Can Imaging Predict Hearing Outcomes in Children With Cochleovestibular Nerve Abnormalities?

2022 ◽  
Elina Kari ◽  
Danielle M. Gillard ◽  
Nathaniel Chuang ◽  
John L. Go
2021 ◽  
pp. 000348942110059
Özge Akdoğan ◽  
Smirnov Exilus ◽  
Bryan K. Ward ◽  
Justin C. McArthur ◽  
Charles C. Della Santina ◽  

Objectives: To report a case of profound bilateral sensorineural hearing and vestibular loss from relapsing polychondritis and hearing outcomes after cochlear implantation. Methods: Case report and literature review. Results: A 43 year-old woman developed sudden loss of hearing and balance that progressed over several weeks to bilateral, profound hearing and vestibular loss. Steroid treatments were ineffective. She underwent vestibular physical therapy and left cochlear implantation. About 10 months after her initial presentation, she developed erythema, warmth, swelling, and pain of the left auricle sparing the lobule, flattening of the bridge of her nose, and right ankle swelling, warmth, and skin erythema. A biopsy of the left auricle revealed histopathologic findings consistent with relapsing polychondritis. She was treated with high dose prednisolone. The ear inflammation resolved, however, despite excellent auditory response to pure tone thresholds, the patient reported no improvement in speech perception after cochlear implantation. Conclusions: Relapsing polychondritis can present with rapidly progressive, profound loss of hearing and vestibular function. Hearing outcomes after cochlear implantation can include poor speech discrimination despite good pure tone detection thresholds.

2021 ◽  
pp. 019459982199066
Sandra Ho ◽  
Prayag Patel ◽  
Daniel Ballard ◽  
Richard Rosenfeld ◽  
Sujana Chandrasekhar

Objective To systematically review the current literature regarding the operative outcomes of stapes surgery for stapes fixation via the endoscopic and microscopic approaches. Data Sources PubMed, Embase, and Web of Science. Review Methods An electronic search was conducted with the keywords “endoscop* or microscop*” and “stapes surgery or stapedectomy or stapedotomy or otosclerosis or stapes fixation.” Studies were included if they compared endoscopy with microscopy for stapes surgery performed for stapes fixation and evaluated hearing outcomes and postoperative complications. Articles focusing on stapes surgery other than for stapes fixation were excluded. Results The database search yielded 1317 studies; 12 remained after dual-investigator screening for quantitative analysis. The mean MINORS score was 18 of 24, indicating a low risk of bias. A meta-analysis demonstrated no statistically significant difference between the groups with regard to operative time, chorda tympani nerve manipulation or sacrifice, or postoperative vertigo. There was a 2.6-dB mean improvement in the change in air-bone gap in favor of endoscopic stapes surgery and a 15.2% increased incidence in postoperative dysgeusia in the microscopic group, but the studies are heterogeneous. Conclusions Endoscopic stapes surgery appears to be a reasonable alternative to microscopic stapes surgery, with similar operative times, complications, and hearing outcomes. Superior visibility with the endoscope was consistently reported in all the studies. Future studies should have standardized methods of reporting visibility, hearing outcomes, and postoperative complications to truly establish if endoscopic stapes surgery is equivalent or superior to microscopic stapes surgery.

2021 ◽  
Vol 108 (Supplement_2) ◽  
S Chiuta ◽  
S Raza-Knight ◽  
A Alalade

Abstract Introduction Vestibular schwannomas (VS) are benign intracranial tumours originating from the vestibular division of the eighth cranial nerve. The mainstay of their surgical management is microsurgery, other options are radiotherapy or radiological monitoring. Endoscopy (ES) is becoming widely used in neurosurgery and may have a role in improving visualisation and outcomes by enhancing extent of resection, facial nerve, and hearing preservation in VS resection and describe the postoperative outcomes. Method The review was conducted according to the PRISMA guidelines and yielded 31 studies for inclusion. Systematic searches of literature databases were done for studies where endoscopic-assisted and/or endoscopic resection of VS were reported. Results ES facial nerve preservation rates (median 91.3%, range 39.0 - 100%) were comparable to microsurgical treatment. Hearing outcomes were more variable in ES series and were under-reported. A median gross total resection rate of 97.4% (61.0 - 100%) was achieved in the ES series. Conclusions Current data suggest that ES-assisted resection of sporadic VS is not inferior to microsurgical resection with respect to facial nerve outcomes and extent of resection. However, some ES series report poor hearing outcomes, which are under-reported in the literature.

2021 ◽  
pp. 1-5
Yanqing Fang ◽  
Ke-guang Chen ◽  
Yu Zhao ◽  
Nikita A. Menon ◽  
Austin J. Scholp ◽  

2021 ◽  
Vol 37 (1) ◽  
Ahmed Gamal Khafagy ◽  
Mohamed El-Begermy ◽  
Marwa Mohamed El-Begermy ◽  
Pretty O. Afifi

Abstract Background This study aims to compare the graft uptake rate and hearing improvement of fat graft versus inlay butterfly tragal cartilage in the repair of perforations in chronic otitis media mucosal in adults. In this retrospective study, twenty-eight patients were included with small dry anteroinferior tympanic membrane perforations (less than 1/3 of the tympanic membrane). The age range was 18 to 44 years old. Myringoplasty was done under general anesthesia for 8 patients with a fat graft (FG) and 20 patients with inlay butterfly cartilage graft (IBCG). Six months postoperatively, a follow-up evaluation was done for successful graft uptake and hearing outcomes. Results The success rate of graft uptake in the first group (fat graft) was 6/8 cases (75%) while in the second group (IBCG) was 19/20 (95%) with no statistically significant difference (P = 0.0148). Also, there was no statistical difference between the two groups as regards postoperative ABG, improvement changes in ABG, and number of patients with improved hearing. Conclusions Inlay butterfly cartilage graft is a useful graft in repairing small tympanic membrane perforations as regard graft take and hearing outcomes.

2021 ◽  
pp. 014556132110376
Pei-Hsin Chen ◽  
Kai-Nan Lin ◽  
Hsiu-Yin Lin ◽  
Rui-Bin Yu ◽  
Pi-Yun Liu ◽  

Objective: To examine the clinical factors associated with the effectiveness of stapedotomy in improving hearing sensitivity in Taiwanese patients with otosclerosis. Methods: In this retrospective study, we reviewed the medical records of 31 patients (36 ears) with otosclerosis undergoing stapedotomy performed by a single surgeon. Preoperative and postoperative hearing results were analyzed to identify factors associated with hearing outcomes after stapedotomy in the Taiwanese population with clinical otosclerosis. Results: Compared with preoperative pure tone averages (PTAs), stapedotomy significantly improved postoperative air conduction (AC) thresholds ( P < .0001), bone conduction (BC) thresholds ( P = .025), and air-bone gaps (ABGs; P < .0001). Postoperative closure of ABGs less than 10 or 20 dB was achieved in 16 (44.4%) and 33 (91.7%) of 36 surgical ears. Improvement in postoperative AC thresholds and ABGs and the size of preoperative ABGs were significantly correlated (r = .650, P < .001 and r = .745, P < .001, respectively). Gender-stratified analysis indicated a stronger correlation between improvement in postoperative AC thresholds and preoperative ABGs in male patients than in female patients (r = .893, P < .001 and r = .476, P = .014, respectively), and in postoperative and preoperative ABGs (r = .933, P < .001 and r = .626, P < .001, respectively). With the more stringent criteria for surgical success, factors including age (≤50 years), type (conductive, BC ≤25 dB), and degree (PTA ≤55 dB) of preoperative hearing loss led to more favorable outcomes. Conclusions: We reported evidence supporting a potential gender difference on hearing outcomes after stapedotomy in Taiwanese patients with otosclerosis. Age, type, and degree of preoperative hearing loss may affect the surgical success rate.

2021 ◽  
Vol 42 (9) ◽  
pp. 1382-1389
Amjad Tobia ◽  
Noam Yehudai ◽  
Riad Khnifes ◽  
Talma Shpak ◽  
Osnat Roth ◽  

2018 ◽  
Vol 23 (5) ◽  
pp. 277-284 ◽  
Chia-Huei Chu ◽  
Shiau-Ru Chiou ◽  
Mao-Che Wang ◽  
An-Suey Shiao ◽  
Tzong-Yang Tu ◽  

Objective: The purpose of this retrospective study was to investigate the difference in treatment outcomes for patients with idiopathic sudden sensorineural hearing loss (SSNHL) undergoing concurrent or sequential intravenous (IV) and intratympanic (IT) steroid therapies. Methods: Patients with idiopathic SSNHL admitted to Taipei Veterans Hospital from August 2011 to August 2012 were enrolled. Patients were treated with both IV dexamethasone 5 mg b.i.d. for 5 days, then tapered over 6 days, and IT injections of dexamethasone 5 mg daily. The administration of IV and IT steroids was given either concurrently or sequentially (IV steroid was administered from days 1–5 followed by IT steroid treatment starting on day 4 or day 5). The hearing outcomes of the concurrent and sequential groups were analyzed. Results: Overall, after ≥2 months following treatment, across frequencies ranging from 250 to 8,000 Hz and pure-tone average (PTA) assessments, hearing improvements were similar between treatment groups, except at the frequencies of 4,000 and 8,000 Hz where the concurrent treatment group had greater hearing gain than the sequential group (4,000 Hz: 30.68 ± 28.96 vs. 14.52 ± 24.06 dB, respectively, p = 0.042; 8,000 Hz: 22.62 ± 23.59 vs. 7.67 ± 21 dB, p = 0.030). Across frequencies and PTA assessments, a similar percentage of patients had ≥20-dB gains in hearing compared with patients treated sequentially, except at 8,000 Hz where a greater percentage of patients in the concurrent group (57.1%) than the sequential group (23.3%) (p = 0.014) had ≥20-dB hearing gains. Conclusion: The findings suggest that both concurrent and sequential treatment improve hearing in patients with idiopathic SSNHL, and that concurrent treatment may show greater benefit than sequential therapy, particularly at high frequencies.

2018 ◽  
Vol 79 (S 01) ◽  
pp. S1-S188
Peter Santa Maria ◽  
Yangyang Shi ◽  
Richard Gurgel ◽  
Carleton Corrales ◽  
Scott Soltys ◽  

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