Journal of Otology最新文献

Objective

Tinnitus—a common clinical symptom—can be categorized into pulsatile tinnitus (PT) and non-PT. Among these, PT is usually associated with sigmoid sinus symptoms, such as sigmoid sinus wall defect or diverticulum, for which various surgical treatments are available. We have discussed the clinical efficacy of surgery for sigmoid sinus-associated PT via the transmastoid approach in this study.

Methods

We conducted a retrospective review of 4 patients who underwent surgery for sigmoid sinus-associated PT via the transmastoid approach at Nanjing Drum Tower Hospital from January to December 2020. Of these, 2 patients had sigmoid sinus wall defect and 2 had sigmoid sinus diverticulum. Post-operative tinnitus grading and surgical efficacy were determined.

Results

After surgery, PT dissolved in 3 patients, while tinnitus significantly decreased in 1 patient. During the follow-up period of 12–18 months, none of the 4 patients showed complications related to increased intracranial pressure or venous sinus thrombosis, and tinnitus symptoms disappeared in 3 patients without recurrence, although 1 patient occasionally developed tinnitus. Postoperative thin-slice CTA of the temporal bone indicated that the sigmoid sinus bone wall defect or diverticulum was completely repaired with a thick soft tissue coverage.

Conclusion

Surgical repair of sigmoid sinus-associated PT via the transmastoid approach deserves clinical promotion as it exhibited better efficiency while being relatively less invasive.

Objectives

The study aimed to determine the most appropriate hearing screening test to identify disabling hearing loss for adults aged 65 years or older.

Methods

This study included 577 older adults. Four hearing screening tests were considered in the study, including the Hearing Handicap Inventory for Elderly Screening (HHIE-s), three single question tests, the whisper test, and the finger rub test. The sensitivity and specificity of these tests referenced to the hearing threshold of disabling hearing loss were estimated.

Results

Among all tests, only the single self-perception question (0.7064 for sensitivity; 0.7225 for specificity) and whisper test (0.7833 for sensitivity; 0.7708 for specificity) could obtain both sensitivity and specificity higher than 70% for adults aged ≥65 years.

Conclusion

Overall, we suggest using the whisper test to identify disabling hearing loss (>40 dB HL at the better ear) for adults aged 65 years or older. However, if the conditions do not permit, the single self-perception question is also acceptable. Moreover, HHIE-s might not be a good test to detect disabling hearing loss for adults aged 80 years or older.

Blast injuries are common among the military service members and veterans. One of the devastating effects of blast wave induced TBI is either temporary or permanent hearing loss. Treating hearing loss using minocycline is restricted by optimal drug concentration, route of administration, and its half-life. Therefore, therapeutic approach using novel therapeutic delivery method is in great need. Among the different delivery methods, nanotechnology-based drug delivery is desirable, which can achieve longer systemic circulation, pass through some biological barriers and specifically targets desired sites. The current study aimed to examine therapeutic effect of minocycline and its nanoparticle formulation in moderate blast induced hearing loss rat model through central auditory system. The I.v. administered nanoparticle at reduced dose and frequency than regularly administered toxic dose. After moderate blast exposure, rats had hearing impairment as determined by ABR at 7- and 30-days post exposure. In chronic condition, free minocycline also showed the significant reduction in ABR threshold. In central auditory system, it is found in this study that minocycline nanoparticles ameliorate excitation in inferior colliculus; and astrocytes and microglia activation after the blast exposure is reduced by minocycline nanoparticles administration. The study demonstrated that in moderate blast induced hearing loss, minocycline and its nanoparticle formulation exhibited the optimal therapeutic effect on the recovery of the ABR impairment and a protective effect through central auditory system. In conclusion, targeted and non-targeted nanoparticle formulation have therapeutic effect on blast induced hearing loss.

Introduction

The masseter vestibular evoked myogenic potential (mVEMP) is a bilaterally generated, electromyographically (EMG)-mediated response innervated by the trigeminal nerve. The purpose of the present investigation was to 1) determine whether subjects could accurately achieve and maintain a range of EMG target levels, 2) to examine the effects of varied EMG levels on the latencies and amplitudes of the mVEMP, and 3) to investigate the degree of side-to-side asymmetry and any effects of EMG activation.

Methods

Subjects were nine neurologically and otologically normal young adults. A high-intensity tone burst was presented monaurally while subjects were seated upright and asked to match a range of EMG target levels by clenching their teeth. Recordings were made from the ipsilateral and contralateral masseter muscles referenced to the ear being monaurally stimulated.

Results

We found that the tonic EMG target had no effect on mVEMP latency. Additionally, although mVEMP amplitudes “scaled” to the EMG target, there was a tendency for the subjects’ EMG level to “undershoot” the EMG target levels greater than 50 μV. While some individuals did generate differences in EMG activation between sides, there were no significant differences on average EMG activation between sides. Further, while average corrected amplitude asymmetry was similar across EMG targets, some individuals demonstrated large, corrected amplitude asymmetry ratios.

Conclusions

The results of this investigation suggest that, as with cVEMP recordings, the underlying EMG activation may vary between subjects and could impact mVEMP amplitudes, yet could be mitigated by amplitude correction techniques. Further it is important to be aware that even young normal subjects have difficulty maintaining large, tonic EMG activity during the mVEMP recording.

Objective

Saccades accompanied by normal gain in video head impulse tests (vHIT) are often observed in patients with vestibular migraine (VM). However, they are not considered as an independent indicator, reducing their utility in diagnosing VM. To better understand clinical features of VM, it is necessary to understand raw saccades data.

Methods

Fourteen patients with confirmed VM, 45 patients with probable VM (p-VM) and 14 age-matched healthy volunteers were included in this study. Clinical findings related to spontaneous nystagmus (SN), positional nystagmus (PN), head-shaking nystagmus (HSN), caloric test and vHIT were recorded. Raw saccades data were exported and numbered by their sequences, and their features analyzed.

Results

VM patients showed no SN, PN or HSN, and less than half of them showed unilateral weakness (UW) on caloric test. The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides. Neither velocity nor time parameters were significantly different when compared between the two sides. Most VM patients (86%) exhibited small saccades, around 35% of the head peak velocity, with a latency of 200–400 ms. Characteristics of saccades were similar in patients with p-VM. Only four normal subjects showed saccades, all unilateral and seemingly random.

Conclusions

Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.

Objectives

This study aimed to determine the prognostic value of otoacoustic emissions (OAEs) in idiopathic sudden sensorineural hearing loss patients.

Methods

The study included 30 subjects with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). Each patient was evaluated four times: at baseline and after one week, one month, and three months of treatment. During each visit, each patient was subjected to full audiological history, otoscopic examination, basic audiological evaluations, and transiently evoked and distortion product otoacoustic emission (TEOAEs & DEOAEs).

Results

The hearing thresholds (frequency range 250–8000 Hz) and word recognition scores of patients with detectable TEOAEs and DPOAEs improved significantly, whereas no significant improvements were observed in those with no response.

Conclusion

Hearing improvement is better in patients with detectable TEOAEs and DPOAEs. As a result, TEOAEs and DPOAEs are recommended as routine tests in all SSNHL patients to predict outcomes and monitor treatment as TEOAEs and DPOAEs reflect the cochlear OHCs activity.

Objective

The goal of this study was to evaluate the quality of life of parents of children who use hearing aids (HA) with those who use cochlear implants (CI) in the Indian context and document any differences found.

Methods

The Kannada version of the AQoL-4D was administered in a modified fashion to 131 parents (87 HA and 44 CI). Sociodemographic details were collected for supplemental information on the intervention strategy used.

Results

A total of 49 parents (29 HA and 20 CI) responded to the questionnaire sent. The mean total scores for both the groups were similar (HA group = 17.9 (SD = 5.5), CI group = 17.2 (SD = 3.4)), as was the score for the first subscale (HA group = 8.6 (SD = 2.9); CI group = 8.5 (SD = 2.6)) of the AQoL-4D. No significant differences were found between the two groups on either scores [Total Score: U (N_HA = 29, N_CI = 20) = 280.5, z = −0.194, p > 0.05; Subscale 1 Score: U (N_HA = 29, N_CI = 20) = 281.5, z = −0.176, p > 0.05]. The degree of hearing loss in the hearing aid group was equivalent to that of the cochlear implant group but this did not appear to influence parental quality of life.

Conclusion

Parents of children with hearing aids and cochlear implants appear to be similar on several psychosocial factors in the realms of functional, social, and psychological well-being. In terms of parental quality of life, hearing aids and cochlear implants appear to be equally effective intervention techniques.

Purpose

To compare cartilage tympanoplasty (CT) combined with eustachian tube balloon dilatation (ETBD) and cartilage tympanoplasty alone as a surgical treatment modality for adhesive otitis media (AdOM) in terms of graft healing, audiological outcomes, and impact on life style, using Chronic Otitis Media Outcome Test 15 (COMOT-15).

Methods

50 patients with AdOM were randomly classified into 2 groups: 25 patients for cartilage tympanoplasty only (CT group) and 25 patients for cartilage tympanoplasty combined with eustachian tube balloon dilatation (CT + ETBD group). Clinical outcomes in both groups were compared at 3 and 6 months of follow up.

Results

There was no significant difference in graft healing between the two groups. Postoperative COMOT-15 scores significantly decreased in both groups with a significant difference between the groups with regard to the decrease in COMOT-15 scores at 3 and 6 months of follow-up (P < 0.05). Hearing improvement was achieved, as the mean preoperative ABG was 26.5 ± 5.4 and 27.1 ± 4.6 dB, and the mean postoperative ABG at 6 months was 19.4 ± 4.4 and 14.6 ± 3.9 dB in the CT and the CT + ETBD groups, respectively. The difference in the magnitude of ABG reduction in the two groups was significant at 3 and 6 months of postoperative follow-up (P < 0.05) in favour of the CT + ETBD group.

Conclusion

ETBD can increase the success rate of cartilage tympanoplasty in patients with AdOM by enhancing the audiological outcome and quality of life.

Background

Diurnal changes can be defined as the time of the day over an individual's performance level for different activities that involve physical and mental tasks.

Objective

The current study aimed to evaluate the effect of diurnal changes in scores obtained for the Dichotic Consonant-Vowel paradigm by young adults with normal hearing sensitivity.

Method

Based on the ‘Morningness-Eveningness questionnaire’ given by Horne & Ostberg, the subjects were divided into moderately-morning, intermediate and moderately-evening categories. The Dichotic Consonant-Vowel tests were performed during morning and evening, and the right ear, left ear and double correct scores were compared between morning and evening for each category.

Results

There was significant diurnal changes noted for moderately morning and evening categories, where morning-type individuals performed better during morning and evening-type individuals performed better during the evening. The scores of intermediate individuals remained unchanged between morning and evening test results.

Conclusion

Diurnal change is a phenomenon associated with an individual's biological clock mechanism. Hence, attention and inhibitory controls aid them in carrying out tasks that require sufficient physical and mental efforts. The current study suggests that clinicians and researchers consider diurnal changes as an extraneous variable that could affect the reliability of the Dichotic Consonant-Vowel test results.

Neural crest (NC) is the primitive neural structure in embryonic stage, which develops from ectodermal neural plate cells and epithelial cells. When the neural fold forms into neural tube, neural crest also forms a cord like structure above the neural tube and below the ectoderm. Neural crest cells (NCC) have strong migration and proliferation abilities. A number of tissue cells differentiate from neural crest cells, such as melanocytes, central and peripheral neurons, glial cells, craniofacial cells, osteoblasts, chondrocytes and smooth muscle cells. The migration and differentiation of neural crest cells are regulated by a gene network where a variety of genes, transcriptional factors, signal pathways and growth factors are involved.