Audiology and Neuro-Otology最新文献

Objective To develop an algorithm, based on the voltage matrix, for detecting regular cochlear implant (CI) electrode position during the implantation procedure, tip fold-over or basal kinking for lateral-wall electrodes. The availability of an algorithm would be valuable in clinical routine, as incorrect positioning of the electrode array can potentially be recognized intraoperatively. Design In this retrospective study intraoperative voltage matrix and postoperative digital volume tomography of 525 CI recipients were analyzed. On the basis of these data an algorithm was developed for detecting various kinds of electrode misplacements. Results Seven incorrect electrode positions, three tip fold (0.57%) and four basal kinking (0.76%) were detected. For detecting correct positioning, a sensitivity of 99.6%, a specificity of 83.3% and a positive predictive value (PPV) of 99.8% were found. For detecting tip fold-over a sensitivity of 100%, a specificity of 99.8% and a PPV of 75% were found. For detecting basal kinking, a sensitivity of 66%, a specificity of 99.8% and a PPV of 66% were determined. Conclusion The algorithm was found to be an effective screening tool for detecting tip fold-over or basal kinking.

Introduction: To date, no study has reported the various otologic conditions associated with coronavirus disease 2019 (COVID-19) using population-based design. The aim of this study was to investigate the incidence and risk of audio-vestibular disorders (benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere's disease, vestibular neuritis, and tinnitus) increasing after COVID-19 infection.

Methods: This retrospective population-based study was conducted using the National Health Insurance Service (NHIS)-COVID-19 cohort database of South Korea. We identified participants in the COVID-19 group using real-time reverse transcription-polymerase chain reaction tests. A matched cohort without COVID-19 was randomly selected in a 1:1 ratio. Benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere's disease, vestibular neuritis, and tinnitus were defined using diagnostic, medication, and procedure codes. The incidence and risk of these disorders were assessed in both groups using univariate and multivariate Cox proportional hazard analyses.

Results: In total, 4,976,589 COVID-19 patients and an equivalent number of matched non-infected controls were analyzed. COVID-19 patients faced an increased risk of developing benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus compared to controls in univariate and multivariate Cox hazard analyses. COVID patients were at an increased risk of Meniere's disease in the univariate analysis; however, the risk of Meniere's disease after COVID-19 did not reach statistical significance in the multivariate analysis.

Conclusion: COVID-19 infection may increase the risk of benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus.

Introduction: Research suggests deaf children who receive cochlear implants (CIs) at an early age can achieve age-appropriate language. Recent studies suggest age at full-time CI use is a better predictor of language outcomes than age at implant. The aim of this study was to investigate whether there are correlations between age at implantation, establishing consistent device use, and language outcomes in a cohort of young children in Aotearoa New Zealand.

Methods: A retrospective analysis was conducted. The study included 46 participants, implanted by the Southern Cochlear Implant Programme by age 18 months. The median age at implant was 8 months. Device use was measured via data logging. Consistent device use was defined as ≥8 h per day. Language outcomes were measured at 2- and 3-year post-implantation using PLS-5.

Results: Consistent use was established by 78.3% by 3 years. Language results were at least one SD higher for children who achieved consistent use within 2 years of implant. Language scores for Maori children were more than one SD lower than non-Maori, a finding not entirely explained by less usage. There was no correlation between age of implantation and length of time to consistent device use. The presence of additional disabilities affected consistent device use.

Conclusion: Simply offering CIs earlier is not sufficient to improve language outcomes in the congenitally deaf population. Earlier consistent use was associated with better language outcomes for those implanted before 18 months of age, and language scores were higher for children who achieved consistent use within 2 years of implantation. There is a need to understand why children with pre-lingual deafness may not be achieving consistent device use, and by doing so, we would be a step closer to being able to tailor culturally appropriate supports and services that could help more children achieve better outcomes.

Objective: We investigated the accuracy of imaging modalities in diagnosis and outcome of otitis media with effusion by correlating the imaging findings with the preoperative otomicroscopic examinations, tympanometric results, and intraoperative findings in patients who underwent cochlear implant surgery.

Methods: The results of the preoperative physical examination and intraoperative findings of patients younger than 18 years who underwent cochlear implant surgery at a single tertiary institution were recorded from their medical charts. Tympanometries, which were performed in maximum 1 week prior to imaging modalities, were analyzed. The high resolution computed tomography of temporal bone and magnetic resonance imaging of internal acoustic meati findings were reviewed. The mastoid cavity and middle ears were evaluated separately.

Results: The data comprising of 280 ears were evaluated. The correlation between imaging findings and both physical examination and tympanometries were statistically significant (p = 0.000). The intraoperative findings supported this correlation.

Conclusions: Our study showed that imaging modalities might detect the middle ear and mastoid cavity effusions. The severity of these changes may differ according to the severity of disease.

Introduction: The totally implantable active middle ear implant Esteem® may be considered an effective alternative to conventional hearing aids (cHAs) to manage moderate-to-severe forms of sensorineural hearing loss. This study aimed to provide long-term comparative data of Esteem performances with those achieved by cHA.

Methods: From a total of 46 subjects who received unilateral application of Esteem®, and were followed up over the years, ten underwent an audiological assessment that compared the outcomes with those achieved in the contralateral ear by a cHA, considering the initially symmetric auditory thresholds in both ears. Other than pure tone audiometry and speech audiometry in quiet, the assessment was performed by using the adaptive speech in noise, i.e., Matrix test.

Results: The mean speech intelligibility in quiet shows in the unaided situation a recognition of 50.7% at 71 dBHL, 71% at 69 dBHL with only contralateral cHA, 92% at 66 dBHL with only Esteem device and 94% at 61 dBHL with Esteem® device and contralateral cHA. The mean speech intelligibility in noise shows in the unaided situation a recognition of 36% at 71 dBHL, 56% at 69 dBHL with only contralateral cHA, 79% at 66 dBHL with only Esteem® device and 84% at 61 dBHL with Esteem® device and contralateral cHA. At Matrix test in the unaided condition, 4 patients reached 50% of intelligibility and the 50% threshold was obtained with a mean sound/noise ratio of +10 dBHL. In the contralaterally aided condition, 10 patients reached a 50% threshold in a condition of mean S/N ratio of +10.6 dBHL. In the Esteem® only and Esteem® plus cHA condition, all patients reached the 50% threshold with a mean S/N ratio of +3.4 dBHL with the Esteem® device and +0.92 dBHL with Esteem® plus a contralateral cHA, with a statistically nonsignificant difference. The mean deviation from the reference value (7.1 dB in the normal hearing population) was 17.1 dBHL, in unaided situation; this condition did not change with only the contralateral cHA (17.6 dBHL), whilst a significant improvement could be identified with only Esteem® device, where the mean deviation was 10.5 dBHL, and mostly with Esteem® device associated with the contralateral cHA, with a value of 8.02 dBHL.

Conclusions: The adaptive speech audiometry in noise (Matrix Test) showed that binaural stimulation provides greater benefits in the speech recognition in noise test in comparison to monaural stimulation, especially when this is carried out only by the cHA. However, the Esteem® device allowed to obtain audiological benefits that are significantly superior to those offered by cHAs, especially in cases where the hearing loss is severe and, in some cases, profound, achieving performances almost comparable to those of a cochlear implant.

Introduction: We were conducting this study to evaluate the effects of different hearing aid adaptation formulas on middle latency responses (MLR) in adult hearing aid users.

Methods: The study included 72 participants: those with moderate hearing loss using hearing aids with two different formulas for the last year, those with moderate hearing loss not using hearing aids, and those without hearing loss. Sixteen participants using NAL-NL1 and NAL-RP formulas were group 1; twenty using NAL-NL2 and DSL formulas were group 2; fifteen with hearing loss not using devices were group 3; and twenty-one without hearing loss were group 4. We obtained and compared MLR responses, including Na latency, Pa latency, and Na-Pa amplitude.

Results: Group 1 mean Na-Pa amplitude value was found to be higher than group 2 (p = 0.001). No significant difference was observed between group 1 and group 2 in terms of Na latency and Pa latency values (p = 0.001; p = 0.035). It was observed that the mean Na-Pa amplitude values in group 1 and group 2 were higher than group 3 (p = 0.001), but this elevation reached the level of statistical significance only in group 1. No difference was observed between group 1, group 2, and group 3 in terms of Na latency and Pa latency values (p = 0.001; p = 0.035). Compared with those without hearing loss (group 4), participants with hearing loss (group 1, group 2, and group 3) had longer Na latency and Pa latency values (p = 0.001; p = 0.035), and Na-Pa amplitudes were lower (p = 0.001). The effect of current (tested) hearing aid usage time on Na latency, Pa latency, and Na-Pa amplitude values of group 1 and group 2 was not observed. In all groups, there was a positive correlation between audiometric airway/bone conduction pure tone averages and speech acquisition threshold values, Na latency and Pa latency values, and a negative correlation between Na-Pa amplitude values. In all groups, there was a negative correlation between speech discrimination scores and Na and Pa latency values, as well as a positive correlation between Na and Pa amplitude values. There was a positive correlation between age and Pa latency values in all groups, as well as a negative correlation between Na and Pa amplitude values.

Conclusion: MLRs are affected by the presence of hearing loss, the use of hearing aids, and different hearing aid adaptation formulas. MLR measurements with a hearing aid can be used as an objective test to evaluate the benefit of hearing aid use.

Introduction: We aimed to investigate electrophysiologically and histopathologically, the protective effects of intratympanic memantine, an N-methyl-D-aspartate receptor antagonist, on ototoxicity caused by cisplatin, an anti-neoplastic agent used in many types of cancer.

Methods: Thirty-seven guinea pigs with a normal auditory function were randomly allocated to group 1 (cisplatin; n = 8), group 2 (memantine; n = 8), group 3 (cisplatin + memantine; n = 8), group 4 (cisplatin + physiological serum [PS]; n = 8), and group 5 (control; n = 5). Auditory assessments were conducted using distortion product otoacoustic emissions (DPOAE) within a frequency range of 1-32 kHz and auditory brainstem responses (ABRs) within 8-32 kHz. A single dose of cisplatin (12 mg/kg) was administered intraperitoneally, followed by intratympanic administration of 0.2 mL of either memantine or PS to both ears at least half an hour before cisplatin administration. Subsequent auditory evaluations were conducted 72 h after cisplatin administration. Histopathological analyses were performed using light microscopy of the right ear and scanning electron microscopy (SEM) of the left ear.

Results: Auditory evaluations conducted before and after treatment revealed significant findings. Specifically, within groups 3 and 4, ABR thresholds were elevated at all frequencies (p = 0.00), whereas the DPOAE signal-to-noise ratios were reduced at frequencies of 8, 12, 16, and 24 kHz (p = 0.001, p = 0.01, p = 0.01, and p = 0.00, respectively). Histopathologically, both light microscopy and SEM revealed that the cisplatin + memantine group exhibited fewer hair cells and nuclear degeneration in the spiral ganglion than the cisplatin and cisplatin + PS groups. Additionally, the stria vascularis thickness was greater in the cisplatin + memantine group than in cisplatin and cisplatin + PS groups.

Conclusion: Despite the negative electrophysiological findings, the histopathological outcomes suggest that intratympanic memantine may have a potential protective effect against cisplatin-induced ototoxicity. However, further investigations are warranted to corroborate these findings and elucidate the underlying mechanisms of action of memantine.

Introduction: Anatomy-based fitting (ABF), a relatively new technique for cochlear implant (CI) programming, attempts to lessen the impact of the electrode insertion location-related frequency-to-place mismatch (FPM). This study aimed to compare vowels and consonant perception in quiet and in noise among experienced adult CI users using the ABF and the regular, conventional-based fitting (CBF) map (pre-ABF) over 6 months.

Methods: Nine ears from eight experienced adult CI users were included in the experimental and longitudinal research. Using surgical planning software called Otoplan, postoperative computed computed tomography scans were used to determine the locations of intracochlear electrodes and their angle of insertion. The anatomy-based frequency bands were produced by Maestro 9.0 CI fitting software using the Otoplan data. Nonsense syllables with consonant-vowel-consonant (CVC) recognition scores in quiet and noise (+5 dB SNR) were compared at baseline, 3, and 6 months after ABF. The vowels involved were /a, i, u/, while the consonants were voiced /b, d, g/ and voiceless /p, t, k/ plosives. Speech pieces were presented at 30 dB SL in a sound-treated room through a loudspeaker positioned at 0° azimuth.

Results: On average, the ABF maps shifted center frequency ranging from 0.46 semitones (0.04 octave) at (E12) to 23.94 semitones (1.99 octave) at (E1) as compared to the CBF maps. The mean vowel and consonant identification scores in quiet and in noise were significantly higher in ABF than in CBF (p < 0.05) with a large effect size and the trend of improvement was seen with time. Voiced consonants had better scores than the voiceless consonants.

Conclusion: The results demonstrated improved perception of vowels and consonants, particularly for sounds containing voicing cues after using the ABF maps. The results also suggested that ABF could be more effective for voice detection in noise. Overall, the findings indicate that correcting place mismatch with an ABF map may improve speech perception, at least among experienced adult CI users.

Introduction: During postoperative implant control, we observed extraordinary peaks in transimpedance measurements. While searching for a possible reason, it appeared that they might correlate with scalar dislocations.

Methods: In this retrospective case series, six adult CI patients who underwent transimpedance measurements and postoperative imaging were analyzed. Intra- and postoperative transimpedance measurements were visual inspected. The intracochlear position of electrodes was radiologically identified.

Results: From 6 patients with transimpedance matrices showing an extraordinary peak in the off-diagonal area, five electrode arrays showed no correct scalar localization in the scala tympani, and one had a correct scalar localization in the scala tympani.

Conclusions: A peaking transimpedance might be a marker for scalar dislocation in CIs.