Audiology and Neuro-Otology最新文献

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: Auditory performance and language proficiency in young children who utilize auditory brainstem implants (ABIs) throughout the first 3 years of life are difficult to predict. ABI users have challenges as a result of delays in language proficiency and the acquisition of reading comprehension, even if ABI technology offers auditory experiences that enhance spoken language development. The aim of this study was to evaluate about the impact of language proficiency on reading comprehension skills in children with ABI.

Method: In this study, 20 children with ABI were evaluated for their reading comprehension abilities and language proficiency using an Informal Reading Inventory, Test of Early Language Development-Third Edition (TELD-3), Categories of Auditory Performance-II (CAP-II), and Speech Intelligibility Rating (SIR). Three distinct aspects of reading comprehension were assessed and analyzed to provide a composite score for reading comprehension abilities. TELD-3, which measures receptive and expressive language proficiency, was presented through spoken language.

Results: Studies have shown that there was a relationship between language proficiency and reading comprehension in children with ABI. In the present study, it was determined that the total scores of reading comprehension skills of the children who had poor language proficiency and enrolled in the school for the deaf were also low. The children use short, basic sentences, often repeat words and phrases, and have a restricted vocabulary. In addition, the children had difficulty reading characters and detailed paragraphs and could not remember events in a logical order.

Conclusion: Children with ABI may potentially have complicated reading comprehension abilities due to lack of access to all the speech formants needed to develop spoken language. In addition, variables affecting the reading levels of children with ABI include factors such as age at implantation, duration of implant use, presence of additional disability, communication model, and access to auditory rehabilitation. The reading comprehension skills of ABI users were evaluated in this study for the first time in the literature and may constitute a starting point for the examination of variables affecting reading comprehension in this area.

Introduction: This study aimed to investigate the impact of auditory input on postural control in young adult cochlear implant users with profound sensorineural hearing loss. The research explores the relationship between auditory cues and static postural stability in individuals with hearing impairment.

Methods: Thirty-four young adult cochlear implant users, consisting of 15 males and 19 females aged 18-35 years, underwent various balance tests, including the modified Clinical Tests of Sensory Interaction on Balance (mCTSIB) and the unilateral stance test (UST), under different auditory conditions: (a) white noise stimulus present with the sound processor activated, (b) ambient noise present with the sound processor activated, and (c) sound processor deactivated. Statistical analysis was performed to evaluate the participants' postural control performance in relation to auditory stimuli.

Results: Statistical analysis revealed that participants exhibited better postural control in the presence of white noise stimuli compared to when the sound processor was turned off in the UST (p = 0.001) and Fukuda Stepping Test (in terms of displacement [p = 0.004]). The composite mCTSIB scores showed no significant difference between sound processors off, sound processors on with ambient noise, and sound processors on with broadband white noise conditions.

Conclusion: The findings suggest that access to auditory cues through cochlear implants plays a crucial role in preserving static postural control in young adults with hearing impairment. This study highlights the positive effect of auditory information on balance performance in individuals with cochlear implants and profound hearing loss. Future research is recommended to further explore the impact of auditory stimuli on dynamic postural abilities and to include preoperative balance assessments in individuals undergoing cochlear implantation.

Introduction: We conducted a prospective study determining the relationship between severity of visual vertigo and extent of visual dependence by comparing the visual vertigo analogue scale (VVAS) with the dynamic subjective visual vertical (dSVV) test.

Methods: A total of 76 patients with chronic dizziness (without peripheral or central vestibular lesions) and 43 healthy controls completed VVAS and dSVV testing. The VVAS uses nine visual analog scales to query visual vertigo across nine specific situations. The dSVV measures visual dependence under three conditions: static background, counterclockwise (CCW) rotating background, and clockwise (CW) rotating background (20°/s). Finally, each patient completed a simulator sickness questionnaire (SSQ) to evaluate the dizziness induced from the dSVV. VVAS, dSVV, and SSQ were compared between the patient and the control groups. Among the patient group, the correlation between VVAS and dynamic SVV were determined. Associations of outcomes measures and gender, age, and migraine were also assessed.

Results: Patients with dizziness had significantly greater VVAS (16.9 vs. 1.6, p < 0.001) and SSQ (25.7 vs. 6.5, p < 0.001) scores, yet less deviation of dSVV (CCW background: -9.2 vs. -11.5, p = 0.05; CW background: 7.4 vs. 10.1, p = 0.02) than controls. In the patient group, VVAS was not correlated with dynamic SVV for either CCW (r = 0.12, p = 0.30) or CW backgrounds (r = -0.01, p = 0.92). During CCW rotation, the SVV deviation was greater in older aged patients and slightly greater in female. During CW rotation, the SVV deviation was less in the patients with migraine.

Conclusion: In chronic dizzy patients that have no measurable peripheral or central vestibular lesion, severity of visual vertigo is not correlated with visual dependence.

Introduction: Neurotrophic factors are widely known for their protective effect on spiral ganglion neurons (SGN) and the protection of these neurons is of great importance to optimize cochlear implants, which directly stimulate SGN in deaf patients. Previous studies have identified Cometin - also known as Meteorin-like - to be neuroprotective and beneficial for metabolic disorders. The aim of our study was to investigate the effects of different concentrations of recombinant human Cometin (hCometin) on SGN in regard to neuroprotection and neurite outgrowth and to evaluate its neurite guidance potential using a neurite outgrowth chamber.

Methods: hCometin was initially tested in two separate dosing experiments: 5, 10, and 15 μg/mL (medium dose group) and 10, 25, and 50 μg/mL (high dose group). The hCometin was added to dissociated neonatal murine SGN. The number, morphology, and neurite length of SGN treated with hCometin were compared to untreated (negative control, NC) and brain-derived neurotrophic factor treated (BDNF, 50 ng/mL) (positive control, PC) cells. Subsequently, to investigate a potential effect on neurite guidance, 10 μg/mL hCometin was delivered via osmotic pumps to neonatal murine spiral ganglion explants (SGE) cultured in a neurite outgrowth chamber to experimentally mimic the scala tympani and the Rosenthal's canal. The amount of pump-released hCometin was measured by enzyme-linked immunosorbent assay and neurite growth was quantified and compared to a Cometin-free NC.

Results: All medium dose group concentrations of hCometin resulted in significant neuronal protection, whereas high dose group concentrations (25 and 50 μg/mL) were neurotoxic. The medium dose concentrations significantly increased the number of monopolar neurons compared to NC, and 10 and 15 μg/mL hCometin increased the number of neurons with a physiological bipolar morphology to an even greater extent than BDNF. For neurite length, 5 and 10 μg/mL hCometin had the greatest effect, which was comparable with the BDNF-PC. The osmotic-pump based delivery of 10 μg/mL hCometin to SGE had no positive effect on the number, extent, or orientation of outgrowing neurites in the culture set up used.

Conclusion: A concentration of 10 μg/mL hCometin significantly protects dissociated SGN from degeneration and significantly increases the outgrowth of neurites, which is favourable in view of induced neurite outgrowth towards cochlear electrode arrays for future optimisation of the nerve-electrode-interface. The study failed to detect a guided neurite outgrowth by pump-based drug release, which may be due to the experimental set up, which could be improved in future studies.

Introduction: The aim of the study was to compare outcomes of oral steroids (OSs) to intratympanic (IT) steroids for treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) in a retrospective cohort study at a tertiary academic center.

Methods: Patients diagnosed with ISSNHL receiving at least one course of OS between January 2009 and February 2022 were reviewed. OS patients were compared to a previously reported cohort of 74 patients who underwent IT treatment.

Interventions: OS or IT steroid therapies are used for treating ISSNHL. Full, partial, or no recovery rates of hearing thresholds stratified by modality of treatment, age, degree of hearing loss, and time to initiation of treatment were measured.

Results: There were 96 patients treated with OS and 74 patients treated with IT steroid. Full recovery was more frequent in patients who underwent OS therapy (43.8%) compared to IT therapy (25.68%, p = 0.017). For patients under 40 years old, full recovery rates were similar between OS (60.0%) and IT (61.5%). In patients over 40 years old, however, full recovery was seen in 40.7% of patients on OS and 18% for IT. Further, while those over 65 years had the worst rates of full recovery to IT steroid (<20%), this age group had a 50% full recovery rate with OSs. Additional factors correlating with response to both OS and IT treatments included degree of hearing loss and time to starting steroids.

Conclusion: OS therapy was associated with greater likelihood of full recovery in all patient age groups compared to those treated with IT steroid alone, in combination with OS, or for salvage. A significant difference in response was seen in those over 65 years raising consideration of age stratification in decision-making for steroid modality in treatment of ISSNHL.

Introduction: Prior studies have demonstrated that comorbid conditions can negatively impact cochlear implantation (CI) outcomes in elderly patients, but few have examined how comorbidities affect younger adult CI recipients. This study examines the relationship between comorbidities and CI outcomes in adults under 60 years old.

Methods: We reviewed all CI recipients between 20 and 60 years old from 2015 to 2019 at a tertiary academic medical center. Patient data were collected including comorbidities, demographics, etiology, and length of deafness (LOD). Patients' Charlson Comorbidity Index (CCI) was calculated. The primary outcome was speech perception scores at 1 year on the consonant-nucleus-consonant (CNC) word test.

Results: There were 118 patients who underwent CI (20-29 years [15%], 30-39 years [22%], 40-49 years [21%], 50-60 years [42%]), averaging 1.8 comorbidities. Mean LOD was 19.7 years, and most etiologies were unknown (53.4%). 34% had no comorbidities, and the most frequent comorbidities were hypertension (14%), asthma (10%), anxiety (8%), acoustic neuroma (8%), and arthritis (7%). Comorbidity frequency was similar across ages, but cardiovascular comorbidities varied by patient decade (50-60 years: 41% vs. 20-49 years: 12-22%, p = 0.004). Compared to studies on elderly CI outcomes, our cohort had fewer comorbidities with reduced cardiac events and neurological conditions. We did not find differences in 1-year CNC scores or complications based on the number of comorbidities or any single comorbidity. However, there was a difference in individual improvement in CNC word scores by age group (p = 0.024). Patients' CCI did not correlate to post-op scores.

Conclusion: Subjects showed improved speech understanding post-CI. The number and type of comorbidities were not meaningful predictors of 1-year speech perception scores, suggesting adult CI users under 60 years with comorbidities can expect comparable outcomes to those without comorbidities.

Introduction: Hearing loss impacts children's ability to learn language and motor skills. This study examined the postural control differences between children who are deaf and hard of hearing (DHH) and typical hearing (TH), who differ in language and literacy performance, across diverse balance tasks.

Methods: Thirty-three children between the ages of 6 and 13 performed a battery of balance tasks evaluating postural control and mobility. Twenty-six children were classified as DHH, while seven were TH children. Children participated in an extended battery of language and literacy measures, not unlike an intense academic day schedule. Assessments of postural control were conducted during a pre- and post-fatigue state.

Results: Children who are DHH exhibited lower degrees of balance than TH children across the clinical, static, and dynamic balance evaluations.

Conclusions: Our findings provide evidence of robust balance impairments for children who are DHH beyond standard clinical evaluations. Fatigue effects induced by testing had a greater impact on TH than DHH children, which may be related to chronic fatigue traits in DHH children. Overall, the results underscore the importance of characterizing balance impairments of children with hearing loss and determining the degree of impact on activities like academics.

Introduction: The aim of this qualitative study was to explore and describe patients' experiences of using and living with the bone conduction implant (BCI).

Methods: Semi-structured interviews were conducted with 10 BCI users and analyzed according to the phenomenographic approach.

Results: Four conceptual themes were formed during the analysis; (1) conceptions of the process receiving the BCI, (2) conceptions of handling the BCI on a daily basis, (3) conceptions of hearing with the BCI, and (4) conceptions of health care issues related to the BCI. The participants' statements include experiences of improved hearing and self-esteem by using the BCI. Noisy situations and not being able to hear in daily life situations causes frustrations. The participants described anxiety about consequences following an MRI examination. The audio processor is easy to handle but the fact that it is not waterproof raise concerns. Despite some frustration and concerns, participants state that the audio processor has become a part of them, and they cannot imagine being without it.

Conclusion: The ability to hear and communicate with other people has a great impact on the participants' daily life quality, and their statements show the importance hearing has on their lives and how they perceive themselves. The BCI seems to be a good hearing rehabilitation alternative for the participants, and they state that the audio processor is easy to use and handle.

Introduction: Cochlear implant (CI) users differ greatly in their rehabilitation outcomes, including speech understanding in noise. This variability may be related to brain changes associated with intact senses recruiting cortical areas from stimulation-deprived senses. Numerous studies have demonstrated such cross-modal reorganization in individuals with untreated hearing loss. How it is affected by regular use of hearing devices remains unclear, however. To shed light on this, the current study measured cortical responses reflecting comprehension abilities in experienced CI users and normal-hearing controls.

Methods: Using multichannel electroencephalography, we tested CI users who had used their devices for at least 12 months and closely matched controls (N = 2 × 13). Cortical responses reflecting comprehension abilities - the N400 and late positive complex (LPC) components - were evoked using congruent and incongruent digit-triplet stimuli. The participants' task was to assess digit-triplet congruency by means of timed button presses. All measurements were performed in speech-shaped noise 15 dB above individually measured speech recognition thresholds. Three stimulus presentation modes were used: auditory-only, visual-only, and visual-then-auditory.

Results: The analyses revealed no group differences in the N400 and LPC responses. In terms of response times, the CI users were slower and differentially affected by the three stimulus presentation modes relative to the controls.

Conclusion: Compared to normal-hearing controls, experienced CI users may need more time to comprehend speech in noise. Response times can serve as a proxy for speech comprehension by CI users.