The journal of international advanced otology最新文献

Background: Despite cochlear microphonic's potential clinical application, especially in ANSD diagnosis, the optimal parameters to record cochlear microphonics and the effect of various stimulus parameters are not well understood yet, which makes its recording a difficult procedure. The present study was undertaken to determine the effect of stimulus polarity, rate, stimulus type, and stimulus frequency on different aspects of cochlear microphonics, which could help to decide an optimal stimulus parameter that can be used to record CM.

Methods: The study involved 32 normal-hearing adults. CM was recorded from these individuals using extratympanic CM measurement from the ear canal independently for tone burst frequencies (500 Hz, 1 kHz, 4 kHz & 8 kHz) and click stimuli having rarefaction and condensation polarity at 30.1/sec and 59.1/sec repetition rates. Amplitude and latency were measured from the recorded waveforms and compared across and between stimulus conditions.

Results: Results reveal that stimulus frequency and stimulus type have a significant effect on different parameters of CM. However, there was no significant effect of stimulus polarity and rate of stimulus on the amplitude and latency of cochlear microphonics. The amplitude and latency of the cochlear microphonics are inversely proportional to the stimulus frequency.

Conclusion: Hence, the study suggests the use of low-frequency tone burst (500 Hz/1 kHz) to elicit robust CM, which has greater application in the assessment of cochlear functioning over OAE as the latter gets affected by environmental and physiological noise and also due to middle ear pathology.

Background: Clear identification of the round window (RW) through the facial recess is a key surgical step for successful cochlear implantation (CI) surgery, which may be very challenging in some cases. Objective is to predict round window (RW) accessibility during CI surgery using high-resolution computed tomography (HRCT).

Methods: We retrospectively reviewed preoperative HRCT scans of 142 patients who underwent CI surgery via the standard posterior tympanotomy approach at our ENT Head and Neck Surgery department. Surgical accessibility of the RW was assessed according to 2 methods, similar to the ones introduced by Mandour et al and Elzayat et al. Pre-operative imaging findings were then compared to the actual surgical accessibility of the RW by reviewing surgical notes and video recordings.

Results: Difficult surgical access to the RW was correctly predicted in our series by Mandour's method in 81.8% of the cases, with a sensitivity and specificity of 56.3% and 96.4%, respectively, and by Elzayat's method in 72.2% of the cases, with a sensitivity and specificity of 50% and 94.5%, respectively. Combining both methods showed an increase in sensitivity levels (Se=71.9%). When the 2 methods both predicted difficult RW access, there was a strong probability that drilling a cochleostomy would be necessary for safe electrode insertion along the scala tympani of the basal turn of the cochlea (P < .001).

Conclusion: These 2 methods are both simple and reliable tools that can help the surgeon anticipate difficult surgical access and prepare for the potential use of alternative techniques.

Background: Paecilomyces spp. are thermo-tolerant fungi found in decaying vegetables and soil. They can cause ocular, cutaneous, and miscellaneous infections. In otorhinolaryngology, most infections occur in the paranasal sinuses, while otological infection is uncommon.

Methods: We report a case of 41-year-old diabetic, male army officer with warm, fluctuant left temporal swelling and reduced hearing. Otoscopy revealed an edematous external auditory canal (EAC) with posterior wall sagging and bulging tympanic membrane. Computed tomography revealed subperiosteal temporal abscess extending intracranially. The pus was drained surgically via an otological and a neurosurgical approach, and pus sent for culture grew paecilomyces. He showed clinical improvement after receiving oral antifungal treatment postoperatively. Retrospectively, his occupation as an army officer and his diabetic immunocompromised state may have predisposed him to the infection.

Results: Paecilomyces middle ear infection leading to intracranial involvement of such magnitude is yet to be reported, and we showcase its successful management through a combined surgical neuro-otology approach and oral antifungal therapy. Fungal ear infections can lead to severe extracranial and intracranial complications if inadequately treated. Differentiating it from cholesteatoma also presents a diagnostic challenge clinically and radiologically. While both can lead to intracranial complications, our patient's brief history and lack of prior ear symptoms contrast with that of cholesteatoma.

Conclusion: The rarity of neuro-otological paecilomyces infections emphasizes the need for awareness and early identification. It is vital to recognize such infections, and prompt surgical management with appropriate antifungal drugs is warranted to prevent disastrous outcomes.

Background: Achondroplasia, the most prevalent form of skeletal dysplasia involving short stature, necessitates a multidisciplinary approach that includes otology and auditory rehabilitation. Despite this, the clinical characteristics of hearing loss and otologic manifestations in achondroplasia patients remain poorly defined. This study aimed to explore the prevalence and treatment outcomes of otologic disease in individuals with achondroplasia.

Methods: A retrospective review of medical records was conducted for 70 patients who visited the otolaryngology clinic at 3 institutions in South Korea from 1999 to 2023. Demographic and clinical characteristics, including audiometric findings, imaging studies, treatment modalities, and outcomes, were analyzed.

Results: Among 53 patients who underwent audiometry, 26 showed conductive hearing loss, 2 had mixed-type hearing loss, and 4 had sensorineural hearing loss. Fifty-one patients (72.9%) had middle ear effusion at least once. Myringotomy or ventilation tube insertion was performed on 33 patients (47.1%), and 16 patients (22.9%) required multiple insertions. Eighteen patients (25.7%) had adenoid hypertrophy, and 16 (22.9%) underwent adenoidectomy. Temporal bone computed tomography (TBCT) scans were taken in 9 patients (12.9%) for middle ear evaluation. Computed tomography (CT) scans showed a high jugular bulb and rotated inner ear structures. Chronic otitis media with cholesteatoma was diagnosed in 2 patients (2.9%), in whom tympanomastoidectomy was performed.

Conclusion: Half of the children with achondroplasia experienced hearing loss, most commonly due to conductive hearing loss. Threequarters of these children exhibited otitis media with effusions, often necessitating the insertion of a ventilation tube and adenoidectomy. Given the anatomical variations present in these children, such as a high jugular bulb and rotated structures of the inner ear and facial nerve, a cautious approach is essential when performing middle ear surgery.

Background: Ebselen is a neuroprotective drug that protects cellular components from oxidative damage by modulating enzymatic cofactors, metalloproteins, gene expression, antioxidant-anti-inflammatory effects, and immunological systems. Our goal was to compare the efficacy of Ebselen and methylprednisolone on rat facial nerve crush injury.

Methods: Thirty healthy male Wistar rats (mean weight of 245 g) were used in this study. The rats were randomly divided into four groups: Group 1 (ebselen group), Group 2 (methylprednisolone group), Group 3 (control group), and Group 4 (sham group (the right side of the control group)). Except for the sham group, all groups had their left facial nerve crushed. Three weeks after surgery, prospective functional, histologic, and electrophysiologic recovery was reported.

Results: The ebselen group and methylprednisolone group had similar and more significant recovery at Nerve Excitability Thresholds (NET) at the end of three weeks. These groups also showed similar features in terms of histopathological parameters such as axonal degeneration, vascular congestion, axon diameter, and myelin thickness. Except for the macrovacuolization parameter, both showed statistically better results than the control group. Although there was an earlier improvement in the whiskers and blink tests in the ebselen group compared to the methylprednisolone and control groups, complete recovery was observed in all groups on the 21st day.

Conclusion: Ebselen was found to be similarly effective to methylprednisolone in nerve regeneration in a rat model of experimental facial nerve crush. Considering that methylprednisolone has serious systemic side effects, ebselen may be a good alternative.

The aim is to analyze Literature concerning mastoid obliteration in adults with either autologous or heterologous grafts in the last 10 years. Data Source: Databases such as NIH PubMed, Bookshelf, NLM Catalog, Cochrane Library, and Embase were consulted. Thirty-seven studies were selected (22 concerning autologous materials, 15 about heterologous ones). Only studies with more than 12 months of follow-up were considered. A statistical analysis with random-effects models was performed to allow the true effect sizes to differ from study to study. The present literature review and meta-analysis does not allow to establish the supremacy of one technique over the other, but underlines the advantages of each reconstructive choice and the importance of mastoid obliteration in cholesteatoma surgery. The total number of obliterated ears was 2882. Overall otorrhea rate was 5% (5.2% for heterologous grafts; 4.9% for autologous materials; P < .05). Recurrent and residual cholesteatoma rate was 4.5% (3.4% in heterologous materials; 5.2% in autologous grafts; P < .05). Recurrent cholesteatoma rate was 1.8% (1.6% when using heterologous grafts, 1.9% with autologous; P < .05). Residual cholesteatoma rate was 1.5% (1.6% with heterologous materials, 1.5% with autologous; P < .05). TM (tympanic membrane) retraction pockets rate was 5.3% (3.6% with heterologous materials; P >.05; 7% with autologous materials; P < .05). TM perforations rate was 2.9% (4.3% with heterologous materials, 2.5% with autologous; P < .05). Infection rate was 2.3% (2.3% with heterologous materials, 2.2% with autologous; P < .05). Heterologous materials are associated with significantly lower rates of recurrent and residual cholesteatoma and retraction pockets development, although they are associated with higher rates of otorrhea and TM perforation.

The significance of emotional prosody in social communication is well-established, yet research on emotion perception among cochlear implant (CI) users is less extensive. This study aims to explore vocal emotion perception in children using CI and bimodal hearing devices and compare them with their normal hearing (NH) peers. The study involved children aged 4-10 years with unilateral CI and contralateral hearing aid (HA), matched with NH peers by gender and listening age. Children were selected using snowball sampling for the CI group and purposive sampling for the NH group. Vocal emotion perception was assessed for semantically neutral sentences in "happy," "sad," and "angry" emotions using a 3 alternate forced choice test. The NH group demonstrated significantly superior emotion perception (P=.002) compared to the CI group. Both groups accurately identified the "happy" emotion. However, the NH group had higher scores for the "angry" emotion compared to the "sad" emotion, while the CI group showed better scores for "sad" than "angry" emotion. Bimodal hearing devices improved recognition of "sad"and "angry" emotions, with a decrease in confusion percentages. The unbiased hit (Hu) value provided more substantial insight than the hit score. Bimodal hearing devices enhance the perception of "sad" and "angry" vocal emotions compared to using a CI alone, likely due to the HA providing the temporal fine structure cues, thereby better representing fundamental frequency variations. Children with unilateral CI benefit significantly in the perception of emotions by using a HA in the contralateral ear, aiding in better socio-emotional development.

Damage to the middle ear (ME) caused by penetrating welding sparks can lead to a variety of adverse outcomes. An exhaustive review of the literature is lacking, particularly with regard to clinical presentation, diagnostic-therapeutic work-up, and outcomes. Here we describe the clinical details of an injury caused by the largest welding foreign body ever reported in the ME. In addition, we present a comprehensive review of the relevant literature.

The study aimed to determine whether there was a difference or an association between auditory memory and visual memory in typically developing children. Eighteen children, aged 8 to 12 years, with normal hearing and visual acuity, were evaluated using the Children's Memory Scale (CMS) to determine their auditory and visual memory performance. Using the core subtest battery of the CMS, auditory/verbal (immediate and delayed), visual/nonverbal (immediate and delayed), and general memory index scores were assessed. No significant difference was found between auditory/verbal memory and visual/nonverbal memory scores for both immediate and delayed recall. Likewise, no correlation between auditory/verbal memory and visual/nonverbal memory scores was found. However, there was a significant correlation between immediate and delayed recall scores within each modality. The non-significant difference between the two modalities for both immediate and delayed recall gives the impression that memory is modality independent. However, the lack of any correlation between the two suggests there was no association between them. The absence of a significant difference between modalities can be attributed to the auditory and visual test material used in CMS not being analogous. It can thus be inferred that the auditory and visual modalities are independent. While the visual material evaluates simultaneous/concurrent perception, the auditory material assesses sequential perception.