Otology & Neurotology最新文献

{"title":"Postoperative Outcomes With Bimodal Hearing and Bilateral Cochlear Implantation in the Elderly.","authors":"William G Cohen, Ankita Patro, Michael W Canfarotta, Natalie Schauwecker, Jourdan Holder, David S Haynes, Elizabeth L Perkins","doi":"10.1097/MAO.0000000000004910","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004910","url":null,"abstract":"<p><strong>Objective: </strong>To compare speech recognition and quality of life outcomes in elderly patients with bimodal hearing and bilateral cochlear implants (CIs).</p><p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Adults older than 65 years with preoperative AzBio sentences in quiet scores <60% bilaterally who underwent cochlear implantation between 2012 and 2021.</p><p><strong>Main outcome measures: </strong>Consonant-nucleus-consonant (CNC), AzBio sentences in quiet, and Speech, Spatial and Qualities of Hearing Scale (SSQ) scores.</p><p><strong>Results: </strong>Two hundred fifty-eight patients met the inclusion criteria, of whom 227 (88.0%) were bimodal hearing, and 31 (12.0%) underwent bilateral cochlear implantation. Bimodal patients were older than bilateral at the time of initial implant [76 (71 to 82) vs 74 (70 to 77), P = 0.03] and had a lower contralateral pure tone average [77 (65 to 90) vs 87 (73 to 100), P = 0.04]. All other preimplant testing was similar. Twelve months after initial implant, those who ultimately pursued a second implant had greater device usage (P = 0.03 ) but similar preoperative audiometric evaluations. At 12 months post-second implant, bilateral CI users had higher bilateral AzBio scores in quiet [87 (77 to 94) vs 77 (58 to 88), P = 0.05] but were otherwise similar to bimodal users. Multivariable regression demonstrated age at first implant as the only predictor of audiometric outcomes.</p><p><strong>Conclusions: </strong>Elderly bilateral CI patients have improved sentence recognition outcomes one year postoperatively compared with elderly bimodal patients. Bilateral CI patients performed similarly after first versus second implant.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778024","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":"Intracochlear Pressure Measurements Quantify Overall Noise Exposure to the Inner Ear During Mastoidectomy: Erratum.","authors":"Emily J Bacalao, Nam K Lee, Juanantonio Ruiz, Brian Herrmann, Nathaniel Greene","doi":"10.1097/MAO.0000000000004924","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004924","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778040","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":"Middle Ear Pressure Assessment to Detect the Stapedius Reflex: A Prospective Observational Feasibility Study.","authors":"José Luis Vargas Luna, Johannes Proksch, Katharina Geißler, Daniel Richter, Daniela Korth, Dirk Arnold, Gerd Fabian Volk, Orlando Guntinas-Lichius","doi":"10.1097/MAO.0000000000004927","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004927","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility of detecting stapedius reflex (SR) through direct middle ear pressure monitoring during contralateral acoustic stimulation.</p><p><strong>Study design: </strong>Prospective, observational, single-centre feasibility study.</p><p><strong>Setting: </strong>Tertiary referral centre; intraoperative setting during tympanotomy procedures.</p><p><strong>Patients: </strong>Eleven adult patients (≥18 y) with unilateral sudden sensorineural hearing loss undergoing transtympanic dexamethasone instillation, with an elicitable SR through contralateral stimulation, were included in this study. Patients with SR thresholds >100 dB HL were excluded.</p><p><strong>Intervention s: </strong>A pressure transducer was inserted intraoperatively into the middle ear. A tympanometer device on the contralateral side apply acoustic stimulation and monitored the SR on that side. Stimulation was ECG-synchronized, and filtering was applied to the pressure signal to enhance detection.</p><p><strong>Main outcome measures: </strong>Detection of SR-related pressure changes using the pressure transducer, compared with tympanometry-based detection.</p><p><strong>Results: </strong>Out of 32 stimulus combinations, 24 elicited confirmed stapedius reflexes, while 8 did not. Among the 24 reflex-positive cases, the pressure-based method correctly identified reflex-related pressure changes in 20 instances, yielding a detection accuracy of 83.3% for confirmed reflexes. In the remaining 4 reflex-positive cases, the system failed to detect a response. In all 8 cases where no reflex was elicited, the system also did not detect any pressure changes, indicating no false positives.</p><p><strong>Conclusions: </strong>Middle ear pressure monitoring is a feasible method for detecting SR. This approach demonstrates feasibility under intraoperative conditions and may, with further development and validation, support future objective reflex assessment in cochlear implant users.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147778023","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":"Comparative Analysis of Intervention With Hearing Implants.","authors":"Tyuana Sandim da Silveira Sassi, Rubens Vuono de Brito Neto, Juliana Nogueira Chaves, Érika Cristina Bucuvic, Valdéia Vieira de Oliveira, Eliane Aparecida Techi Castiquini, Luiz Fernando Manzoni Lourençone","doi":"10.1097/MAO.0000000000004922","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004922","url":null,"abstract":"<p><strong>Introduction: </strong>Hearing rehabilitation aims to enhance or restore auditory perception, which is critical for oral language development and to mitigate the cognitive and psychosocial impacts of hearing loss. Although air-conduction hearing aids represent the standard approach, they may be unsuitable for conductive or mixed hearing loss, particularly in cases of ear malformations or chronic otitis media. In such cases, bone-conduction implants, available since the 1980s, offer an alternative by bypassing the outer and middle ear. These implants, passive or active transcutaneous, percutaneous, and middle ear, differ in surgical approach, coupling to the sound processor, and sound-transmission mechanisms.</p><p><strong>Objective: </strong>To evaluate and compare the audiological performance and speech recognition in individuals with conductive and mixed hearing loss implanted with different hearing implants.</p><p><strong>Materials and methods: </strong>A retrospective, comparative longitudinal study analyzed audiological outcomes in 101 individuals implanted with 5 implant types. Free-field pure-tone audiometry and speech recognition were analyzed unaided, at activation, and at 3-month follow-up.</p><p><strong>Results: </strong>All implants yielded improvements compared with the unaided condition. Aided free-field thresholds showed mean gains of 15.59 to 39.41 dB at activation and 20.00 to 39.71 dB at follow-up. Speech recognition also improved, with mean gains in silence of 19.95 to 31.99 dB at activation and 25.07 to 35.15 dB at follow-up, and in noise of 1.97 to 6.95 dB at activation and 2.16 to 7.56 dB at follow-up. Additional advantages were observed for Baha-p and Ponto.</p><p><strong>Conclusions: </strong>All implants provided benefits in audibility and speech perception. However, percutaneous implants, Baha-p and Ponto, offered superior overall performance compared with other implants.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723435","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":"Prospective Short-Term Observation for Spontaneous Recovery of Sudden Sensorineural Hearing Loss.","authors":"Seoyun Jang, Han-Seul Na, Seokhwan Lee, Hyun Min Lee, Il-Woo Lee, Sung-Won Choi, Se-Joon Oh","doi":"10.1097/MAO.0000000000004923","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004923","url":null,"abstract":"<p><strong>Objective: </strong>To determine the rate of spontaneous recovery in sudden sensorineural hearing loss (SSNHL) within 1 week of onset and evaluate the effect of corticosteroid treatment in patients without early recovery.</p><p><strong>Study design: </strong>Prospective, non-randomized comparative study.</p><p><strong>Setting: </strong>Tertiary academic medical center.</p><p><strong>Patients: </strong>Patients with SSNHL who presented within 3 days of onset between September 2023 and December 2024.</p><p><strong>Intervention: </strong>Patients were observed for 1 week from the onset, followed by corticosteroid therapy only in insufficient early recovery group.</p><p><strong>Main outcome measures: </strong>Pure-tone average (PTA), word recognition score (WRS), and hearing gain.</p><p><strong>Results: </strong>Among 41 patients who completed the 3-month follow-up, 13 (31.7%) showed complete or partial recovery after 1 week and were classified into the observation group. The remaining 28 patients (68.3%) received corticosteroid therapy. At the end of the observation, the observation group showed significantly better PTA (17.7±8.0 dB), WRS (94.2±3.5%), and hearing gain (36.4±12.3 dB) than the treatment group (P<0.001). Frequency-specific analysis demonstrated significant spontaneous recovery across all measured frequencies (250 to 8000 Hz, P<0.05). Logistic regression identified initial PTA as the only significant predictor of spontaneous recovery, with a cutoff value of 71 dB (AUC=0.934). In the treatment group, PTA improved significantly from the end of observation to 3 months (mean change: 33.8±23.9 dB, P<0.001).</p><p><strong>Conclusions: </strong>Approximately one-third of patients with SSNHL recovered spontaneously within 1 week. Initial PTA was the strongest predictor of spontaneous recovery, with a threshold of 71 dB. For patients with limited early recovery, corticosteroid therapy resulted in meaningful hearing improvement.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699174","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":"Cochlear Morphology and Its Influence on Electrode Array Proximity to Modiolus.","authors":"Moayyad Malas, Mariam Aljehani, Abdulrahman Alsanosi","doi":"10.1097/MAO.0000000000004921","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004921","url":null,"abstract":"<p><strong>Introduction: </strong>As the number of cochlear implant (CI) surgeries increases, greater emphasis should be placed on incremental improvements and on planning for a patient-centered approach. The shape of the basal turn (BT) of the cochlea has recently been evaluated and classified as either elliptical or round. However, the electrode position inside different shapes was not investigated.</p><p><strong>Objective: </strong>This study aims to evaluate the impact of different cochlear shapes on the electrode-to-modiolus distance (EMD) among the CI patients.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with normal cochleae who underwent cochlear implantation. Postoperative imaging was reconstructed using dedicated Otological planning software to assess cochlear morphology and electrode positioning. The cochlear shape was quantified using the basal turn width-to-height ratio (B/A ratio), and the EMD distance was measured.</p><p><strong>Results: </strong>The final analysis included 41 ears. The mean EMD was 3.3 mm in the basal electrodes, decreasing to 2.8 mm in the middle region and reaching 1.9 mm at the apical electrodes. The mean basal turn width-to-height ratio (B/A) was 0.8 (range: 0.7 to 0.9). Simple linear regression revealed that cochleae with a round-shaped basal turn (B/A >0.75) had a slightly shorter, but comparable, EMD in the basal region compared with those with an elliptical shape (3.3 vs. 3.5 mm). The apical region showed a bigger but nonsignificant distance in round-shaped cochleae (2.0 vs. 1.8 mm). In addition, impedance measurements at the 12-month interval showed a significant difference in basal electrode impedance between round and elliptical cochleae.</p><p><strong>Conclusion: </strong>This study reported no statistically significant association between cochlear anatomic parameters and electrode-to-modiolus distance. Lateral wall electrodes demonstrated comparable distances to the modiolus in both elliptical and round-shaped basal turn cochleae, suggesting stable positioning across anatomic variations. Although descriptive trends were observed, these findings should be interpreted as exploratory. Larger prospective studies are needed to further evaluate the influence of cochlear morphology on electrode positioning across different electrode designs.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699261","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":"Imaging Case of the Month: Otic Capsule Disease in a Patient With Granulomatosis With Polyangiitis: Implications for Cochlear Implantation.","authors":"Fatima Al Rashed, Peter K Moon, Jennifer Alyono","doi":"10.1097/MAO.0000000000004918","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004918","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699186","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":"Association of Total Cochlear Volume and Initial Hearing Preservation With a Straight Electrode Array.","authors":"Claire Dzan, Andrea Overton, Margaret Dillon, Kevin D Brown","doi":"10.1097/MAO.0000000000004907","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004907","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate total cochlear volume and its association with low-frequency hearing preservation for CI recipients receiving a straight electrode array.</p><p><strong>Study design: </strong>A retrospective clinical capsule report.</p><p><strong>Setting: </strong>Tertiary academic referral center.</p><p><strong>Patients: </strong>Adult CI recipients implanted with a 23 mm straight array between 2019 and 2023 with preoperative computed tomography (CT) imaging and an unaided low-frequency hearing threshold ≤45 dB HL at 250 Hz.</p><p><strong>Main outcome measure: </strong>Assess the relationship between total cochlear volume as estimated from the preoperative CT image and hearing preservation (at CI activation and 6 months postactivation). The shift in the low-frequency pure tone average (LFPTA; 125, 250, and 500 Hz) relative to the preoperative visit was calculated for the activation and 6-month visits.</p><p><strong>Results: </strong>Fourteen patients met the inclusion criteria and had sufficient imaging to estimate total cochlear volume. There were significant correlations between total cochlear volume and LFPTA shifts at activation (r=0.28, P=0.05; mean shift: 21 dB HL) and at 6 months postactivation (r=0.29, P=0.048; mean shift: 22 dB HL).</p><p><strong>Conclusions: </strong>For CI recipients of a 23 mm straight array, a larger total cochlea volume is associated with better low-frequency hearing preservation. These data support review of an individual's cochlear anatomy to assist in stratifying individual patient risk for loss of residual hearing as well as for assisting in device selection.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691244","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":"White Matter Tracts of the Auditory Pathways in Experimental Unilateral Ear Canal Atresia.","authors":"Malin Siegbahn, Sandra Kraft Birkne, Fillippo Maschio, Malou Hultcrantz, Cecilia Engmér Berglin, Rodrigo Moreno","doi":"10.1097/MAO.0000000000004916","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004916","url":null,"abstract":"<p><strong>Hypothesis: </strong>Congenital unilateral conductive hearing impairment alters auditory white matter tract connections of the brain.</p><p><strong>Background: </strong>Unilateral conductive hearing loss has negative effects on speech perception in noise and sound localization ability. This study examines auditory white matter tracts in a rat model with surgically induced unilateral ear canal atresia, compared with controls.</p><p><strong>Materials and methods: </strong>Twelve-month euthanized rats, 7 with left-sided surgically created ear canal atresia (UCA) and 4 controls, were scanned in a 9.4 T MRI scanner for animal research purposes. Diffusion-weighted images were acquired. Two different methods for probabilistic fiber tracking were used. Fractional anisotropy (FA) was calculated from whole brains and from tracts between defined auditory regions of interest.</p><p><strong>Results: </strong>Both methods of fiber tracking show significantly higher global FA in rats with UCA. Within-group comparisons in UCA show higher FA on the hearing side between the cochlear nucleus and inferior colliculus, compared with the side of hearing loss, while in controls, there was no asymmetry. Lower FA was also found between the medial geniculate complex and the auditory cortex on the left side than on the right in UCA, in contrast to controls, where there was no difference between the hemispheres.</p><p><strong>Conclusion: </strong>The asymmetry found in UCA indicates alterations of auditory white matter tracts as a response to asymmetric hearing, partly confirming previous findings in experiments on ferrets.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691292","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":"Cochlear Implantation and Vestibular Schwannoma Removal: The Gruppo Otologico Experience in 73 Consecutive Cases.","authors":"Beatrice Francavilla, Lucia B Musumano, Gianluca Piras, Mario Sanna","doi":"10.1097/MAO.0000000000004917","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004917","url":null,"abstract":"<p><strong>Background: </strong>Cochlear implantation (CI) following vestibular schwannoma (VS) resection, traditionally controversial, is increasingly accepted due to advances in surgical techniques. Current evidence is limited to small, short-term studies. This report presents the largest consecutive single-center cohort and offers long-term audiological outcomes.</p><p><strong>Material and methods: </strong>This retrospective study analyzed 73 consecutive patients who underwent VS resection with either simultaneous (97%) or delayed (3%) CI at the Gruppo Otologico between 1985 and 2025, among more than 4000 patients who underwent VS removal during the same period. Sixty-three patients (86%) had sporadic VS, and 10 (14%) had neurofibromatosis type 2 (NF2). Tumor removal was performed using the enlarged translabyrinthine approach (ETLA). Outcomes were assessed through pure-tone average (PTA), speech discrimination scores (SDS), and open-set speech recognition.</p><p><strong>Results: </strong>After a median 35-month follow-up, 48 patients (66%) were active CI users; 20 (27%) were nonusers or nonresponders. Five patients were \"removed/non activated\" (never activated due to postoperative complications or device malfunction or later explanted despite initial benefit) and were therefore not included in postoperative audiological outcome tables. Due to complications requiring explantation. Among users, the median postoperative PTA was 45.0 dB HL (IQR: 40.0-61.3), and the median SDS was 60.0% (IQR: 20.0-70.0). Open-set performance demonstrated high-to-median scores across word, sentence, and comprehension tests. Performance group analysis revealed that 52% of patients achieved intermediate-to-high outcomes, including 75% of NF2 patients.</p><p><strong>Conclusions: </strong>Performing CI immediately after VS resection is feasible and offers long-term functional benefits for most patients, including carefully selected NF2 cases. Although results can vary, more than half of the patients attain meaningful speech perception. This extensive, long-term, single-center experience strongly supports the feasibility of CI in this context, emphasizing the importance of surgical technique, nerve preservation, and precise patient selection.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691287","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}