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Moberly AC, Pisoni DB, Tamati TN. Audiovisual Processing Skills Before Cochlear Implantation Predict Postoperative Speech Recognition in Adults. Ear Hear 2024; 45:617-625. [PMID: 38143302 PMCID: PMC11025067 DOI: 10.1097/aud.0000000000001450] [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] [Indexed: 12/26/2023]
Abstract
OBJECTIVES Adults with hearing loss (HL) demonstrate greater benefits of adding visual cues to auditory cues (i.e., "visual enhancement" [VE]) during recognition of speech presented in a combined audiovisual (AV) fashion when compared with normal-hearing peers. For patients with moderate-to-profound sensorineural HL who receive cochlear implants (CIs), it is unclear whether the restoration of audibility results in a decrease in the VE provided by visual cues during AV speech recognition. Moreover, it is unclear whether increased VE during the experience of HL before CI is beneficial or maladaptive to ultimate speech recognition abilities after implantation. It is conceivable that greater VE before implantation contributes to the enormous variability in speech recognition outcomes demonstrated among patients with CIs. This study took a longitudinal approach to test two hypotheses: (H1) Adult listeners with HL who receive CIs would demonstrate a decrease in VE after implantation; and (H2) The magnitude of pre-CI VE would predict post-CI auditory-only speech recognition abilities 6 months after implantation, with the direction of that relation supporting a beneficial, redundant, or maladaptive effect on outcomes. DESIGN Data were collected from 30 adults at two time points: immediately before CI surgery and 6 months after device activation. Pre-CI speech recognition performance was measured in auditory-only (A-only), visual-only, and combined AV fashion for City University of New York (CUNY) sentences. Scores of VE during AV sentence recognition were computed. At 6 months after CI activation, participants were again tested on CUNY sentence recognition in the same conditions as pre-CI. H1 was tested by comparing post- versus pre-CI VE scores. At 6 months of CI use, additional open-set speech recognition measures were also obtained in the A-only condition, including isolated words, words in meaningful AzBio sentences, and words in AzBio sentences in multitalker babble. To test H2, correlation analyses were performed to assess the relation between post-CI A-only speech recognition scores and pre-CI VE scores. RESULTS Inconsistent with H1, after CI, participants did not demonstrate a significant decrease in VE scores. Consistent with H2, preoperative VE scores positively predicted postoperative scores of A-only sentence recognition for both sentences in quiet and in babble (rho = 0.40 to 0.45, p < 0.05), supporting a beneficial effect of pre-CI VE on post-CI auditory outcomes. Pre-CI VE was not significantly related to post-CI isolated word recognition. The raw pre-CI CUNY AV scores also predicted post-CI A-only speech recognition scores to a similar degree as VE scores. CONCLUSIONS After implantation, CI users do not demonstrate a decrease in VE from before surgery. The degree of VE during AV speech recognition before CI positively predicts A-only sentence recognition outcomes after implantation, suggesting the potential value of AV testing of CI patients preoperatively to help predict and set expectations for postoperative outcomes.
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Affiliation(s)
- Aaron C. Moberly
- Department of Otolaryngology – Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David B. Pisoni
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA
| | - Terrin N. Tamati
- Department of Otolaryngology – Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- University Medical Center Groningen, University of Groningen, Department of Otorhinolaryngology/Head and Neck Surgery, Groningen, The Netherlands
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Derks LSM, Smit AL, Thomeer HGXM, Topsakal V, Grolman W, Stokroos RJ, Wegner I. Quality of life, hearing results, patient satisfaction and postoperative complications of day-case versus inpatient unilateral cochlear implantation in adults: a randomized controlled, equivalence trial. Eur Arch Otorhinolaryngol 2024; 281:2313-2325. [PMID: 38180606 PMCID: PMC11023990 DOI: 10.1007/s00405-023-08352-8] [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: 08/22/2023] [Accepted: 11/13/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE To investigate the hypothesis that day-case cochlear implantation is associated with equal quality of life, hearing benefits and complications rates, compared to inpatient cochlear implantation. STUDY DESIGN A single-center, non-blinded, randomized controlled, equivalence trial in a tertiary referral center. METHODS Thirty adult patients with post-lingual bilateral sensorineural hearing loss eligible for unilateral cochlear implantation surgery were randomly assigned to either the day-case or inpatient treatment group. The effect on general quality of life, patient satisfaction, (subjective) hearing improvement, postoperative complications and causes of crossover and/or readmission were assessed using questionnaires, auditory evaluations and patients' charts over a follow-up period of 1 year. RESULTS Overall quality of life measured by the HUI3 was equal between the day-case (n = 14) and inpatient group (n = 14). The overall patients' satisfaction showed a slight favor towards an inpatient approach. There was no significant difference in the subjective and objective hearing improvement between both treatment groups. During the 1-year follow-up period no major complications occurred. Minor complications occurred intraoperatively in three day-case patients resulting in three out of nine admissions of day-case patients. Other causes of admission of day-case patients were nausea and vomiting (n = 1), drowsiness (n = 1), late scheduled surgery (n = 2), social reasons (n = 1), or due to an unclear reason (n = 1). No patients required readmission. CONCLUSION We found equal outcomes of QoL, patient satisfaction, objective, and subjective hearing outcomes between day-case and inpatient unilateral cochlear implantation. Nine out of 14 day-case patients were admitted for at least one night postoperatively (crossover). No major complications occurred in both groups. A day-case approach seems feasible when using specific patient selection, surgical planning and the preoperative provision of patient information into account. Besides this, the familiarity with a day-case approach of both patient and the surgical team can increase the feasibility of day-case surgery. LEVEL OF EVIDENCE: 1
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Affiliation(s)
- Laura S M Derks
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Adriana L Smit
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hans G X M Thomeer
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Vedat Topsakal
- University Department Otorhinolaryngology, Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium
| | - Wilko Grolman
- Jean Causse Ear Clinic, Traverse de Béziers, Colombiers, France
| | - Robert J Stokroos
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, G05.129, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inge Wegner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Groningen, Groningen, The Netherlands
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3
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Ahmad JG, Lovin BD, Lee A, Nader ME, Gidley PW. Cochlear Implantation After Head and Neck Radiation: A Case Series, Systematic Review, and Meta-analysis. Otol Neurotol 2024; 45:352-361. [PMID: 38361317 PMCID: PMC10940186 DOI: 10.1097/mao.0000000000004127] [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 determine if cochlear implant (CI) is safe and effective in patients with radiation therapy (XRT)-induced sensorineural hearing loss and to discuss considerations in this population through a retrospective cohort review, systematic review, and meta-analysis. DATABASES REVIEWED PubMed, Cochrane Library, and Embase. METHODS We retrospectively reviewed all CI cases after head and neck (HN) XRT at our institution, noting intraoperative findings, postoperative complications, and hearing outcomes. Change in speech discrimination scores (SDSs) was the primary outcome measure. Systematic review was performed to identify all cases of CI after HNXRT. A meta-analysis was performed to assess SDS change. RESULTS The retrospective cohort review identified 12 patients who underwent CI after HNXRT. One patient with HN cancer (HNC) and one with central nervous system pathology (CNSP) received bilateral implants. Six had HNC, three had CNSP, and one had Langerhans cell histiocytosis. Eleven had abnormal findings during CI. There were no postoperative complications. Twenty articles with an additional 97 patients were suitable for systematic review inclusion. Of the 109 patients, 67 (61.5%) had HNC and 18 (16.5%) had CNSP. Abnormal intraoperative findings were common (30.3%), most frequently in the mastoid (66.7%). Postoperative complications, including wound dehiscence and infection with some requiring explantation, occurred in 10.1% of patients. Sixty-six patients were included in the meta-analysis. All demonstrated SDS improvement (mean increase, 56.2%). CONCLUSION Patients with prior HNXRT benefit from CI. Paying careful attention to surgical planning and technique, postoperative care, and patient expectations is imperative, as complications are not uncommon.
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Affiliation(s)
- Jumah G. Ahmad
- Department of Otorhinolaryngology – Head and Neck Surgery, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Benjamin D. Lovin
- Department of Otolaryngology – Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Anna Lee
- Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marc-Elie Nader
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Paul W. Gidley
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Swords C, Ghedia R, Blanchford H, Arwyn–Jones J, Heward E, Milinis K, Hardman J, Smith ME, Bance M, Muzaffar J. Socioeconomic and ethnic disparities associated with access to cochlear implantation for severe-to-profound hearing loss: A multicentre observational study of UK adults. PLoS Med 2024; 21:e1004296. [PMID: 38573882 PMCID: PMC10994380 DOI: 10.1371/journal.pmed.1004296] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 02/08/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Patients with severe-to-profound hearing loss may benefit from management with cochlear implants. These patients need a referral to a cochlear implant team for further assessment and possible surgery. The referral pathway may result in varied access to hearing healthcare. This study aimed to explore referral patterns and whether there were any socioeconomic or ethnic associations with the likelihood of referral. The primary outcome was to determine factors influencing referral for implant assessment. The secondary outcome was to identify factors impacting whether healthcare professionals had discussed the option of referral. METHODS AND FINDINGS A multicentre multidisciplinary observational study was conducted in secondary care Otolaryngology and Audiology units in Great Britain. Adults fulfilling NICE (2019) audiometric criteria for implant assessment were identified over a 6-month period between 1 July and 31 December 2021. Patient- and site-specific characteristics were extracted. Multivariable binary logistic regression was employed to compare a range of factors influencing the likelihood of implant discussion and referral including patient-specific (demographics, past medical history, and degree of hearing loss) and site-specific factors (cochlear implant champion and whether the hospital performed implants). Hospitals across all 4 devolved nations of the UK were invited to participate, with data submitted from 36 urban hospitals across England, Scotland, and Wales. Nine hospitals (25%) conducted cochlear implant assessments. The majority of patients lived in England (n = 5,587, 86.2%); the rest lived in Wales (n = 419, 6.5%) and Scotland (n = 233, 3.6%). The mean patient age was 72 ± 19 years (mean ± standard deviation); 54% were male, and 75·3% of participants were white, 6·3% were Asian, 1·5% were black, 0·05% were mixed, and 4·6% were self-defined as a different ethnicity. Of 6,482 submitted patients meeting pure tone audiometric thresholds for cochlear implantation, 311 already had a cochlear implant. Of the remaining 6,171, 35.7% were informed they were eligible for an implant, but only 9.7% were referred for assessment. When adjusted for site- and patient-specific factors, stand-out findings included that adults were less likely to be referred if they lived in more deprived area decile within Indices of Multiple Deprivation (4th (odds ratio (OR): 2·19; 95% confidence interval (CI): [1·31, 3·66]; p = 0·002), 5th (2·02; [1·21, 3·38]; p = 0·05), 6th (2·32; [1·41, 3·83]; p = 0.05), and 8th (2·07; [1·25, 3·42]; p = 0·004)), lived in London (0·40; [0·29, 0·57]; p < 0·001), were male (females 1·52; [1·27, 1·81]; p < 0·001), or were older (0·97; [0·96, 0·97]; p < 0·001). They were less likely to be informed of their potential eligibility if they lived in more deprived areas (4th (1·99; [1·49, 2·66]; p < 0·001), 5th (1·75; [1·31, 2·33], p < 0·001), 6th (1·85; [1·39, 2·45]; p < 0·001), 7th (1·66; [1·25, 2·21]; p < 0·001), and 8th (1·74; [1·31, 2·31]; p < 0·001) deciles), the North of England or London (North 0·74; [0·62, 0·89]; p = 0·001; London 0·44; [0·35, 0·56]; p < 0·001), were of Asian or black ethnic backgrounds compared to white patients (Asian 0·58; [0·43, 0·79]; p < 0·001; black 0·56; [0·34, 0·92]; p = 0·021), were male (females 1·46; [1·31, 1·62]; p < 0·001), or were older (0·98; [0·98, 0·98]; p < 0·001). The study methodology was limited by its observational nature, reliance on accurate documentation of the referring service, and potential underrepresentation of certain demographic groups. CONCLUSIONS The majority of adults meeting pure tone audiometric threshold criteria for cochlear implantation are currently not appropriately referred for assessment. There is scope to target underrepresented patient groups to improve referral rates. Future research should engage stakeholders to explore the reasons behind the disparities. Implementing straightforward measures, such as educational initiatives and automated pop-up tools for immediate identification, can help streamline the referral process.
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Affiliation(s)
- Chloe Swords
- Cambridge Hearing Group, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- INTEGRATE (The Otolaryngology Trainee Research Network), United Kingdom
| | - Reshma Ghedia
- INTEGRATE (The Otolaryngology Trainee Research Network), United Kingdom
- Royal National ENT and Eastman Dental Hospitals, London, United Kingdom
| | - Hannah Blanchford
- INTEGRATE (The Otolaryngology Trainee Research Network), United Kingdom
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - James Arwyn–Jones
- INTEGRATE (The Otolaryngology Trainee Research Network), United Kingdom
- Charing Cross Hospital, London, United Kingdom
| | - Elliot Heward
- INTEGRATE (The Otolaryngology Trainee Research Network), United Kingdom
- Wythenshawe Hospital, Manchester, United Kingdom
| | - Kristijonas Milinis
- INTEGRATE (The Otolaryngology Trainee Research Network), United Kingdom
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom
| | - John Hardman
- INTEGRATE (The Otolaryngology Trainee Research Network), United Kingdom
- Royal Marsden Hospital, Fulham Road, London, United Kingdom
| | - Matthew E. Smith
- Cambridge Hearing Group, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Manohar Bance
- Cambridge Hearing Group, University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Jameel Muzaffar
- Cambridge Hearing Group, University of Cambridge, Cambridge, United Kingdom
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Job K, Wiatr A, Skladzien J, Wiatr M. The Audiometric Assessment of the Effectiveness of Surgical Treatment of Otosclerosis Depending on the Preoperative Incidence of Carhart's Notch. Ear Nose Throat J 2024; 103:241-247. [PMID: 34633243 DOI: 10.1177/01455613211043685] [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: 11/15/2022] Open
Abstract
Objective: The presence of Carhart's notch at 2000 Hz in otosclerosis links the changed bone conduction for this frequency with the otosclerotic process occurring in the oval window. The aim of this study is to perform an audiometric assessment of the effectiveness of surgical treatment of otosclerosis depending on the incidence of Carhart's notch. Methods: The analysis included 116 patients treated surgically for the first time due to otosclerosis. Patients were divided into 4 groups depending on the occurrence of Carhart's notch, determined by pure-tone audiometry (PTA) before the surgery and 36 months afterward. The mean value of bone conduction thresholds was calculated for 500 Hz, 1000 Hz, 2000 Hz, and 3000 Hz in the groups in which the Cahart's notch was observed. This value of bone conduction (BC) was a reference point for further analysis in patients who had no preoperative or postoperative Carhart's notch. Results: The analysis indicated that Cahart's notch in preoperative PTA is a statistically significant improvement factor for average BC. It was found that over a longer observation period, the presence of Carhart's notch has adverse effects on the size of the postoperative air-bone gap, and consequently on hearing improvement after surgical treatment. A comparison between patients from the two groups without preoperative Carhart's notch found that no beneficial effects of the surgery on speech comprehension were observed regarding high-level sensorineural hearing loss (SNHL). Conclusions: (1) In a long-term observation post-stapedotomy, average BC values were found to improve. Nevertheless, the improvement is less evident in patients with preoperative Carhart's notch. (2) Disappearance of Cahart's notch after surgical treatment of otosclerosis is a good prognosis of improvement in speech audiometry. (3) Deep SNHL in the absence of Carhart's notch in PTA constitutes a bad prognostic factor for improvement in speech audiometry in patients qualified for surgical treatment of otosclerosis.
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Affiliation(s)
- Katarzyna Job
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Krakow, Poland
| | - Agnieszka Wiatr
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Krakow, Poland
| | - Jacek Skladzien
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Krakow, Poland
| | - Maciej Wiatr
- Department of Otolaryngology, Jagiellonian University Medical College in Kraków, Krakow, Poland
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Wu YL, Chen L, Zhu HY, Luo WY, Shi K, Hou XY, Sun JW, Sun JQ, Guo XT. Relationships between bilateral auditory brainstem activity and inter-implant interval in children with cochlear implants. Eur Arch Otorhinolaryngol 2024; 281:1735-1743. [PMID: 37924365 DOI: 10.1007/s00405-023-08285-2] [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: 07/03/2023] [Accepted: 10/09/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE To investigate the effect of the interval between bilateral cochlear implantation on the development of bilateral peripheral auditory pathways as revealed by the electrically evoked auditory brainstem response (EABR). METHODS Fifty-eight children with profound bilateral sensorineural hearing loss were recruited. Among them, 33 children received sequential bilateral cochlear implants (CIs), and 25 children received simultaneous bilateral CIs. The bilateral EABRs evoked by electrical stimulation from the CI electrode were recorded on the day of second-side CI activation. RESULTS The latencies of wave III (eIII) and wave V (eV) were significantly shorter on the first CI side than on the second CI side in children with sequential bilateral CIs but were similar between the two sides in children with simultaneous bilateral CIs. Furthermore, the latencies were prolonged from apical to basal channels along the cochlea in the two groups. In children with sequential CIs, the inter-implant interval was negatively correlated with the eV latency on the first CI side and was positively correlated with bilateral differences in the eIII and eV latencies. CONCLUSIONS Unilateral CI use promotes the maturation of ipsilateral auditory conduction function. However, a longer inter-implant interval results in more unbalanced development of bilateral auditory brainstem pathways. Bilateral cochlear implantation with no or a short interval is recommended.
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Affiliation(s)
- Yan-Lin Wu
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Li Chen
- Department of Otolaryngology-Head and Neck Surgery, The Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai, 519100, Guangdong, China
| | - Han-Yu Zhu
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Wen-Yun Luo
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Kai Shi
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Xiao-Yan Hou
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Jing-Wu Sun
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
| | - Jia-Qiang Sun
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
| | - Xiao-Tao Guo
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
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Zhan KY, Mazul A, Kallogjeri DL, Buchman CA. Use of Diagnostic Audiology and Cochlear Implantation in the US. JAMA Otolaryngol Head Neck Surg 2024; 150:353-354. [PMID: 38386348 PMCID: PMC10884948 DOI: 10.1001/jamaoto.2023.4738] [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: 09/26/2023] [Accepted: 12/29/2023] [Indexed: 02/23/2024]
Abstract
This study examined if cochlear implant (CI) use varies geographically within the US and if diagnostic audiology use correlates with CI usage.
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Affiliation(s)
- Kevin Y. Zhan
- Department of Otolaryngology–Head & Neck Surgery, Division of Otology & Neurotology, Northwestern Medicine, Chicago, Illinois
- Department of Otolaryngology–Head & Neck Surgery, Washington University in St Louis, St Louis, Missouri
| | - Angela Mazul
- Department of Otolaryngology–Head & Neck Surgery, University of Pittsburgh Hillman Cancer Center, Pittsburgh, Pennsylvania
- Department of Otolaryngology–Head & Neck Surgery, Washington University in St Louis, St Louis, Missouri
| | - Dorina L. Kallogjeri
- Department of Otolaryngology–Head & Neck Surgery, Washington University in St Louis, St Louis, Missouri
| | - Craig A. Buchman
- Department of Otolaryngology–Head & Neck Surgery, Washington University in St Louis, St Louis, Missouri
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Mahrous MM, El-Khattib YA. The challenge of a mature final diagnosis of hearing loss severity and early cochlear implantation. Eur Arch Otorhinolaryngol 2024; 281:2011-2022. [PMID: 38191746 DOI: 10.1007/s00405-023-08439-2] [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: 10/04/2023] [Accepted: 12/26/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE Despite the recent trend of cochlear implantation (CI) at the age of six or even four months is prevalent in many centers around the world, clinicians should be cautious because perinatal risk factors of auditory neuropathy and/or delayed maturation carry the possibility of reversible hearing loss, yielding better auditory performance at the age of one year. The purpose of this study is to raise awareness that early CI may not be universal for all patients. In addition, we specify the factors to be considered in the pre-operative evaluation of CI in infants younger than one year. METHODS AND RESULTS This study describes four cases provisionally diagnosed with severe to profound sensorineural hearing loss that were presented to the CI clinic to determine candidacy for implantation. Two cases had histories of prematurity, one had Down syndrome, and one had a family history of hearing loss. None of the study cases were candidates for CI, as they had varying degrees of hearing improvement. CONCLUSION Although early CI may yield better auditory performance, the final diagnosis should be made only after repeated subjective and objective measurements as well as family feedback on the child's auditory performance, especially in preterm children. Early auditory brainstem response (ABR) prior to the age of one year in children with cognitive, neurologic, or developmental comorbidities should be interpreted with caution, as ABR "alone" could not accurately represent the child's true hearing ability in this patient population.
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Affiliation(s)
- Mahmoud M Mahrous
- Audio-Vestibular Medicine Unit, Otorhinolaryngology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
- Audio-Vestibular Medicine Unit, Otorhinolaryngology Department, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Yomna A El-Khattib
- Physiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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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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10
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Riaz I, Rashid A, Majeed A. Demographic analysis of hearing impairment based on various parameters in patients with cochlear implant. J PAK MED ASSOC 2024; 74:476-479. [PMID: 38591281 DOI: 10.47391/jpma.8708] [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: 04/10/2024]
Abstract
Objectives To analyse the demographic and clinical variables in children having undergone cochlear implant surgery because of deafness. METHODS The cross-sectional study was conducted from January to November 2022 at the Centre for Research in Experimental and Applied Medicine laboratory of the Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan, in collaboration with the Ear, Nose and Throat Department of Combined Military Hospital, Rawalpindi, and comprised children of eith gender aged up to 10 years who had received cochlear implant. Data was collected through questionnaire-based detailed interviews. Syndromic Hearing Loss, Non-Syndromic Hearing Loss, and Acquired Hearing Loss were identified among the subjects. Data was analysed using SPSS 22. RESULTS Of the 250 cases, 147(58.8%) were boys, 146(58.4%) were aged 0-5 years, 219(87.6%) had prelingual onset of disease, and 202(80.8%) had a non-progressive disease course. In 203(81.2%) cases, normal developmental milestones were seen. Parental consanguinity was observed in 219(87.6%) cases. However, 63(25.2%) patients had a first-degree relative who had a history of deafness. In 170(68%) cases, hearing loss was hereditary, whereas in 80(32%) it was acquired. Meningitis was the most commonly identified risk factor 55(68.75%). Acquired risk factors and family history had significant association with hearing loss (p<0.05). Speech perception significantly improved in all 219(100%) patients with prelingual hearing loss who underwent cochlear implantation. CONCLUSIONS Majority of the cases were found to be male, had a prelingual disease onset and a non-progressive disease course. Family history was a significant factor, while meningitis was the most common acquired cause of hearing loss.
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Affiliation(s)
- Isma Riaz
- Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan
| | - Amir Rashid
- Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan
| | - Asifa Majeed
- Department of Biochemistry and Molecular Biology, Army Medical College, Rawalpindi, Pakistan
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11
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Wang B, Guo X, Wei C, Cao K. Preoperative EABR evaluation of auditory pathway integrity in patients with different etiology and postoperative effect estimation. Eur Arch Otorhinolaryngol 2024; 281:1185-1193. [PMID: 37615702 DOI: 10.1007/s00405-023-08198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES To evaluate the effect of electrical auditory brainstem response (EABR) on the integrity evaluation of auditory pathway and the prediction of postoperative effect of cochlear implantation in patients with different etiology of hearing loss. METHODS A total of 580 patients with neuropathic deafness who underwent cochlear implantation surgery from August 2011 to December 2020 were selected for EABR test. The preoperative EABR waveform was analyzed, and parameters such as V wave amplitude, threshold, latency and interval of each wave, and slope of V wave I/O curve were measured. Neural response telemetry (NRT) test was performed during MAP 1 month after operation, and C and T values of the machine were recorded. RESULTS The total EABR extraction rate was 98.45% among 580 patients, including 100% for the normal structure group and enlarged vestibular aqueduct group (LVAS), 92.44% for other malformed group. The average threshold of V wave in patients with normal cochlear structure was significantly better than the malformation groups (p < 0.05). The total extraction rate of NRT was 78.62%, including 99.72% in the group with normal structure, 95.65% in the LVAS group, 1.85-88.24% in the group with other malformations, and 0% in the cochlear ossification group. The correlation analysis showed a statistically significant correlation between the average preoperative EABR threshold and the C value of NRT. CONCLUSIONS Preoperative EABR could evaluate the integrity of auditory conduction pathway of patients with cochlear implantation and predict the postoperative hearing rehabilitation effect.
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Affiliation(s)
- Bin Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Xiaohui Guo
- Department of Ophthalmology, the Third Medical Center of PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Chaogang Wei
- Department of Otolaryngology-Head and Neck Surgery, Peking University First Hospital, No. 8 Xishku Street, Xicheng District, 100034, Beijing, China
| | - Keli Cao
- Department of Otolaryngology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, 100730, Beijing, China.
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12
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Xiao Q, Wu Q, Zhang Q, He J, Liu Y, Shen J, Lv J, Duan M, Lopez-Escamez JA, Yang J, Zhang Q. Treatment of Meniere's disease with simultaneous triple semicircular canal occlusion and cochlear implantation. Eur Arch Otorhinolaryngol 2024; 281:1603-1608. [PMID: 38150022 DOI: 10.1007/s00405-023-08387-x] [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: 07/08/2023] [Accepted: 11/30/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE Report three cases of simultaneous triple semicircular canal occlusion (TSCO) and cochlear implantation (CI) as the treatment of intractable Meniere's disease (MD). CASE REPORTS Patients with MD can present occasionally with intractable vertigo and profound sensorineural hearing loss (SNHL). TSCO and CI have been proposed to control vertigo and restore profound deafness in patients with MD separately. However, a few studies have reported simultaneous TSCO and CI in the same surgical procedure for the treatment of MD. In the present study, we described three patients with MD showing incapacitating vertigo and severe SNHL who underwent simultaneous TSCO and CI after examinations of auditory system, vestibular system, and imaging. Their symptoms were significantly alleviated during the follow-up period. CONCLUSION The combined TSCO and CI remains a viable treatment option which is effective for the control of vertigo as well as the restoring of hearing in patients with MD.
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Affiliation(s)
- Qianwen Xiao
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
- Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai 411 Hospital, China RongTong Medical Healthcare Group Co. Ltd., Shanghai, China
| | - Qiong Wu
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Qin Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jingchun He
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Yupeng Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jiali Shen
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Jingrong Lv
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China
| | - Maoli Duan
- Department of Otolaryngology-Head and Neck Surgery, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - Jose A Lopez-Escamez
- Meniere's Disease Neuroscience Research Program, Faculty of Medicine and Health, School of Medical Sciences, The Kolling Institute, University of Sydney, Sydney, NSW, Australia.
- Otology and Neurotology Group CTS495, Department of Genomic Medicine, Centre for Genomics and Oncology Research, Pfizer/Universidad de Granada/Junta de Andalucía (GENyO), PTS, Granada, Spain.
- Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria Ibs. GRANADA, Universidad de Granada, Granada, Spain.
| | - Jun Yang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China.
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
| | - Qing Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
- Shanghai Jiaotong University School of Medicine Ear Institute, Shanghai, China.
- Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
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13
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Zagabathuni A, Padi KK, Kameswaran M, Subramani K. Development of Automated Tool for Electrode Array Insertion and its Study on Intracochlear Pressure. Laryngoscope 2024; 134:1388-1395. [PMID: 37584398 DOI: 10.1002/lary.30966] [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: 11/10/2022] [Revised: 06/05/2023] [Accepted: 07/14/2023] [Indexed: 08/17/2023]
Abstract
Cochlear implantation is the most successful approach for people with profound sensorineural hearing loss. Manual insertion of the electrode array may result in damaging the soft tissue structures and basilar membrane. An automated electrode array insertion device is reported to be less traumatic in cochlear implant surgery. OBJECTIVES The present work develops a simple, reliable, and compact device for automatically inserting the electrode array during cochlear implantation and test the device to observe intracochlear pressure during simulated electrode insertion. METHODS The device actuates the electrode array by a roller mechanism. For testing the automated device, a straight cochlea having the dimension of the scala tympani and a model electrode is developed using a 3D printer. A pressure sensor is utilized to observe the pressure change at different insertional conditions. RESULTS The electrode is inserted into a prototype cochlea at different speeds without any pause, and it is noticed that the pressure is increased with the depth of insertion of the electrode irrespective of the speed of electrode insertion. The rate of pressure change is observed to be increased exponentially with the speed of insertion. CONCLUSION At an insertion speed of 0.15 mm/s, the peak pressure is observed to be 133 Pa, which can be further evaluated in anatomical models for clinical scenarios. LEVEL OF EVIDENCE N/A Laryngoscope, 134:1388-1395, 2024.
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Affiliation(s)
- Aparna Zagabathuni
- School of Materials Science and Engineering, National Institute of Technology Calicut, Calicut, India
| | - Kishore Kumar Padi
- Department of Mechanical Engineering, Indian Institute of Technology Guwahati, Guwahati, India
| | | | - Kanagaraj Subramani
- Department of Mechanical Engineering, Indian Institute of Technology Guwahati, Guwahati, India
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14
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Homans NC, van der Toom HFE, Pauw RJ, Vroegop JL. Pilot study of a multidisciplinary single-day cochlear implant selection protocol. Am J Otolaryngol 2024; 45:104190. [PMID: 38101132 DOI: 10.1016/j.amjoto.2023.104190] [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: 10/31/2023] [Accepted: 12/09/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE This study aimed to explore and introduce the potential of a MSCS (Multidisciplinary Single-day Cochlear Implant Selection) protocol. The primary objectives of this pilot were to reduce the duration between referral and surgery, minimize hospital visits and decrease the time healthcare professionals dedicate to the cochlear implant (CI) selection process. MATERIALS AND METHODS We established a pilot program at the CI center of the Erasmus MC, a tertiary referral center in the Netherlands, with the goal of improving and shorten the selection process. We evaluated our pilot, including 15 CI candidates, and conducted a retrospective analysis for time and cost savings. RESULTS The results showed that the pilot of the MSCS protocol significantly reduced the length of the CI selection phase (84 days vs 1; standard intake vs MSCS protocol) and the number of hospital visits (6 vs 2 visits; standard vs MSCS protocol), resulting in less travel time and lower costs for the CI candidates. The total time of professionals spend on patients was also reduced with 27 %. CONCLUSION This study highlights the potential benefits of the MSCS protocol in terms of reducing the burden on patients and healthcare providers and improving the efficiency of the CI selection process.
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Affiliation(s)
- Nienke C Homans
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, the Netherlands.
| | - Hylke F E van der Toom
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, the Netherlands
| | - Robert J Pauw
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, the Netherlands
| | - Jantien L Vroegop
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, the Netherlands
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15
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Quinlan BP, Africa RE, McKinnon BJ. Familial psychosocial impact of cochlear implantation. Am J Otolaryngol 2024; 45:104137. [PMID: 38101134 DOI: 10.1016/j.amjoto.2023.104137] [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: 09/25/2023] [Accepted: 12/02/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Adult cochlear implantation rates are increasing, and the resulting change in hearing capabilities has vast impacts in the psychosocial domain of life for the cochlear implant users and their families. However, there is currently no published evidence synthesis of the ways in which adult cochlear implantation affects the psychosocial sphere of the family unit. OBJECTIVE (1) Describe the existing literature on the psychosocial impact of cochlear implantation on adults. (2) Assess the range of impacts on the family unit and highlight areas warranting further investigation. DATA SOURCES Ovid, CINAHL, and Scopus. REVIEW METHODS Databases were systematically searched from January 1, 2007 to May 1, 2022. Eligibility assessment was performed via two independent investigators. Disagreements in selection were discussed and consulted on with a third investigator as needed. RESULTS Of the 875 unique articles identified, 13 remained in the final review. The most frequently noted psychosocial impacts on the family was quality of life (100 %), family relations (85 %), conversational access (85 %), everyday hearing (77 %), and less feelings of isolation (77 %). 6 of the studies only considered the viewpoint of the CI user and did not have a congruent survey response from an individual from their family unit. CONCLUSION This study describes the existing literature on the familial psychosocial impact of adult cochlear implantation, focusing on the general well-being, social integration, and psychological aspects noted post-implantation. This review identifies gaps in this research, with large numbers of studies on CI user benefits and little insight into the impact on the family unit. We recommend shifting research on CI impact toward a focus on the family unit, rather than individual, and an evaluation of familial influence in electing to receive a CI.
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Affiliation(s)
- Brian P Quinlan
- School of Medicine, University of Texas Medical Branch at Galveston, TX, United States of America.
| | - Robert E Africa
- Department of Otolaryngology, University of Texas Medical Branch at Galveston, TX, United States of America
| | - Brian J McKinnon
- Department of Otolaryngology, University of Texas Medical Branch at Galveston, TX, United States of America
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16
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Zeitler DM, Prentiss SM, Sydlowski SA, Dunn CC. American Cochlear Implant Alliance Task Force: Recommendations for Determining Cochlear Implant Candidacy in Adults. Laryngoscope 2024; 134 Suppl 3:S1-S14. [PMID: 37435829 PMCID: PMC10914083 DOI: 10.1002/lary.30879] [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: 09/30/2022] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 07/13/2023]
Abstract
The indications for cochlear implantation have expanded over time due to evidence demonstrating identification and implantation of appropriate cochlear implant (CI) candidates lead to significant improvements in speech recognition and quality of life (QoL). However, clinical practice is variable, with some providers using outdated criteria and others exceeding current labeled indications. As a results, only a fraction of those persons who could benefit from CI technology receive it. This document summarizes the current evidence for determining appropriate referrals for adults with bilateral hearing loss into CI centers for formal evaluation by stressing the importance of treating each ear individually and a "revised 60/60 rule". By mirroring contemporary clinical practice and available evidence, these recommendations will also provide a standardized testing protocol for CI candidates using a team-based approach that prioritizes individualized patient care. This manuscript was developed by the Adult Cochlear Implantation Candidacy Task Force of the American Cochlear Implant Alliance using review of the existing literature and clinical consensus. LEVEL OF EVIDENCE: N/A Laryngoscope, 134:S1-S14, 2024.
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Affiliation(s)
- Daniel M. Zeitler
- Listen for Life Center, Department of Otolaryngology-Head and Neck Surgery, Virginia Mason Medical Center, Seattle, WA
| | - Sandra M. Prentiss
- Department of Otolaryngology-Head and Neck Surgery, University of Miami, Miami, FL
| | | | - Camille C. Dunn
- The University of Iowa Cochlear Implant Clinical Research Center, Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA
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17
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Minami S, Takahashi M, Shinden S, Shirai K, Oishi N, Nishimura H, Masuda M, Masuda S, Nishiyama T, Hosoya M, Ueno M, Kashio A, Yamada H, Matsunaga T, Kaga K, Shintani A, Nemoto K. Prediction of Cochlear Implant Effectiveness With Surface-Based Morphometry. Otol Neurotol 2024; 45:114-120. [PMID: 38082456 DOI: 10.1097/mao.0000000000004070] [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: 01/12/2024]
Abstract
OBJECTIVE This study aimed to determine whether surface-based morphometry of preoperative whole-brain three-dimensional T1-weighted magnetic resonance imaging (MRI) images can predict the clinical outcomes of cochlear implantation. STUDY DESIGN This was an observational, multicenter study using preoperative MRI data. SETTING The study was conducted at tertiary care referral centers. PATIENTS Sixty-four patients with severe to profound hearing loss (≥70 dB bilaterally), who were scheduled for cochlear implant (CI) surgery, were enrolled. The patients included 19 with congenital hearing loss and 45 with acquired hearing loss. INTERVENTIONS Participants underwent CI surgery. Before surgery, high-resolution three-dimensional T1-weighted brain MRI was performed, and the images were analyzed using FreeSurfer. MAIN OUTCOME MEASURES The primary outcome was monosyllable audibility under quiet conditions 6 months after surgery. Cortical thickness residuals within 34 regions of interest (ROIs) as per the Desikan-Killiany cortical atlas were calculated based on age and healthy-hearing control regression lines. RESULTS Rank logistic regression analysis detected significant associations between CI effectiveness and five right hemisphere ROIs and five left hemisphere ROIs. Predictive modeling using the cortical thickness of the right entorhinal cortex and left medial orbitofrontal cortex revealed a significant correlation with speech discrimination ability. This correlation was higher in patients with acquired hearing loss than in those with congenital hearing loss. CONCLUSIONS Preoperative surface-based morphometry could potentially predict CI outcomes and assist in patient selection and clinical decision making. However, further research with larger, more diverse samples is necessary to confirm these findings and determine their generalizability.
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Affiliation(s)
| | - Masahiro Takahashi
- Department of Otolaryngology, Mita Hospital, International University of Health and Welfare, Tokyo
| | - Seiichi Shinden
- Department of Otolaryngology, Saiseikai Utsunomiya Hospital, Tochigi
| | - Kyoko Shirai
- Department of Otolaryngology, Head and Neck Surgery, Tokyo Medical University
| | - Naoki Oishi
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Keio University, Tokyo
| | | | - Masatsugu Masuda
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Kyorin University, Tokyo
| | - Sawako Masuda
- Department of Otorhinolaryngology, NHO Mie National Hospital, Mie
| | - Takanori Nishiyama
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Keio University, Tokyo
| | - Makoto Hosoya
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Keio University, Tokyo
| | - Masafumi Ueno
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Keio University, Tokyo
| | - Akinori Kashio
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, The University of Tokyo, Tokyo
| | | | | | - Kimitaka Kaga
- Department of Otolaryngology, NHO Tokyo Medical Center
| | - Ayumi Shintani
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka
| | - Kiyotaka Nemoto
- Department of Psychiatry, Institute of Medicine, University of Tsukuba, Ibaraki, Japan
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18
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Gülşen S, Çıkrıkcı S. Cochlear implantation in Bjornstad syndrome: a case series with literature review. Eur Arch Otorhinolaryngol 2024; 281:1047-1052. [PMID: 37816838 DOI: 10.1007/s00405-023-08265-6] [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: 07/23/2023] [Accepted: 09/25/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND To report the presentation, diagnostic process, management and results of cochlear implantation of patients diagnosed with Bjornstad syndrome with profound sensorineural hearing loss (SNHL). CASE PRESENTATION AND MANAGEMENT A retrospective report of two siblings with Bjornstad syndrome suffering profound SNHL unresponsive to conventional hearing aids treated with bilateral simultaneous cochlear implantation. SETTING Tertiary-referral center. RESULTS Cochlear implant surgeries of two siblings (four ears) with profound SNHL and bilateral inner ear anomaly (incomplete partition type 1) were performed without complications. Postoperative audiometric measurements showed a significiant improvement in pure-tone threshold and a word recognition score. In the literature review, no previous case of Bjornstad syndrome treated with cochlear implantation has been reported. CONCLUSIONS Cochlear implantation is an effective, safe, and ultimate treatment option for Bjornstad syndrome with profound SNHL not responding to hearing aids.
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Affiliation(s)
- Secaattin Gülşen
- Department of Otolaryngology, Head and Neck Surgery, Dr Ersin Arslan Training and Research Hospital, Eyüpoğlu Mah. Hürriyet Cad. No: 40, Şahinbey, Gaziantep, Turkey
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19
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Tercyak S, Evans Z, Nahas G, Behzadpour H, Preciado D, Reilly B. Pediatric cochlear implantation: Early surgical intervention and parental quality of life. Int J Pediatr Otorhinolaryngol 2024; 177:111867. [PMID: 38290273 DOI: 10.1016/j.ijporl.2024.111867] [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: 11/06/2023] [Revised: 12/18/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVES Pediatric cochlear implantation (CI) provides sound perception to children with significant sensorineural hearing loss and, despite its challenging process, early implantation can enhance children's speech/language outcomes and potentially improve parental quality of life (PQoL). This study aims to examine parental perspectives on quality of life and parenting children with CI. METHODS This study combined retrospective chart review and parent reported outcomes. Data were abstracted from medical charts of 85 children who underwent CI between 2016 and 2022 at a tertiary pediatric hospital. Parents were administered the Acceptance and Action Questionnaire (AAQ-MCHL), an 8-item self-report assessment of quality of life for parents of children with CI. Multivariate linear regression analyses examined clinical factors associated with PQoL scores. RESULTS Parents whose children were implanted at less than two years of age reported significantly higher PQoL, indicated by lower AAQ scores, with a mean AAQ-MCHL of 7.6 + 5.7. In contrast, implantation at age >2 years yielded a mean AAQ-MCHL of 16.2 + 9.6. Parents interviewed within one year post-surgery reported lower PQoL, with a mean AAQ-MCHL of 12.3 + 8.8 compared to those interviewed after one year, with 20.5 + 10.4. CONCLUSION Early identification of profound hearing loss in children, coupled with early surgical CI, may be associated with higher parental quality of life. The beneficial outcomes appear to be potentiated over time. Further research is essential to fully comprehend the impact of CI on the quality of life of children and their parents.
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Affiliation(s)
- Samuel Tercyak
- Department of Otolaryngology, Children's National Hospital, United States
| | - Zoe Evans
- Department of Otolaryngology, Children's National Hospital, United States
| | - Gabriel Nahas
- Department of Otolaryngology, Children's National Hospital, United States
| | | | - Diego Preciado
- Department of Otolaryngology, Children's National Hospital, United States
| | - Brian Reilly
- Department of Otolaryngology, Children's National Hospital, United States.
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Sahara T, Kashio A, Kamogashira T, Ogata E, Akamatsu Y, Yamasoba T. Cochlear implantation for progressive hearing loss caused by an A8296G mutation in mitochondrial DNA. Auris Nasus Larynx 2024; 51:82-85. [PMID: 37573175 DOI: 10.1016/j.anl.2023.07.007] [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: 12/17/2022] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/14/2023]
Abstract
Mitochondrial DNA mutations such as A3243G or A1555G are widely reported to cause hearing loss, but few reports exist on the A8296G mutation, which can also cause hearing loss. This report presents the case of a patient with the A8296G mutation and severe bilateral sensorineural hearing loss (SNHL) that progressed over two decades. The patient had no history of diabetes, but did have a family history of SNHL in her father and maternal grandmother. She was first diagnosed with SNHL at 45 years of age, and an A8296G mutation was found. The hearing threshold in the low-frequency range of the right ear was preserved at diagnosis, but eventually declined resulting in severe bilateral hearing loss by the age of 66 years, and cochlear implantation (CI) was performed in the left ear. The hearing threshold three months after CI was 25-45 dB HL, and the phoneme speech discrimination score in the left ear improved from 20% without CI to 74% with CI. SNHL patients with the A8295G mutation are good candidates for treatment with CI.
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Affiliation(s)
- Toshihito Sahara
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Akinori Kashio
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Teru Kamogashira
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Erika Ogata
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yusuke Akamatsu
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
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21
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An P, Gao Y, Lou L, Zhao Y. Cochlear implantation for syphilis-associated sensorineural hearing loss. Asian J Surg 2024; 47:1172-1174. [PMID: 38001001 DOI: 10.1016/j.asjsur.2023.11.013] [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: 09/26/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Affiliation(s)
- Ping An
- Department of Otorhinolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Gao
- Department of Otorhinolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Lou
- Department of Otorhinolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu Zhao
- Department of Otorhinolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Yang T, Fan X, Fan Y, Song W, Liu X, Wang J, Chen X. Co-Occurrence of Sensorineural Hearing Loss and Congenital Heart Disease: Etiologies and Management. Laryngoscope 2024; 134:400-409. [PMID: 37254944 DOI: 10.1002/lary.30799] [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: 02/09/2023] [Revised: 05/02/2023] [Accepted: 05/13/2023] [Indexed: 06/01/2023]
Abstract
OBJECTIVES/HYPOTHESIS The co-occurrence of sensorineural hearing loss (SNHL) and congenital heart disease (CHD) is a rare condition with complex etiologies. The purpose of this study is to assess the etiologies, clinical features, and outcomes of cochlear implant (CI) in this patient population. STUDY DESIGN Case series and literature review. METHODS Clinical data of children who were diagnosed with SNHL and CHD and received CIs at a tertiary hospital from 2016 to 2021 were retrospectively analyzed. A literature review was performed to identify patients with SNHL and CHD. FINDINGS Of the 382 children who underwent cochlear implantation at our center, eight (2.1%) were diagnosed with SNHL and CHD. A literature review identified 1525 patients from 254 studies; the database therefore consisted of 1533 patients. The most common genetic etiologies of co-occurring SNHL and CHD were CHARGE syndrome (36.3%), Turner syndrome (8.4%), 22q11.2 deletion (3.0%), Noonan syndrome (2.9%), and Down syndrome (2.5%), whereas the most common non-genetic etiologies were congenital rubella syndrome (22.9%) and SNHL after early cardiac surgery (5.5%). Most of the patients presented with congenital, bilateral, severe-profound SNHL requiring early rehabilitation. Of the 126 children who received CIs at a median age of 2.5 years, half showed delayed speech development at last follow-up. CONCLUSIONS Co-occurring SNHL and CHD is a rare condition with complex etiologies. Timely hearing intervention with long-term follow-up and proper timing of heart surgery is essential for these children. LEVEL OF EVIDENCE 4, case series Laryngoscope, 134:400-409, 2024.
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Affiliation(s)
- Tengyu Yang
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Xinmiao Fan
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Yue Fan
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Wenjie Song
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Xingrong Liu
- Department of Cardiac Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Jian Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
| | - Xiaowei Chen
- Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China
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23
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Sagar M, Sagar P, Kumar R, Rani P. Troubleshooting Cochlear Implant Malfunction Using Neural Response Telemetry and Normal Saline. J Int Adv Otol 2024; 20:89-93. [PMID: 38454296 PMCID: PMC10895891 DOI: 10.5152/iao.2024.231116] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/26/2023] [Indexed: 03/09/2024] Open
Abstract
Cochlear implantation has become a standard of care for a child diagnosed with bilateral profound sensorineural hearing loss with a structured surgical standard operating procedure. A 3-year-old boy with bilateral profound prelingual sensorineural deafness underwent a Med-EL Sonata Ti100 implant. We faced a peculiar situation intraoperatively after inserting the electrodes and closing the wound. The impedance recording indicated high ground path impedance with short-circuiting of few electrodes. As a bionic implant, its electronic components may at times malfunction both intraoperatively and/or postoperatively; therefore, neural response telemetry (NRT) was invented to check it. By using NRT and a few milliliters of normal saline, we were able to diagnose as well as rectify the malfunctioning of the implant.
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Affiliation(s)
- Milind Sagar
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Prem Sagar
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Rajeev Kumar
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Pallavi Rani
- Department of Otorhinolaryngology and Head Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
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Whitehead RA, Michaelides E. "Repository of Cochlear Implant Information:" A Multi-Institutional REDCap Database. Am J Otolaryngol 2024; 45:104100. [PMID: 37977060 DOI: 10.1016/j.amjoto.2023.104100] [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] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To describe the creation of a multi-center cochlear implant database as a template for future medical database design. The first clinical question examined was the association between BMI on cochlear implant surgical time and postoperative outcome. MATERIALS AND METHODS A retrospective repository in REDCap, named the "Repository of Cochlear Implant Information" (ROCII), was created and collected de-identified data on patients who underwent cochlear implantation. Data was exported and stratified into three BMI groupings (<25, 25.0-29.9, ≥ 30.0). Differences in surgical time and AZBio Sentence Test postoperative score changes were analyzed using the mixed-effect model. RESULTS The mean BMI (n = 145) was 28.52, and the mean surgical time was 128.9 min. The BMI < 25 reference group (n = 50) and the BMI 25.0-29.9 group (n = 50) had an identical mean surgical time of 127.5 min. The BMI ≥30.0 group (n = 45) had a mean surgical time of 132 min, however this difference was not statistically significant when compared to the reference group (p = 0.4727). The mean AZBio postoperative score change (n = 74) was 63.32. The BMI < 25 reference group (n = 29) had a mean postoperative change of 56.66. The BMI 25.0-29.9 group (n = 22) and BMI ≥30.0 group (n = 23) had mean postoperative changes of 61.32 and 73.65 respectively, however these differences were not statistically significant compared to the reference group (p = 0.5847, 0.0637). CONCLUSION BMI did not have a significant association with surgical time or postoperative outcome and therefore should not be a contraindication for implantation. ROCII will facilitate a deeper understanding of the evaluation process, outcomes, and patient experience of cochlear implantation across institutions. LEVEL OF EVIDENCE Level 1.
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Affiliation(s)
- Russell A Whitehead
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL 60612, United States of America.
| | - Elias Michaelides
- Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL 60612, United States of America
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Corbin AF, Gawel EM, Piccillo E, Carr MM. Are children with unilateral sensorineural hearing loss receiving cochlear implants? Int J Pediatr Otorhinolaryngol 2024; 176:111833. [PMID: 38147729 DOI: 10.1016/j.ijporl.2023.111833] [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: 07/19/2023] [Revised: 11/25/2023] [Accepted: 12/16/2023] [Indexed: 12/28/2023]
Abstract
INTRODUCTION The US Food and Drug Administration (FDA) granted its first approval for cochlear implants (CI) in children with bilateral sensorineural hearing loss (SNHL) in 1990. In 2019, the FDA expanded CI indications to include children with unilateral SNHL. OBJECTIVE The aim of this study was to assess the prevalence of children with unilateral SNHL in the population of new pediatric CI recipients between 2012 and 2021. METHODS A retrospective analysis using the American College of Surgeons National Surgical Quality Improvement Pediatric database examined patients under 18 years of age with bilateral or unilateral SNHL who underwent CI between 2012 and 2021. Current Procedural Terminology code 69930 identified patients with 'cochlear device implantation, with or without mastoidectomy.' The percentage of children undergoing CI for unilateral versus bilateral SNHL during the study period was calculated and subjected to statistical analysis. RESULTS 9863 pediatric CI patients were included with a mean age of 5.1 (95 % CI 5.1-5.2) years at the time of implantation. 7.5 % (N = 739) of patients had unilateral SNHL and 92.5 % (N = 9124) had bilateral SNHL. Children with bilateral SNHL undergoing CI were significantly younger (5.0 years versus 6.9 years for those with unilateral SNHL, p < .001). There was a statistically significant difference in the percentage of children receiving CI for unilateral versus bilateral SNHL (3.3 % in 2012 to 14.3 % in 2021, p < .001) before and after the FDA changes. CONCLUSIONS The proportion of CIs placed for unilateral SNHL has increased annually even before 2019 when the FDA expanded its CI indications to include children with unilateral SNHL for the first time.
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Affiliation(s)
- Alexandra F Corbin
- Jacobs School Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
| | - Erin M Gawel
- Jacobs School Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
| | - Ellen Piccillo
- Department of Otolaryngology, Jacobs School Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, Alexandra, USA.
| | - Michele M Carr
- Department of Otolaryngology, Jacobs School Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, Alexandra, USA.
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26
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Nowariak M, Strack N, Greenlund L, Hegde S, Novak JL, Meyer A, Roby BB. Risk factors and outcomes in patients with cochlear nerve deficiency. Int J Pediatr Otorhinolaryngol 2024; 176:111797. [PMID: 38056092 DOI: 10.1016/j.ijporl.2023.111797] [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: 09/28/2023] [Revised: 10/30/2023] [Accepted: 11/19/2023] [Indexed: 12/08/2023]
Abstract
INTRODUCTION Cochlear nerve deficiency (CND) is a cause of sensorineural hearing loss made by radiologic criteria. There is sparse literature involving audiological outcomes and cochlear implantation (CI) success in patients with CND. METHODS A retrospective chart review of all patients with sensorineural hearing loss at a tertiary children's hospital from 2000 to 2020 was conducted. Patients with CND on radiographic imaging were included and categorized as hypoplastic, aplastic, or indeterminate. RESULTS In this study, 53 patients were identified with CND, totaling 70 ears. Of the 53 patients, 30 (56.6 %) were male, 8 (16.0 %) had a family history of childhood hearing loss, 6 (11.3 %) were born preterm, and 11 (23.4 %) required neonatal intensive care admission. The median maternal age was 29 years old [IQR: 27, 35], and 8 (15 %) patients were born to mothers with diabetes. Of the 70 ears, 49 (70 %) utilized conventional hearing aids, 12 (17.1 %) utilized a bone-anchored hearing aid, and 10 (14.3 %) underwent CI. Of the 10 ears implanted, 4 (40 %) ears had nerves classified as hypoplastic, 3 (30 %) as aplastic, and 3 (30 %) as indeterminate. Improvement in pure tone averages compared to preoperative testing was demonstrated in 8 (80 %), and 6 (60 %) displayed improved speech awareness thresholds. CONCLUSION This study demonstrates that there may be an association between CND and maternal diabetes and NICU admission. There are variable results with hearing amplification options in patients with CND, and further research is needed to better describe the role of CI, bone-anchored hearing aids and conventional hearing aids in patients with CND.
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Affiliation(s)
- Meagan Nowariak
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Natalie Strack
- Children's Minnesota Pediatric ENT and Facial Plastic Surgery, Minneapolis, MN, USA
| | | | - Shilpa Hegde
- Children's Minnesota Radiology, Minneapolis, MN, USA
| | - Jessica Ls Novak
- Children's Minnesota Pediatric ENT and Facial Plastic Surgery, Minneapolis, MN, USA
| | - Abby Meyer
- Children's Minnesota Pediatric ENT and Facial Plastic Surgery, Minneapolis, MN, USA; University of Minnesota Dept of Otolaryngology-Head and Neck Surgery, Minneapolis, MN, USA
| | - Brianne Barnett Roby
- Children's Minnesota Pediatric ENT and Facial Plastic Surgery, Minneapolis, MN, USA; University of Minnesota Dept of Otolaryngology-Head and Neck Surgery, Minneapolis, MN, USA.
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Fehrmann MLA, Huinck WJ, Thijssen MEG, Haer-Wigman L, Yntema HG, Rotteveel LJC, Widdershoven JCC, Goderie T, van Dooren MF, Hoefsloot EH, van der Schroeff MP, Mylanus EAM, Lanting CP, Pennings RJE. Stable long-term outcomes after cochlear implantation in subjects with TMPRSS3 associated hearing loss: a retrospective multicentre study. J Otolaryngol Head Neck Surg 2023; 52:82. [PMID: 38102706 PMCID: PMC10724910 DOI: 10.1186/s40463-023-00680-3] [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: 06/20/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The spiral ganglion hypothesis suggests that pathogenic variants in genes preferentially expressed in the spiral ganglion nerves (SGN), may lead to poor cochlear implant (CI) performance. It was long thought that TMPRSS3 was particularly expressed in the SGNs. However, this is not in line with recent reviews evaluating CI performance in subjects with TMPRSS3-associated sensorineural hearing loss (SNHL) reporting overall beneficial outcomes. These outcomes are, however, based on variable follow-up times of, in general, 1 year or less. Therefore, we aimed to 1. evaluate long-term outcomes after CI implantation of speech recognition in quiet in subjects with TMPRSS3-associated SNHL, and 2. test the spiral ganglion hypothesis using the TMPRSS3-group. METHODS This retrospective, multicentre study evaluated long-term CI performance in a Dutch population with TMPRSS3-associated SNHL. The phoneme scores at 70 dB with CI in the TMPRSS3-group were compared to a control group of fully genotyped cochlear implant users with post-lingual SNHL without genes affecting the SGN, or severe anatomical inner ear malformations. CI-recipients with a phoneme score ≤ 70% at least 1-year post-implantation were considered poor performers and were evaluated in more detail. RESULTS The TMPRSS3 group consisted of 29 subjects (N = 33 ears), and the control group of 62 subjects (N = 67 ears). For the TMPRSS3-group, we found an average phoneme score of 89% after 5 years, which remained stable up to 10 years post-implantation. At both 5 and 10-year follow-up, no difference was found in speech recognition in quiet between both groups (p = 0.830 and p = 0.987, respectively). Despite these overall adequate CI outcomes, six CI recipients had a phoneme score of ≤ 70% and were considered poor performers. The latter was observed in subjects with residual hearing post-implantation or older age at implantation. CONCLUSION Subjects with TMPRSS3-associated SNHL have adequate and stable long-term outcomes after cochlear implantation, equal to the performance of genotyped patient with affected genes not expressed in the SGN. These findings are not in line with the spiral ganglion hypothesis. However, more recent studies showed that TMPRSS3 is mainly expressed in the hair cells with only limited SGN expression. Therefore, we cannot confirm nor refute the spiral ganglion hypothesis.
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Affiliation(s)
- M L A Fehrmann
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, The Netherlands
| | - W J Huinck
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, The Netherlands
| | - M E G Thijssen
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, The Netherlands
| | - L Haer-Wigman
- Department of Clinical Genetics, Radboudumc, Nijmegen, The Netherlands
| | - H G Yntema
- Department of Clinical Genetics, Radboudumc, Nijmegen, The Netherlands
| | - L J C Rotteveel
- Department of Otorhinolaryngology, Leiden UMC, Leiden, The Netherlands
| | - J C C Widdershoven
- Department of Otorhinolaryngology, Maastricht UMC, Maastricht, The Netherlands
| | - T Goderie
- Department of Otorhinolaryngology-Head and Neck Surgery, Ear and Hearing, Amsterdam UMC, Amsterdam, The Netherlands
| | - M F van Dooren
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | - E H Hoefsloot
- Department of Clinical Genetics, Erasmus MC, Rotterdam, The Netherlands
| | | | - E A M Mylanus
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, The Netherlands
| | - C P Lanting
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, The Netherlands
| | - R J E Pennings
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, The Netherlands.
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Machado A, Dias J, Silva A, Meireles L. Chiari Type 1 Malformation: An Unusual Cause of Tinnitus. Int Tinnitus J 2023; 27:6-9. [PMID: 38050878 DOI: 10.5935/0946-5448.20230002] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Chiari Malformations are a group of conditions defined in 1891 with 5 degrees being described. These malformations present with several symptoms such as cervical protrusion and are associated with hydrocephalus. Also, they can also present with different clinical signs and symptoms, such as deafness and tinnitus. We present a case of a 45-year-old man with unilateral tinnitus evaluated in otolaryngology office. No other symptoms on otolaryngological physical exam were detected in the audiogram performed it was described a significant unilateral sensorineural hearing loss. During the study of this patient, Magnetic Resonance Imaging was requested, showing a type I Chiari malformation. The patient was then observed by Ophthalmology, Neurology, and Neurosurgery. No other neurological symptoms of malformation Chiari syndrome or cranial nerve abnormalities were presented at the respective exam. The surgical management of these pathologies takes into account an adequate CSF and venous blood flow - that was seen in this patient, therefore, there was no surgical indication for decompression. The patient maintains its follow-up in the otolaryngology, neurology, and neurosurgery office, and tinnitus was minimized after prosthetic adaptation was recommended to optimize the quality of life, which was achieved.
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Affiliation(s)
- André Machado
- Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Porto, Portugal
- Faculty of Health Sciences, Universidade da Beira Interior, Covilha, Portugal
| | - Joana Dias
- Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Silva
- Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luís Meireles
- Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Porto, Portugal
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29
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Vanstrum EB, Castellanos CX, Ziltzer RS, Ulloa R, Moen R, Choi JS, Cortessis VK. Cochlear implantation in Waardenburg syndrome: Systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol 2023; 175:111738. [PMID: 37847940 DOI: 10.1016/j.ijporl.2023.111738] [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: 05/01/2023] [Revised: 08/16/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE Waardenburg syndrome (WS) is a genetic condition associated with moderate to profound sensorineural hearing loss. The aim of this review is to characterize cochlear implant (CI) outcomes in patients with a confirmed clinical diagnosis of WS. DATA SOURCES MEDLINE, Ovid EMBASE, and Cochrane Library. REVIEW METHODS All reports describing defined sets of patients with WS who underwent CI and subsequent evaluation of clinical outcomes were included. To harmonize outcome data between studies that used different measures, a binary variable Favored CI was developed to capture success of procedures (1 = favored, 0 = unfavored) based on original authors' description, commentary, discussion, and conclusions. Expert reviewers independently reviewed and selected articles, extracted data and scored Favored CI values. Synthetic and analytic meta-analyses were implemented using standard analytic techniques. RESULTS Twenty articles meeting inclusion criteria provided data on 192 WS patients and 210 CIs. The mean age at CI was 3.8 years (95% confidence interval [95%CI]; 3.1-4.5 years), and the mean duration of follow up was 5.2 years (95% CI; 3.4-7.0 years). Surgical complications were rare (11/210 implants, 5.2%) where gusher was the most common complication. CIs yielded favorable hearing outcomes in 90% (95% CI; 84-94%) of cases, and appear successful for those with temporal bone anomalies (p = 0.04). CONCLUSIONS Quantitative synthesis of the study data demonstrates that in the majority of patients with WS, CI yield favorable hearing outcomes and low rates of surgical complications. CI has shown to provide clinical benefits in patients with WS.
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Affiliation(s)
- Erik B Vanstrum
- Department of Head and Neck Surgery, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA.
| | | | | | - Ruben Ulloa
- Keck School of Medicine, Los Angeles, CA, USA
| | | | - Janet S Choi
- Department of Otolaryngology - Head and Neck Surgery, University of Minnesota, USA
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30
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Said NM, Telmesani LS, Telmesani LM. Effect of congenital inner ear malformations (IEMs) on electrically evoked compound action potential (ECAP) responses in cochlear implant children. Eur Arch Otorhinolaryngol 2023; 280:5193-5204. [PMID: 37606729 DOI: 10.1007/s00405-023-08196-2] [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: 06/17/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE The study was designed to assess the electrically evoked compound action potential (ECAP) responses in children with inner ear malformations compared to children with normal inner ear anatomy. METHODS The study included 235 prelingual deaf children who were implanted in cochlear implant unit in King Fahad University hospital-Imam Abdulrahman Bin Faisel University. Subjects were using either Cochlear Nucleus or Medel cochlear implant devices. We had 171 (64.5%) subjects with normal inner ear anatomy and 94 (35.5%) subjects with inner ear malformations (IEMs) and they were classified into 6 groups according to inner ear anatomy. Fourteen subjects (14.9%) subjects had enlarged vestibular aqueduct (EVA), 30 (32%) subjects had Mondini deformity, 25 (26.6%) subjects had incomplete partition type two (IPII), 9 (9.6%) subjects had incomplete partition type one (IPI) and 16 (17%) subjects had hypoplastic cochlea type III or IV. Intraoperative electrically evoked compound action potential (ECAP) responses were analyzed and compared in all subjects. RESULTS AND CONCLUSIONS Measurable ECAP responses can be elicited in patients with IEMs in most of the channels. Severe malformations can affect the prevalence of measuring ECAP and getting identifiable waveform morphology. Additionally, increased thresholds and lower slope of AGF was observed in IEMs specially in more severe malformations (e.g. IPI). IPI patients with better word recognition scores tended to show more identifiable ECAP measurements. This could suggest the presence of some correlation between ECAP responses and patients' performance after cochlear implantation.
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Affiliation(s)
- Nithreen M Said
- Audiovestibular Medicine Unit, Otorhinolaryngology Department, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
- Audio-Vestibular Medicine Unit, Otorhinolaryngology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Lena S Telmesani
- Otorhinolaryngology Department, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Laila M Telmesani
- Otorhinolaryngology Department, Faculty of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Sturm JJ, Brandner G, Ma C, Schvartz-Leyzac KC, Dubno JR, McRackan TR. Why Do Candidates Forgo Cochlear Implantation? Laryngoscope 2023; 133:3548-3553. [PMID: 37114650 DOI: 10.1002/lary.30721] [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: 12/07/2022] [Revised: 03/15/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE Identify barriers and facilitating factors in cochlear implant (CI) utilization by comparing functional measures between CI candidates who undergo or forgo implantation. METHODS Forty-three participants were separated into two groups: (1) 28 participants who underwent CI and (2) 15 participants who elected not to proceed with CI despite meeting eligibility criteria (no-CI). Prior to implantation, all participants completed the CI Quality of Life (CIQOL)-35 Profile and CIQOL-Expectations instrument. They were also surveyed on factors contributing to their decision to either undergo or forgo CI. Word and speech recognition were determined using the Consonant-Nucleus-Consonant (CNC) and the AzBio tests, respectively. RESULTS CIQOL-Expectations scores were indistinguishable between groups, but there were substantial differences in baseline CIQOL-35 Profile scores. Compared to the CI group, the no-CI group exhibited higher pre-CI scores in the Emotional (Cohen's d [95% CI] = 0.8 [0.1, 1.5]) and Entertainment (Cohen's d [95% CI] = 0.8 [0.1, 1.5]) domains. Survey data revealed that the most commonly reported barriers to pursuing CI in the no-CI cohort were fear of surgical complications (85%), cost associated with implantation (85%), and perception that hearing was not poor enough for CI surgery (85%). CONCLUSIONS AND RELEVANCE The results of this study indicate that functional outcome expectations are similar between candidates who elect to receive or forgo CI, yet those who forgo CI have higher baseline CI-specific QOL abilities. LEVEL OF EVIDENCE 4 Laryngoscope, 133:3548-3553, 2023.
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Affiliation(s)
- Joshua J Sturm
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Gabriel Brandner
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Cheng Ma
- Department of Otolaryngology - Head and Neck Surgery, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kara C Schvartz-Leyzac
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Judy R Dubno
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Theodore R McRackan
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
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Drake M, Friedland DR, Hamad B, Marfowaa G, Adams JA, Luo J, Flanary V. Factors associated with delayed referral and hearing rehabilitation for congenital sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2023; 175:111770. [PMID: 37890209 DOI: 10.1016/j.ijporl.2023.111770] [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: 08/22/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023]
Abstract
OBJECTIVES To identify the impact of social determinants of health and clinical status on referral and intervention for congenital sensorineural hearing loss. STUDY DESIGN Retrospective chart review of children with confirmed sensorineural or mixed hearing loss between 2013 and 2021 at a single academic medical institution. METHODS Referral rates and timing for hearing rehabilitation, rates and timing of completed evaluation, and rate and timing of amplification were recorded. Patient demographics included gestational age, race, ethnicity, sex, hearing loss severity, and CMV status. RESULTS There were 216 children with confirmed sensorineural or mixed hearing loss, of which 77 had a unilateral hearing loss and 89 a severe or profound hearing loss. Delayed referral for hearing aid evaluation was noted in premature patients (median 375 days premature, median 147 term; p < 0.01) and publicly insured patients (median 215 days, median 123 private; p = 0.04). Delayed time to hearing aid fitting was noted for non-white patients (median 325 days, median 203 white patients; p < 0.01), publicly insured patients (median 309 days, median 212 private insurance; p < 0.02), and premature patients (median 462 days, median 224 term; p = 0.03). White patients were more likely to be referred for cochlear implant (p = 0.03).Privately insured patients and patients with a positive CMV test were more likely to be referred for cochlear implant evaluation, be seen in the cochlear implant clinic, and undergo implantation (p < 0.05). Non-white patients had a delay in cochlear implantation referral (median 928 days, median 398 days white patients; p = 0.05). Prolonged interval between evaluation in cochlear implant clinic to implantation was noted for privately insured patients (median 125 days; median 78 days publicly insured; p = 0.05). CONCLUSIONS Sociodemographic factors were significantly associated with hearing amplification referral rates and time until amplification for children with identified congenital sensorineural hearing loss. For cochlear implantation, insurance type, CMV status were significantly associated with rate and timing of cochlear implant pathway.
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Affiliation(s)
- Marc Drake
- Medical College of Wisconsin, Department of Otolaryngology and Communication Sciences, United States
| | - David R Friedland
- Medical College of Wisconsin, Department of Otolaryngology and Communication Sciences, United States
| | - Bushra Hamad
- Medical College of Wisconsin, Department of Otolaryngology and Communication Sciences, United States
| | - Gifty Marfowaa
- Medical College of Wisconsin, Department of Otolaryngology and Communication Sciences, United States
| | - Jazzmyne A Adams
- Medical College of Wisconsin, Department of Otolaryngology and Communication Sciences, United States
| | - Jake Luo
- Department of Health Informatics and Administration, University of Wisconsin, Milwaukee, United States
| | - Valerie Flanary
- Medical College of Wisconsin, Department of Otolaryngology and Communication Sciences, United States.
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Idei K, Kitamura M, Shimanuki MN, Hosoya M, Tsuzuki N, Hasebe N, Nishiyama T, Ozawa H, Oishi N. Effective cochlear implantation for idiopathic hypertrophic pachymeningitis with bilateral profound hearing loss: A case report. Medicine (Baltimore) 2023; 102:e36124. [PMID: 38013369 PMCID: PMC10681438 DOI: 10.1097/md.0000000000036124] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/25/2023] [Indexed: 11/29/2023] Open
Abstract
RATIONALE Hypertrophic pachymeningitis (HP) is a local or diffuse fibrous thickness of the dura mater of the brain or spinal cord, caused by infection or connective tissue disease. Headache is the most common clinical symptom, followed by various cranial nerve disorders such as visual impairment, diplopia, and hearing loss. HP can be classified into secondary and idiopathic. Here, we report a case of bilateral progressive profound sensorineural hearing loss diagnosed in a patient with idiopathic HP, where a cochlear implant was effectively used. PATIENT CONCERNS The patient was a 77-year-old woman. Hearing loss gradually progressed bilaterally, and magnetic resonance imaging showed a space-occupying lesion with a continuous contrast enhancement in the bilateral internal auditory canals, and diffused dural thickening from the middle to the posterior cranial fossa. DIAGNOSES A trans-labyrinthine biopsy was conducted, and a definite diagnosis of idiopathic HP was made. Thickening of the dura mater in the bilateral internal auditory canals was thought to cause profound hearing loss. INTERVENTIONS AND OUTCOMES A cochlear implant was implemented 4 months after biopsy, and a favorable hearing response was obtained postoperatively. LESSONS This is the first report of a cochlear implant in a patient with idiopathic HP. Cochlear implantation was considered a good treatment for profound hearing loss due to idiopathic HP, which provides a reference for patients to receive timely and correct treatment.
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Affiliation(s)
- Katsuyoshi Idei
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Hospital, Tokyo, Japan
| | - Mitsuru Kitamura
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Hospital, Tokyo, Japan
| | - Marie N. Shimanuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Hospital, Tokyo, Japan
| | - Makoto Hosoya
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Hospital, Tokyo, Japan
| | - Nobuyoshi Tsuzuki
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Hospital, Tokyo, Japan
| | - Natsuki Hasebe
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Hospital, Tokyo, Japan
| | - Takanori Nishiyama
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Hospital, Tokyo, Japan
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Hospital, Tokyo, Japan
| | - Naoki Oishi
- Department of Otorhinolaryngology, Head and Neck Surgery, Keio University Hospital, Tokyo, Japan
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Garcia A, Haleem A, Chari DA, Morse-Fortier C, Arenberg JG, Lee DJ. Influence of listening environment on usage patterns in cochlear implant patients with single-sided deafness. Cochlear Implants Int 2023; 24:335-341. [PMID: 36846887 DOI: 10.1080/14670100.2023.2176990] [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: 03/01/2023]
Abstract
OBJECTIVE To compare cochlear implant (CI) data logging of patients with single-sided deafness (SSD) and bilateral sensorineural hearing loss (biSNHL) in various acoustic environments and study the implications of data logging on auditory performance. STUDY DESIGN Retrospective case control study. METHODS Adult CI patients with SSD or biSNHL from 2010 to 2021 with usage data collected at 3-, 6-, and 12-months following device activation were identified. The CI listening environment was defined as speech in noise, speech in quiet, quiet, music or noise. Auditory performance was measured using the CNC word, AzBio sentence tests and the Tinnitus Handicap Index (THI). RESULTS 60 adults with SSD or biSNHL were included. CI patients with biSNHL wore their devices more than those with SSD at 3-months post-activation (11.18 versus 8.97 hours/day, p = 0.04), though there were no significant differences at 6-12 months. Device usage was highest in the speech in quiet environment. In SSD CI users, there was a positive correlation (p = 0.03) between device use and CNC scores at 12-months and an improvement in THI scores at 12-months (p = 0.0004). CONCLUSIONS CI users with SSD and biSNHL have comparable duration of device usage at longer follow-up periods with greatest device usage recorded in speech in quiet environments.
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Affiliation(s)
- Alejandro Garcia
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Afash Haleem
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Divya A Chari
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Charlotte Morse-Fortier
- Department of Audiology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Julie G Arenberg
- Department of Audiology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
| | - Daniel J Lee
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
- Eaton Peabody Laboratories (EPL), Massachusetts Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA, USA
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Chhantyal S. Navigating Medical School with Hearing Loss. JNMA J Nepal Med Assoc 2023; 61:837-839. [PMID: 38289765 PMCID: PMC10579756 DOI: 10.31729/jnma.8313] [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: 09/29/2023] [Indexed: 02/01/2024] Open
Abstract
Hearing impairment is a significant challenge faced by medical students and physicians, impacting their communication abilities and stethoscope use. This condition, though prevalent, remains under-addressed in medical education, with many institutions lacking explicit support systems and some even imposing exclusionary standards. This personal narrative chronicles the journey of a medical student who experienced a gradual and severe bilateral sensorineural hearing loss. This article also highlights the pivotal role of cochlear implants in significantly enhancing the author's academic and social life. Medical educators are encouraged to understand the challenges faced by hearing-impaired students and adapt their teaching methods to support them effectively. Keywords communication; hearing loss; medical students; patients; speech.
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Gröger M, Loth A, Helbig S, Stöver T, Leinung M. Bilateral simultaneous cochlear implantation is a safe method of hearing rehabilitation in adults. Eur Arch Otorhinolaryngol 2023; 280:4445-4454. [PMID: 37191916 PMCID: PMC10477109 DOI: 10.1007/s00405-023-07977-z] [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: 02/28/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE Bilateral cochlear implantation is an effective treatment for patients with bilateral profound hearing loss. In contrast to children, adults mostly choose a sequential surgery. This study addresses whether simultaneous bilateral CI is associated with higher rates of complications compared to sequential implantation. METHODS 169 bilateral CI surgeries were analyzed retrospectively. 34 of the patients were implanted simultaneously (group 1), whereas 135 patients were implanted sequentially (group 2). The duration of surgery, the incidence of minor and major complications and the duration of hospitalization of both groups were compared. RESULTS In group 1, the total operating room time was significantly shorter. The incidences of minor and major surgical complications showed no statistically significant differences. A fatal non-surgical complication in group 1 was particularly extensively reappraised without evidence of a causal relationship to the chosen mode of care. The duration of hospitalization was 0.7 days longer than in unilateral implantation but 2.8 days shorter than the combined two hospital stays in group 2. CONCLUSION In the synopsis of all considered complications and complication-relevant factors, equivalence of simultaneous and sequential cochlear implantation in adults in terms of safety was found. However, potential side effects related to longer surgical time in simultaneous surgery must be considered individually. Careful patient selection with special consideration to existing comorbidities and preoperative anesthesiologic evaluation is essential.
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Affiliation(s)
- Maximilian Gröger
- University Hospital Frankfurt, Dept. of Otorhinolaryngology, Frankfurt am Main, Germany.
| | - Andreas Loth
- University Hospital Frankfurt, Dept. of Otorhinolaryngology, Frankfurt am Main, Germany
| | - Silke Helbig
- University Hospital Frankfurt, Dept. of Otorhinolaryngology, Frankfurt am Main, Germany
| | - Timo Stöver
- University Hospital Frankfurt, Dept. of Otorhinolaryngology, Frankfurt am Main, Germany
| | - Martin Leinung
- University Hospital Frankfurt, Dept. of Otorhinolaryngology, Frankfurt am Main, Germany
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Heuninck E, Van de Heyning P, Van Rompaey V, Mertens G, Topsakal V. Audiological outcomes of robot-assisted cochlear implant surgery. Eur Arch Otorhinolaryngol 2023; 280:4433-4444. [PMID: 37043021 DOI: 10.1007/s00405-023-07961-7] [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: 11/23/2022] [Accepted: 04/03/2023] [Indexed: 04/13/2023]
Abstract
PURPOSE The main objective of this study is to evaluate the short-term and long-term audiological outcomes in patients who underwent cochlear implantation with a robot-assisted system to enable access to the cochlea, and to compare outcomes with a matched control group of patients who underwent cochlear implantation with conventional access to the cochlea. METHODS In total, 23 patients were implanted by robot-assisted cochlear implant surgery (RACIS). To evaluate the effectiveness of robotic surgery in terms of audiological outcomes, a statistically balanced control group of conventionally implanted patients was created. Minimal outcome measures (MOM), consisting of pure-tone audiometry, speech understanding in quiet and speech understanding in noise were performed pre-operatively and at 3 months, 6 months, 12 months and 2 years post-activation of the audioprocessor. RESULTS There was no statistically significant difference in pure-tone audiometry, speech perception in quiet and speech perception in noise between robotically implanted and conventionally implanted patients pre-operatively, 3 months, 6 months, 12 months and 2 years post-activation. A significant improvement in pure-tone hearing thresholds, speech understanding in quiet and speech understanding in noise with the cochlear implant has been quantified as of the first measurements at 3 months and this significant improvement remained stable over a time period of 2 years for HEARO implanted patients. CONCLUSION Clinical outcomes in robot-assisted cochlear implant surgery are comparable to conventional cochlear implantation. CLINICALTRAILS. GOV TRAIL REGISTRATION NUMBERS NCT03746613 (date of registration: 19/11/2018), NCT04102215 (date of registration: 25/09/2019).
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Affiliation(s)
- Emilie Heuninck
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Brussels, Vrije Universiteit Brussel, Brussels Health Campus, Brussels, Belgium.
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Griet Mertens
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
- Experimental Laboratory of Translational Neurosciences and Dento-Otolaryngology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vedat Topsakal
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Brussels, Vrije Universiteit Brussel, Brussels Health Campus, Brussels, Belgium
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Wang X, Lin Z, Guo Y, Liu Y, Zhou X, Bai J, Liu H. Correlation between cortical auditory evoked potential and auditory speech performance in children with cochlear implants. Int J Pediatr Otorhinolaryngol 2023; 172:111687. [PMID: 37515869 DOI: 10.1016/j.ijporl.2023.111687] [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: 05/27/2023] [Revised: 07/13/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVES This study aimed to explore the correlation between the characteristics of cortical auditory evoked potential (CAEP) of children with cochlear implants (CIs) and auditory and speech rehabilitation performance by an objective evaluation technique and subjective auditory and speech skills measurements. METHODS All participants were recruited from Beijing Children's Hospital, Beijing, China. 19 children with CIs had their responses to the CAEP and MMN recorded. The LittlEARs® Auditory Questionnaire (LEAQ), Categories of Auditory Performance (CAP), Speech Intelligibility Rating Scale (SIR), Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS), and Meaningful Use of Speech Scale (MUSS) measures were taken to assess the children's speech and hearing abilities. RESULTS P1 and MMN of CAEP were negatively related to the duration of CI usage. The duration of CI usage and scores of auditory-verbal assessment questionnaires all showed significant relationships. Additionally, scores of these questionnaires were significantly inversely associated with the latency of P1 and MMN. CONCLUSION P1 and MMN could be used as objective methods to evaluate the effectiveness of hearing and speech rehabilitation in children with CIs. In particular to those who cannot give effectively feedback of auditory and verbal effects, these methods might have a certain guiding significance.
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Affiliation(s)
- Xuetong Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Zhihan Lin
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Ying Guo
- Royal National Ear, Nose, Throat & Eastman Dental Hospitals, London, 110686, UK.
| | - Yidi Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Xin Zhou
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Jie Bai
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Haihong Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China; Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Ministry of Education (MOE) Key Laboratory of Major Diseases in Children, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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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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40
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Schlacter JA, Kay-Rivest E, McMenomey SO, Roland JT, Friedmann DR, Jethanamest D. Bilateral cochlear implantation after immunotherapy-related profound hearing loss: A case report. Cochlear Implants Int 2023; 24:268-272. [PMID: 36988037 DOI: 10.1080/14670100.2023.2193918] [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: 03/30/2023]
Abstract
OBJECTIVES Immune-checkpoint inhibitors (ICI) are being utilized with increasing frequency and may be linked to neurologic and audiovestibular toxicities. This report aimed to describe a case of ICI-induced sensorineural hearing loss ultimately requiring bilateral cochlear implantation. METHODS A 42-year-old female with stage IV metastatic melanoma of the perianal skin was treated with ipilimumab (blocker of cytotoxic T-lymphocyte associated protein 4 [CTLA-4]) and nivolumab (anti-programmed cell death protein 1 [PD1]). After 21 weeks of therapy, she developed sudden vertigo and bilateral hearing loss. A full workup including MRI and lumbar puncture ruled out intracranial parenchymal metastases, leptomeningeal metastases, stroke and intracranial infection. ICI-associated aseptic meningoencephalitis was therefore diagnosed. The patient received systemic steroids as well as intratympanic steroids, which temporarily improved hearing, but eventually developed permanent, bilateral profound sensorineural hearing loss. RESULTS The patient received bilateral cochlear implants and has demonstrated good performance one year after implantation. DISCUSSION ICI are being increasingly used to treat a variety of advanced malignancies. This is the first report of bilateral cochlear implants in the context of profound hearing loss after an immunotherapy induced meningoencephalitis. CONCLUSION ICI carries the risk of potential ototoxicity, including profound SNHL as depicted in our case. Cochlear implantation proved to be beneficial and may be considered in patients with ICI-related hearing loss.
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Affiliation(s)
| | - Emily Kay-Rivest
- Department of Otolaryngology-Head & Neck Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Sean O McMenomey
- Department of Otolaryngology-Head & Neck Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | - J Thomas Roland
- Department of Otolaryngology-Head & Neck Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | - David R Friedmann
- Department of Otolaryngology-Head & Neck Surgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Daniel Jethanamest
- Department of Otolaryngology-Head & Neck Surgery, NYU Grossman School of Medicine, New York, NY, USA
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Rasmussen KD, West NC, Bille M, Cayé-Thomasen P. Tinnitus suppression in a prospective cohort of 45 cochlear implant recipients: occurrence, degree and correlates. Eur Arch Otorhinolaryngol 2023; 280:4073-4082. [PMID: 37099145 DOI: 10.1007/s00405-023-07921-1] [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: 11/16/2022] [Accepted: 03/08/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVE To determine tinnitus prevalence and severity in a cohort of unselected first-time cochlear implant (CI) recipients whose primary motive for CI was sensorineural hearing loss (SNHL), and to evaluate the effect of CI on tinnitus after cochlear implantation. METHODS Prospective longitudinal study of 45 adult CI recipients with moderate to profound SNHL. Patients completed the Danish version of the Tinnitus Handicap Inventory (THI) and a visual analogue scale (VAS) for tinnitus burden before implantation, 4 months after implantation and 14 months after implantation. RESULTS The study included 45 patients, of which 29 (64%) had pre-implant tinnitus. Median THI score (IQR) significantly decreased from 20 (34) to 12 (24) at first follow-up (p < 0.05) and to 6 points (17) at second follow-up (p < 0.001). Median VAS (IQR) for tinnitus burden decreased from 33 (62) to 17 (40; p = 0.228) and 12 (27, p < 0.05) at the first and second follow-ups, respectively. Tinnitus was totally suppressed in 19% of patients, improved in 48%, remained unchanged in 19% and worsened in 6%. 2 patients reported new tinnitus. At the second follow-up, 74% of patients had slight or no tinnitus handicap, 16% had mild handicaps, 6% had moderate handicaps, and 3% had severe handicaps. High pre-implant THI and VAS scores correlated with greater decrease in THI scores over time. CONCLUSION 64% of the patients with SNHL had pre-implant tinnitus, which was decreased 4 and 14 months after implantation. Overall, 68% of patients with tinnitus improved their tinnitus handicap after CI. Patients with higher THI and VAS scores had a larger decline and the highest benefits in terms of tinnitus handicap improvement. The study findings demonstrate that the majority of patients with moderate to profound SNHL eligible for cochlear implantation benefit from complete or partial tinnitus suppression and improved quality of life after implantation.
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Affiliation(s)
- Kasper Dyre Rasmussen
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Niels Cramer West
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Bille
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Per Cayé-Thomasen
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Alahmadi A, Abdelsamad Y, Al-Zuraiqi B, Alghamdi S, Hagr A, Saleh E. Cochlear Implantation in Radiation-Induced Hearing Loss: A Systematic Review. Otol Neurotol 2023; 44:767-774. [PMID: 37464460 DOI: 10.1097/mao.0000000000003953] [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: 07/20/2023]
Abstract
OBJECTIVE Cochlear implantation (CI) has been reported as a treatment modality for radiation-induced sensorineural hearing loss (SNHL). However, its efficacy is based on individual reports with no cumulative supporting evidence. Therefore, we conducted the current systematic review to provide cumulative evidence regarding the feasibility and safety of CI in this context. DATABASES REVIEWED An online bibliographic search was conducted in PubMed, ProQuest, Scopus, Google Scholar, and Web of Science using MeSH-based terms. METHODS A systematic review was conducted to retrieve both observational and interventional studies that reported the outcomes of CI for patients suffering from radiation-induced SNHL. RESULTS We included 12 studies that recruited 88 patients who underwent CI because of radiation-induced SNHL. All included studies reported satisfactory hearing/speech perception outcomes. No serious complications were reported, whereas some manageable adverse events were reported, such as paroxysmal facial spams (n = 1), postauricular wound dehiscence with mastoid cutaneous fistula (n = 1), dehiscence in blind sac closure (n = 1), and electrode exposure (n = 1). Four studies assessed the postoperative quality of life/patient satisfaction, showing improved outcomes. CONCLUSION CI could be considered to be feasible and safe in patients with irradiation-induced SNHL. The adverse events of CI in such cases are manageable. Future studies are needed to be strengthened this context.
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Affiliation(s)
- Asma Alahmadi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, ORL department, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Abdulrahman Hagr
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, ORL department, King Saud University, Riyadh, Saudi Arabia
| | - Essam Saleh
- King Abdullah Medical City, Makkah, Saudi Arabia
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Wimmer W, Zbinden M, Gawliczek T, Huber A, Caversaccio M, Kompis M. Performance with a new bone conduction implant audio processor in patients with single-sided deafness. Eur Arch Otorhinolaryngol 2023; 280:3585-3591. [PMID: 36692617 PMCID: PMC10313841 DOI: 10.1007/s00405-023-07852-x] [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: 10/13/2022] [Accepted: 01/18/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE The SAMBA 2 BB audio processor for the BONEBRIDGE bone conduction implant features a new automatic listening environment detection to focus on target speech and to reduce interfering speech and background noises. The aim of this study was to evaluate the audiological benefit of the SAMBA 2 BB (AP2) and to compare it with its predecessor SAMBA BB (AP1). METHODS Prospective within-subject comparison study. We compared the aided sound field hearing thresholds, speech understanding in quiet (Freiburg monosyllables), and speech understanding in noise (Oldenburg sentence test) with the AP1 and AP2. Each audio processor was worn for 2 weeks before assessment and seven users with single-sided sensorineural deafness (SSD) participated in the study. For speech understanding in noise, two complex noise scenarios with multiple noise sources including single talker interfering speech were used. The first scenario included speech presented from the front (S0NMIX), while in the second scenario speech was presented from the side of the implanted ear (SIPSINMIX). In addition, subjective evaluation using the SSQ12, APSQ, and the BBSS questionnaires was performed. RESULTS We found improved speech understanding in quiet with the AP2 compared to the AP1 aided condition (on average + 17%, p = 0.007). In both noise scenarios, the AP2 lead to improved speech reception thresholds by 1.2 dB (S0NMIX, p = 0.032) and 2.1 dB (SIPSINMIX, p = 0.048) compared to the AP1. The questionnaires revealed no statistically significant differences, except an improved APSQ usability score with the AP2. CONCLUSION Clinicians can expect that patients with SSD will benefit from the SAMBA 2 BB by improved speech understanding in both quiet and in complex noise scenarios, when compared to the older SAMBA BB.
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Affiliation(s)
- Wilhelm Wimmer
- Department of ENT, Head and Neck Surgery, Bern University Hospital, University of Bern, Bern, Switzerland.
- Hearing Research Laboratory, ARTORG Center, University of Bern, Bern, Switzerland.
| | - Michael Zbinden
- Department of ENT, Head and Neck Surgery, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tom Gawliczek
- Department of ENT, Head and Neck Surgery, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Marco Caversaccio
- Department of ENT, Head and Neck Surgery, Bern University Hospital, University of Bern, Bern, Switzerland
- Hearing Research Laboratory, ARTORG Center, University of Bern, Bern, Switzerland
| | - Martin Kompis
- Department of ENT, Head and Neck Surgery, Bern University Hospital, University of Bern, Bern, Switzerland
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44
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Stern Shavit S, Adelman C, Yehezkely Kaufmann M. [COCHLEAR IMPLANTATION FOR PATIENTS WITH CONSERVATIVELY TREATED VESTIBULAR SCHWANNOMA]. Harefuah 2023; 162:419-423. [PMID: 37561030] [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] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Vestibular Schwannoma, a benign slow growing tumor on the eight cranial nerve, will eventually cause in most patients, a severe sensory neural hearing loss in the ipsilateral ear. Patients with asymmetric hearing loss experience difficulties in hearing in the presence of noise, in sound localization and an increase in listening effort, especially if contralateral hearing loss exists. Cochlear implant is the treatment of choice for hearing rehabilitation in severe to profound sensorineural hearing loss. This treatment was shown to be effective in patients with vestibular schwannoma whether they were treated by surgery, radiation or conservative surveillance only. In this case report we present 2 patients with stable growth of over 10 years, who presented with a severe decrease in hearing loss on the ipsilateral side and a known contralateral moderate loss. Both underwent cochlear implant with no other intervention and demonstrated great speech perception results and continue to use the implant regularly for several years. The cochlear implant is an effective tool for hearing rehabilitation for patients with a stable vestibular schwannoma under conservative surveillance. It is of grave importance to properly educate these patients on hearing rehabilitation and recommend cochlear implant for appropriate patients.
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Affiliation(s)
| | - Cahtia Adelman
- 2Speech and Hearing Clinic, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
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45
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Fraga GA, Peixoto RH, Zabeu JS, Lourençone LFM. Evolution of speech perception in patients with ossified cochlea and short array cochlear implant. Acta Otolaryngol 2023; 143:699-703. [PMID: 37603291 DOI: 10.1080/00016489.2023.2244992] [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: 05/29/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023]
Abstract
Background: Short array cochlear implant is indicated as rehabilitation in patients with severe to profound deafness, especially when there is cochlear ossification. In these cases, with reduced intracochlear patency, total insertion becomes more difficult, requiring the use of this type of electrode (15 mm). Few studies have been published to evaluate auditory performance, presenting controversial audiological results.Aims/Objectives: To report the speech perception of users of cochlear implants (CI) with short array. Material and Methods: A retrospective analysis of medical records of patients who underwent surgery for cochlear implantation with a short array, between 2009 and 2020, at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC-USP) was carried out. Results: There was performance evolution in the speech perception tests in the data analysis. Meningitis and congenital hearing loss were the main indications for CI in the sample. Conclusion. CI with a short array is an alternative in the management of patients with a history of cochlear ossification and severe or profound sensorineural hearing loss. Significance: To demonstrate the evolution of speech perception tests with short array cochlear implant in patients with or without ossified cochlea and its characteristics for application in clinical practice.
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Affiliation(s)
- Guilherme Adam Fraga
- Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo, Bauru, Brazil
| | - Rhaissa Heinen Peixoto
- Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo, Bauru, Brazil
| | - Julia Speranza Zabeu
- Cochlear Implant Section, Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo, Bauru, Brazil
| | - Luiz Fernando Manzoni Lourençone
- Cochlear Implant Section and Department of Otolaryngology, Hospital for Rehabilitation of Craniofacial Anomalies (HRAC), University of São Paulo, Bauru, Brazil
- Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Nassiri AM, Marinelli JP, Lohse CM, Carlson ML. Incidence of Cochlear Implantation Among Adult Candidates in the United States. Otol Neurotol 2023; 44:549-554. [PMID: 37205861 DOI: 10.1097/mao.0000000000003894] [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: 05/21/2023]
Abstract
OBJECTIVES To investigate the associations of age and year of cochlear implantation (CI) with CI incidence among adults 20 years and older residing in the US. STUDY DESIGN Deidentified cochlear implant data were acquired from prospective patient registries from two cochlear implant manufacturers (Cochlear Americas and Advanced Bionics), which supply an estimated 85% of cochlear implants in the US. Population estimates for severe-to-profound sensorineural hearing loss by age group were extracted from Census and National Health and Nutrition Examination Survey data. SETTING US CI centers. PATIENTS Adults 20 years and older who underwent CI. INTERVENTIONS CI. MAIN OUTCOME MEASURES CI incidence. RESULTS The study cohort included 30,066 adults 20 years and older who underwent CI from 2015 to 2019. When combining actual and estimated data from all three manufacturers, the annual number of cochlear implants increased 5,406 in 2015 to 8,509 in 2019. Overall, the incidence of CI among adult traditional (bilateral severe-to-profound hearing loss) CI candidates increased from 244 per 100,000 person-years in 2015 to 350 in 2019 ( p < 0.001). Although the elderly (80 years and older) population had the lowest incidence of CI, this cohort experienced the largest growth from an incidence of 105 per 100,000 person-years to 202 during the study period. CONCLUSIONS Despite growing incidence among those with qualifying hearing loss, cochlear implants remain widely underutilized. Elderly adults continue to exhibit the lowest relative cochlear implant utilization rates; however, trends over the last half-decade suggest a shift has occurred, resulting in improved access among this underserved subset.
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Affiliation(s)
- Ashley M Nassiri
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado
| | - John P Marinelli
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
| | - Christine M Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Matthew L Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota
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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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Nijmeijer HGB, Huinck WJ, Kramer SE, Donders ART, van der Wilt GJ, Mylanus EAM. Changes on clinical and participatory outcomes in people with severe-to-profound hearing loss after cochlear implantation: protocol of a multicentre prospective observational cohort study - Societal Merit of Intervention on Hearing Loss Evaluation (SMILE). BMJ Open 2023; 13:e072689. [PMID: 37369408 PMCID: PMC10410821 DOI: 10.1136/bmjopen-2023-072689] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Cochlear implantation (CI) is a (cost-)effective intervention for people with severe or profound hearing loss. Since its introduction experience increased and the technology evolved, leading to better results and relaxation of CI eligibility criteria. Meanwhile, with national healthcare costs increasing there is a need for evidence of healthcare technology's value. This protocol describes a study to investigate clinical and participatory outcomes after CI for the currently (expanded) eligible hearing impaired population. The study adds to the current evidence base through its multicentre design, long-term follow-up and use of participatory outcomes alongside standard clinical outcomes. METHODS This multicentre prospective observational cohort study will include at least 156 adult patients with severe-to-profound hearing loss, approximately evenly divided into two groups (1, ages 18-65 years and 2, age >65 years). The measurements consist of audiometry, cognition tests, listening effort tests and multiple generic and disease specific questionnaires. Questionnaires will be administered twice before CI, soon after inclusion at CI referral and shortly before CI surgery, with an annual follow-up of 3 years after CI. The Impact on Participation and Autonomy questionnaire will be used to assess participation. Generalised models (linear, logistic, Poisson) will be used. Mixed effects models will be used to investigate changes over time while exploring differences in subgroups and the influence of covariates. ETHICS AND DISSEMINATION The study has received ethical approval from the Medical Ethical Committee of all participating centres. The results could provide valuable insights into changes in participatory outcomes of people with severe-to-profound hearing loss after CI. Results will be disseminated through peer-reviewed journals, scientific conferences and professional and patient organisation meetings. TRIAL REGISTRATION NUMBER NCT05525221.
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Affiliation(s)
- Hugo G B Nijmeijer
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Wendy J Huinck
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
| | - Sophia E Kramer
- Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, Netherlands
| | | | - Gert Jan van der Wilt
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
- Department for Health Evidence, Radboudumc, Nijmegen, Netherlands
| | - Emmanuel A M Mylanus
- Department of Otorhinolaryngology, Radboudumc, Nijmegen, Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands
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Lee SJ, Lee S, Han JH, Choi BY, Lee JH, Lee DH, Lee SY, Oh SH. Structural analysis of pathogenic TMPRSS3 variants and their cochlear implantation outcomes of sensorineural hearing loss. Gene 2023; 865:147335. [PMID: 36871673 DOI: 10.1016/j.gene.2023.147335] [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: 12/31/2022] [Revised: 02/13/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
TMPRSS3, a type II transmembrane serine protease, is involved in various biological processes including the development and maintenance of the inner ear. Biallelic variants in TMPRSS3 typically result in altered protease activity, causing autosomal recessive non-syndromic hearing loss (ARNSHL). Structural modeling has been conducted to predict the pathogenicity of TMPRSS3 variants and to gain a better understanding of their prognostic correlation. The mutant-driven changes in TMPRSS3 had substantial impacts on neighboring residues, and the pathogenicity of variants was predicted based on their distance from the active site. However, a more in-depth analysis of other factors, such as intramolecular interactions and protein stability, which affect proteolytic activities is yet to be conducted for TMPRSS3 variants. Among 620 probands who provided genomic DNA for molecular genetic testing, eight families with biallelic TMPRSS3 variants that were segregated in a trans configuration were included. Seven different mutant alleles, either homozygous or compound heterozygous, contributed to TMPRSS3-associated ARNSHL, expanding the genotypic spectrum of disease-causing TMPRSS3 variants. Through three-dimensional modeling and structural analysis, TMPRSS3 variants compromise protein stability by altering intramolecular interactions, and each mutant differently interacts with the serine protease active site. Furthermore, the changes in intramolecular interactions leading to regional instability correlate with the results of functional assay and residual hearing function, but overall stability predictions do not. Our findings also build on previous evidence indicating that most recipients with TMPRSS3 variants have favorable cochlear implantation (CI) outcomes. We found that age at CI was significantly correlated with speech performance outcomes; genotype was not correlated with these outcomes. Collectively, the results of this study contribute to a more structural understanding of the underlying mechanisms of ARNSHL caused by TMPRSS3 variants.
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Affiliation(s)
- Seung Jae Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Somin Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Hee Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | | | - Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea.
| | - Seung-Ha Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea; Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
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Sprinzl G, Toner J, Koitschev A, Berger N, Keintzel T, Rasse T, Baumgartner WD, Honeder C, Magele A, Plontke S, Götze G, Schmutzhard J, Zelger P, Corkill S, Lenarz T, Salcher R. Multicentric study on surgical information and early safety and performance results with the Bonebridge BCI 602: an active transcutaneous bone conduction hearing implant. Eur Arch Otorhinolaryngol 2023; 280:1565-1579. [PMID: 36625869 PMCID: PMC9988757 DOI: 10.1007/s00405-022-07792-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 11/18/2022] [Accepted: 12/10/2022] [Indexed: 01/11/2023]
Abstract
AIM This European multicentric study aimed to prove safety and performance of the Bonebridge BCI 602 in children and adults suffering from either conductive hearing loss (CHL), mixed hearing loss (MHL), or single-sided sensorineural deafness (SSD). METHODS 33 patients (13 adults and 10 children with either CHL or MHL and 10 patients with SSD) in three study groups were included. Patients were their own controls (single-subject repeated measures), comparing the unaided or pre-operative to the 3-month post-operative outcomes. Performance was evaluated by sound field thresholds (SF), word recognition scores (WRS) and/or speech reception thresholds in quiet (SRT) and in noise (SNR). Safety was demonstrated with a device-specific surgical questionnaire, adverse event reporting and stable pure-tone measurements. RESULTS The Bonebridge BCI 602 significantly improved SF thresholds (+ 25.5 dB CHL/MHL/SSD), speech intelligibility in WRS (+ 68.0% CHL/MHL) and SRT in quiet (- 16.5 dB C/MHL) and in noise (- 3.51 dB SNR SSD). Air conduction (AC) and bone conduction (BC) thresholds remained stable over time. All adverse events were resolved, with none unanticipated. Mean audio processor wearing times in hours [h] per day for the CHL/MHL group were ~ 13 h for adults, ~ 11 h for paediatrics and ~ 6 h for the SSD group. The average surgical length was 57 min for the CHL/MHL group and 42 min for the SSD group. The versatility of the BCI 602 (reduced drilling depth and ability to bend the transition for optimal placement) allows for treatment of normal, pre-operated and malformed anatomies. All audiological endpoints were reached. CONCLUSIONS The Bonebridge BCI 602 significantly improved hearing thresholds and speech understanding. Since implant placement follows the patient's anatomy instead of the shape of the device and the duration of surgery is shorter than with its predecessor, implantation is easier with the BCI 602. Performance and safety were proven for adults and children as well as for the CHL/MHL and SSD indications 3 months post-operatively.
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Affiliation(s)
- Georg Sprinzl
- Hals-Nasen-Ohren-Abteilung, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften und Karl-Landsteiner Institut für Implantierbare Hörsysteme, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100 St. Pölten, Austria
| | - Joseph Toner
- Regional Auditory Implant Centre, Beech Hall Centre, Belfast, Northern Ireland, UK
| | - Assen Koitschev
- Klinik für HNO-Krankheiten, Plastische Operationen, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
| | - Nadine Berger
- Klinik für HNO-Krankheiten, Plastische Operationen, Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
| | - Thomas Keintzel
- Abteilung für Hals-, Nasen-, Ohrenkrankheiten, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Thomas Rasse
- Abteilung für Hals-, Nasen-, Ohrenkrankheiten, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Wolf-Dieter Baumgartner
- Allgemeines Krankenhaus der Stadt Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Clemens Honeder
- Allgemeines Krankenhaus der Stadt Wien, Universitätsklinik für Hals-, Nasen- und Ohrenkrankheiten, Vienna, Austria
| | - Astrid Magele
- Hals-Nasen-Ohren-Abteilung, Karl Landsteiner Privatuniversität für Gesundheitswissenschaften und Karl-Landsteiner Institut für Implantierbare Hörsysteme, Universitätsklinikum St. Pölten, Dunant-Platz 1, 3100 St. Pölten, Austria
| | - Stefan Plontke
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Gerrit Götze
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Joachim Schmutzhard
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde Innsbruck, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Philipp Zelger
- Universitätsklinik für Hör-, Stimm- und Sprachstörungen, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Stephanie Corkill
- Regional Auditory Implant Centre, Beech Hall Centre, Belfast, Northern Ireland, UK
| | - Thomas Lenarz
- Medizinische Hochschule Hannover, Klinik und Poliklinik für HNO-Heilkunde, Hannover, Germany
| | - Rolf Salcher
- Medizinische Hochschule Hannover, Klinik und Poliklinik für HNO-Heilkunde, Hannover, Germany
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