Journal of Audiology and Otology最新文献

Sensorineural hearing loss (SNHL) is known to be associated with lesions at various sites, including outer hair cell (OHC) and inner hair cell (IHC) injury, as well as auditory dyssynchrony or vestibulocochlear nerve tumors. Therefore, it is important to establish the differential diagnosis of SNHL, which however is particularly challenging in patients with unilateral SNHL. The test battery approach is effective for accurate diagnosis in such cases. In this report, we discuss the usefulness of the test battery approach to accurately detect the site of the lesion in a patient with unilateral hearing loss. A 14-year-9-month-old adolescent who observed decreased hearing sensitivity in the left ear accompanied by difficulty with understanding speech at a distance was diagnosed with unilateral hearing loss in the left ear. In this report, we describe a rare and diagnostically challenging case of unilateral SNHL in a patient with normal OHC function and selective injury to IHCs, which was diagnosed using a test battery approach.

Background and objectives: Indonesians encounter several barriers to regular functional hearing assessment. Hearing loss screening is only provided by tertiary-care hospitals that are not reachable by people in remote regions. This study aimed to develop a website-based hearing screening application that is accessible and inexpensive. Subjects and.

Methods: This comparative study was conducted between July and August 2022 in the Otolaryngology Clinic of Muhammadiyah Bandung Hospital with noise levels below 50 dB. The hearing screening was conducted using a website-based application (www.Screenout.id) and audiogram as the gold standard method. On ScreenOut, patients heard sounds with frequencies at 500, 1,000, 2,000, 4,000, and 8,000 Hz and sound intensity of each frequency at 35, 55, and 75 dB using earphones.

Results: A total of 133 participants were enrolled in our study. ScreenOut showed high sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (90.9%, 98.9%, 93.6%, 99.4%, and 84.8%, respectively). Regarding hearing threshold, a very strong correlation was found between ScreenOut and audiogram, ranging between r=0.843 and r=0.899. Aside from that, there was no significant difference in hearing threshold values between ScreenOut and audiogram.

Conclusions: Many advantages of the ScreenOut were found, including low-cost, accessibility, and easy-to-use interface, making it favorably used in low-middle-income countries such as Indonesia.

Background and objectives: This study was aimed at assessing recovery from otitis media (OM) and variables associated with it among 1- to 6-year-old children. Subjects and.

Methods: We assessed 87 children with OM otologically and audiologically. Medicines were prescribed, and medication compliance was ensured. The children were followed up after 3 months to judge the status of OM as resolved or recurrent. Data were statistically analyzed to derive the risk of recurrence of OM with effusion (OME) and acute OM by degree of hearing loss, type of tympanogram, age group, and sex.

Results: The overall recurrence rate was 26%. The risk of recurrence was higher for OME (odds ratio [OR]=4.33; 95% confidence interval [CI]: 1.90 to 9.83); at AC auditory brainstem peak V responses up to 40 dBnHL (OR=5.20; 95% CI: 2.05 to 13), 50 dBnHL (OR=3.47; 95% CI: 0.5 to 23), and 60 dBnHL (OR=16.09; 95% CI: 4.36 to 1.2); in B (OR= 3.16; 95% CI: 1.36 to 7.33) and C tympanograms (OR=2.83; 95% CI: 0.70 to 11.41); and in the age group of 5-6 years (OR=8, 95% CI: 2.23 to 28). The risk of recurrence of OM did not differ between male and female patients.

Conclusions: The rate of recurrence was comparable to or lower than that reported in the pediatric population of other countries. The findings suggest that children with OME, severe pathology, or age of 5-6 years require more attention and frequent monitoring to minimize the risk of recurrence.

Granulomatosis with polyangiitis (GPA) is a chronic and systematic autoimmune condition characterized by granuloma formation and necrotizing vasculitis of small to medium-sized vessels. GPA initially presents itself as respiratory and renal symptoms. Although temporal bone involvement is not uncommon, an otologic disorder is rarely the initial symptom. We present a case of a 36-year-old man who presented with unilateral ear pain, hearing loss, and facial palsy. After a series of diagnostics and temporal bone and chest imaging, he was diagnosed with GPA with multiorgan involvement. Cyclophosphamide and methylprednisolone relieved the patient's ear pain and partially improved his hearing, facial palsy, and overall clinical condition. Although uncommon, systemic GPA may cause initial otologic symptoms and should not be dismissed as a possible cause of an otologic disease resistant to standard therapy.

Glomus tympanicum are benign tumors of vascular origin, arising from the neural crest cells and located on promontory. The treatment of choice is surgical excision of the lesion. Traditionally, it is performed under microscopic observation. With the introduction of endoscopes in the field of ear surgeries, an endoscopic approach has also evolved. Herein, we present case reports of three patients diagnosed with glomus tympanicum tumors who were operated on using an endoscopic approach. A review of the literature is also performed. The mass was completely excised in all patients, and there were no signs of recurrence at the follow-up at least a year later. Endoscopic ear surgery is a safe and effective method of managing glomus tympanicum tumors. Its main limitation is the tumor size; however, in most cases, tumors of stages I to II as per the Glasscock-Jackson classification and types A1 to B1 according to the modified Fisch-Mattox classification can be completely removed endoscopically. Careful preoperative selection of patients warrants the best outcomes.

Background and objectives: The speech tests used to evaluate language performance in patients with bilateral deafness (BiD) and cochlear implant (CI) are problematic if applied to patients with single-sided deafness (SSD) because normal ear hearing should be excluded. Thus, we investigated the feasibility of using wireless connection to evaluate speech intelligibility of the CI ear in patients with SSD. Subjects and.

Methods: Patients with BiD and SSD were administered the word recognition scores (WRS) and speech intelligibility tests using an iPadbased wireless connection and conventional methods. To exclude normal side hearing in patients with SSD, masking noise and "plugged and muffed" method were used in the WRS and speech intelligibility tests, respectively.

Results: In patients with BiD, the WRS and speech intelligibility tests results using wireless connection and conventional methods were similar. In patients with SSD, the WRS using masking noise in the normal hearing ear was similar to that of using wireless connection. However, 3 of 11 patients with SSD showed under-masked results if using the "plugged and muffed" method.

Conclusions: Speech intelligibility testing using wireless connection is a convenient and reliable method for evaluating CI performance in patients with SSD. The "plugged and muffed" method is not recommended for evaluating CI performance in patients with SSD.

In this study, we report our findings of comprehensive evaluation in a man with syndromic craniofacial features, cognitive impairment, and hearing loss. The patient underwent psychological and genetic testing and screening for 133 genetic mutations associated with hearing loss, as well as extensive audiological evaluation to assess the auditory pathway between the middle ear and the auditory cortex. Psychological testing showed moderate cognitive impairment. Genetic testing did not reveal a genetic mutation for hearing loss. Audiological evaluation revealed mixed hearing loss and signs of auditory neuropathy spectrum disorder (ANSD) despite absence of otoacoustic emissions and an absent click-evoked auditory brainstem response (ABR) without recording of cochlear microphonics (CM). ANSD was characterized by abnormal speech discrimination, bilateral robust CM to 2,000 Hz tone-burst (TB) ABR, and abnormal left thalamocortical and cortical pathways diagnosed based on auditory middle latency and cortical N1-P2 responses. These behavioral and electrophysiological findings suggest post-synaptic ANSD at the brainstem level. An abnormal left thalamocortical auditory pathway may be attributable to the combined effect of lack of neural synchrony secondary to ANSD mainly on the left and/or brain injury. The findings in this study support the use of TB ABR and auditory cortical potentials in the ANSD test protocol and in patients with craniofacial anomalies.

Background and objectives: To evaluate the health-related quality of life (HRQoL) in parents of children with cochlear implants and assess influencing factors. These data can enable practitioners to support patients and their families in utilizing the cochlear implant and its benefits to the fullest extent. Subjects and.

Methods: A retrospective descriptive and analytic study was conducted at the Implantation center Mohammed VI. Parents of cochlear implant patients were asked to fill out forms and answer a questionnaire. Participants included parents of children <15 years old who underwent unilateral cochlear implantation between January 2009 and December 2019, presenting with bilateral severe to profound neurosensory deafness. Participants completed the children with cochlear implantation: parent's perspective (CCIPP) HRQoL questionnaire.

Results: The mean age of the children was 6.49±2.55 years. The mean time between implantation for each patient and this study was calculated as 4.33±2.05 years. There was a positive correlation between this variable and the following subscales: communication, well-being and happiness, and the process of implantation. For these subscales, the score was higher as the delay was greater. Parents of children who received speech therapy before implantation were more satisfied on the following subscales: communication, general functioning, well-being and happiness, implantation process, implantation effectiveness, and support for the child.

Conclusions: The HRQoL is better in families of children who received their implant at an early age. This finding raises awareness of the importance of systemic screening in newborns.

Cochlear implants (CIs) restore hearing in patients with severe-to-profound deafness. Post-CI meningitis is a rare but redoubted complication. We present the case of a five-year-old CI recipient who experienced an episode of chronic meningitis caused by chronic otitis media with cholesteatoma encasing the electrode lead. We hypothesize that the cholesteatoma led to an ascending infection to the cochlea, passing through the labyrinths, resulting in chronic meningitis. Although positive neural responses were initially noted on cochlear electrical stimulation, these responses resolved a few weeks after reimplantation. Our report highlights the importance of careful otoscopic examination and diagnostic work-up in patients presenting with otogenic meningitis to rule out cholesteatoma formation and to ensure prompt surgical exploration if warranted.