Otology & Neurotology最新文献

{"title":"Outcomes of a New Minimally Invasive Single-Drill Procedure for Installing Percutaneous Bone-Anchored Hearing Implants in Adult Patients.","authors":"Miguel Angelo Hyppolito, Ana Cláudia Mirândola Barbosa Reis, Letícia Cândido de Oliveira, Karine Eying da Silva, Denny Marcos Garcia, Fabiana Danieli-Hyppolito","doi":"10.1097/MAO.0000000000004484","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004484","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the surgical and audiological outcomes in adult bone-anchored hearing system (BAHS) users who underwent implantation using a minimally invasive, single-drill procedure (MONO procedure).</p><p><strong>Study design: </strong>Retrospective cohort design.</p><p><strong>Setting: </strong>University hospital.</p><p><strong>Patients: </strong>Adult subjects (≥18 yr), with conductive and mixed hearing loss, or single-sided deafness (SSD), who underwent BAHS surgery using MONO from 2021 to 2023.</p><p><strong>Intervention: </strong>BAHS implantation.</p><p><strong>Main outcome measures: </strong>Surgical and postoperative complications were investigated during the entire follow-up period. Preoperative unaided air- and bone-conduction thresholds, pure-tone average (PTA), air-bone gap (ABG), and monosyllabic word recognition scores (unaided- and softband-aided) were compared with the postoperative BAHS aided PTA, remaining ABG, functional gain, and monosyllabic word recognition scores.</p><p><strong>Results: </strong>Forty-four subjects aged between 20 and 70 (52 ± 15) years met the inclusion criteria. One subject (2.3%) required two punch incisions due to implant instability during surgery. Two subjects (4.6%) experienced adverse skin reactions. Pain (6.9%) and moisture (6.9%) at implant site were also reported. No other complications were reported over a mean follow-up time of 12.2 ± 5.7 months. The mean BAHS aided score was significantly greater than the mean unaided- and softband-aided scores. All subjects showed functional improvements after surgery (25-31 dB), and the average effective gain was 1.3 dB.</p><p><strong>Conclusion: </strong>The MONO procedure was shown to be a viable option for routine BAHS surgery in adults. The auditory performance of the subjects improved postoperatively, and complications were minimal and easily resolved. Further studies are required to investigate the long-term outcomes of MONO in this population.</p><p><strong>Level of evidence: </strong>4-Retrospective review.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586518","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 Systematic Review of the Incidence of Cochlear Nerve Deficiency in Pediatric Single-Sided Deafness.","authors":"Christina Zhu, Jasmine Gulati, Daniel Swanson, Anuja Shah, Paul Chisolm, Michael Hoa","doi":"10.1097/MAO.0000000000004474","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004474","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the variability in cochlear nerve deficiency (CND) incidence in pediatric single-sided deafness (SSD), assess how study parameters and inclusion criteria affect these rates, and examine the diagnostic tools utilized, including magnetic resonance imaging (MRI) and computed tomography (CT), in identifying CND.</p><p><strong>Data sources: </strong>Databases including MEDLINE, Embase, Cochrane CENTRAL, and Web of Science.</p><p><strong>Review methods: </strong>A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guidelines with predefined search criteria using terms related to pediatric unilateral hearing loss and CND from 2010 to January 2024. Studies were selected based on their focus on CND incidence in pediatric SSD, excluding case reports, nonhuman or adult studies, and analyses limited to bilateral deafness.</p><p><strong>Results: </strong>Out of 518 articles screened, 17 underwent full-text review, and 10 were included. Incidence rates of CND ranged from 15.7% to 100%, with all studies using MRI and 60% using CT as an adjunct diagnostic tool. Age criteria varied: five studies included patients 18 years and older, one study included patients up to age 21 years, and four studies targeted children under 5 years, including two studies on neonates. Variability stemmed from differing inclusion criteria; studies on younger cohorts generally excluded noncongenital causes, while older children's studies were less restrictive. Additionally, two studies excluded syndromic SSD, impacting incidence rates. Larger studies show an overall incidence of 35% to 45%, which this systematic review of the literature reports as the approximate incidence of CND in SSD, with higher incidence rates observed in studies excluding syndromic causes and broader criteria linked to decreased incidence.</p><p><strong>Conclusion: </strong>This systematic review highlights how age-specific inclusion criteria and management of syndromic causes significantly influence reported CND incidence rates in pediatric SSD, underscoring the need for standardized reporting to improve clinical understanding and treatment approaches.Level of Evidence: 1.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586533","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":"Effect of Simvastatin on Irradiated Primary Vestibular Schwannoma Cells.","authors":"Matthew Wiefels, Olena Bracho, Mikhail Marasigan, Fred Telischi, Michael E Ivan, Scott Welford, Cristina Fernandez-Valle, Christine T Dinh","doi":"10.1097/MAO.0000000000004469","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004469","url":null,"abstract":"<p><strong>Hypothesis: </strong>Simvastatin enhances radiation cytotoxicity of primary vestibular schwannoma (VS) and NF2-mutant human Schwann (HS01) cells.</p><p><strong>Background: </strong>Approximately 10% of VS progress after radiotherapy. Simvastatin is a lipid-lowering medication that promotes apoptosis, inhibits cell proliferation, and enhances radiation response in various cancers. In this study, we determine the effect of simvastatin on the viability of irradiated and nonirradiated primary VS and HS01 cells.</p><p><strong>Methods: </strong>Primary VS (N = 5) and HS01 cells were pretreated with simvastatin (0 or 1 μM) prior to irradiation (0 or 18 Gy). A cell-based assay was used to measure cell viability. Immunocytochemistry was performed for γH2AX (DNA damage marker) and RAD51 (DNA repair protein). Statistical analysis was conducted with parametric and nonparametric one-way analysis of variance tests.</p><p><strong>Results: </strong>Radiation initiated double-stranded breaks in DNA in both VS and HS01 cells. Two VS were radiation-resistant and the remaining three VS were radiation-sensitive. In response to radiation, radiation-resistant VS cells activated RAD51-mediated DNA repair. Simvastatin blocked RAD51 activation in radiation-resistant VS, increased levels of lethal DNA damage, and enhanced radiation-induced cell death. Simvastatin also enhanced radiation-induced cell death in radiation-sensitive VS cells through RAD51-independent mechanisms. However, simvastatin was not effective as a radiosensitizer in HS01 cells.</p><p><strong>Conclusion: </strong>Simvastatin improved radiation response of radiation-resistant primary VS cells by inhibiting RAD51-related DNA repair. Although through RAD51-independent mechanisms, simvastatin also improved radiation response in radiation-sensitive VS cells. Additional preclinical investigations are warranted to evaluate the mechanisms of action and efficacy of statin drugs as radiosensitizers for VS patients.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586535","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":"Noninvasive Targeted Temperature Management of the Inner Ear: Numerical Simulations and Experimental Measurements in a Human Cadaver Model.","authors":"Maria Fernanda Yepes, Michael E Hoffer, Juan Armando Chiossone, Nathaniel Soejima, Curtis S King, Suhrud M Rajguru","doi":"10.1097/MAO.0000000000004476","DOIUrl":"10.1097/MAO.0000000000004476","url":null,"abstract":"<p><strong>Hypothesis: </strong>Mild therapeutic hypothermia (MTH) could be delivered to the human inner ear using a localized, noninvasive approach to achieve protective temperature reductions without systemic side effects.</p><p><strong>Background: </strong>MTH has demonstrated protective effects in the cochlea following injuries such as device implantation, ototoxicity, and noise overexposure. It targets key cellular mechanisms, including proinflammatory pathways, oxidative stress, pyroptosis, and apoptosis. However, systemic and invasive methods for MTH carry risks and are less practical for broader clinical applications. Developing a localized, noninvasive approach could offer a safer, more accessible solution for hearing preservation after cochlear injury.</p><p><strong>Methods: </strong>Cadaveric middle and inner ear structures, maintained near physiological conditions, were used to test a custom-designed cooling gel pack (ReBound) placed externally on the temporal bone. Temperature changes were recorded over 60 or 30 minutes. To complement experimental findings, three-dimensional geometrical models were created from imaging data, and finite element heat transfer analysis simulated temperature changes across inner ear structures.</p><p><strong>Results: </strong>With external gel pack application, inner ear temperatures dropped by 2.9°C within 30 minutes and 4.6°C within 60 minutes. Cooling persisted for 10 minutes post-device removal. Numerical modeling corroborated these findings, indicating average temperature reductions of 2°C to 4°C. Biological sex differences were observed in cooling efficiency and overall temperature drop.</p><p><strong>Conclusion: </strong>This study demonstrates that localized, noninvasive MTH can effectively reduce inner ear temperatures to therapeutically relevant levels. These findings support a promising, clinically translatable approach for protecting cochlear structure and function after injury, with minimal systemic risks.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516176","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":"Unique Cell Type-Specific Signaling Patterns Define Cholesteatoma.","authors":"Christopher M Welch, Shuze Wang, Joerg Waldhaus","doi":"10.1097/MAO.0000000000004455","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004455","url":null,"abstract":"<p><strong>Objective: </strong>To identify cell types and signaling pathways that drive cholesteatoma.</p><p><strong>Methods: </strong>Single-cell RNA sequencing (scRNA-seq) was applied to identify differences between human cholesteatoma specimens and previously published scRNA-seq data for normal human tympanic membrane. The CellChat algorithm determined differential signaling pathways between both tissues. Cholesteatoma-specific markers were validated utilizing immunohistochemistry on human cholesteatoma specimens.</p><p><strong>Background: </strong>Cholesteatoma is a complex, expansile, and destructive cystic epithelial lesion that occurs within the temporal bone. It destroys surrounding tissue, leading to significant otologic complications. Currently, the only treatment option is surgical removal of the disease, and despite surgical treatment, rates of recurrent or residual cholesteatoma following surgery approach 40% to 50% a decade later. Extensive research has attempted to generate medical treatments by delineating signaling pathways that drive cholesteatoma behavior, with numerous pathways identified. However, progress in developing pharmacologic treatment of cholesteatoma has been hampered by the inherent cellular heterogeneity, with cell type-specific behaviors obscured by bulk analysis of tissue.</p><p><strong>Results: </strong>Cholesteatoma cellular composition differs notably from normal tympanic membrane, with increased numbers of immune cells in cholesteatoma. A number of cell signaling pathways are also differentially regulated between cholesteatoma and normal tissues, including several growth factors, Wnt, interleukin, cell adhesion, and tumor necrosis factor pathways, with unique cell type-specific patterns in cholesteatoma.</p><p><strong>Conclusions: </strong>scRNA-seq data define the cellular composition and cell type-specific signaling pathways in cholesteatoma, thereby identifying potential drug targets and informing future strategies to improve treatment of the disease.</p><p><strong>Professional practice gap and educational need: </strong>The molecular understanding of cholesteatoma remains poor, resulting in a lack of medical treatments for this relatively common and troublesome condition.</p><p><strong>Learning objective: </strong>To define the cellular profile and cell type-specific signaling pathways of cholesteatoma relative to normal tympanic membrane.</p><p><strong>Desired result: </strong>To define the unique cell type-specific signaling pathways within cholesteatoma that may warrant further evaluation as potential therapeutic targets for medical treatment of cholesteatoma.</p><p><strong>Level of evidence: </strong>Not applicable, in silico cellular study.</p><p><strong>Indicate irb or iacuc: </strong>IRB HUM00153531.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586487","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 Implantable Hearing Devices on Delirium Risk in Patients with Hearing Loss: A National Database Study.","authors":"Bryce Hambach, Jena Patel, Kathryn Nunes, Elliott M Sina, Pablo Llerena, Alexander Knops, Rebecca C Chiffer, Jacob B Hunter","doi":"10.1097/MAO.0000000000004416","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004416","url":null,"abstract":"<p><strong>Objective: </strong>Exploring whether the utilization of implantable hearing rehabilitation devices is associated with a reduced likelihood of developing delirium in patients with hearing loss.</p><p><strong>Study design: </strong>A retrospective cohort database study with propensity score matching (PSM) utilizing TriNetX clinical database.</p><p><strong>Setting: </strong>The US Collaborative Network within the TriNetX database (100 million people).</p><p><strong>Patients: </strong>Patients over 55 years old were selected based on three categories: a non-hearing loss study control (ICD-10: H90-91), a hearing loss (HL without implantable device), and an implantable device cohort (ICD-10: Z96.21, Z96.29, 09HD, 09HE; CPT: 69714, 69930). Patients with prior dementia or memory loss diagnosis were excluded (F01-03, 27-29).</p><p><strong>Interventions: </strong>Observational.</p><p><strong>Main outcome measures: </strong>Odds ratios with 95% confidence intervals for delirium diagnosis code (F0.5).</p><p><strong>Results: </strong>The control cohort (n = 36.5 million) was 1:1 PSM for age and sex with the HL cohort (n = 1.77 million) in which 0.28% of patients developed delirium compared to 0.74% in the HL cohort (OR 2.66, 95% CI = 2.58-2.75). When looking at the same PSM between HL and implantable device cohorts (n = 20,847), 0.81% developed a delirium diagnosis compared to 0.45% in the implantable device cohort (OR = 1.79, 95% CI = 1.39-2.31). Further analysis accounting for 16 PSM covariates showed that 0.74% of the HL cohort developed delirium compared to 0.45% of the implantable device cohort (OR = 1.64, 95% CI = 1.27-2.13).</p><p><strong>Conclusions: </strong>The present study shows that patients with hearing loss were more likely to develop delirium than those with normal hearing. Importantly, patients with implantable hearing devices were significantly less likely to develop delirium compared to hearing loss patients without an implantable device. Our research highlights the importance of treating hearing loss to prevent delirium.Level of Evidence: III.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586540","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 Rare Case of Osteoblastic Osteosarcoma of the Temporal Bone and Comprehensive Review of the Literature.","authors":"Yousuf Khalil, John I Lane, Jeremy F Molligan, Jamie J Van Gompel, Kendall K Tasche, Matthew L Carlson","doi":"10.1097/MAO.0000000000004481","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004481","url":null,"abstract":"<p><strong>Introduction: </strong>Although osteosarcoma represents the most common primary malignant bone tumor in children, they comprise only 0.2% of all cancers. Osteosarcoma frequently involves long bones; however, 8% of osteosarcomas involve the skull or mandible. Osteosarcoma is generally categorized based on location within the bone (central, surface, or extraskeletal) and histological grade (high-grade or low-grade). Osteoblastic osteosarcoma is a central, high-grade subtype and may be difficult to diagnose; it may present similarly to osteoblastoma, another rare, but benign, type of osteoblastic bone tumor. In this report, we present a rare case of osteoblastic osteosarcoma involving the temporal-occipital skull.</p><p><strong>Study design: </strong>Case report and systematic review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Results: </strong>A 21-year-old male presented for assessment of a mass appearing over his left mastoid region, first noticed within the previous 12 months. He experienced growth of the lesion and pain that increased when pressure was applied to the mass. Results from fine needle aspiration and CT-guided core biopsy were positive for osteosarcoma, osteoblastic-type. Magnetic resonance imaging of the brain and skull base revealed the mass to be 2.8 cm in maximal diameter. Given a somewhat favorable location, the tumor could be completely excised en bloc with negative margins, and the patient subsequently received adjuvant chemotherapy. The patient is doing well at last follow-up 10 months after surgery, with no evidence of recurrence to date.</p><p><strong>Conclusion: </strong>The temporal bone is an uncommon location for a primary osteosarcoma, and there are numerous conditions that could present in a similar manner. This case highlights this rare occurrence of osteoblastic osteosarcoma of the temporal bone without previous exposure to radiation. There are a limited number of similar cases in the literature, and our report serves to bring awareness to this potential diagnosis and considerations related to treatment.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586531","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":"Microscale Proteomic Analysis of the Endolymphatic Sac in Menière's Disease Patients.","authors":"Wenting Deng, Yuelian Luo, Haoyang Wu, Huilin Lao, Yafeng Zhu, Lingshuo Wang, Yuxuan Cao, Suijun Chen, Yongkang Ou, Hao Xiong","doi":"10.1097/MAO.0000000000004464","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004464","url":null,"abstract":"<p><strong>Objective: </strong>Endolymphatic hydrops is the primary pathological feature of Menière's disease (MD). An imbalance between endolymphatic fluid production and absorption due to endolymphatic sac (ES) dysfunction may be the major cause of endolymphatic hydrops. This study aimed to identify and characterize global protein expression of the ES in MD patients using microscale proteomics for the first time.</p><p><strong>Methods: </strong>Liquid chromatography-tandem mass spectrometry was used to analyze the ES samples from six MD patients and six acoustic neuroma (AN) patients (as control) for microscale proteomics and differentially expressed proteins (DEPs) were screened.</p><p><strong>Results: </strong>A total of 1,213 proteins in the ES were identified. Among them, there were 40 DEPs between the two groups. Of these proteins, 34 were upregulated (e.g., DPT and CHMP1B), and 6 were downregulated (e.g., PLPP3 and SCARB2) in the MD group compared to the AN group. DEPs were significantly enriched in coagulation and complement cascades.</p><p><strong>Conclusion: </strong>Microscale proteomics revealed a unique protein expression pattern in the ES of MD patients. Several proteins such as DPT, CHMP1B, and LTA4H may be involved in the pathogenesis of MD.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586511","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":"Investigation of Automated Cochlear Length and Cochlear Implant Insertion Angle Predictions with a Surgical Planning Platform.","authors":"Emilio Avallone, Max E Timm, Thomas Lenarz, Daniel Schurzig","doi":"10.1097/MAO.0000000000004480","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004480","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative anatomical assessment is essential to optimize the outcome of individualized cochlear implantation. Algorithms based on cochlear diameters simplify this evaluation. The new version of a surgical planning platform is capable of performing this determination automatically. Our study evaluated the robustness of automated measurements and compared individual differences between automated and manual measurements, including predicting cochlear duct length and insertion angles.</p><p><strong>Materials and methods: </strong>The preoperative cone beam CT scans of 55 MED-EL cochlear implant patients were analyzed. Using the surgical planning platform, the anatomical diameters were measured automatically and manually. The values were compared, as well as the predictions of the insertion angles and prediction of cochlear duct length.</p><p><strong>Results: </strong>The analyses showed good agreement between manual and automatic measurements of cochlear diameters, with the exception of cochlear height, where a significant difference was observed. Some discrepancies were noted for the prediction of the cochlear length duct without, however, a significant impact. Predictions of insertion angles based on automated measurements were comparable to the postoperative evaluations, with no significant difference from the manual ones.</p><p><strong>Discussion: </strong>The robustness of automated assessments is essential for integration into clinical practice. Automated measurements of cochlear dimensions are comparable to manual ones. However, image quality and the presence of anatomical abnormalities may influence the results. In this study, the evaluation of the insertion angle prediction was strengthened by comparison with postoperative results taking into account the actual insertion depth.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586554","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":"Longitudinal Trends in Cochlear Implant Programming from a Single-Institution Review of Over 400 Adult Implant Recipients: Evidence to Support Selective De-Escalation of Device Programming.","authors":"James R Dornhoffer, Karl R Khandalavala, Aniket A Saoji, Christine M Lohse, Matthew L Carlson","doi":"10.1097/MAO.0000000000004459","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004459","url":null,"abstract":"<p><strong>Objective: </strong>To examine comfort (C) and threshold (T) levels in adult cochlear implant (CI) recipients over the first 18 months postactivation.</p><p><strong>Study design: </strong>Retrospective review of longitudinal CI programming data.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Patients: </strong>A total of 480 CIs among 428 adult CI recipients.</p><p><strong>Interventions: </strong>Cochlear implantation with Cochlear Ltd. devices with subsequent programming to behavioral standards using Custom Sound® fitting software.</p><p><strong>Main outcome measures: </strong>Charge levels needed to achieve C and T levels were measured longitudinally using Custom Sound®, from time of activation to a minimum of 6 and a maximum of 18 months postactivation. Charge (nC) levels were calculated as the product of pulse width (μs) and current amplitude (μA) to standardize among implant models. Changes in C and T charge levels over time were evaluated using repeated-measures analysis of variance.</p><p><strong>Results: </strong>When considering the entire electrode, the largest increases were seen at 1 month postactivation, and C and T charge levels did not increase significantly after 6 and 12 months, respectively. These findings were consistent across patient age at implantation and sex. When considering proximal electrodes only, C and T levels did not increase significantly after 6 months. In distal electrodes only, C levels did not increase significantly after 6 months, but T levels continued to demonstrate small, but statistically significant increases up to 18 months postactivation.</p><p><strong>Conclusions: </strong>Across the entire electrode, we observed the largest changes in C and T charge levels at 1 month postactivation. Small increases in C and T levels continued out to 6 and 12 months, respectively, but may be of limited clinical significance. The stability of programming levels over time may support selective de-escalation of CI follow-up after the initial postactivation period, but, given small yet persistent increases with time, most notably in the distal electrodes, alternatives for follow-up or remote programming may still be encouraged.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586557","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}