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Scala tympani drill-out technique for oval window atresia with malformed facial nerve:update.
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-23 DOI: 10.1080/00016489.2024.2416601
Xiaoyu Li, Qiaohui Lu, Yang Liu

Background: In some rare cases of congenital aplasia of the oval window (OW), malformed facial nerve (FN) locations covering the most or entire OW present a challenge to hearing reconstruction, there is no a highly effective surgical hearing reconstruction methods.

Aims/objectives: To update a Scala tympani drill-out technique (SDT) for abnormal FN course covering the OW.

Material and methods: All patients of congenital atresia of the OW was recruited between August 2014 and July 2023 in a tertiary-care center. When it's inability to perform the vestibulotomy with FN covering the OW, The SDT surgery was made with a titanium TORP between the tympanic membrane and scala tympani fenestration for hearing reconstruction. Air conduction (AC) thresholds, bone conduction (BC) thresholds, and air-bone gap (ABG) at 0.5, 1, 2, 4 kHz pure tone frequencies were compared before and 3 months after surgery.

Results: A total of 11 patients underwent SDT surgery during the study period. All cases showed no bone conduction (BC) hearing loss, facial paralysis, tinnitus, or dizziness. The ABG has decreased by 21.2 ± 10.8 dB 3 month after operation. In the long term, three cases had the same hearing as pre-operative, three cases felt their hearing gradually decreased but better than pre-operative.

Conclusions and significance: As a new and optional method, our results suggest an effective way to reconstruct hearing for middle ear deformities with FN occlusion, the short-term effect can be confirmed, while the long-term effect is mixed, and a large amount of clinical research is still needed.

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引用次数: 0
The effect of caffeic acid phenethyl ester on facial nerve regeneration.
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-23 DOI: 10.1080/00016489.2024.2433704
Veysel Alparslan Gölcük, Lütfü Şeneldir

Background: Caffeic acid phenethyl ester (CAPE), an active component of honey bee propolis, has been demonstrated in animal models and studies to have anti-inflammatory, antioxidant, immunomodulatory, neuroprotective, and cytoprotective properties.

Objective: We investigated the efficacy of CAPE, which we believe may be therapeutically useful in facial nerve restoration due to its neuroprotective and antioxidant properties.

Material and methods: 20 Sprague Dawley rats were divided randomly into 4 primary and 2 secondary groups and assigned as control, methylprednisolone, CAPE, CAPE+methylprednisolone groups and the sham and the trauma groups. Except for the sham group, all groups had the left facial nerve crushed. Three weeks after surgery, prospective functional, electrophysiologic, and histologic recovery was assessed.

Results: The CAPE and CAPE+methylprednisolone group had similar and more significant recovery at Nerve Excitability Thresholds and achieved a significantly faster improvement in histopathological evaluation at the end of three weeks.

Conclusions and significance: The combination of CAPE and methylprednisolone was found to be efficient in nerve regeneration in an experimental rat facial nerve crush model. Given the strong systemic adverse effects of methylprednisolone, the combination of CAPE may be a good alternative for lowering the dose of methylprednisolone and thereby reducing its negative effects.

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引用次数: 0
Gait patterns in unstable older patients related with vestibular hypofunction. Preliminary results in assessment with time-frequency analysis. 与前庭功能减退相关的不稳定老年患者的步态模式。时频分析的初步评价结果。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-22 DOI: 10.1080/00016489.2025.2450221
Francisco de Izaguirre, Mariana Del Castillo, Enrique D Ferreira, Hamlet Suárez

Background: Gait instability and falls significantly impact life quality and morbi-mortality in elderly populations. Early diagnosis of gait disorders is one of the most effective approaches to minimize severe injuries.

Objective: To find a gait instability pattern in older adults through an image representation of data collected by a single sensor.

Methods: A sample of 13 older adults (71-85 years old) with instability by vestibular hypofunction is compared to a sample of 19 adults (21-75 years old) without instability and normal vestibular function. Image representations of the gait signals acquired on a specific walk path were generated using a continuous wavelet transform and analyzed as a texture using grey level co-occurrence matrix metrics as features. A support vector machine (SVM) algorithm was used to discriminate subjects.

Results: First results show a good classification performance. According to analysis of extracted features, most information relevant to instability is concentrated in the medio-lateral acceleration (X axis) and the frontal plane angular rotation (Z axis gyroscope). Performing a ten-fold cross-validation through the first ten seconds of the sample dataset, the algorithm achieves a 92,3 F1 score corresponding to 12 true-positives, 1 false positive and 1 false negative.

Discussion: This preliminary report suggests that the method has potential use in assessing gait disorders in controlled and non-controlled environments. It suggests that deep learning methods could be explored given the availability of a larger population and data samples.

背景:步态不稳定和跌倒显著影响老年人的生活质量和发病率-死亡率。早期诊断步态障碍是减少严重损伤的最有效方法之一。目的:通过单个传感器采集数据的图像表示,发现老年人步态不稳定模式。方法:将13例因前庭功能减退而不稳定的老年人(71-85岁)与19例无不稳定且前庭功能正常的成年人(21-75岁)进行比较。采用连续小波变换生成特定行走路径上步态信号的图像表示,并以灰度共生矩阵度量为特征进行纹理分析。采用支持向量机(SVM)算法对受试者进行识别。结果:第一种方法具有良好的分类性能。根据提取的特征分析,与失稳相关的大部分信息集中在中侧向加速度(X轴)和前平面角旋转(Z轴陀螺仪)。通过样本数据集的前十秒进行十倍交叉验证,该算法获得了92,3 F1分数,对应于12个真阳性,1个假阳性和1个假阴性。讨论:这一初步报告表明,该方法在评估受控和非受控环境下的步态障碍方面具有潜在的用途。这表明,考虑到更大的人口和数据样本的可用性,可以探索深度学习方法。
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引用次数: 0
Intraoperative impedance and ECAP results in cochlear implant recipients with inner ear malformations and normal cochlear anatomy: a retrospective analysis. 内耳畸形和耳蜗解剖正常的人工耳蜗受者术中阻抗和ECAP的结果:回顾性分析。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-21 DOI: 10.1080/00016489.2025.2452346
Merve İkiz Bozsoy, Aysun Parlak Kocabay, Betül Koska, Beyza Demirtaş Yılmaz, Merve Özses, Nizamettin Burak Avcı, Selvet Akkaplan, Zeynep Budak Ateş, Betül Çiçek Çınar, Mehmet Yaralı, Merve Özbal Batuk, Gonca Sennaroğlu, Levent Sennaroğlu

Background: The intraoperative measurements are essential steps in cochlear implant (CI) surgery for confirming correct electrode placement.

Objectives: To examine the intraoperative impedance and electrically evoked action potential (ECAP) measurement results of cochlear implant (CI) users with normal cochlear anatomy (NCA) and to compare them with CI users with inner ear malformations (IEM).

Material and methods: This retrospective study included intraoperative data of 300 ears from 258 individuals using Medel® and Cochlear (Nucleus®) CI devices.

Results: Impedance values differed through all regions, and that differences in ECAPs results mainly stemmed from the basal region in Cochlear users, when comparing the impedance values and ECAPs recording prevalence between the NCA and IEM groups, it was observed that there was no significant difference in the impedance values across the intracochlear regions of the groups (apical; p = .26, middle; p = .12, basal; p = .99). However, it was found that the prevalence of measurable ECAPs in all intracochlear regions of the NCA group was higher than the IEM group (p = .000).

Conclusion and significance: The robustness of cochlear structures is a crucial factor in the recording of ECAPs. Furthermore, findings in the IEM group demonstrated that proper placement of intracochlear electrodes did not guarantee effective auditory nerve stimulation.

背景:术中测量是人工耳蜗(CI)手术中确定正确电极放置的重要步骤。目的:观察正常耳蜗解剖结构(NCA)的人工耳蜗(CI)使用者术中阻抗和电诱发动作电位(ECAP)测量结果,并与内耳畸形(IEM)的人工耳蜗使用者进行比较。材料和方法:本回顾性研究包括258例使用Medel®和Cochlear (Nucleus®)CI装置的患者300只耳的术中数据。结果:各区域阻抗值存在差异,ecap结果的差异主要来自耳蜗使用者的基底区,当比较NCA组和IEM组耳蜗内阻抗值和ecap记录流行率时,观察到两组耳蜗内阻抗值无显著差异(耳蜗尖区;p =。26日,中间;p =。12、基底;p = .99)。然而,我们发现NCA组所有耳蜗内区域可测量的ecap患病率高于IEM组(p = .000)。结论及意义:耳蜗结构的稳健性是记录ecap的关键因素。此外,IEM组的研究结果表明,耳蜗内电极的适当放置并不能保证有效的听神经刺激。
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引用次数: 0
Clinical features and short-term outcomes of bilateral sudden sensorineural hearing loss: an eight-year experience at a tertiary center. 双侧突发性感音神经性听力损失的临床特征和短期预后:一个三级中心的8年经验。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-20 DOI: 10.1080/00016489.2025.2451735
Yang Li, Jie Wang, Chungang Yu, Xiaoyu Ma

Background: Sudden sensorineural hearing loss (SSNHL) typically affects one ear and is often linked to various underlying causes. However, bilateral SSNHL (BSSHL), where both ears are affected, is much rarer and presents a more severe clinical challenge.

Aims/objectives: To report the clinical features and short-term outcomes of patients with BSSHL.

Material and methods: The clinical features and outcomes of cases with BSSHL treated in between January 2016 and November 2024 were retrospectively analyzed.

Results: A total of 1212 cases with SSNHL were collected, and only 24 cases showed BSSHL (2.0%). The average hearing thresholds before treatment in the simultaneous onset group were significantly higher than that of the sequential onset group (p < .05). After prednisolone therapy, the effective rate of cases treated within 7 days was 18.2%, significantly higher than that of cases (0%) treated after 7 days (p < .05).

Conclusions and significance: BSSHL is more common in females and may be related to viral infection. Simultaneous BSSHL is more common than sequential BSSHL. Hearing loss in patients with simultaneous onset of BSSHL is more severe than those with sequential onset. Prednisolone treatment for BSSHL within 7 days is critical for recovery.

背景:突发性感音神经性听力损失(SSNHL)通常影响一只耳朵,通常与各种潜在原因有关。然而,双耳受损伤的双侧SSNHL (BSSHL)更为罕见,临床挑战更为严峻。目的:报道BSSHL患者的临床特征和短期预后。材料与方法:回顾性分析2016年1月至2024年11月收治的BSSHL患者的临床特点及转归。结果:共收集SSNHL 1212例,其中BSSHL仅24例(2.0%)。同时起病组治疗前平均听力阈值显著高于顺序起病组(p p)。结论及意义:BSSHL多见于女性,可能与病毒感染有关。同步BSSHL比顺序BSSHL更常见。同时发病的BSSHL患者的听力损失比顺序发病的患者更严重。强的松龙治疗BSSHL 7天内是恢复的关键。
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引用次数: 0
Clinical diagnosis and treatment of G2 laryngeal neuroendocrine tumors. G2喉神经内分泌肿瘤的临床诊断与治疗。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-19 DOI: 10.1080/00016489.2024.2437017
Zhen Xu, Xiuyun Wu, Yanjiao Hu, Ce Wu, Xin Wang, Xiaojuan Zhang, Yong Zhang, Yichuan Huang

Background: Neuroendocrine tumors are rare malignancies of the head and neck, especially in the larynx. Variations in the location and morphology of laryngeal neuroendocrine tumors result in a lack of standardized clinical treatment.

Objective: This study aimed to examine the treatment and prognosis of laryngeal neuroendocrine tumors in the G2 stage.

Material and methods: Data from eight patients diagnosed with G2 stage laryngeal neuroendocrine tumors, this collection of common clinical cases was analyzed retrospectively to examine the disease's clinical characteristics, treatment, and prognosis affecting the larynx.

Results: Seven cases were supraglottic type and one was a glottic type. These cases were treated with open surgery and CO2 laser resection with support laryngoscopy, respectively. After surgery, six patients survived, one passed away due to pulmonary metastasis, and one case was lost to follow-up. OS and DSF rates at 1, 3, 5 years were 87.50%, 65.63% and 65.60%, respectively.

Conclusion and significance: The clinical manifestations of G2 stage laryngeal neuroendocrine tumors varied across different locations. Surgical resection of the lesion is the standard treatment. Selection between open neck surgery and support laryngoscope CO2 laser surgery depends on the tumor's size and location. Following radical surgery, the tumor demonstrates a favorable prognosis.

背景:神经内分泌肿瘤是一种罕见的头颈部恶性肿瘤,尤其是在喉部。喉神经内分泌肿瘤的位置和形态的变化导致缺乏标准化的临床治疗。目的:探讨喉神经内分泌肿瘤G2期的治疗及预后。材料与方法:回顾性分析8例确诊为G2期喉部神经内分泌肿瘤的临床常见病例,探讨其临床特点、治疗方法及影响喉部的预后。结果:声门上型7例,声门上型1例。这些病例分别在支持喉镜下进行开放手术和CO2激光切除术。术后6例存活,1例因肺转移死亡,1例失访。1、3、5年OS和DSF率分别为87.50%、65.63%和65.60%。结论及意义:G2期喉神经内分泌肿瘤不同部位的临床表现不同。手术切除病变是标准的治疗方法。选择开放颈部手术和支持喉镜CO2激光手术取决于肿瘤的大小和位置。根治性手术后,肿瘤预后良好。
{"title":"Clinical diagnosis and treatment of G2 laryngeal neuroendocrine tumors.","authors":"Zhen Xu, Xiuyun Wu, Yanjiao Hu, Ce Wu, Xin Wang, Xiaojuan Zhang, Yong Zhang, Yichuan Huang","doi":"10.1080/00016489.2024.2437017","DOIUrl":"https://doi.org/10.1080/00016489.2024.2437017","url":null,"abstract":"<p><strong>Background: </strong>Neuroendocrine tumors are rare malignancies of the head and neck, especially in the larynx. Variations in the location and morphology of laryngeal neuroendocrine tumors result in a lack of standardized clinical treatment.</p><p><strong>Objective: </strong>This study aimed to examine the treatment and prognosis of laryngeal neuroendocrine tumors in the G2 stage.</p><p><strong>Material and methods: </strong>Data from eight patients diagnosed with G2 stage laryngeal neuroendocrine tumors, this collection of common clinical cases was analyzed retrospectively to examine the disease's clinical characteristics, treatment, and prognosis affecting the larynx.</p><p><strong>Results: </strong>Seven cases were supraglottic type and one was a glottic type. These cases were treated with open surgery and CO<sub>2</sub> laser resection with support laryngoscopy, respectively. After surgery, six patients survived, one passed away due to pulmonary metastasis, and one case was lost to follow-up. OS and DSF rates at 1, 3, 5 years were 87.50%, 65.63% and 65.60%, respectively.</p><p><strong>Conclusion and significance: </strong>The clinical manifestations of G2 stage laryngeal neuroendocrine tumors varied across different locations. Surgical resection of the lesion is the standard treatment. Selection between open neck surgery and support laryngoscope CO<sub>2</sub> laser surgery depends on the tumor's size and location. Following radical surgery, the tumor demonstrates a favorable prognosis.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-7"},"PeriodicalIF":1.2,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ultrasound guided procedures in the head and neck: a clinician centered model. 超声引导头颈部手术:以临床医生为中心的模型。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-19 DOI: 10.1080/00016489.2025.2449829
Claudia Crescio, Sebastiana Lai, Alessandra Manca, Angelo Deiana, Michele Angelo Bella, Andrea Tondo, Laila El Bachiri, Simona Varrucciu, Davide Rizzo, Jacopo Galli, Antonio Cossu, Francesco Bussu

Background: US guided sampling is a validated diagnostic approach for non-thyroid deep head and neck masses.

Aim: To describe the setting of a clinician-driven Lump Clinic and analyze a monoinstitutional 7-year database of 849 patients undergoing US-guided sampling.

Methods: FNA with Rapid OnSite Evalutation (ROSE) was the first diagnostic step. In the last years in selected cases, upon ROSE and discussion between clinician and histopathologist, a core biopsy was performed, usually in the same access. If cytology is non-diagnostic, and core biopsy have not been obtained, all available clinical and diagnostic data were re-examined by surgeons and cytopathologists to establish a multiparametric diagnosis (MD).

Results: Cytology and MD showed a sensitivity of 91.8% and 95.3% respectively and a specificity of 95.7% in diagnosing malignancy. Complication rate of US guided sampling was 0,12% (considering the number of patients: 1/849), without any serious adverse event.

Conclusions and significance: Present data confirm the great safety and utility of US guided procedures in the management of head and neck non-thryoid deep masses, while demonstrating the added value of a lump clinic built on the close cooperation between the head and neck surgeon and the histopathologists.

背景:超声引导取样是一种有效的诊断非甲状腺性头颈部深部肿块的方法。目的:描述临床驱动的肿块诊所的设置,并分析接受美国指导抽样的849名患者的单一机构7年数据库。方法:FNA与快速现场评价(ROSE)是诊断的第一步。在过去几年中,在选定的病例中,根据ROSE和临床医生和组织病理学家之间的讨论,通常在相同的通道中进行了核心活检。如果细胞学无法诊断,并且没有获得核心活检,则外科医生和细胞病理学家重新检查所有可用的临床和诊断数据,以建立多参数诊断(MD)。结果:细胞学和MD诊断恶性肿瘤的敏感性分别为91.8%和95.3%,特异性为95.7%。US引导取样的并发症发生率为0.12%(考虑到患者数量:1/849),未发生严重不良事件。结论和意义:目前的数据证实了US引导手术治疗头颈部非甲状腺深部肿块的安全性和实用性,同时也证明了头颈部外科医生和组织病理学家密切合作所建立的肿块诊所的附加价值。
{"title":"Ultrasound guided procedures in the head and neck: a clinician centered model.","authors":"Claudia Crescio, Sebastiana Lai, Alessandra Manca, Angelo Deiana, Michele Angelo Bella, Andrea Tondo, Laila El Bachiri, Simona Varrucciu, Davide Rizzo, Jacopo Galli, Antonio Cossu, Francesco Bussu","doi":"10.1080/00016489.2025.2449829","DOIUrl":"https://doi.org/10.1080/00016489.2025.2449829","url":null,"abstract":"<p><strong>Background: </strong>US guided sampling is a validated diagnostic approach for non-thyroid deep head and neck masses.</p><p><strong>Aim: </strong>To describe the setting of a clinician-driven Lump Clinic and analyze a monoinstitutional 7-year database of 849 patients undergoing US-guided sampling.</p><p><strong>Methods: </strong>FNA with Rapid OnSite Evalutation (ROSE) was the first diagnostic step. In the last years in selected cases, upon ROSE and discussion between clinician and histopathologist, a core biopsy was performed, usually in the same access. If cytology is non-diagnostic, and core biopsy have not been obtained, all available clinical and diagnostic data were re-examined by surgeons and cytopathologists to establish a multiparametric diagnosis (MD).</p><p><strong>Results: </strong>Cytology and MD showed a sensitivity of 91.8% and 95.3% respectively and a specificity of 95.7% in diagnosing malignancy. Complication rate of US guided sampling was 0,12% (considering the number of patients: 1/849), without any serious adverse event.</p><p><strong>Conclusions and significance: </strong>Present data confirm the great safety and utility of US guided procedures in the management of head and neck non-thryoid deep masses, while demonstrating the added value of a lump clinic built on the close cooperation between the head and neck surgeon and the histopathologists.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-8"},"PeriodicalIF":1.2,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does cochlear implant electrode array design affect audiologic outcomes? A systematic review and meta-analysis. 人工耳蜗电极阵列设计是否影响听力学结果?系统回顾和荟萃分析。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-18 DOI: 10.1080/00016489.2025.2451074
Kelsey A Duckett, Mohamed Faisal Kassir, Christopher C Munhall, Kara C Schvartz-Leyzac, Shaun A Nguyen, Robert F Labadie

Background: There is conflicting literature regarding whether cochlear implants (CI) electrode array (EA) selection impacts audiologic outcomes.

Objective: To compare outcomes for the two EA designs, precurved and straight.

Methods: A systematic search of CINAHL, Cochrane Library, PubMed, and SCOPUS was conducted according to PRISMA guidelines. Included studies reported word recognition scores, sentence recognition scores in quiet or noise, or hearing preservation (HP) rates for patients with post-lingual hearing loss who underwent CI with either EA type. Primary outcome measures included mean difference (baseline vs. post-surgery) and proportions (%) with 95% confidence intervals (CI).

Results: Of 4134 unique abstracts screened, 92 studies (N = 5365 patients, 5658 ears) were included. Mean improvement of overall word recognition scores for patients with precurved EAs (46.5%, 95% CI: 43.13-49.88%) was significantly (p = 0.0009) superior to that of patients with straight EAs (36.33%; 95% CI, 31.4-41.27%). There was no significant difference between mean improvement of Azbio Quiet scores, mean improvement of overall sentences in noise scores, or HP or pure-tone averages between patients with precurved EAs and those with straight EAs.

Conclusions: Precurved EAs were superior in mean word recognition score improvement, but there was no superior EA design regarding sentence recognition or hearing preservation.

背景:关于人工耳蜗(CI)电极阵列(EA)的选择是否影响听力学结果,文献存在矛盾。目的:比较预弯和直两种EA设计的效果。方法:根据PRISMA指南系统检索CINAHL、Cochrane Library、PubMed、SCOPUS。纳入的研究报告了语言后听力损失患者在安静或噪音下的单词识别评分、句子识别评分或听力保留(HP)率,这些患者接受了两种EA类型的CI。主要结果测量包括平均差异(基线与术后)和95%可信区间(CI)的比例(%)。结果:在筛选的4134份独特摘要中,纳入了92项研究(N = 5365例患者,5658耳)。预弯曲ea患者整体单词识别评分的平均改善(46.5%,95% CI: 43.13-49.88%)显著(p = 0.0009)优于直直ea患者(36.33%;95% ci, 31.4-41.27%)。预弯曲ea患者与直直ea患者的Azbio Quiet评分的平均改善、噪声评分的整体句子平均改善、HP或纯音平均改善之间无显著差异。结论:预先弯曲的EA在平均单词识别评分改善方面具有优势,但在句子识别和听力保护方面没有优势。
{"title":"Does cochlear implant electrode array design affect audiologic outcomes? A systematic review and meta-analysis.","authors":"Kelsey A Duckett, Mohamed Faisal Kassir, Christopher C Munhall, Kara C Schvartz-Leyzac, Shaun A Nguyen, Robert F Labadie","doi":"10.1080/00016489.2025.2451074","DOIUrl":"https://doi.org/10.1080/00016489.2025.2451074","url":null,"abstract":"<p><strong>Background: </strong>There is conflicting literature regarding whether cochlear implants (CI) electrode array (EA) selection impacts audiologic outcomes.</p><p><strong>Objective: </strong>To compare outcomes for the two EA designs, precurved and straight.</p><p><strong>Methods: </strong>A systematic search of CINAHL, Cochrane Library, PubMed, and SCOPUS was conducted according to PRISMA guidelines. Included studies reported word recognition scores, sentence recognition scores in quiet or noise, or hearing preservation (HP) rates for patients with post-lingual hearing loss who underwent CI with either EA type. Primary outcome measures included mean difference (baseline vs. post-surgery) and proportions (%) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Of 4134 unique abstracts screened, 92 studies (<i>N</i> = 5365 patients, 5658 ears) were included. Mean improvement of overall word recognition scores for patients with precurved EAs (46.5%, 95% CI: 43.13-49.88%) was significantly (<i>p</i> = 0.0009) superior to that of patients with straight EAs (36.33%; 95% CI, 31.4-41.27%). There was no significant difference between mean improvement of Azbio Quiet scores, mean improvement of overall sentences in noise scores, or HP or pure-tone averages between patients with precurved EAs and those with straight EAs.</p><p><strong>Conclusions: </strong>Precurved EAs were superior in mean word recognition score improvement, but there was no superior EA design regarding sentence recognition or hearing preservation.</p>","PeriodicalId":6880,"journal":{"name":"Acta Oto-Laryngologica","volume":" ","pages":"1-17"},"PeriodicalIF":1.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Leveraging eCAP thresholds in a logistic model to predict speech outcomes after implantation in anomalous cochlea. 利用逻辑模型中的eCAP阈值预测异常耳蜗植入后的语音结果。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-16 DOI: 10.1080/00016489.2024.2449251
Das K Nidhin, Amit Keshri, Ravisankar Manogaran, Nazrin Hameed, Prabhakar Mishra, Mohd Aqib, Kalyan Chidambaram, Mohit Sinha

Background: Pediatric cochlear implant (CI) recipients with cochlear malformations face challenges due to variable speech recognition outcomes.

Aims/objectives: This study assesses the predictive value of intraoperative electrically evoked compound action potential (eCAP) thresholds, residual hearing, age at implantation, Intelligent Quotient (IQ), and malformation type for speech recognition outcomes.

Material and methods: A prospective cohort of 52 children (aged 1-4 years) with cochlear malformations who underwent CI between 2016 and 2024 was analyzed. Intraoperative eCAP thresholds were recorded, and disyllable word recognition scores (WRS) were evaluated 24 months postoperatively.

Results: Patients included incomplete partition (IP-II, 46.2%), cochlear hypoplasia (30.8%), IP-I (13.5%), and common cavity (9.6%). IP-II cases had higher mean eCAP thresholds (18.85 µV) compared to cochlear hypoplasia and common cavity cases. Higher eCAP thresholds correlated with better WRS outcomes (p < 0.001). Logistic regression revealed eCAP thresholds, residual hearing, age, IQ, and malformation type as significant predictors, with an AUC of 0.92.

Conclusions and significance: Intraoperative eCAP thresholds and residual hearing strongly predict auditory outcomes in children with cochlear malformations. Tailored CI strategies based on individual profiles can optimize speech recognition outcomes.

背景:患有耳蜗畸形的儿童人工耳蜗(CI)受者由于语音识别结果的变化而面临挑战。目的:本研究评估术中电诱发复合动作电位(eCAP)阈值、残余听力、植入年龄、智商(IQ)和畸形类型对语音识别结果的预测价值。材料和方法:对2016年至2024年间接受人工耳蜗手术的52名耳蜗畸形儿童(1-4岁)进行前瞻性队列分析。记录术中eCAP阈值,并评估术后24个月双音节词识别评分(WRS)。结果:患者包括IP-II型(46.2%)、耳蜗发育不全(30.8%)、IP-I型(13.5%)、共腔(9.6%)。与耳蜗发育不全和普通腔相比,IP-II患者的平均eCAP阈值(18.85µV)更高。结论和意义:术中eCAP阈值和残余听力能很好地预测耳蜗畸形患儿的听觉结局。基于个人配置文件的定制CI策略可以优化语音识别结果。
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引用次数: 0
Transmastoid superior semicircular canal dehiscence plugging: VHIT findings. 乳突上半规管裂孔封堵:VHIT表现。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2025-01-15 DOI: 10.1080/00016489.2025.2449593
Charlotte Benoit, Charlotte Hautefort, Benjamin Verillaud, Philippe Herman, Romain Kania

Background: Superior canal dehiscence syndrome (Minor's syndrome) is a condition characterized by a bony defect in the superior semicircular canal (SSCC), with treatment primarily being surgical, notably through plugging of SSCC.

Aims/objectives: To examine the clinical outcome and postoperative VHIT findings after transmastoid plugging of the SSCC.

Materials and methods: Patients having a superior semicircular canal dehiscence (SSCCD) syndrome with debilitating symptoms who underwent a plugging of the SSCC via a transmastoid approach were included. Through a retrospective chart review and literature review, postop video head impulse test (VHIT) findings, pre and post-operative audiological/vestibular symptoms and audiograms were analyzed in a tertiary care university hospital.

Results: All patients operated by plugging of the SSCC through a transmastoid approach had a significative post-operative VHIT deficit in the function of the SSCC (range 0.34-0.70, median gain function 0.41, mean gain function 0.46, standard deviation of 0.15, p = 0.0391) Almost all patients had improvement of their preoperative symptoms. No surgical complication was noted. The literature review also highlighted safety and effectiveness of this surgical technique.

Conclusion and significance: Post-operative VHIT findings showed an elective deficit of the SSCC function thus confirming the surgical SSCC plugging through a trans mastoid approach.

背景:上半圆形椎管开裂综合征(Minor’s syndrome)是一种以上半圆形椎管(SSCC)骨缺损为特征的疾病,治疗主要是手术,尤其是封堵上半圆形椎管。目的/目的:探讨经乳突封堵SSCC的临床结果和术后VHIT表现。材料和方法:包括有衰弱症状的上半规管裂(SSCCD)综合征,经乳突入路封堵SSCC的患者。通过回顾性图表复习和文献复习,分析了某大学三级医院手术后视频头部脉冲试验(VHIT)的结果、术前和术后听力学/前庭症状和听力图。结果:所有经乳突肌入路封堵SSCC的患者术后SSCC功能均出现明显的VHIT缺损(范围0.34 ~ 0.70,中位增益函数0.41,平均增益函数0.46,标准差0.15,p = 0.0391),几乎所有患者术前症状均有改善。无手术并发症。文献回顾也强调了这种手术技术的安全性和有效性。结论和意义:术后VHIT检查结果显示SSCC功能选择性缺陷,从而证实了经乳突入路手术封堵SSCC。
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引用次数: 0
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Acta Oto-Laryngologica
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