Journal of Otology最新文献

Several technical variations of tympanoplasty have been reported, usually involving the type of graft and/or instruments used. Few studies have focused on the outcome of type-1 tympanoplasty specifically in teaching scenarios. We aimed to describe the results of type-1 tympanoplasty performed by residents, and to investigate potential predictive factors of surgical success. To do so, we did a retrospective analysis of medical records of patients who underwent type-1 tympanoplasty in a tertiary university hospital. We evaluated the tympanic membrane closure and audiometric outcomes during the first year of follow-up, and compared the results according to some clinical and surgical factors. 130 operated ears were included in the study. The closure rate reached 84.12% after one month and 72.72% after twelve months of surgery. The mean air-bone gap was 22.98 dB preoperatively, and reached 10.55 dB after surgery. Perforation closure rates were 85% and 57.14% for those operated by endoscopic and microscopic-assisted approaches, respectively (p = 0.004). The use of cartilage grafts and time without otorrhea of more than three months prior to surgery were also predictors of surgical success (p = 0.002 and 0.041, respectively). Gender, age, perforation size, contralateral disease, operated side, reoperation, and degree of hearing loss did not significantly interfere with outcomes. Tympanoplasty showed good overall results when performed by residents, although inferior to those reported by experienced surgeons. The use of the endoscope, cartilage grafting, and longer preoperative time without otorrhea were predictors of surgical success in this scenario.

Level of evidence

IIB.

Background

Musical perception requires a host of skills. Instrumental musicians place greater emphasis on motor coordination, whereas vocal musicians rehearse vocal sounds. The study explored the differential advantages of musical background on binaural integration and interaction in musicians (instrumentalists, vocalists) and compared them with age-matched non-musicians.

Methods

Eight six participants aged 20–40 y with normal hearing sensitivity were subjected to binaural tests using a standard group comparison research design. The participants were segregated into three groups – Group 1 included instrumentalists (n = 26, mean age: 17.73 ± 2.83 y), while Group 2 and Group 3 consisted of vocalists (n = 30, mean age: 19.30 ± 2.47 y) and non-musicians (n = 30, mean age: 18.20 ± 3.02 y) respectively. The binaural processes namely integration (Dichotic syllable test, DST; and virtual acoustic space identification - VASI) and interaction (Interaural difference thresholds for time and level: ITD & ILD), were administered on all the participants.

Results

Statistical analyses showed the main effect of musicianship. Bonferroni pair-wise test revealed that the musicians (instrumentalists and vocalists) outperformed (p < 0.05) non-musicians in all the tests. The differential advantage of the musical background was seen on the binaural integration test with instrumentalists performing better in the VASI test compared to vocalists, and vice-versa for DST. No difference was observed in interaction tasks (ITD & ILD) between vocalists and instrumentalists (p > 0.05).

Conclusion

Musical background-induced differential advantages can be reasonably noted in the binaural skills of instrumentalists and vocalists (compared to non-musicians).

Several technical variations of tympanoplasty have been reported, usually involving the type of graft and/or instruments used. Few studies have focused on the outcome of type-1 tympanoplasty specifically in teaching scenarios. We aimed to describe the results of type-1 tympanoplasty performed by residents, and to investigate potential predictive factors of surgical success. To do so, we did a retrospective analysis of medical records of patients who underwent type-1 tympanoplasty in a tertiary university hospital. We evaluated the tympanic membrane closure and audiometric outcomes during the first year of follow-up, and compared the results according to some clinical and surgical factors. 130 operated ears were included in the study. The closure rate reached 84.12% after one month and 72.72% after twelve months of surgery. The mean air-bone gap was 22.98 dB preoperatively, and reached 10.55 dB after surgery. Perforation closure rates were 85% and 57.14% for those operated by endoscopic and microscopic-assisted approaches, respectively (p = 0.004). The use of cartilage grafts and time without otorrhea of more than three months prior to surgery were also predictors of surgical success (p = 0.002 and 0.041, respectively). Gender, age, perforation size, contralateral disease, operated side, reoperation, and degree of hearing loss did not significantly interfere with outcomes. Tympanoplasty showed good overall results when performed by residents, although inferior to those reported by experienced surgeons. The use of the endoscope, cartilage grafting, and longer preoperative time without otorrhea were predictors of surgical success in this scenario.

Level of evidence

IIB.

Safe and efficient drug delivery to the inner ear has always been the focus of prevention and treatment of sensorineural deafness. The rapid development of nanodrug delivery systems based on hydrogel has provided a new opportunity. Among them, thermo-sensitive hydrogels promote the development of new dosage form for intratympanic injection. This smart biomaterial could transform to semisolid phase when the temperature increased. Thermo-sensitive hydrogel nanodrug delivery system is expected to achieve safe, efficient, and sustained inner ear drug administration. This article introduces the key techniques and the latest progress in this field.

The role of intercalatus nucleus of Staderini (INS), the most caudal of the perihypoglossal nuclei, is much debated. Last research seems to suggest that this nucleus plays a role as a vertical eyes movements integrator. The few clinical reports present in the literature that describe isolated lesions of the INS have described patients presenting in acute with up-beating vertical spontaneous nystagmus. Isolated acute lesion of INS is, in fact, much rare, and, without other neurological signs, is exceptional. We present a case of acute isolated vertigo with no other neurological signs or symptoms, due to INS ischemia provoked by vertebral artery stenosis. The patient presented with spontaneous vertical up-beating nystagmus that showed at videonystagmographic recording, a clear exponential decay of angular slow-phase velocity, that is considered a typical sign of neural integrator impairment. This case seems to represent a further confirm that INS is part, as a vertical-to-position neural integrator, of the neural circuit controlling the vertical eyes movements.

Objective

Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are commonly employed in pre-operative evaluation for cochlear implant surgery. However, with a decrease in the age of implantation, even minor radiation exposure can cause detrimental effects on children over their lifetime. The current study compares different cochlear measurements from CT and MRI scans and evaluates the feasibility of using only an MRI scan for radiological evaluation before cochlear implantation.

Methods

A longitudinal observational study was conducted on 94 ears/47 children, employing CT and MRI scans. The CT and MRI scan measurements include, A value, B value, Cochlear duct length (CDL), two-turn cochlear length, alpha and beta angles to look for cochlear orientation. Cochlear nerve diameter was measured using MRI. The values were compared.

Results

The mean difference between measurements from CT and MRI scans for A value, B value, CDL, and two-turn cochlear length values was 0.567 ± 0.413 mm, 0.406 ± 0.368 mm, 2.365 ± 1.675 mm, and 2.063 ± 1.477 mm respectively without any significant difference. The alpha and beta angle measures were comparable, with no statistically significant difference.

Conclusion

The study suggests that MRI scans can be the only radiological investigation needed with no radiation risk and reduces the cost of cochlear implant program in the paediatric population. There is no significant difference between the measurements obtained from CT and MRI scans. However, observed discrepancies in cochlear measurements across different populations require regionally or race-specific standardized values to ensure accurate diagnosis and precision in cochlear implant surgery. This aspect must be addressed to ensure positive outcomes for patients.

Background

Studies on animals have demonstrated that maternal iron deficiency anaemia (IDA) could result in decreased cochlear sensory hair cells and reduced amplitudes of distortion-product otoacoustic emissions (DPOAEs) of young guinea pigs. Thus, it is essential to study the functioning of cochlear hair cells using DPOAEs in human newborn babies with maternal IDA. The current study explores maternal IDA's effect on DPOAEs in newborn babies.

Method

A total of 110 newborn babies with gestational age ≥34 weeks were considered and a ‘between-subjects’ design was used. The participants were divided into 3 groups- “Normal” (61 babies without maternal IDA), “Mild” (28 babies with mild maternal IDA) and “Moderate” (21 babies with moderate maternal IDA). The cord blood was collected and the DPOAEs were recorded for each baby for a range of frequencies (1 k – 8 kHz) and a range of intensities (70–40 dB SPL in 10 dB steps).

Results

The analysis of both DP-gram and DP input-output (I/O) function showed that there was no significant difference (p > 0.05) across the normal, mild, and moderate groups in the overall presence of DPOAEs as well as the amplitude across frequencies or intensities (70–40 dB SPL). Also, the overall correlation of RBC indices with DPOAE amplitude across frequencies as well as the slope of the I/O function showed no relationship.

Conclusion

The current study concludes that there is no effect of late-term maternal IDA on the DPOAEs of newborn babies.

Background/purpose

With increasing accessibility to the Internet, patients frequently use the Internet for hearing healthcare information. No study has examined the information about hearing loss available in the Mandarin language on online video-sharing platforms. The study's primary purpose is to investigate the content, source, understandability, and actionability of hearing loss information in the Mandarin language's one hundred most popular online videos.

Method

In this project, publicly accessible online videos were analyzed. One hundred of the most popular Mandarin-language videos about hearing loss were identified (51 videos on YouTube and 49 on the Bilibili video-sharing platform). They were manually coded for different popularity metrics, sources, and content. Each video was also rated using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-AV) to measure the understandability and actionability scores.

Results

The video sources were classified as either media (n = 36), professional (n = 39), or consumer (n = 25). The videos covered various topics, including symptoms, consequences, and treatment of hearing loss. Overall, videos attained adequate understandability scores (mean = 73.6%) but low (mean = 43.4%) actionability scores.

Conclusions

While existing online content related to hearing loss is quite diverse and largely understandable, those videos provide limited actionable information. Hearing healthcare professionals, media, and content creators can help patients better understand their conditions and make educated hearing healthcare decisions by focusing on the actionability information in their online videos.

Ménière's disease (MD) patients may suffer episodes of sudden falls, named Tumarkin drop attacks (DAs). This fall occurs abruptly and without warning or loss of consciousness. DAs usually aggravate the clinical picture of MD and are challenging to manage. The present report describes a case treated by cochlear implantation (CI) due to concomitant deafness and offers some clinical considerations for this condition. A male patient aged 48 years with a 10-year history of definite bilateral MD had profound SNHL on the right and severe SNHL on the left side. He suffered from intermittent attacks of vertigo, ear fullness, and tinnitus and, in the last year, had developed DAs and experienced 14 episodes in the previous six months. The preoperative category of acoustic performance was 3. The Dizziness Handicap Inventory (DHI) questionnaire showed a total score of 46, which indicated a moderate degree of disability. A CI was planned for the right side. The patient did not report any further DAs episode for two years since then. The postoperative category of acoustic performance became 11, and the postoperative DHI questionnaire showed a decrease in the total score (from 46 to 19), which indicated a mild disability. Unilateral CI effectively alleviated the DAs associated with bilateral MD. Our report proposes a new modality for managing vertiginous symptoms in cases of MD with hearing loss without the need for more aggressive surgical interventions with the need for clinical trials to confirm our results.

Objective

To describe audiological symptoms, audiometric profile, and distortion product otoacoustic emission in symptomatic patients recovering from SARS-CoV-2 infection (positive RT-PCR test) and asymptomatic patients (negative RT-PCR test).

Methods

An analytical cross-sectional study was conducted using data obtained from clinical charts, physical examination, audiometry, and distortion product otoacoustic emission on 40 patients [case patients (CP)] recovering from SARS-CoV-2 infection diagnosed by a positive RT-PCR test and 22 asymptomatic participants with a negative RT-PCR test [non-case (NC)].

Results

Sixty-two patients (mean age: 31.1 and 28.2 years in the CP and NC groups, respectively) were included. All participants were young without significant comorbidities, risk factors for hearing loss or otological history. Vertigo (5%), tinnitus (17.5%) and aural fullness/hearing loss (35%) were found in the CP group. A statistically significant difference was found in specific frequencies (1000, 4000, and 8000 Hz) and pure tone average (low and high conversational frequencies with increased threshold in the PC group compared with the NC group), which was not found in distortion product otoacoustic emission.

Conclusion

Audiovestibular symptoms are frequent in symptomatic patients recovering from SARS-CoV-2 infection. SARS-CoV-2 infection was consistently associated with an increased audiometric hearing threshold at specific frequencies and low tone average.