Otology & Neurotology最新文献

{"title":"Pöschl Reformations Created from High-Resolution Noncontrast Enhanced CT Head Exams Can Be Used to Detect and Classify Superior Semicircular Canal Abnormalities.","authors":"Nahill H Matari, Erli Mingomataj, Akinrinola Famuyide, Pamela Nguyen, Anil K Lalwani, Ernst Garcon","doi":"10.1097/MAO.0000000000004395","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004395","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic capability of Pöschl reformations created from temporal bone CT (TBCT) and high-resolution noncontrast CT head exams (HR-NECTH) to detect and classify superior semicircular canal (SSC) abnormalities.</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Individuals with normal and abnormal SSC who received TBCT and HR-NECTH.</p><p><strong>Interventions: </strong>Pöschl reformations of each patient's temporal bones (TB) were created using TBCT and HR-NECTH. Screenshots displaying the SSC were randomized into an interpretation test sent to neuroradiologists who interpreted the SSC as normal/abnormal and classified abnormalities as thinning (SST)/dehiscence (SSD).</p><p><strong>Main outcome measure: </strong>Analysis of responses to interpretation test, interrater reliability, and sensitivity, specificity, and positive/negative predictive values of Pöschl reformations from TBCT and HR-NECTH.</p><p><strong>Results: </strong>Fourteen patients were enrolled, 28 TB were reviewed. Sixteen TB demonstrated SST/SDD and 12 were normal as per gold standard TBCT. Interpretation test displaying screenshots of the SSC, in a randomized, blinded fashion, was completed by four neuroradiologists. Analysis of TBCT and HR-NECTH Pöschl reformation interpretations yielded no statistically significant difference in proportion of true/false-positive/negative responses (χ2 = 3.37, p = 0.83), similar and substantial interrater reliability (k = 0.78 vs. 0.73, respectively), and similar sensitivity, specificity, and positive/negative predictive values (0.86, 1, 1, 0.84 vs. 0.78, 0.96, 0.96, 0.77, respectively). Neuroradiologists also correctly classified SST/SSD on TBCT and HR-NECTH Pöschl reformations at a rate of 70.9% vs. 78.0%, respectively.</p><p><strong>Conclusion: </strong>Pöschl reformations created from HR-NECTH demonstrated similar diagnostic capability as those created from TBCT to detect and classify SSC abnormalities.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 2","pages":"176-182"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiotensin-Receptor Blockers Prevent Vestibular Schwannoma-Associated Hearing Loss.","authors":"Samuel Early, Alyssa Brown, Lei Xu, Konstantina M Stankovic","doi":"10.1097/MAO.0000000000004376","DOIUrl":"10.1097/MAO.0000000000004376","url":null,"abstract":"<p><strong>Background introduction: </strong>Vestibular schwannoma (VS) tumors typically present with sensorineural hearing loss (SNHL). Losartan has recently demonstrated prevention of tumor-associated SNHL in a mouse model of VS through suppression of inflammatory and pro-fibrotic factors, and the current study investigates this association in humans.</p><p><strong>Methods: </strong>This is a retrospective study of patients with unilateral VS and hypertension followed with sequential audiometry at a tertiary referral hospital from January 1994 to June 2023. Patients were stratified into subgroups by anti-hypertensive medication class. SNHL progression was assessed using Kaplan-Meier analysis to account for variable follow-up times.</p><p><strong>Results: </strong>Two hundred thirty-six patients were identified with diagnosis of both VS and hypertension, and with sequential audiometry. Of these, 186 were taking anti-hypertensive therapy at the time of initial VS diagnosis, and 23 were taking losartan or another angiotensin receptor blocker (ARB). Patients taking an ARB were both more likely to have normal baseline hearing and no progressive hearing loss with 36.5 total patient-years of follow-up. Patients taking other anti-hypertensives all showed expected declines in hearing consistent with natural history of VS tumors.</p><p><strong>Discussion conclusion: </strong>This study represents the first statistically significant association between ARB intake and hearing preservation in a real-world VS patient population. Significant confounding factors, such as concomitant hypertension in these patients, could still cloud the full effect of ARB medications' interaction with SNHL progression. Given that ARBs are well tolerated and safe, the results advocate for a prospective clinical trial to validate this effect.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 2","pages":"183-189"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Necessity of Ear Packing After Otologic Surgery: A Randomized Controlled Trial.","authors":"Alper Tabaru, Zeliha Kapusuz Gencer, Sahin Ogreden, Salih Akyel, Iskender Bayram","doi":"10.1097/MAO.0000000000004399","DOIUrl":"10.1097/MAO.0000000000004399","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the necessity of ear packing in otological operations where the annulus fibrosus is not elevated, focusing on graft success rates and postoperative hearing outcomes.</p><p><strong>Methods: </strong>A randomized controlled prospective clinical trial was conducted at a tertiary care hospital involving 200 patients aged 18 years and above undergoing myringoplasty for inactive chronic suppurative otitis media. Patients were randomly assigned to receive either ear packing with absorbable gelatin sponge (Gelfoam®) or no packing. The primary outcome is graft success assessed via microscopic examination at 3 and 6 months post-surgery. Secondary outcomes include hearing gains measured by pure-tone audiometry at 500-, 1000-, 2000-, and 4000-Hz frequencies.</p><p><strong>Results: </strong>At 3 months, the graft take rate was 92% in the ear packing group and 90% in the no packing group, with no statistically significant difference ( p = 0.63). At 6 months, the graft take rate was 90% in the packing group and 88% in the no packing group ( p = 0.67). Hearing improvements, as measured by air conduction thresholds, were also similar between the two groups ( p = 0.73).</p><p><strong>Conclusion: </strong>This study demonstrates that myringoplasty without ear packing yields comparable graft take rates and hearing improvements to traditional myringoplasty with ear packing. These findings suggest that omitting ear packing in appropriate cases may simplify the procedure without compromising patient outcomes.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"156-160"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship between Chronic Unilateral Hearing Loss, Balance Function, and Falls Is Not Informed by Vestibular Status.","authors":"Anat V Lubetzky, Jennifer L Kelly, Katherine Scigliano, Brittani Morris, Kristyn Cheng, Daphna Harel, Maura Cosetti","doi":"10.1097/MAO.0000000000004400","DOIUrl":"10.1097/MAO.0000000000004400","url":null,"abstract":"<p><strong>Objectives: </strong>Recent studies suggest that hearing loss is associated with balance dysfunction and an increased risk of falls. The purpose of this study was to investigate whether adults with unilateral hearing loss (UHL) have an underlying vestibular dysfunction and whether vestibular testing explains balance function and fall risk.</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Urban otology practice and a human motion laboratory.</p><p><strong>Patients: </strong>We recruited 41 healthy controls (mean age, 52 years; range, 22-78 years) and 29 adults with stable UHL (mean age, 53 years; range, 18-80 years) who denied symptoms of dizziness (Dizziness Handicap Inventory average, 1.86; range, 0-14). UHL occurred an average of 4 years (range from sudden loss, 4 months to 27.5 years) prior to testing.</p><p><strong>Interventions: </strong>We conducted the caloric portion of the videonystagmography test, video head impulse test (vHIT), and a battery of balance tests: standing on foam with eyes closed, timed up and go test, four square step test, 10-meter walk, and a virtual reality (VR) assessment of postural control.</p><p><strong>Main outcome measures: </strong>Hearing was quantified by four-frequency pure-tone average (PTA). Caloric weakness was defined as asymmetry greater than 25%. Participants self-reported falls over the past 12 months and history of vertigo. Performance on balance tests was quantified by time to completion or duration of hold. Performance on the VR assessment was quantified by root-mean-square velocity of head sway.</p><p><strong>Results: </strong>Proportion of unilateral caloric weakness was significantly higher in the UHL group (25%) than the control group (12%). Five participants with UHL refused caloric testing. vHIT gains of lateral canals were normal in both groups. The majority of participants in the UHL group experienced vertigo at the onset of hearing loss (72%). There were five fallers in the UHL group (17%) and three in the control group (7%). Participants with caloric weakness or vertigo at onset did not differ from those without in age or in any of the balance tests. Participants with history of falls differed in head sway and duration of hold standing on foam with eyes closed.</p><p><strong>Conclusions: </strong>Individuals with UHL are more likely to have caloric weakness than healthy controls; however, these findings are not correlated with functional outcomes or history of falls. Postural control testing using virtual reality or standing on foam with eyes closed may help detect those at a risk for falls.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"221-228"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Research for Academic Otologists/Neurotologists in the United States.","authors":"Aaron K Remenschneider, Jenny X Chen, Susan D Emmett, Ronna Hertzano","doi":"10.1097/MAO.0000000000004396","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004396","url":null,"abstract":"<p><strong>Objective: </strong>The physician-scientist workforce is shrinking in the United States. Academic otologists/neurotologists face a diverse set of barriers to successful careers. We aimed to characterize the factors affecting contemporary otology/neurotology surgeon-scientists.</p><p><strong>Study design: </strong>An electronic survey was distributed to faculty members of the American Neurotology Society and the American Otological Society in 2021. The survey queried demographics, practice setting, compensation, and barriers to conducting research for respondents in academic practice.</p><p><strong>Results: </strong>One hundred fifty-seven otologists/neurotologists responded to the survey, corresponding to an overall response rate of 25%. Of the respondents, 94 were in academic practice. The median protected research time was 0.5 days/wk, whereas the mode was zero. Across academic rank, salary compensation was lower for academic surgeons with active research funding and for female academic surgeons as compared with their male counterparts. Grant-funded female academic surgeons had significantly worse compensation compared with rank-matched male surgeons with similar protected time. No grant-funded female earned more than the 30th percentile for their rank. Identified barriers to research were pressure to maintain clinical productivity, insufficient protected time, and personal/family demands. Respondents highlighted several areas for improvement: compensation for research activity, administrative support, and improved grant funding mechanisms for clinician-scientists.</p><p><strong>Conclusions: </strong>Otology/neurotology surgeon-scientists face barriers to research, including limited protected time, poor administrative support, increasingly competitive funding environments, and misaligned compensation models. New initiatives by the National Institute on Deafness and other Communication Disorders aim to increase the surgeon-scientist workforce, but their success may depend upon removing identified barriers at the level of academic institutions.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 2","pages":"229-236"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Accuracy and Reliability of ABC/2 and Planimetry for Vestibular Schwannoma Volume Assessment.","authors":"Kanwar P Singh, Hisham Abdou, Neelima Panth, Veronica Chiang, Frank D Buono, Nofrat Schwartz, Amit Mahajan","doi":"10.1097/MAO.0000000000004392","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004392","url":null,"abstract":"<p><strong>Background: </strong>Vestibular schwannoma (VS) is a common intracranial tumor that affects patients' quality of life. Reliable imaging techniques for tumor volume assessment are essential for guiding management decisions. The study aimed to compare the ABC/2 method to the gold standard planimetry method for volumetric assessment of VS.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients with VS diagnosed between 2007 and 2022 at Yale New Haven Hospital. Both ABC/2 and planimetry methods were used for tumor volume assessment, and their correlations were evaluated.</p><p><strong>Results: </strong>Among 140 patients, the mean tumor volumes using the planimetry and ABC/2 methods were 1307.99 ± 142.13 and 1482.76 ± 165.75 mm3, respectively. A strong correlation was observed between the methods (r = 0.99, p < 0.0001). For patients who underwent follow-up scans, the ABC/2 method accurately detected tumor volume changes over time. Subgroup analysis based on tumor size also displayed a significant positive correlation across all size categories.</p><p><strong>Conclusion: </strong>The ABC/2 method demonstrates a high correlation with the planimetry method for VS volume assessment and can be a reliable, less time-intensive alternative in clinical settings. However, it generally overestimates tumor volume compared to planimetry. Subgroup-specific correction formulae were provided to enhance the accuracy of ABC/2-derived measurements. Future studies may explore the integration of these methods for improved clinical decision making.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 2","pages":"196-200"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Hearing Aids Embedded with Inertial Sensors and Artificial Intelligence to Identify Patients at Risk for Falling.","authors":"Kristen K Steenerson, Bryn Griswold, Donald P Keating, Majd Srour, Justin R Burwinkel, Erin Isanhart, Yifei Ma, David A Fabry, Achintya K Bhowmik, Robert K Jackler, Matthew B Fitzgerald","doi":"10.1097/MAO.0000000000004386","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004386","url":null,"abstract":"<p><strong>Objective: </strong>To compare fall risk scores of hearing aids embedded with inertial measurement units (IMU-HAs) and powered by artificial intelligence (AI) algorithms with scores by trained observers.</p><p><strong>Study design: </strong>Prospective, double-blinded, observational study of fall risk scores between trained observers and those of IMU-HAs.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Two hundred fifty participants aged 55-100 years who were at risk for falls.</p><p><strong>Interventions: </strong>Fall risk was categorized using the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) test battery consisting of the 4-Stage Balance, Timed Up and Go (TUG), and 30-Second Chair Stand tests. Performance was scored using bilateral IMU-HAs and compared to scores by clinicians blinded to the hearing aid measures.</p><p><strong>Main outcome measures: </strong>Fall risk categorizations based on 4-Stage Balance, Timed Up and Go (TUG), and 30-Second Chair Stand tests obtained from IMU-HAs and clinicians.</p><p><strong>Results: </strong>Interrater reliability was excellent across all clinicians. The 4-Stage Balance and TUG showed no statistically significant differences between clinician and HAs. However, the IMU-HAs failed to record a response in 12% of TUG trials. For the 30-Second Chair Stand test, there was a significant difference of nearly one stand count, which would have altered fall risk classification in 21% of participants.</p><p><strong>Conclusions: </strong>These results suggest that fall risk as determined by the STEADI tests was in most instances similar for IMU-HAs and trained observers; however, differences were observed in certain situations, suggesting improvements are needed in the algorithm to maximize accurate fall risk categorization.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 2","pages":"121-127"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Clinical Outcomes for Bone-Anchored Hearing Implants: 3-Year Comparison Between Minimally Invasive Ponto Surgery and the Linear Incision Technique With Tissue Preservation.","authors":"Emma Teunissen, Coosje Caspers, Ivo Kruyt, Emmanuel Mylanus, Myrthe Hol","doi":"10.1097/MAO.0000000000004398","DOIUrl":"10.1097/MAO.0000000000004398","url":null,"abstract":"<p><strong>Objective: </strong>To compare the 3-year outcomes of the modified minimally invasive Ponto surgery (m-MIPS) to both the original MIPS (o-MIPS) and linear incision technique with soft tissue preservation (LIT-TP) for inserting bone-anchored hearing implants (BAHIs).</p><p><strong>Study design: </strong>Prospective study with three patient groups: m-MIPS, o-MIPS, and LIT-TP.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>In the m-MIPS group, 24 patients with 25 implants were enrolled. The o-MIPS and LIT-TP groups included 25 patients (25 implants) each.</p><p><strong>Interventions: </strong>The patients underwent BAHI surgery using m-MIPS, o-MIPS, or LIT-TP.</p><p><strong>Main outcome measures: </strong>Implant survival and implant stability were compared between all groups. Soft tissue status, skin sensibility, subjective numbness, and hearing-related quality of life (HRQoL) were compared between m-MIPS and LIT-TP and o-MIPS and LIT-TP, respectively.</p><p><strong>Results: </strong>Implant survival was comparable between m-MIPS and LIT-TP (96 versus 100%), with o-MIPS showing nonsignificant lower survival (88%). Both MIPS groups exhibited fewer (adverse) skin reactions, better skin sensibility, and less subjective numbness than LIT-TP throughout visits. At 3 years, soft tissue status, sensibility, and numbness were comparable between groups. Device use was consistent among groups (83-86% daily users). All groups demonstrated significant improvement in HRQoL post-surgery based on GBI, GHSI, and APHAB total scores.</p><p><strong>Conclusions: </strong>Compared with LIT-TP, m-MIPS showed comparable long-term implant survival, fewer (adverse) skin reactions, and earlier sensibility and numbness recovery. M-MIPS resulted in favorable clinical and QoL outcomes with low intra- and postoperative complication rates until 3 years after surgery. It is therefore considered a safe technique for BAHI insertion. Moreover, with a shorter surgery time and the ability to operate under local anesthesia in a controlled outpatient setting, m-MIPS appears to be a more efficient alternative to LIT-TP.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 2","pages":"161-169"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphometric Measurements of the Incomplete Partition Type II (IP-II) Cochlea and Implications on Cochlear Implantation.","authors":"Adam Y Xiao, Miryam Saad, Rance J T Fujiwara, Emily C Wong, Grant O Korte, Levent Sennaroglu, Ivan A Lopez, Gail Ishiyama, Akira Ishiyama","doi":"10.1097/MAO.0000000000004370","DOIUrl":"10.1097/MAO.0000000000004370","url":null,"abstract":"<p><strong>Hypothesis: </strong>The objective of this study is to obtain comprehensive morphometric measurements of the incomplete partition type II (IP-II) cochlea to provide a better understanding of intracochlear anatomy and important considerations for electrode selection and insertion.</p><p><strong>Background: </strong>IP-II is the most common bony inner ear malformation that often requires cochlear implantation. Currently, there is significant controversy on electrode selection due to a lack of research that can provide reliable, high-resolution measurements.</p><p><strong>Methods: </strong>Three-dimensional reconstructions of the cochlea were made from hematoxylin and eosin-stained slides from 11 archival human temporal bones from 8 adult IP-II patients (one paired) and 2 fetuses. Detailed measurements of the angular and linear length of the spiral ganglion neurons and cochlear duct at the modiolar and lateral wall of the scala tympani as well as cross-sectional areas and vertical height measurements of the scala tympani at 90-degree intervals were measured.</p><p><strong>Results: </strong>The spiral ganglia neurons terminated at 540.5 ± 45.4 degrees, which corresponded to the beginning of the interscalar septal defect. The corresponding Rosenthal's canal length was 12.75 ± 0.82 mm, and the lateral wall length was 23.95 ± 1.04. The average cochlear duct length was 32.44 mm ± 1.58 mm, corresponding to an average angular distance of 951.6 ± 80 degrees. The modiolar height demonstrated less variation within the scala tympani but was significantly smaller at 0 and 90 degrees compared with the normal cochlea. The lateral wall height was also significantly smaller at 0, 180, and 540 degrees. There was a drastic decrease in lateral wall height at 540 degrees to 0.4 mm, which is smaller than the apical dimension of many electrodes.</p><p><strong>Conclusion: </strong>This is the first study to provide detailed morphometric measurements of the IP-II cochlea including spiral ganglion neuron length and scala tympani height. These measurements directly relate to electrode selection for cochlear implantation.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"206-214"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Postoperative Prophylactic Antibiotics and Severe Infections After Cochlear Implantation: A Retrospective Cohort Study.","authors":"Thomas Hudlebusch Meldgaard, Martin Abou Taha, Christian Emil Faber, Jesper Roed Sorensen","doi":"10.1097/MAO.0000000000004393","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004393","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between postoperative antibiotic prophylaxis and the risk of infections leading to implant explantation or hospitalization, with a follow-up of up to 12 years.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary medical institution.</p><p><strong>Patients: </strong>Adult patients (≥18 yr) receiving cochlear implant surgery between 2010 and 2022.</p><p><strong>Intervention: </strong>Postoperative oral prophylactic antibiotic treatment for 4 to 10 days.</p><p><strong>Main outcome measures: </strong>The medical records of patients receiving cochlear implants were assessed (n = 927). Two groups were formed: group A, receiving postoperative oral antibiotic treatment (period: 2010-2015) (n = 526), and group B, not receiving postoperative oral antibiotic treatment (period: 2016-2022) (n = 401). The two groups were compared regarding infections leading to hospitalization or explantation, and baseline characteristics.</p><p><strong>Results: </strong>In total, 28 patients (3.0%) had infections requiring explantation or hospitalization. Of these, 13 were explantations (1.4%). The infection rate in group A was 2.9%, compared with 3.2% in group B, with an odds ratio of 1.2 in group B (p = 0.646). Group B had a 2.2 odds ratio of explantation caused by infection compared with group A (p = 0.179). We observed a significant correlation between severe infections in patients previously having otologic surgery (7.7%, p = 0.011) and in patients with previous issues of chronic otitis (16.7%, p = 0.005).</p><p><strong>Conclusion: </strong>Occurrence of postoperative infection leading to explantation and hospitalization was not significantly associated with the use of postoperative antibiotic prophylaxis. However, infections were higher in patients not receiving antibiotic prophylaxis, despite having a lower risk of postoperative infection.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 2","pages":"133-139"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}