Otology & Neurotology最新文献

{"title":"Audiological Progression and Treatment Outcomes in Superficial Siderosis: A 10-Year Retrospective Review of 46 Patients.","authors":"Ayako Nishio, Yoshiyuki Kawashima, Takamori Takeda, Taku Ito, Ayako Maruyama, Yoshimaru Mizoguchi, Natsuko Kurata, Ryo Iwase, Satoru Egawa, Takashi Hirai, Motonori Hashimoto, Takanori Yokota, Toshitaka Yoshii, Nobuo Sanjo, Takeshi Tsutsumi","doi":"10.1097/MAO.0000000000004535","DOIUrl":"10.1097/MAO.0000000000004535","url":null,"abstract":"<p><strong>Objective: </strong>To describe long-term hearing outcomes and evaluate the efficacy of interventions in patients with superficial siderosis (SS) of the central nervous system (CNS).</p><p><strong>Study design: </strong>Retrospective case review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Forty-six patients diagnosed with SS.</p><p><strong>Interventions: </strong>Auditory examinations, including pure-tone audiometry, speech audiometry, and auditory brainstem response (ABR). Treatment modalities include surgical closure of the dural defect with postoperative iron chelator administration and cochlear implantation.</p><p><strong>Main outcome measures: </strong>Pure-tone average (PTA), maximum speech discrimination score, and interpeak latency between ABR waves I and V.</p><p><strong>Results: </strong>Sensorineural hearing loss (SNHL) was observed in 39 patients (84.8%), typically presenting in the fifth to sixth decades of life, and progressed gradually. Among the patients, SNHL was bilateral in 76.9%, with 56.7% showing asymmetry. The severity ranged from minimal to profound, with high-frequency loss being the most common (63.8%). Abnormal ABRs were observed in 82.6% of the ears. Long-term follow-up (median, 39 months) revealed hearing deterioration of ≥10 dB PTA in 25.9% of the ears. The long-term hearing prognosis can be predicted based on audiological changes within the first 12 months after the initial visit. Dural defect closure with iron chelator treatment seemed to prevent hearing deterioration in seven patients. Cochlear implantation showed limited effectiveness in three patients.</p><p><strong>Conclusions: </strong>SS-related hearing loss can mimic age-related hearing loss, potentially leading to misdiagnoses. Clinicians should consider SS in middle-aged to elderly patients with progressive SNHL of unknown etiology and conduct comprehensive examinations, including speech audiometry, ABR, and T2*-weighted MRI, to facilitate an early diagnosis and appropriate management.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"895-902"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507293","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":"Systematic Review of the Impact of Magnetic Resonance Imaging on Diametric Magnet Cochlear Implants.","authors":"Quan Lu, Sidney Spencer, Anita Jeyakumar","doi":"10.1097/MAO.0000000000004556","DOIUrl":"10.1097/MAO.0000000000004556","url":null,"abstract":"<p><strong>Objective: </strong>Review the properties, safety, and artifacts of current cochlear implants (CI) with freely rotatable magnets during MRI scans.</p><p><strong>Databases reviewed: </strong>PubMed, Cochrane, and Web of Science; last accessed September 2023.</p><p><strong>Methods: </strong>The study was BSMH IRB exempted. MESH term \"magnetic resonance imaging\" and phrases of \"Med-el Synchrony,\" \"Cochlear Nucleus Profile Plus,\" \"Advanced Bionics HiRes Ultra 3D,\" \"rotatable magnet cochlear,\" \"rotatable magnet,\" \"diametric magnet,\" \"diametric magnet cochlear implant,\" and \"MRI-safe cochlear implant\" using \"AND\" function. Non-English, non-human, non-implanted CI, and cadaveric studies were excluded. Methodological quality was assessed using the Mixed Methods Appraisal Tool, and quality of the evidence was evaluated using the GRADE criteria.</p><p><strong>Results: </strong>The review included 18 studies. Fifteen assessed pain as a complication, with two reporting its occurrence: two cases for Synchrony and one for Ultra 3D. Demagnetization did not occur in the 12 studies that reported on it. One magnet displacement was noted with the Ultra 3D implant out of the 16 reporting studies. Artifacts were reported by 11 studies, with most scans retaining most to limited diagnostic usability. One Synchrony device required explantation due to artifact, and one was explanted before MRI.</p><p><strong>Conclusion: </strong>Of the CI models reviewed with diametric magnets, Med-El Synchrony may enable MRI usage with fewer safety concerns when following the manufacturer's recommendations. However, clinical reports of freely rotatable CI safety during MRI scans are sparse and contain incomplete data. MRI artifacts from CI still pose concerns for image quality but can be minimized with appropriate implant location and scanning protocols.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"918-923"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226147","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 Between Cochlear Implants and Dementia in Severe-to-Profound Hearing Loss Patients: Results From the National Insurance Service Survey 2010-2020.","authors":"Young-Soo Chang, Young Joon Seo, Chul Young Yoon, Kyoung Ho Park","doi":"10.1097/MAO.0000000000004575","DOIUrl":"10.1097/MAO.0000000000004575","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate whether restoring hearing through a cochlear implant (CI) influences the risk of dementia development, using data obtained from the South Korea's National Health Information Database.</p><p><strong>Study design: </strong>A longitudinal follow-up study.</p><p><strong>Setting: </strong>Data from the Korean National Health Insurance Service.</p><p><strong>Patients and intervention: </strong>This study examines the association between CIs and dementia in patients with severe-to-profound hearing loss. Data were collected from January 2010 to December 2020. All eligible patients were confirmed to have no previous diagnosis of dementia at the time of their hearing loss diagnosis. A total of 356,850 patients 50 years and older were included, with 2,447 having had Cis implanted and 354,403 who had not.</p><p><strong>Main outcome measures: </strong>Patients who had CIs were compared with those who did not, focusing on the newly diagnosed dementia.</p><p><strong>Results: </strong>Among the CI recipients, 274 (11.2%) were newly diagnosed with dementia, compared with 61,939 (17.5%) among the nonrecipients. This difference was statistically significant ( p < 0.001). For patients 70 years and older, a similar level of significance was observed. The interval between the diagnosis of the hearing loss and the subsequent development of dementia was significantly associated with the use of CIs (587.7 versus 1886.9 d, p < 0.001).</p><p><strong>Conclusions: </strong>The study elucidated the association between CIs and reduced dementia in patients with severe-to-profound hearing loss using nationwide data in South Korea. CIs are beneficial in preventing dementia, even in patients older than 70 years.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"938-943"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275539","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 Tonotopic Mismatch With the Speech Recognition of Cochlear Implant Users With Unilateral Hearing Loss.","authors":"Saangyoung E Lee, Kevin D Brown, Andrea B Overton, Nicholas J Thompson, Amanda D Sloop, Margaret E Richter, Michael W Canfarotta, A Morgan Selleck, Matthew M Dedmon, Margaret T Dillon","doi":"10.1097/MAO.0000000000004543","DOIUrl":"10.1097/MAO.0000000000004543","url":null,"abstract":"<p><strong>Objective: </strong>Review the relationship of tonotopic mismatch with the speech recognition of cochlear implant (CI) users with unilateral hearing loss (UHL; also known as single-sided deafness).</p><p><strong>Patients: </strong>Twenty-seven adults (≥18 yr of age) with late-onset UHL.</p><p><strong>Intervention: </strong>Cochlear implantation.</p><p><strong>Main outcome measures: </strong>Speech recognition was assessed at 6 months post-activation with consonant-nucleus-consonant (CNC) words in the CI alone condition (contralateral ear masked). In the combined condition (CI plus the normal-hearing ear), masked speech recognition was assessed using AzBio sentences in a 10-talker masker (0-dB signal-to-noise ratio) in three target-to-masker configurations. Tonotopic mismatch was calculated as the semitone deviation between the center filter frequency and the cochlear place frequency of the most apical electrode contact.</p><p><strong>Results: </strong>There was a significant, negative association between tonotopic mismatch and CNC scores ( r27 = -0.43, p = 0.013) and masked speech recognition when the target was from the front and the masker was presented toward the normal-hearing ear ( r27 = -0.36, p = 0.033).</p><p><strong>Conclusions: </strong>The speech recognition of adult CI users with UHL in the CI alone and bilateral listening conditions may be significantly influenced by tonotopic mismatches. These findings support the need for prospective investigation of methods to reduce or eliminate tonotopic mismatches (e.g., implantation of electrode arrays that approximate cochlear place and/or individualized mapping of filter frequencies) for CI users with UHL.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e302-e306"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151383","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":"A New Type of Third Window Lesion: Vestibular Aqueduct Dehiscence With Hyperpneumatized Air Cells.","authors":"Sawsan Abuzaid, Qamar Malabeh, Pasquale Malara, Salvatore Martellucci, Andrea Castellucci","doi":"10.1097/MAO.0000000000004561","DOIUrl":"10.1097/MAO.0000000000004561","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"1002-1004"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151377","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":"Impact of Vestibular Schwannoma Management on Cochlear Implant Programming and Outcomes.","authors":"Courtney Kolberg, Jamie Bogle, Melissa D DeJong, Nicholas Deep, Peter Weisskopf, James R Dornhoffer, Brian A Neff, Colin L W Driscoll, Matthew L Carlson, Aniket A Saoji","doi":"10.1097/MAO.0000000000004572","DOIUrl":"10.1097/MAO.0000000000004572","url":null,"abstract":"<p><strong>Objectives: </strong>To compare electrical stimulation and speech perception in vestibular schwannoma (VS) patients across treatment modalities and standard cochlear implant (CI) patients.</p><p><strong>Study design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Patients: </strong>Sixty-seven CI ears consisting of 23 standard CI controls and 44 VS patients with ipsilateral CI. VS patients were separated by treatment modality: 24 microsurgical resection, 15 radiation therapy, and 5 observation. Eleven VS patients with CI did not receive auditory sensation from electrical stimulation.</p><p><strong>Interventions: </strong>VS microsurgical resection, radiation therapy, and observation.</p><p><strong>Main outcome measures: </strong>Threshold (T-levels), comfort (C-levels), consonant-nucleus-consonant (CNC) word score, and AzBio sentence recognition scores.</p><p><strong>Results: </strong>Patients who underwent microsurgical resection required significantly higher ( p < 0.001) T-levels and C-levels compared with the standard CI group. Stimulation levels in the VS radiation therapy and observation groups were higher but not significantly different compared with standard CI controls. Overall rate of CI nonstimulation across all VS patients was 25%: 38% for microsurgery and 13% for radiation. Average CNC score for microsurgery group was 18% compared with 44% for radiation, 55% for observation, and 68.5% for standard CI controls. CNC word and AzBio scores were significantly lower ( p < 0.001) for the microsurgery group compared with standard CI group.</p><p><strong>Conclusions: </strong>Resection may negatively affect auditory nerve function, leading to higher stimulation levels, increased risk of nonstimulation, and poorer postoperative CI speech outcomes compared with observation or radiosurgery. When medically appropriate, nonsurgical VS management may be used to allow for optimization of CI programming and postoperative hearing outcomes.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"903-908"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249054","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":"Progression of Peripheral Vestibular System Degeneration Secondary to Otitis Media in the Chinchilla Model.","authors":"Nevra Keskin Yilmaz, Tomotaka Shimura, Rafael da Costa Monsanto, Meredith Adams, Sebahattin Cureoglu","doi":"10.1097/MAO.0000000000004564","DOIUrl":"10.1097/MAO.0000000000004564","url":null,"abstract":"<p><strong>Hypothesis: </strong>Untreated otitis media (OM) may associate with progressive histopathological changes in the peripheral vestibular system structures in the chinchilla model.</p><p><strong>Background: </strong>Previous studies have suggested a link between OM and vestibular pathology. However, the mechanisms underlying this relationship are not well understood.</p><p><strong>Objectives: </strong>To evaluate the progression of peripheral vestibular pathology in chinchilla temporal bones with OM.</p><p><strong>Methods: </strong>Chinchilla temporal bones, both control and Streptococcus pneumoniae -inoculated, were obtained from the Paparella Otopathology & Ear Pathogenesis Laboratory and evaluated at 3, 7, 14, 21, and 28 days. Peripheral vestibular pathology was assessed by evaluating organ-specific cell densities in the sensory epithelia and quantifying vestibular ganglion cells for potential pathologies.</p><p><strong>Results: </strong>Compared with controls, S. pneumoniae -inoculated specimens exhibited significantly lower densities of type I and II cells starting from 7 days postinoculation. The exceptions were in the utricle for both cell types and the posterior semicircular canals for type II cells, where the decrease first became noticeable on day 14 ( p < 0.05). Loss of transitional cell and dark cells was initially identified in the 14-day and 21-day groups, respectively. The density of vestibular ganglion cells were decreased only in the 28-day group.</p><p><strong>Conclusion: </strong>Our results revealed progressive loss of peripheral vestibular cells and ganglion neurons in cases with persistent OM, which closely aligns with the findings from human otopathology studies. This supports the chinchilla as a reliable model for vestibular pathology research.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e335-e341"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226145","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 Nerve Atrophy in Postlingual ANSD: Diagnostic Clue and Implications for Cochlear Implantation.","authors":"Kyu Ha Shin, Kherlen Altanbayar, Hye-Rim Park, Jin Hee Han, Jiyeon Yang, Pil Geum Jang, Ngoc-Trinh Tran, Ju Ang Kim, Bong Jik Kim, Byung Yoon Choi","doi":"10.1097/MAO.0000000000004567","DOIUrl":"10.1097/MAO.0000000000004567","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate cochlear nerve (CN) atrophy in postlingual auditory neuropathy spectrum disorder (post-ANSD) versus simple sensorineural hearing loss (sSNHL) and its implications for cochlear implantation (CI).</p><p><strong>Design: </strong>A retrospective study of 61 CI recipients (15 post-ANSD, 46 sSNHL) assessed CN size through imaging, analyzed auditory performance, and compared outcomes based on etiology, age, and molecular subtypes.</p><p><strong>Results: </strong>Post-ANSD exhibited more severe CN atrophy despite better pure tone averages than sSNHL. Postsynaptic post-ANSD showed significantly greater CN atrophy than presynaptic cases and sSNHL. Although CN atrophy was pronounced, it did not predict poor CI outcomes within the observed thresholds. Speech scores improved markedly post-CI, with no correlation to CN size.</p><p><strong>Conclusion: </strong>CN atrophy severity is etiology-dependent and most pronounced in postsynaptic post-ANSD. Severe atrophy could serve as a diagnostic marker of postsynaptic post-ANSD without auditory test clues. Early CI is recommended for optimal outcomes, emphasizing timely intervention in post-ANSD patients.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"e293-e301"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226137","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":"Blastomycosis of the Temporal Bone With Intracranial Extension.","authors":"Bronson Wessinger, Michael Nisiewicz, Monica McGrath, Matthew Bush, Nathan Cass","doi":"10.1097/MAO.0000000000004565","DOIUrl":"10.1097/MAO.0000000000004565","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"998-999"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249053","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":"Development and First Evaluation of a Spatial Auditory Training Program for SSD Cochlear Implant Users.","authors":"Benjamin Lentz, Rainer Martin, Lorena Weber, Christiane Völter","doi":"10.1097/MAO.0000000000004557","DOIUrl":"10.1097/MAO.0000000000004557","url":null,"abstract":"<p><strong>Purpose: </strong>Cochlear implants (CIs) allow single-sided deafness (SSD) patients to regain hearing on both sides. However, current rehabilitation programs primarily focus on speech perception, leaving a significant gap in spatial hearing abilities compared with normal-hearing individuals. In this study, we developed and evaluated a novel method for training spatial hearing abilities in SSD CI users.</p><p><strong>Methods: </strong>Twelve SSD CI patients underwent a 4-week training program. Twice a week, subjects completed training sessions of approximately 30 minutes, each involving 50 stimuli presented by 7 loudspeakers arranged from -90 to +90 degrees in the horizontal plane. Spatial hearing was evaluated before and after training using the root mean square error (RMSE), the mean absolute error (MAE), and the bias of source location angles, and by the Speech, Spatial and Quality of Hearing Scale (SSQ) questionnaire.</p><p><strong>Results: </strong>Localization abilities assessed by MAE and by RMSE were better with CI than without ( p < 0.001), but further significantly improved after spatial auditory training (both p < 0.05), especially for signals presented from the frontal direction. Furthermore, subjective spatial hearing abilities measured by the SSQ also improved after training ( p < 0.01). Subjects with a larger pretraining bias showed a greater reduction in bias after training.</p><p><strong>Conclusion: </strong>A 4-week lasting spatial auditory training led to significant improvements both in subjective and in objective spatial hearing outcomes in adult SSD CI subjects. Therefore, the inclusion of such training programs in the postoperative rehabilitation setting of SSD CI patients and its evaluation in larger studies is a worthwhile next step.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"909-917"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226139","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}