu-city, Fukuoka, Japan
| | - Taeko Ito
- Department of Otorhinolaryngology Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-city, Nara, Japan
| | - Tadashi Kitahara
- Department of Otorhinolaryngology Head and Neck Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-city, Nara, Japan
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Patel ND, Ascha MS, Manzoor NF, Gupta A, Semaan M, Megerian C, Otteson TD. Morphology and cochlear implantation in enlarged vestibular aqueduct. Am J Otolaryngol 2018; 39:657-663. [PMID: 30153950 DOI: 10.1016/j.amjoto.2018.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 06/05/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this work is to explore audiometry following cochlear implantation (CI) in patients with enlarged vestibular aqueduct (EVA) and to investigate the effects of inner ear morphological variation on post CI audiometry. METHODS This was a retrospective review of both natural and cochlear-implant-aided audiometry results, using all available measurements in a mixed-effects model accounting for longitudinal change and the grouping structure of ears. Patients who visited our tertiary academic medical center between 2000 and 2016 were identified as having EVA according to Cincinnati criteria on radiological examination; patients eligible for CI were then selected for analysis. RESULTS Multivariable modeling showed a statistically significant hearing improvement in ears with EVA undergoing CI with regards to pure tone average (-64.0 dB, p < 0.0001), speech reception threshold (-57.90 dB, p < 0.0001), and word score (34.8%, p > 0.0001). Vestibular aqueduct midpoint size and the presence of incomplete partition type II (IP II) did not have significant independent associations with audiometric findings. However, multivariable modeling revealed a statistically significant interaction between IP II and CI such that IP II ears demonstrated a decrease in WS improvement of 30.2% (p = 0.0059) compared to non-IP II ears receiving CI. CONCLUSION There is a statistically significant audiometric benefit to ears with EVA receiving CI. Morphology, specifically the presence of IP II, may hinder CI benefit in terms of word score however this finding needs clinical validation. This data improves personalization of surgical counseling and planning for patients with EVA considering CI.
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Affiliation(s)
- Nilam D Patel
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, USA
| | - Mustafa S Ascha
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Center for Clinical Investigation, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nauman F Manzoor
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Amit Gupta
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Maroun Semaan
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Center for Clinical Investigation, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Cliff Megerian
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Center for Clinical Investigation, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Todd D Otteson
- Ear, Nose, and Throat Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Center for Clinical Investigation, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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Pereira-Jorge MR, Andrade KC, Palhano-Fontes FX, Diniz PRB, Sturzbecher M, Santos AC, Araujo DB. Anatomical and Functional MRI Changes after One Year of Auditory Rehabilitation with Hearing Aids. Neural Plast 2018; 2018:9303674. [PMID: 30275823 PMCID: PMC6151682 DOI: 10.1155/2018/9303674] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 07/08/2018] [Accepted: 08/08/2018] [Indexed: 11/25/2022] Open
Abstract
Hearing aids (HAs) are an effective strategy for auditory rehabilitation in patients with peripheral hearing deficits. Yet, the neurophysiological mechanisms behind HA use are still unclear. Thus far, most studies have focused on changes in the auditory system, although it is expected that hearing deficits affect a number of cognitive systems, notably speech. In the present study, we used audiometric evaluations in 14 patients with bilateral hearing loss before and after one year of continuous HA use and functional magnetic resonance imaging (fMRI) and cortical thickness analysis in 12 and 10 of them compared with a normal hearing control group. Prior to HA fitting, fMRI activity was found reduced in the auditory and language systems and increased in visual and frontal areas, expanding to multimodal integration cortices, such as the superior temporal gyrus, intraparietal sulcus, and insula. One year after rehabilitation with HA, significant audiometric improvement was observed, especially in free-field Speech Reception Threshold (SRT) test and functional gain, a measure of HA efficiency. HA use increased fMRI activity in the auditory and language cortices and multimodal integration areas. Individual fMRI signal changes from all these areas were positively correlated with individual SRT changes. Before rehabilitation, cortical thickness was increased in parts of the prefrontal cortex, precuneus, fusiform gyrus, and middle temporal gyrus. It was reduced in the insula, supramarginal gyrus, medial temporal gyrus, occipital cortex, posterior cingulate cortex, and claustrum. After HA use, increased cortical thickness was observed in multimodal integration regions, particularly the very caudal end of the superior temporal sulcus, the angular gyrus, and the inferior parietal gyrus/superior temporal gyrus/insula. Our data provide the first evidence that one year of HA use is related to functional and anatomical brain changes, notably in auditory and language systems, extending to multimodal cortices.
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Affiliation(s)
- M. R. Pereira-Jorge
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - K. C. Andrade
- Brain Institute/Onofre Lopes University Hospital, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - F. X. Palhano-Fontes
- Brain Institute/Onofre Lopes University Hospital, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - P. R. B. Diniz
- Department of Internal Medicine, Federal University of Pernambuco, Recife, PE, Brazil
| | - M. Sturzbecher
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - A. C. Santos
- Department of Neuroscience and Behavior, University of São Paulo, Ribeirao Preto, SP, Brazil
- Department of Internal Medicine, University of São Paulo, Ribeirao Preto, SP, Brazil
| | - D. B. Araujo
- Brain Institute/Onofre Lopes University Hospital, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
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Abstract
Cytomegalovirus (CMV) is the most common congenital virus passed from mother to fetus in the United States, and the most common acquired cause of sensorineural hearing loss. Neuroimaging in patients with symptomatic congenital CMV demonstrates abnormalities frequently, but many providers are unaware of the extent of these findings. We present a case of a 15-month-old girl with progressive sensorineural hearing loss and developmental delays. Magnetic resonance imaging of her brain was done by her otolaryngologist as part of a routine cochlear implant evaluation where it was found to be drastically abnormal and reported as a likely leukodystrophy. It was subsequently found to be related to congenital CMV on further evaluation. Congenital CMV should be considered in the differential of white matter hyperintensities, especially in the setting of sensorineural hearing loss, developmental delays, or both, and given how common CMV is around the world.
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Affiliation(s)
- Benjamin Louis Moresco
- Department of Pediatrics, Baylor College of Medicine, The Children's Hospital of San Antonio, San Antonio, TX
| | - Melissa Dziuk Svoboda
- Department of Pediatrics, Baylor College of Medicine, The Children's Hospital of San Antonio, San Antonio, TX.
| | - Yu-Tze Ng
- Department of Pediatrics, Baylor College of Medicine, The Children's Hospital of San Antonio, San Antonio, TX
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Booth TN, Wick C, Clarke R, Kutz JW, Medina M, Gorsage D, Xi Y, Isaacson B. Evaluation of the Normal Cochlear Second Interscalar Ridge Angle and Depth on 3D T2-Weighted Images: A Tool for the Diagnosis of Scala Communis and Incomplete Partition Type II. AJNR Am J Neuroradiol 2018; 39:923-927. [PMID: 29545247 DOI: 10.3174/ajnr.a5585] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/12/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND PURPOSE Cochlear malformations may be be subtle on imaging studies. The purpose of this study was to evaluate the angle and depth of the lateral second interscalar ridge or notch in ears without sensorineural hearing loss (normal ears) and compare them with ears that have a documented incomplete type II partition malformation. MATERIALS AND METHODS The second interscalar ridge notch angle and depth were measured on MR imaging in normal ears by a single experienced neuroradiologist. The images of normal and incomplete partition II malformation ears were then randomly mixed for 2 novice evaluators to measure both the second interscalar ridge notch angle and depth in a blinded manner. For the mixed group, interobserver agreement was calculated, normal and abnormal ear measurements were compared, and receiver operating characteristic curves were generated. RESULTS The 94 normal ears had a mean second interscalar ridge angle of 80.86° ± 11.4° and depth of 0.54 ± 0.14 mm with the 98th percentile for an angle of 101° and a depth of 0.3 mm. In the mixed group, agreement between the 2 readers was excellent, with significant differences for angle and depth found between normal and incomplete partition type II ears for angle and depth on average (P < .001). Receiver operating characteristic cutoffs for delineating normal from abnormal ears were similar for both readers (depth, 0.31/0.34 mm; angle, 114°/104°). CONCLUSIONS A measured angle of >114° and a depth of the second interscalar ridge notch of ≤0.31 mm suggest the diagnosis of incomplete partition type II malformation and scala communis. These measurements can be accurately made by novice readers.
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Affiliation(s)
- T N Booth
- From the Departments of Radiology (T.N.B., R.C., D.G.)
| | - C Wick
- Otolaryngology (C.W., J.W.K., M.M., B.I.), Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, Dallas, Texas
| | - R Clarke
- From the Departments of Radiology (T.N.B., R.C., D.G.)
| | - J W Kutz
- Otolaryngology (C.W., J.W.K., M.M., B.I.), Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, Dallas, Texas
| | - M Medina
- Otolaryngology (C.W., J.W.K., M.M., B.I.), Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, Dallas, Texas
| | - D Gorsage
- From the Departments of Radiology (T.N.B., R.C., D.G.)
| | - Y Xi
- Department of Radiology (Y.X.), University of Texas Southwestern Medical Center, Dallas, Texas
| | - B Isaacson
- Otolaryngology (C.W., J.W.K., M.M., B.I.), Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, Dallas, Texas
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McArthur N, Rehm A, Shenker N, Richards AJ, McNinch AM, Poulson AV, Tanner J, Snead MP, Bearcroft PWP. Stickler syndrome in children: a radiological review. Clin Radiol 2018; 73:678.e13-678.e18. [PMID: 29661559 DOI: 10.1016/j.crad.2018.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/08/2018] [Indexed: 11/19/2022]
Abstract
AIM To review the radiological findings of the largest cohort to date of paediatric patients with Stickler syndrome, all with confirmed molecular genetic analysis and sub-typing. PATIENTS AND METHODS It is understood that the National Health Service (NHS) commissioned service at Addenbrookes Hospital, Cambridge, UK has the largest cohort of Stickler syndrome patients in the paediatric age group worldwide with 240 registered children. Fifty-nine were assessed radiologically and for their genotypes. These radiographs were reviewed and 74 knee, 45 pelvic, and 47 spinal examinations were evaluated. RESULTS Radiological features were noted in 45.9% of knee radiographs, 11.1% of pelvic radiographs, and 42.6% of spinal radiographs. The findings were reviewed in the light of each patient's specific genetic Stickler syndrome subtype. CONCLUSION The prevalence of orthopaedic abnormalities overall in the present series is substantially below those published in previous smaller case series. This would support the more recent findings of an array of ocular only phenotypes of Stickler syndrome described in the literature.
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Affiliation(s)
- N McArthur
- Department of Orthopaedics, Addenbrookes Hospital, Hills Rd, Cambridge CB2 0QQ, UK.
| | - A Rehm
- Department of Paediatric Orthopaedics, Addenbrookes Hospital, Hills Rd, Cambridge CB2 0QQ, UK
| | - N Shenker
- Department of Rheumatology, Addenbrookes Hospital, Hills Rd, Cambridge CB2 0QQ, UK
| | - A J Richards
- NHS England Stickler Syndrome Diagnostic Service, BOX 153, Cambridge University NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK
| | - A M McNinch
- NHS England Stickler Syndrome Diagnostic Service, BOX 153, Cambridge University NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK
| | - A V Poulson
- NHS England Stickler Syndrome Diagnostic Service, BOX 153, Cambridge University NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK
| | - J Tanner
- Department of Radiology, Addenbrookes Hospital, Hills Rd, Cambridge CB2 0QQ, UK
| | - M P Snead
- NHS England Stickler Syndrome Diagnostic Service, BOX 153, Cambridge University NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK
| | - P W P Bearcroft
- Department of Radiology, Addenbrookes Hospital, Hills Rd, Cambridge CB2 0QQ, UK
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Rasmussen SM, Johansen IR. [Enlarged vestibular aqueduct in a ten-year-old girl]. Ugeskr Laeger 2017; 179:V05170373. [PMID: 29084617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Enlarged vestibular aqueduct (EVA) is a malformation in the inner ear and occurs in approximately 1-12% of the hearing-impaired individuals. A ten-year-old girl was seen at the emergency room (ER) because of sudden hearing loss on the right ear. The patient was known with sudden deafness on the left ear. In the ER she appeared completely deaf. A head CT-scan showed EVA, and she was treated with cochlear implant. This case report illustrates the importance of performing MR- or CT-scan, especially when diagnosing children with sudden hearing loss after a head injury.
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Höhl M, DeTemple D, Lyutenski S, Leuteritz G, Varkentin A, Schmitt HA, Lenarz T, Roth B, Meinhardt-Wollweber M, Morgner U. Optical properties of the human round window membrane. J Biomed Opt 2017; 22:1-7. [PMID: 29076311 DOI: 10.1117/1.jbo.22.10.105007] [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] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 09/26/2017] [Indexed: 06/07/2023]
Abstract
Optical techniques are effective tools for diagnostic applications in medicine and are particularly attractive for the noninvasive analysis of biological tissues and fluids in vivo. Noninvasive examinations of substances via a fiber optic probe need to consider the optical properties of biological tissues obstructing the optical path. This applies to the analysis of the human perilymph, which is located behind the round window membrane. The composition of this inner ear liquid is directly correlated to inner ear hearing loss. In this work, experimental methods for studying the optical properties of the human round window membrane ex vivo are presented. For the first time, a comprehensive investigation of this tissue is performed, including optical transmission, forward scattering, and Raman scattering. The results obtained suggest the application of visible wavelengths (>400 nm) for investigating the perilymph behind the round window membrane in future.
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Affiliation(s)
- Martin Höhl
- Leibniz Universität Hannover, Institut für Quantenoptik, Hannover, Germany
- Leibniz Universität Hannover, Hannoversches Zentrum für Optische Technologien, Hannover, Germany
- Cluster of Excellence "Hearing4all," Oldenburg, Germany
| | - Daphne DeTemple
- Leibniz Universität Hannover, Institut für Quantenoptik, Hannover, Germany
- Leibniz Universität Hannover, Hannoversches Zentrum für Optische Technologien, Hannover, Germany
- Cluster of Excellence "Hearing4all," Oldenburg, Germany
| | - Stefan Lyutenski
- Medizinische Hochschule Hannover, Experimentelle Otorhinolaryngologie, Hannover, Germany
| | - Georg Leuteritz
- Leibniz Universität Hannover, Hannoversches Zentrum für Optische Technologien, Hannover, Germany
| | - Arthur Varkentin
- Leibniz Universität Hannover, Hannoversches Zentrum für Optische Technologien, Hannover, Germany
| | - Heike Andrea Schmitt
- Cluster of Excellence "Hearing4all," Oldenburg, Germany
- Medizinische Hochschule Hannover, Experimentelle Otorhinolaryngologie, Hannover, Germany
| | - Thomas Lenarz
- Cluster of Excellence "Hearing4all," Oldenburg, Germany
- Medizinische Hochschule Hannover, Experimentelle Otorhinolaryngologie, Hannover, Germany
| | - Bernhard Roth
- Leibniz Universität Hannover, Hannoversches Zentrum für Optische Technologien, Hannover, Germany
| | - Merve Meinhardt-Wollweber
- Leibniz Universität Hannover, Institut für Quantenoptik, Hannover, Germany
- Leibniz Universität Hannover, Hannoversches Zentrum für Optische Technologien, Hannover, Germany
- Cluster of Excellence "Hearing4all," Oldenburg, Germany
| | - Uwe Morgner
- Leibniz Universität Hannover, Institut für Quantenoptik, Hannover, Germany
- Leibniz Universität Hannover, Hannoversches Zentrum für Optische Technologien, Hannover, Germany
- Cluster of Excellence "Hearing4all," Oldenburg, Germany
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van Beeck Calkoen EA, Sanchez Aliaga E, Merkus P, Smit CF, van de Kamp JM, Mulder MF, Goverts ST, Hensen EF. High prevalence of abnormalities on CT and MR imaging in children with unilateral sensorineural hearing loss irrespective of age or degree of hearing loss. Int J Pediatr Otorhinolaryngol 2017; 97:185-191. [PMID: 28483233 DOI: 10.1016/j.ijporl.2017.04.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/31/2017] [Accepted: 04/01/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Evaluation of causal abnormalities identified on CT and MR imaging in children with unilateral sensorineural hearing loss (USNHL), and the association with age and severity of hearing loss. STUDY DESIGN Retrospective cohort study. SETTING Tertiary referral otology/audiology center. PATIENTS AND DIAGNOSTIC INTERVENTIONS 102 children diagnosed with USNHL between 2006 and 2016 were included. They underwent CT and/or MR imaging for the evaluation of the etiology of their hearing loss. MAIN OUTCOME MEASURES Radiologic abnormalities of the inner ear and brain associated with USNHL. RESULTS Using CT and/or MR imaging, causal abnormalities were identified in 49%, which is higher than previously reported (25-40%). The most frequently affected site was the labyrinth (29%), followed by the cochlear nerve (9%) and brain (7%). No significant difference in the number or type of abnormalities was found for the degree of hearing loss or age categories. CONCLUSIONS Imaging is essential in the etiologic analysis of USNHL because of the high prevalence of causative abnormalities that can be identified with radiology, irrespective of the patients' age or degree of hearing loss. CT and MR imaging are complementary imaging options. The ideal imaging algorithm is controversial. Based on our findings, we conclude that there is limited additional diagnostic value of simultaneous dual modality imaging over sequential diagnostics. We therefore perform a stepwise radiological workup in order to maximize the diagnostic yield while minimizing impact and costs. If the primary imaging modality does not identify a cause for USNHL, performing the alternative imaging modality should be considered. LEVEL OF EVIDENCE Retrospective cohort study 2b.
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Affiliation(s)
- E A van Beeck Calkoen
- Department of Otolaryngology-Head and Neck Surgery, Section Ear & Hearing VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| | - E Sanchez Aliaga
- Department of Radiology, VU University Medical Center, Amsterdam, The Netherlands
| | - P Merkus
- Department of Otolaryngology-Head and Neck Surgery, Section Ear & Hearing VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| | - C F Smit
- Department of Otolaryngology-Head and Neck Surgery, Section Ear & Hearing VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| | - J M van de Kamp
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
| | - M F Mulder
- Department of Pediatry, VU University Medical Center, Amsterdam, The Netherlands
| | - S T Goverts
- Department of Otolaryngology-Head and Neck Surgery, Section Ear & Hearing VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| | - E F Hensen
- Department of Otolaryngology-Head and Neck Surgery, Section Ear & Hearing VU University Medical Center, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands.
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Ramzan K, Bin-Abbas B, Al-Jomaa L, Allam R, Al-Owain M, Imtiaz F. Two novel LHX3 mutations in patients with combined pituitary hormone deficiency including cervical rigidity and sensorineural hearing loss. BMC Endocr Disord 2017; 17:17. [PMID: 28302169 PMCID: PMC5356396 DOI: 10.1186/s12902-017-0164-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/22/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Congenital combined pituitary hormone deficiency (CPHD) is a rare heterogeneous group of conditions. CPHD-type 3 (CPHD3; MIM# 221750) is caused by recessive mutations in LHX3, a LIM-homeodomain transcription factor gene. The isoforms of LHX3 are critical for pituitary gland formation and specification of the anterior pituitary hormone-secreting cell types. They also play distinct roles in the development of neuroendocrine and auditory systems. CASE PRESENTATION Here, we summarize the clinical, endocrinological, radiological and molecular features of three patients from two unrelated families. Clinical evaluation revealed severe CPHD coupled with cervical vertebral malformations (rigid neck, scoliosis), mild developmental delay and moderate sensorineural hearing loss (SNHL). The patients were diagnosed with CPHD3 based on the array of hormone deficiencies and other associated syndromic symptoms, suggestive of targeted LHX3 gene sequencing. A novel missense mutation c.437G > T (p. Cys146Phe) and a novel nonsense mutation c.466C > T (p. Arg156Ter), both in homozygous forms, were found. The altered Cys146 resides in the LIM2 domain of the encoded protein and is a phylogenetically conserved residue, which mediates LHX3 transcription factor binding with a zinc cation. The p. Arg156Ter is predicted to result in a severely truncated protein, lacking the DNA binding homeodomain. CONCLUSIONS Considering genotype/phenotype correlation, we suggest that the presence of SNHL and limited neck rotation should be considered in the differential diagnosis of CPHD3 to facilitate molecular diagnosis. This report describes the first LHX3 mutations from Saudi patients and highlights the importance of combining molecular diagnosis with the clinical findings. In addition, it also expands the knowledge of LHX3-related CPHD3 phenotype and the allelic spectrum for this gene.
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Affiliation(s)
- Khushnooda Ramzan
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, P.O.Box 3354, Riyadh, 11211 Saudi Arabia
| | - Bassam Bin-Abbas
- Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Lolwa Al-Jomaa
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, P.O.Box 3354, Riyadh, 11211 Saudi Arabia
| | - Rabab Allam
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, P.O.Box 3354, Riyadh, 11211 Saudi Arabia
| | - Mohammed Al-Owain
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Faiqa Imtiaz
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, P.O.Box 3354, Riyadh, 11211 Saudi Arabia
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