Cochlear Implants in Pediatric Bacterial Meningitis

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P63-P63
Author(s):  
Brandon Isaacson ◽  
Kenneth H Lee ◽  
Joe W Kutz ◽  
Peter S Roland
Keyword(s):  
Hearing Loss ◽  
Bacterial Meningitis ◽  
Cochlear Implant ◽  
Tertiary Care ◽  
Performance Outcomes ◽  
Case Review ◽  
Retrospective Case ◽  
Labyrinthitis Ossificans ◽  
Cochlear Ossification ◽  
And Performance

Objective 1) To determine pediatric cochlear implant performance outcomes for hearing loss secondary to bacterial meningitis. 2) To determine if a performance difference exists in pediatric cochlear implant patients with and without labyrinthitis ossificans. Methods A retrospective case review was performed at a tertiary care multi-disciplinary cochlear implant program. 45 children were implanted from 1991 to 2006 whose hearing loss resulted from bacterial meningitis. Mode of communication, school placement and performance were reviewed. Results 21 patients(52%) were in a mainstream educational enviroment and 19 (48%) were in a special needs enviroment. 24 subjects (58%) used an auditory-verbal mode of communication, while 17 (42%) used total communication. The mean speech reception threshold was 28dB with a range from 5 to 65dB. 14 subjects (56%) had labyrinthis ossifcans, while 11 subjects (44%) did not. Conclusions The present study demonstrated that over half of our subjects developed labyrinthitis ossificans. Despite the presence of cochlear ossification, patients with bacterial meningitis-induced hearing loss can often perform in a main-stem classroom with auditory-verbal communication.

Labyrinthitis ossificans: How accurate is MRI in predicting cochlear obstruction?

2009 ◽  
Vol 140 (5) ◽  
pp. 692-696 ◽  
Author(s):  
Brandon Isaacson ◽  
Timothy Booth ◽  
Joe W. Kutz ◽  
Kenneth H. Lee ◽  
Peter S. Roland
Keyword(s):  
High Resolution ◽  
Bacterial Meningitis ◽  
Cochlear Implant ◽  
Tertiary Care ◽  
Fibrous Tissue ◽  
Case Series ◽  
Prior History ◽  
Basal Turn ◽  
Labyrinthitis Ossificans ◽  
History Of

Objective: To determine the accuracy of preoperative MRI in predicting cochlear obstruction in pediatric patients with a history of bacterial meningitis. Methods: A case series with chart review was performed at a tertiary care multidisciplinary cochlear implant program. Forty-five children with hearing loss that resulted from bacterial meningitis were implanted from 1991 to 2006. Twenty-five children had preoperative MRI with high-resolution axial T2-weighted images to assess for cochlear patency. Results: Seventeen of 25 patients (68%) had surgical evidence of cochlear obstruction. Six patients (37.5%) required circummodiolar drill-outs, and one patient (6.25%) underwent placement of a double array cochlear implant. The nine remaining patients (56%) with cochlear obstruction required removal of fibrous tissue or drilling of the inferior basal turn, but did not require manipulation of the ascending basal turn to achieve full electrode insertion. The sensitivity, specificity, and positive and negative predictive value of MRI predicting intraoperative cochlear obstruction with 95 percent confidence intervals was 94.1 percent (71–99), 87.5 percent (47–99), 94.1 percent (71–99) and 87.5 percent (47–99), respectively. Conclusion: Preoperative high-resolution T2 MRI may be useful in predicting cochlear obstruction in patients with a prior history of bacterial meningitis.

scholarly journals Neurotologic Complications Following Microvascular Decompression: A Retrospective Study

2019 ◽  
Vol 81 (01) ◽  
pp. 037-042
Author(s):  
Matthew Bartindale ◽  
Ayah Mohamed ◽  
Jason Bell ◽  
Matthew Kircher ◽  
Jacqueline Hill ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Retrospective Study ◽  
Microvascular Decompression ◽  
Tertiary Care ◽  
Significant Risk ◽  
Complication Rates ◽  
Case Review ◽  
Inclusion Criteria ◽  
Retrospective Case ◽  
Significant Difference

Objective The main purpose of this article is to determine the frequency of neurotologic complications after posterior fossa microvascular decompression (MVD) surgery. Design Retrospective case review. Setting Tertiary care referral center. Participants A total of 215 consecutive MVD operations by a single surgeon between March 1996 and May 2016 were reviewed with 192 surgeries on 183 patients meeting inclusion criteria. Main Outcome Measures Neurotologic complications secondary to MVD. Results The 52 males and 131 females had a mean age of 58.52 years (range, 28–92 years). Indications for MVD were trigeminal neuralgia (n = 162), hemifacial spasm (n = 23), glossopharyngeal neuralgia (n = 13), vagal palsy (n = 1), and tinnitus (n = 1). The outcomes examined were postoperative hearing loss, tinnitus, vertigo, and hemifacial paresis. At least one of these complications was present in 17.7% of patients. There were 4.17% with permanent hearing loss, 6.77% with transient hearing loss, 5.21% with tinnitus, 5.73% with vertigo, and 0.52% with hemifacial paresis. There was no significant difference in complication rates based on surgical indication. Conclusions Neurotologic complications are a significant risk when performing MVD. It is important for otolaryngologists as well as neurosurgeons to be aware of such complications. We recommend perioperative audiometry in all patients undergoing MVD and believe there is utility in routine otolaryngologist involvement.

Cochlear Implant Performance in Adult Patients with Absent Intraoperative Electrically Evoked Compound Action Potentials

2020 ◽  
Vol 162 (5) ◽  
pp. 725-730
Author(s):  
Timothy Cooper ◽  
Katie L. Melder ◽  
Rick Hyre ◽  
Candace E. Hobson ◽  
Andrew A. McCall ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cochlear Implant ◽  
Performance Outcomes ◽  
Adult Patients ◽  
Electrode Placement ◽  
Retrospective Case ◽  
Wide Range ◽  
Tertiary Center ◽  
The Mean ◽  
Compound Action

Objective To describe cochlear implant performance outcomes in adult patients in whom no intraoperative electrically evoked compound action potential (ECAP) responses were able to be obtained despite intracochlear electrode placement. Study Design Retrospective case review. Setting Academic tertiary center. Subjects and Methods Patients 18 years of age and older undergoing cochlear implantation between May 2010 and September 2018 with absent ECAP measurements intraoperatively with intracochlear electrode positioning were identified. Patient performance on sentence recognition testing using the Hearing in Noise Test (HINT) and AzBio at 6 to 12 months postoperatively was compared to preimplantation scores. Additional collected data included patient demographics, etiology of hearing loss, and preoperative pure-tone average (PTA) and word recognition scores (WRSs). Results Intraoperative ECAP measurements were unable to be obtained in 15 cochlear implants performed on 14 patients out of 383 cochlear implant cases. Of the patients with absent ECAP measures, the mean ± SD age was 61.7 ± 15.7 years. Causes of hearing loss included congenital hearing loss, meningitis, autoimmune inner ear disease, otosclerosis, presbycusis, and Ménière’s disease. The average preoperative PTA was 103.5 ± 17.0 dB. Twelve implanted ears had a WRS of 0% and 9 had a HINT score of 0% prior to surgery. The mean HINT score at 6 to 12 months postimplantation was 57.8% ± 37.8% and had improved by 42.6% ± 35.6% compared to the mean preimplantation HINT score (95% confidence interval, 22.0%-63.1%, P = .001, paired Student t test). Conclusion There is a wide range of cochlear implant performance in patients with absent intraoperative ECAP measures ranging from sound awareness to HINT scores of 100%.

Progressive Hearing Loss among Patients with Cystic Fibrosis and Parenteral Aminoglycoside Treatment

2018 ◽  
Vol 159 (5) ◽  
pp. 887-894 ◽  
Author(s):  
Erika M. Zettner ◽  
Malcolm A. Gleser
Keyword(s):  
Cystic Fibrosis ◽  
Hearing Loss ◽  
Adult Population ◽  
Tertiary Care ◽  
Hearing Threshold ◽  
Study Groups ◽  
Adult Patients ◽  
Case Review ◽  
Retrospective Case ◽  
Before And After

Objective Hearing loss is a significant and growing problem as patients with cystic fibrosis (CF) live longer and experience frequent courses of intravenous aminoglycoside antibiotics (hereafter, “IVs”). This study seeks to document that risk in a large adult population with CF, accounting for age and aminoglycoside exposure. Study Design Retrospective case review of patients with CF who had multiple audiograms over years. Setting Tertiary care cystic fibrosis setting. Subject and Methods The first and last audiograms recorded over a 10-year period were compared for 165 adult patients with CF. Patients were divided into 3 study groups: 34 patients with no intervening aminoglycoside IVs (0 IVs), 103 patients with 1 to 9 IVs, and 28 patients with ≥10 IVs. Threshold shift (TS) between the audiograms were examined for the 3 groups before and after age/sex adjustments. Two new hearing loss metrics were tested. Results At first examination, 48% of patients (average age, 30.0 years) already had hearing loss. At last examination (average, 4.4 years later), 64% of the patients had hearing loss even with age/sex adjustment. Use of the age/sex hearing threshold adjustment eliminated the TS in the 0 IVs group. Two new metrics calculated for each patient demonstrated that 48% of patients who had 1 to 9 IVs had ototoxic scores, while almost 80% of the ≥10 IV group had ototoxic scores. Conclusion The majority of adult patients with CF are (often repeatedly) exposed to parenteral aminoglycosides and lose hearing at a rate that far exceeds that predicted from aging alone.

Cochlear Implant Patients with Superficial Siderosis

2009 ◽  
Vol 20 (06) ◽  
pp. 348-352 ◽  
Author(s):  
Sarah A. Sydlowski ◽  
Michael J. Cevette ◽  
Jon Shallop ◽  
David M. Barrs
Keyword(s):  
Central Nervous System ◽  
Hearing Loss ◽  
Cochlear Implant ◽  
Cochlear Implantation ◽  
Case Reports ◽  
Superficial Siderosis ◽  
Viable Option ◽  
Retrospective Case ◽  
Fatal Disease ◽  
The Central Nervous System

Background: Considered a rare disorder, superficial siderosis of the central nervous system (SSCN) has become more frequently diagnosed in recent years. As it is characterized by progressive sensorineural hearing loss, patients' needs may surpass the capability of hearing aid technology. Despite the retrocochlear nature of the disorder, patients have undergone cochlear implantation (CI) with varying success. Purpose: To summarize the issues surrounding cochlear implant candidates with SSCN as well as highlight trends in performance postimplantation. Research Design: Retrospective case reports of seven cochlear implant candidates detail the symptoms, typical audiologic presentation, and array of clinical issues for patients with this progressive and potentially fatal disease. Results: Despite the retrocochlear component of a hearing loss caused by SSCN, cochlear implantation may be a viable option. Conclusions: It is essential that the CI audiologist not only be aware of the disorder but also be well versed in the resulting implications for the cochlear implant process. A more thorough case history, an expanded candidacy test battery, and knowledge of the typical presentation of SSCN are critical. The diagnosis of SSCN will impact expectations for success with the cochlear implant, and counseling should be adjusted accordingly.

Asymmetric Hearing Loss Prompting MRI Referral in a Military Population: Redefining Audiometric Criteria

2018 ◽  
Vol 158 (4) ◽  
pp. 695-701 ◽  
Author(s):  
Anthony M. Tolisano ◽  
Ricardo M. Burgos ◽  
Michael B. Lustik ◽  
Lex A. Mitchell ◽  
Philip D. Littlefield
Keyword(s):  
Hearing Loss ◽  
Military Service ◽  
Noise Exposure ◽  
Medical Center ◽  
Tertiary Care ◽  
Military Population ◽  
Retrospective Case ◽  
Referral Criteria ◽  
Diagnosis Rate ◽  
History Of

Objective To reevaluate asymmetric sensorineural hearing loss (ASNHL) criteria used to justify magnetic resonance imaging (MRI) in the evaluation of retrocochlear tumors in a military population. Study Design Retrospective case-control study. Setting Tertiary care military medical center. Subjects and Methods Patients with military service and a history of ASNHL prompting referral for MRI, with or without retrocochlear tumors, were compared between 2005 and 2016. Predictor variables included pure tone ASNHL, speech audiometry, and a history of noise exposure. Logistic regression models for hearing asymmetries were performed, and receiver operator curves were used to calculate sensitivity and specificity. Results Thirty-eight retrocochlear tumors were identified. The MRI diagnosis rate for patients with ASHNL was 0.85%. Patients with tumors were slightly older (42 vs 37 years, P = .021) and had less noise exposure (47% vs 85%, P < .001). A sensitivity of 0.83 and a specificity of 0.58 were calculated for asymmetries ≥10 dB at 2000 Hz without adjusting for noise exposure. Instituting this imaging threshold would have reduced the number of MRI scans by half while missing 16% of tumors. Conclusion The tumor diagnosis rate among those undergoing MRI for ASNHL is low in the military population, likely because service-related noise exposure commonly causes ASNHL. Optimal MRI referral criteria should conserve resources while balancing the risks of over- and underdiagnosis. For those with a history of military service, an asymmetry ≥10 dB at 2000 Hz among patients meeting current ANSHL referral criteria is most predictive of a retrocochlear tumor.

Cochlear Implantation Outcomes in Children With CDH23 Mutations–Associated Hearing Loss

2021 ◽  
pp. 019459982110574
Author(s):  
Kaitian Chen ◽  
Bixue Huang ◽  
Jincangjian Sun ◽  
Yue Liang ◽  
Guanxia Xiong
Keyword(s):  
Hearing Loss ◽  
Cochlear Implantation ◽  
Outer Hair Cell ◽  
Cell Function ◽  
Hearing Level ◽  
Case Review ◽  
Retrospective Case ◽  
Profound Hearing Loss ◽  
Tertiary Referral Center ◽  
Cadherin 23

Objective Mutations in the cadherin 23 gene ( CDH23) have been reported to cause cochlear damage, but few studies have investigated the auditory and speech outcome of patients after cochlear implantation. Here, we describe the genetic, auditory, and postoperative outcomes of patients with CDH23 mutations who received cochlear implants. Study Design Retrospective case review. Setting Tertiary referral center. Methods Targeted deafness-related gene panels were sequenced in Chinese families with profound sensorineural hearing loss. The clinical features of subjects carrying potentially pathogenic CDH23 mutations were analyzed. Results Between 2017 and 2019, we identified 5 children with prelinguistically profound hearing loss at our center who harbored 6 variants of CDH23 that segregated with the disease. Of these, 4 variants were novel (c.2591G>T, c.4785G>C, c.5765A>G, and c.9280_9281insTT). All affected individuals had a loss of outer hair cell function, with an average residual hearing level of 3 to 10 dB SPL. Cochlear implantations were arranged for the patients at 11 to 36 months of age. All children made gains in their hearing, language, and speech performances 14 to 120 months after surgery. Their auditory outcomes improved during follow-up intervals. Conclusion This study revealed that children with congenital cochlear defects caused by CDH23 variants can acquire an acceptable auditory and speech outcome after cochlear implantation. Early genetic detection and prenatal counseling for rare deafness genes such as CDH23 remain a priority for the future.

scholarly journals Early Posttreatment Audiometry Underestimates Hearing Recovery after Intratympanic Steroid Treatment of Sudden Sensorineural Hearing Loss

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Benjamin J. Wycherly ◽  
Jared J. Thompkins ◽  
H. Jeffrey Kim
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Sudden Hearing Loss ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Speech Discrimination ◽  
Case Review ◽  
Retrospective Case ◽  
Hearing Recovery ◽  
History Of

Objective. To review our experience with intratympanic steroids (ITSs) for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL), emphasizing the ideal time to perform follow-up audiograms.Methods. Retrospective case review of patients diagnosed with ISSNHL treated with intratympanic methylprednisolone. Injections were repeated weekly with a total of 3 injections. Improvement was defined as an improved pure-tone average ≥20 dB or speech-discrimination score ≥20%.Results. Forty patients met the inclusion criteria with a recovery rate of 45% (18/40). A significantly increased response rate was found in patients having an audiogram >5 weeks after the first dose of ITS (9/13) over those tested ≤5 weeks after the first dose of ITS (9/27) ().Conclusions. Recovery from ISSNHL after ITS injections occurs more frequently >5 weeks after initiating ITS. This may be due to the natural history of sudden hearing loss or the prolonged effect of steroid in the inner ear.

Facial Nerve Outcomes in Middle Cranial Fossa vs Translabyrinthine Approaches

2005 ◽  
Vol 133 (6) ◽  
pp. 906-910 ◽  
Author(s):  
Brandon Isaacson ◽  
Steven A. Telian ◽  
Hussam K. El-Kashlan
Keyword(s):  
Facial Nerve ◽  
Tertiary Care ◽  
Middle Cranial Fossa ◽  
Vestibular Schwannomas ◽  
Care Hospital ◽  
Case Review ◽  
Retrospective Case ◽  
Increased Risk ◽  
Significant Difference ◽  
Cranial Fossa

OBJECTIVE: To compare the final facial nerve outcomes between middle cranial fossa (MCF) vs translabyrinthine (TL) resection of size-matched vestibular schwannomas. STUDY DESIGN AND SETTING: Retrospective case review at a tertiary care hospital. All patients who underwent resection utilizing either MCF or TL approaches with tumors 18 mm or smaller and complete data were included in the analysis. One hundred twenty-four patients were identified meeting the above criteria, with sixty-three in the translabyrinthine group and sixty-one in the middle fossa group. One-week-postoperative and final facial nerve examinations were compared in the two surgical groups. Patients were separately analyzed in subgroups: tumors smaller than 10 mm and those that were between 10 and 18 mm. RESULTS: The tumor size range for the MCF group was 3-18 mm while it was 4-18 mm for the TL group. No statistically significant difference was found in facial nerve outcomes between the two surgical groups, at the first postoperative visit week and at last follow-up. CONCLUSION: Facial nerve outcomes are similar using TL and MCF approaches for resection of vestibular schwannomas up to 18 mm in size. SIGNIFICANCE: Patients undergoing the MCF approach for hearing preservation can be counseled that there is no increased risk of permanent facial nerve weakness, compared to the TL approach. EBM RATING: B-3

Reversible hearing loss following cryptococcal meningitis: case study

2016 ◽  
Vol 130 (7) ◽  
pp. 691-695 ◽  
Author(s):  
W L Neo ◽  
N Durisala ◽  
E C Ho
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Bacterial Meningitis ◽  
Sensorineural Hearing Loss ◽  
Cochlear Implantation ◽  
Cryptococcal Meningitis ◽  
Sudden Onset ◽  
Sensorineural Hearing ◽  
Labyrinthitis Ossificans

AbstractBackground:Sensorineural hearing loss is a recognised complication of cryptococcal meningitis. The mechanism of hearing loss in patients with cryptococcal meningitis is different from that in bacterial meningitis.Case report:An immune-competent man with cryptococcal meningitis presented with sudden onset, bilateral, severe to profound sensorineural hearing loss and vestibular dysfunction. He was initially evaluated for cochlear implantation. However, he had a significant recovery; he no longer required surgery and was able to cope without a hearing aid.Conclusion:Typically, cochlear implantation is performed with some urgency in patients with hearing loss post-bacterial meningitis, because of the risk of labyrinthitis ossificans. However, this process has not been described in patients with cryptococcal meningitis. Furthermore, patients with hearing loss associated with cryptococcal meningitis have shown varying degrees of reversibility. In this case report, hearing loss from cryptococcal meningitis is compared with that from bacterial meningitis, and the need for cochlear implantation in patients with cryptococcal meningitis is discussed.

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