Pub Date : 2024-07-01Epub Date: 2024-05-21DOI: 10.1097/MAO.0000000000004223
Moises Arriaga
{"title":"Book Review: Disorders of the Vestibular System: Diagnosis and Management : Benjamin T. Crane, Lawrence Lustig, and Christopher de Souza, eds.; Switzerland: Springer, 2023.","authors":"Moises Arriaga","doi":"10.1097/MAO.0000000000004223","DOIUrl":"10.1097/MAO.0000000000004223","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-21DOI: 10.1097/MAO.0000000000004205
Hajime Koyama, Akinori Kashio, Tatsuya Yamasoba
Objective: This study aimed to evaluate the differences in electrically evoked compound action potential (ECAP) thresholds and postoperative mapping current (T) levels between electrode types after cochlear implantation, the correlation between ECAP thresholds and T levels, and the performance of machine learning techniques in predicting postoperative T levels.
Study design: Retrospective case review.
Setting: Tertiary hospital.
Patients: We reviewed the charts of 124 ears of children with severe-to-profound hearing loss who had undergone cochlear implantation.
Interventions: We compared ECAP thresholds and T levels from different electrodes, calculated correlations between ECAP thresholds and T levels, and created five prediction models of T levels at switch-on and 6 months after surgery.
Main outcome measures: The accuracy of prediction in postoperative mapping current (T) levels.
Results: The ECAP thresholds of the slim modiolar electrodes were significantly lower than those of the straight electrodes on the apical side. However, there was no significant difference in the neural response telemetry thresholds between the two electrodes on the basal side. Lasso regression achieved the most accurate prediction of T levels at switch-on, and the random forest algorithm achieved the most accurate prediction of T levels 6 months after surgery in this dataset.
Conclusion: Machine learning techniques could be useful for accurately predicting postoperative T levels after cochlear implantation in children.
研究目的本研究旨在评估人工耳蜗植入术后不同电极类型的电诱发复合动作电位(ECAP)阈值和术后映射电流(T)水平的差异、ECAP阈值和T水平之间的相关性,以及机器学习技术在预测术后T水平方面的性能:背景:三级医院地点:三级医院:干预措施:比较 ECAP 阈值和 T 水平:我们比较了来自不同电极的ECAP阈值和T水平,计算了ECAP阈值和T水平之间的相关性,并创建了5个T水平预测模型,用于预测开机时和术后6个月的T水平:主要结果指标:术后映射电流(T)水平预测的准确性:结果:细长的小叶电极的ECAP阈值明显低于心尖侧的直电极。然而,基底侧两个电极的神经反应遥测阈值没有明显差异。在该数据集中,Lasso 回归对开关机时的 T 水平预测最为准确,随机森林算法对术后 6 个月的 T 水平预测最为准确:机器学习技术有助于准确预测儿童人工耳蜗植入术后的 T 值。
{"title":"Prediction of Cochlear Implant Fitting by Machine Learning Techniques.","authors":"Hajime Koyama, Akinori Kashio, Tatsuya Yamasoba","doi":"10.1097/MAO.0000000000004205","DOIUrl":"10.1097/MAO.0000000000004205","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the differences in electrically evoked compound action potential (ECAP) thresholds and postoperative mapping current (T) levels between electrode types after cochlear implantation, the correlation between ECAP thresholds and T levels, and the performance of machine learning techniques in predicting postoperative T levels.</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary hospital.</p><p><strong>Patients: </strong>We reviewed the charts of 124 ears of children with severe-to-profound hearing loss who had undergone cochlear implantation.</p><p><strong>Interventions: </strong>We compared ECAP thresholds and T levels from different electrodes, calculated correlations between ECAP thresholds and T levels, and created five prediction models of T levels at switch-on and 6 months after surgery.</p><p><strong>Main outcome measures: </strong>The accuracy of prediction in postoperative mapping current (T) levels.</p><p><strong>Results: </strong>The ECAP thresholds of the slim modiolar electrodes were significantly lower than those of the straight electrodes on the apical side. However, there was no significant difference in the neural response telemetry thresholds between the two electrodes on the basal side. Lasso regression achieved the most accurate prediction of T levels at switch-on, and the random forest algorithm achieved the most accurate prediction of T levels 6 months after surgery in this dataset.</p><p><strong>Conclusion: </strong>Machine learning techniques could be useful for accurately predicting postoperative T levels after cochlear implantation in children.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-21DOI: 10.1097/MAO.0000000000004210
Zahra N Sayyid, Diane Jung, Jenny X Chen, Adrian G Paez, Jun Hua, Francis Deng, John P Carey, Bryan K Ward
{"title":"Clinical Application of 7T MRI: A Case Study of Vestibular Schwannoma Imaging.","authors":"Zahra N Sayyid, Diane Jung, Jenny X Chen, Adrian G Paez, Jun Hua, Francis Deng, John P Carey, Bryan K Ward","doi":"10.1097/MAO.0000000000004210","DOIUrl":"10.1097/MAO.0000000000004210","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/MAO.0000000000004221
Kristen Rak, Bjoern Spahn, Franz-Tassilo Müller-Graff, Jonas Engert, Johannes Voelker, Stephan Hackenberg, Rudolf Hagen, Bernhard Petritsch, Jan-Peter Grunz, Thorsten Bley, Tilmann Neun, Henner Huflage
Introduction: Cochlear duct length (CDL) measurement plays a role in the context of individualized cochlear implant (CI) surgery regarding an individualized selection and implantation of the CI electrode carrier and an efficient postoperative anatomy-based fitting process. The level of detail of the preoperative temporal bone CT scan depends on the imaging modality with major impact on CDL measurements and CI electrode contact position determination. The aim of this study was to evaluate the accuracy of perioperative CDL measurements and electrode contact determination in photon-counting CT (PCCT).
Methods: Ten human fresh-frozen petrous bone specimens were examined with a first-generation PCCT. A clinically applicable radiation dose of 27.1 mGy was used. Scans were acquired before and after CI insertion. Postoperative measurement of the CDL was conducted using an otological planning software and 3D-curved multiplanar reconstruction. Investigation of electrode contact position was performed by two respective observers. Measurements were compared with a conventional multislice CT and to a high-resolution flat-panel volume CT with secondary reconstructions.
Results: Pre- and postoperative CDL measurements in PCCT images showed no significant difference to high-resolution flat-panel volume CT. Postoperative CI electrode contact determination was also as precise as the flat-panel CT-based assessment. PCCT and flat-panel volume CT were equivalent concerning interobserver variability.
Conclusion: CDL measurement with PCCT was equivalent to flat-panel volume CT with secondary reconstructions. PCCT enabled highly precise postoperative CI electrode contact determination with substantial advantages over conventional multislice CT scanners.
导言:人工耳蜗导管长度(CDL)测量在个体化人工耳蜗植入(CI)手术中起着重要作用,它涉及 CI 电极载体的个体化选择和植入,以及基于解剖的高效术后验配过程。术前颞骨 CT 扫描的详细程度取决于对 CDL 测量和 CI 电极接触位置确定有重大影响的成像模式。本研究旨在评估光子计数 CT(PCCT)围术期 CDL 测量和电极接触确定的准确性:方法:使用第一代 PCCT 检查了十个人体新鲜冷冻的岩骨标本。使用的临床适用辐射剂量为 27.1 mGy。在插入 CI 之前和之后进行扫描。术后使用耳科规划软件和三维曲面多平面重建对 CDL 进行了测量。电极接触位置的调查由两名观察员分别进行。测量结果与传统的多层 CT 和二次重建的高分辨率平板容积 CT 进行了比较:结果:PCCT 图像的术前和术后 CDL 测量结果与高分辨率平板容积 CT 没有明显差异。术后 CI 电极接触测定也与基于平板 CT 的评估一样精确。在观察者间变异性方面,PCCT 和平板容积 CT 相当:结论:使用 PCCT 测量 CDL 与使用二次重建的平板容积 CT 相当。与传统的多层 CT 扫描仪相比,PCCT 能够高度精确地确定术后 CI 电极的接触情况。
{"title":"The Photon-Counting CT Enters the Field of Cochlear Implantation: Comparison to Angiography DynaCT and Conventional Multislice CT.","authors":"Kristen Rak, Bjoern Spahn, Franz-Tassilo Müller-Graff, Jonas Engert, Johannes Voelker, Stephan Hackenberg, Rudolf Hagen, Bernhard Petritsch, Jan-Peter Grunz, Thorsten Bley, Tilmann Neun, Henner Huflage","doi":"10.1097/MAO.0000000000004221","DOIUrl":"10.1097/MAO.0000000000004221","url":null,"abstract":"<p><strong>Introduction: </strong>Cochlear duct length (CDL) measurement plays a role in the context of individualized cochlear implant (CI) surgery regarding an individualized selection and implantation of the CI electrode carrier and an efficient postoperative anatomy-based fitting process. The level of detail of the preoperative temporal bone CT scan depends on the imaging modality with major impact on CDL measurements and CI electrode contact position determination. The aim of this study was to evaluate the accuracy of perioperative CDL measurements and electrode contact determination in photon-counting CT (PCCT).</p><p><strong>Methods: </strong>Ten human fresh-frozen petrous bone specimens were examined with a first-generation PCCT. A clinically applicable radiation dose of 27.1 mGy was used. Scans were acquired before and after CI insertion. Postoperative measurement of the CDL was conducted using an otological planning software and 3D-curved multiplanar reconstruction. Investigation of electrode contact position was performed by two respective observers. Measurements were compared with a conventional multislice CT and to a high-resolution flat-panel volume CT with secondary reconstructions.</p><p><strong>Results: </strong>Pre- and postoperative CDL measurements in PCCT images showed no significant difference to high-resolution flat-panel volume CT. Postoperative CI electrode contact determination was also as precise as the flat-panel CT-based assessment. PCCT and flat-panel volume CT were equivalent concerning interobserver variability.</p><p><strong>Conclusion: </strong>CDL measurement with PCCT was equivalent to flat-panel volume CT with secondary reconstructions. PCCT enabled highly precise postoperative CI electrode contact determination with substantial advantages over conventional multislice CT scanners.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/MAO.0000000000004219
Sanjay Patel, Ben Walters, Valerie Kim, Hussein Walijee
Objectives: Iatrogenic facial nerve palsy following otological surgery is a devastating complication that results in adverse aesthetic and functional outcomes. This study aims to review studies that have reported cases of immediate facial nerve palsy to learn why and where injuries occurred and to assess outcomes following management.
Databases reviewed: MEDLINE, Embase, Cochrane CENTRAL, and Pubmed up to June 20, 2023.
Methods: Clinical studies of immediate facial nerve palsies following middle ear and cochlear implantation surgery were included. Risk of bias was examined using the Brazzelli risk of bias tool. Due to the inconsistency in reporting of outcomes, we were unable to perform a meta-analysis.
Results: Of 234 studies identified, 11 met the inclusion criteria. The most common causes of injury were excessive drilling, use of sharp hooks to remove disease, or disorientation of the surgeon secondary to bleeding or inflammation. Variable usage of preoperative computed tomography (CT) imaging and intraoperative facial nerve monitoring was reported. The tympanic segment was the most common site of injury. A variety of surgical techniques were employed to approach the facial nerve injury including facial nerve decompression, direct closure, and repair using an autologous nerve graft.
Conclusions: Otological surgeons should consider utilizing preoperative CT imaging to establish a three-dimensional mental image of key landmarks and anatomical variations before embarking on surgery. Intraoperative FN monitoring enables safe practice. Despite these measures, complex disease processes and hostile intraoperative conditions can present difficulty. Multiple treatment options are available to treat the underlying injury.
{"title":"Immediate Facial Nerve Palsy Secondary to Otological Surgery: A Systematic Review and Narrative Synthesis.","authors":"Sanjay Patel, Ben Walters, Valerie Kim, Hussein Walijee","doi":"10.1097/MAO.0000000000004219","DOIUrl":"10.1097/MAO.0000000000004219","url":null,"abstract":"<p><strong>Objectives: </strong>Iatrogenic facial nerve palsy following otological surgery is a devastating complication that results in adverse aesthetic and functional outcomes. This study aims to review studies that have reported cases of immediate facial nerve palsy to learn why and where injuries occurred and to assess outcomes following management.</p><p><strong>Databases reviewed: </strong>MEDLINE, Embase, Cochrane CENTRAL, and Pubmed up to June 20, 2023.</p><p><strong>Methods: </strong>Clinical studies of immediate facial nerve palsies following middle ear and cochlear implantation surgery were included. Risk of bias was examined using the Brazzelli risk of bias tool. Due to the inconsistency in reporting of outcomes, we were unable to perform a meta-analysis.</p><p><strong>Results: </strong>Of 234 studies identified, 11 met the inclusion criteria. The most common causes of injury were excessive drilling, use of sharp hooks to remove disease, or disorientation of the surgeon secondary to bleeding or inflammation. Variable usage of preoperative computed tomography (CT) imaging and intraoperative facial nerve monitoring was reported. The tympanic segment was the most common site of injury. A variety of surgical techniques were employed to approach the facial nerve injury including facial nerve decompression, direct closure, and repair using an autologous nerve graft.</p><p><strong>Conclusions: </strong>Otological surgeons should consider utilizing preoperative CT imaging to establish a three-dimensional mental image of key landmarks and anatomical variations before embarking on surgery. Intraoperative FN monitoring enables safe practice. Despite these measures, complex disease processes and hostile intraoperative conditions can present difficulty. Multiple treatment options are available to treat the underlying injury.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/MAO.0000000000004222
Benjamin R Johnson, Ezer H Benaim, Nicholas J Thompson, Azmi Marouf, Matthew M Dedmon, Melissa R Anderson, A Morgan Selleck, Kevin D Brown, Margaret T Dillon
Objective: Misplacement of electrode arrays in the internal auditory canal (IAC) presents a unique clinical challenge. Speech recognition is limited for cochlear implant (CI) users with misplaced arrays, and there are risks with revision surgery including facial and/or cochlear nerve injury.
Databases reviewed: PubMed, Embase, and Scopus.
Methods: A literature search was performed from inception to September 2023. The search terms were designed to capture articles on misplaced arrays and the management options. Articles written in English that described cases of array misplacement into the IAC for children and adults were included. The level of evidence was assessed using Oxford Center for Evidence Based Medicine guidelines. Descriptive statistical analyses were performed.
Results: Twenty-eight cases of arrays misplaced in the IAC were identified. Thirteen (46%) were patients with incomplete partition type 3 (IP3), and 7 (25%) were patients with common cavity (CC) malformations. Most misplaced arrays were identified postoperatively (19 cases; 68%). Of these cases, 11 (58%) were managed with array removal. No facial nerve injuries were reported with revision surgery. Eight cases (42%) were left in place. Several underwent mapping procedures in an attempt improve the sound quality with the CI.
Conclusion: Electrode array misplacement in the IAC is a rare complication that reportedly occurs predominately in cases with IP3 and CC malformations. Removal of misplaced arrays from the IAC reportedly has not been associated with facial nerve injuries. Cases identified with IAC misplacement postoperatively can potentially be managed with modified mapping techniques before proceeding with revision surgery.
{"title":"Management of Cochlear Implant Electrode Arrays Misplaced in the Internal Auditory Canal: A Systematic Review.","authors":"Benjamin R Johnson, Ezer H Benaim, Nicholas J Thompson, Azmi Marouf, Matthew M Dedmon, Melissa R Anderson, A Morgan Selleck, Kevin D Brown, Margaret T Dillon","doi":"10.1097/MAO.0000000000004222","DOIUrl":"10.1097/MAO.0000000000004222","url":null,"abstract":"<p><strong>Objective: </strong>Misplacement of electrode arrays in the internal auditory canal (IAC) presents a unique clinical challenge. Speech recognition is limited for cochlear implant (CI) users with misplaced arrays, and there are risks with revision surgery including facial and/or cochlear nerve injury.</p><p><strong>Databases reviewed: </strong>PubMed, Embase, and Scopus.</p><p><strong>Methods: </strong>A literature search was performed from inception to September 2023. The search terms were designed to capture articles on misplaced arrays and the management options. Articles written in English that described cases of array misplacement into the IAC for children and adults were included. The level of evidence was assessed using Oxford Center for Evidence Based Medicine guidelines. Descriptive statistical analyses were performed.</p><p><strong>Results: </strong>Twenty-eight cases of arrays misplaced in the IAC were identified. Thirteen (46%) were patients with incomplete partition type 3 (IP3), and 7 (25%) were patients with common cavity (CC) malformations. Most misplaced arrays were identified postoperatively (19 cases; 68%). Of these cases, 11 (58%) were managed with array removal. No facial nerve injuries were reported with revision surgery. Eight cases (42%) were left in place. Several underwent mapping procedures in an attempt improve the sound quality with the CI.</p><p><strong>Conclusion: </strong>Electrode array misplacement in the IAC is a rare complication that reportedly occurs predominately in cases with IP3 and CC malformations. Removal of misplaced arrays from the IAC reportedly has not been associated with facial nerve injuries. Cases identified with IAC misplacement postoperatively can potentially be managed with modified mapping techniques before proceeding with revision surgery.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1097/MAO.0000000000004218
Carlos A Perez-Heydrich, Ilahi Creary-Miller, Marcus Spann, Yuri Agrawal
Background: People with vestibular dysfunction encounter many obstacles when seeking vestibular rehabilitation treatment. Remote delivery of vestibular rehabilitation may offer a promising avenue for overcoming these barriers, ensuring uninterrupted and cost-effective care.
Objective: To evaluate clinical trials studying telerehabilitation and virtual reality devices as therapeutic interventions for individuals with vestibular dysfunction.
Methods: A PRISMA systematic review of PubMed, EMBASE, Cochrane, Web of Science, and SCOPUS was conducted for randomized controlled trials describing the use of remote care delivery for vestibular rehabilitation. Bias of studies was assessed with the revised Cochrane risk-of-bias tool (RoB2).
Results: The search identified 1,358 unique articles and 14 articles matched the search criteria. Study samples size ranged from 20 to 337, with mean ages ranging from 29.3 to 77.7 years. Interventions included telephone and online communication, exergaming devices, web-based applications, and head-mounted devices to deliver vestibular rehabilitation. Outcomes included validated questionnaires, objective clinical tests, and physical examinations.
Conclusions: The studies reviewed in this article reported greater or equivalent outcomes when incorporating remote care options as supplements or alternatives to standard care for patients with vestibular dysfunction. Further research is required to address limitations in these studies such as heterogeneity of control groups and cost-effectiveness of these interventions.
{"title":"Remote Delivery of Vestibular Rehabilitation for Vestibular Dysfunction: A Systematic Review.","authors":"Carlos A Perez-Heydrich, Ilahi Creary-Miller, Marcus Spann, Yuri Agrawal","doi":"10.1097/MAO.0000000000004218","DOIUrl":"10.1097/MAO.0000000000004218","url":null,"abstract":"<p><strong>Background: </strong>People with vestibular dysfunction encounter many obstacles when seeking vestibular rehabilitation treatment. Remote delivery of vestibular rehabilitation may offer a promising avenue for overcoming these barriers, ensuring uninterrupted and cost-effective care.</p><p><strong>Objective: </strong>To evaluate clinical trials studying telerehabilitation and virtual reality devices as therapeutic interventions for individuals with vestibular dysfunction.</p><p><strong>Methods: </strong>A PRISMA systematic review of PubMed, EMBASE, Cochrane, Web of Science, and SCOPUS was conducted for randomized controlled trials describing the use of remote care delivery for vestibular rehabilitation. Bias of studies was assessed with the revised Cochrane risk-of-bias tool (RoB2).</p><p><strong>Results: </strong>The search identified 1,358 unique articles and 14 articles matched the search criteria. Study samples size ranged from 20 to 337, with mean ages ranging from 29.3 to 77.7 years. Interventions included telephone and online communication, exergaming devices, web-based applications, and head-mounted devices to deliver vestibular rehabilitation. Outcomes included validated questionnaires, objective clinical tests, and physical examinations.</p><p><strong>Conclusions: </strong>The studies reviewed in this article reported greater or equivalent outcomes when incorporating remote care options as supplements or alternatives to standard care for patients with vestibular dysfunction. Further research is required to address limitations in these studies such as heterogeneity of control groups and cost-effectiveness of these interventions.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-21DOI: 10.1097/MAO.0000000000004203
Derya Ümit Talas, Onurhan Güven, Pourya Taghipour, Funda Acar, Orhan Beger, Ecenur Işık, Kemal Koray Bal, Mesut Yeşilova, Yusuf Vayısoğlu
Purpose: This cadaveric anatomical study aimed to explore precise morphometric measurements of the eustachian tube (ET) and adjacent structures in the middle cranial fossa, focusing on identifying reliable surgical landmarks when traditional markers are compromised due to tumors or trauma.
Methods: Twenty-two temporal bones from 11 adult cadavers (mean age: 75.70 ± 13.75 yr, range: 40-90 yr; sex: 5 females and 6 males) were dissected bilaterally. Surgical tools, including an operation microscope, endoscope, and digital caliper, were used for meticulous measurements. Parameters such as ET dimensions, distances between key points, and relevant angles were quantified, ensuring precise anatomical data.
Results: ET width at the foramen spinosum (FS) level, the midline level, and the eustachian orifice level were measured as 2.18 ± 0.68, 2.42 ± 0.70, and 2.30 ± 0.74 mm, respectively. The distances from the zygomatic root (ZR) to FS, ET, superior semicircular canal (SSC), and internal carotid artery (ICA) were 29.61 ± 2.56, 23.28 ± 2.61, 26.53 ± 2.56, and 32.61 ± 3.69 mm, respectively. The angles between SSC-ZR-ICA and FS-ZR-ICA were measured as 36.57 ± 10.32 and 13.63 ± 3.72 degrees, respectively. No statistical difference was found between right-left or male-female measurements ( p > 0.05).
Conclusion: The present study offers invaluable insights for neurotological surgeons performing middle fossa approaches. ET and ZR may serve as crucial reference points, enhancing surgical orientation and minimizing risks during complex procedures. These precise anatomical data may empower surgeons, ensuring safer and more confident middle cranial fossa operations, even in challenging clinical scenarios.
{"title":"Anatomical Analysis of the Eustachian Tube in the Temporal Bone Through the Middle Fossa Window.","authors":"Derya Ümit Talas, Onurhan Güven, Pourya Taghipour, Funda Acar, Orhan Beger, Ecenur Işık, Kemal Koray Bal, Mesut Yeşilova, Yusuf Vayısoğlu","doi":"10.1097/MAO.0000000000004203","DOIUrl":"10.1097/MAO.0000000000004203","url":null,"abstract":"<p><strong>Purpose: </strong>This cadaveric anatomical study aimed to explore precise morphometric measurements of the eustachian tube (ET) and adjacent structures in the middle cranial fossa, focusing on identifying reliable surgical landmarks when traditional markers are compromised due to tumors or trauma.</p><p><strong>Methods: </strong>Twenty-two temporal bones from 11 adult cadavers (mean age: 75.70 ± 13.75 yr, range: 40-90 yr; sex: 5 females and 6 males) were dissected bilaterally. Surgical tools, including an operation microscope, endoscope, and digital caliper, were used for meticulous measurements. Parameters such as ET dimensions, distances between key points, and relevant angles were quantified, ensuring precise anatomical data.</p><p><strong>Results: </strong>ET width at the foramen spinosum (FS) level, the midline level, and the eustachian orifice level were measured as 2.18 ± 0.68, 2.42 ± 0.70, and 2.30 ± 0.74 mm, respectively. The distances from the zygomatic root (ZR) to FS, ET, superior semicircular canal (SSC), and internal carotid artery (ICA) were 29.61 ± 2.56, 23.28 ± 2.61, 26.53 ± 2.56, and 32.61 ± 3.69 mm, respectively. The angles between SSC-ZR-ICA and FS-ZR-ICA were measured as 36.57 ± 10.32 and 13.63 ± 3.72 degrees, respectively. No statistical difference was found between right-left or male-female measurements ( p > 0.05).</p><p><strong>Conclusion: </strong>The present study offers invaluable insights for neurotological surgeons performing middle fossa approaches. ET and ZR may serve as crucial reference points, enhancing surgical orientation and minimizing risks during complex procedures. These precise anatomical data may empower surgeons, ensuring safer and more confident middle cranial fossa operations, even in challenging clinical scenarios.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141069947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01Epub Date: 2024-05-21DOI: 10.1097/MAO.0000000000004198
Atte Sjövall, Ella Mustanoja, Annina Lyyski, Petri Auvinen, Juha Silvola, Antti Aarnisalo, Anu Pätäri-Sampo, Anu Laulajainen-Hongisto
Objective: To investigate the microbial changes of long-term hearing aid use culture independently.
Study design: Cross-sectional study.
Patients: Fifty long-term hearing aid users and 80 volunteer controls with asymptomatic ears.
Intervention: External auditory canal (EAC) sampling with DNA-free swabs.
Main outcome measures: Microbial communities in the samples were investigated with amplicon sequencing of the 16S rRNA gene.
Results: The final analysis contained 48 hearing aid users, 59 controls. Twenty-four samples were excluded because of low sequence count, recent use of antimicrobials and/or corticosteroids, recent cold, or missing health status. The groups showed significant differences in bacterial diversity (beta div., p = 0.011), and hearing aid users showed lower species richness than the control group (alpha div., p < 0.01). The most frequent findings in both groups were Staphylococcus auricularis , Alloiococcus otitis , Cutibacterium acnes , Corynebacterium otitidis , and Staphylococcus unclassified sp. Hearing aid users' samples presented more Corynebacterium tuberculostearicum than the control samples. Common EAC pathogens, such as Staphylococcus aureus or Pseudomonas aeruginosa were rare.
Conclusion: Long-term hearing aid use lowers bacterial diversity and modulates the EAC microbiome. The changes mostly affect commensals. Lowered diversity may predispose individuals to EAC conditions and needs more research.
{"title":"Microbiome of the External Auditory Canal: Changes After Long-Term Hearing Aid Use.","authors":"Atte Sjövall, Ella Mustanoja, Annina Lyyski, Petri Auvinen, Juha Silvola, Antti Aarnisalo, Anu Pätäri-Sampo, Anu Laulajainen-Hongisto","doi":"10.1097/MAO.0000000000004198","DOIUrl":"10.1097/MAO.0000000000004198","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the microbial changes of long-term hearing aid use culture independently.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Patients: </strong>Fifty long-term hearing aid users and 80 volunteer controls with asymptomatic ears.</p><p><strong>Intervention: </strong>External auditory canal (EAC) sampling with DNA-free swabs.</p><p><strong>Main outcome measures: </strong>Microbial communities in the samples were investigated with amplicon sequencing of the 16S rRNA gene.</p><p><strong>Results: </strong>The final analysis contained 48 hearing aid users, 59 controls. Twenty-four samples were excluded because of low sequence count, recent use of antimicrobials and/or corticosteroids, recent cold, or missing health status. The groups showed significant differences in bacterial diversity (beta div., p = 0.011), and hearing aid users showed lower species richness than the control group (alpha div., p < 0.01). The most frequent findings in both groups were Staphylococcus auricularis , Alloiococcus otitis , Cutibacterium acnes , Corynebacterium otitidis , and Staphylococcus unclassified sp. Hearing aid users' samples presented more Corynebacterium tuberculostearicum than the control samples. Common EAC pathogens, such as Staphylococcus aureus or Pseudomonas aeruginosa were rare.</p><p><strong>Conclusion: </strong>Long-term hearing aid use lowers bacterial diversity and modulates the EAC microbiome. The changes mostly affect commensals. Lowered diversity may predispose individuals to EAC conditions and needs more research.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}