Otology & Neurotology最新文献

{"title":"Speech Recognition for Pediatric Electric-Acoustic Stimulation Users with Unilateral Hearing Loss.","authors":"Samuel P O'Rourke, Margaret E Richter, Lisa R Park, Emily Buss, Kevin D Brown, Margaret T Dillon","doi":"10.1097/MAO.0000000000004460","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004460","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric cochlear implant (CI) recipients with unilateral hearing loss (UHL) and functional low-frequency acoustic hearing in the implanted ear could be fit with an electric-acoustic stimulation (EAS) device, which is the combination of acoustic and CI technologies in one device. Outcomes for this unique patient population are currently unknown. The present study assessed the speech recognition of pediatric EAS users with UHL.</p><p><strong>Study design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Tertiary academic referral center.</p><p><strong>Patients: </strong>Pediatric CI recipients with functional acoustic hearing in the implanted ear (i.e., ≤ 80 dB HL) and a contralateral pure-tone average (0.5, 1, 2, and 4 kHz) ≤ 25 dB HL.</p><p><strong>Main outcome measures: </strong>Speech recognition was assessed with the consonant-nucleus-consonant (CNC) test for the affected ear preoperatively and at 6 and 12 months postactivation. Masked speech recognition was assessed with the Bamford-Kowal-Bench speech-in-noise test in the bilateral condition for three spatial configurations: target from the front and masker colocated with the target or presented 90° toward the implanted or contralateral ear.</p><p><strong>Results: </strong>Children experienced a significant improvement in CNC scores with EAS as compared to preoperative abilities with a hearing aid (F(2,7) = 10.0, p = 0.009). Preliminary masked sentence recognition data suggest a benefit in performance when the target was spatially separated from the masker, and a benefit with EAS as compared to an unaided listening condition.</p><p><strong>Conclusions: </strong>Children with UHL and functional acoustic hearing in the implanted ear experience better speech recognition with EAS as compared to preoperative abilities or listening unaided.</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":"143586466","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":"Idiopathic Sudden Sensorineural Hearing Loss Caused by Infarction of the Vestibulo-Cochlear Artery Can Be Detected by Testing Semicircular Canal Function and Audiometry: Proposal for Angiopathic Sudden Sensorineural Hearing Loss.","authors":"Nobuyoshi Tsuzuki, Kanako Masuda, Yoshiharu Yamanobe, Kohei Mizuno, Hiroyuki Ozawa, Koichiro Wasano","doi":"10.1097/MAO.0000000000004473","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004473","url":null,"abstract":"<p><strong>Background: </strong>Although the specific pathogenesis of idiopathic sudden sensorineural hearing loss (ISSNHL) remains unknown, vascular impairment is one of the leading causes of ISSNHL. Establishing diagnostic criteria for ISSNHL due to vascular impairment is essential. We hypothesized that isolated posterior semicircular canal dysfunction (IPSCD) in ISSNHL patients results from infarction of the vestibulo-cochlear artery (VCA). The aim of this preliminary retrospective study is to identify possible diagnostic characteristics of ISSNHL patients with IPSCD.</p><p><strong>Methods: </strong>Seventeen ISSNHL patients were enrolled. They underwent video head impulse testing within 28 days of ISSNHL onset between September 2019 and November 2023. We obtained patient characteristics and clinical information, including results of audiometric and balance function tests. Eligible patients were divided into two groups according to the presence or absence of IPSCD. Patient characteristics and clinical information of the two groups were compared.</p><p><strong>Results: </strong>Of the 17 ISSNHL patients included, 6 had IPSCD. Compared to the 11 patients without IPSCD, the 6 patients with IPSCD had significantly more coronary artery disease (odds ratio, infinite; p = 0.03) and had regularly used antithrombotic medications (odds ratio, infinite; p < 0.01). The audiogram shapes of the six ISSNHL-IPSCD patients were profound, flat, or high-frequency descending forms.</p><p><strong>Conclusions: </strong>Given that VCA impairment is associated with profound, flat, and high-frequency hearing loss and consistent with the arterial anatomy of the inner ear, ISSNHL-IPSCD patients are more likely to have vascular impairment. Conducting trials that target ISSNHL-IPSCD patients may lead to the discovery of new and effective treatments for ISSNHL.</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":"143586537","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":"LETTER TO THE EDITOR CONCERNING: \"HEARING DEVICE COIL PLACEMENT LATERAL TO THE TEMPORALIS: AN ALTERNATIVE TO FLAP THINNING FOR COCHLEAR AND TRANSCUTANEOUS BONE-ANCHORED IMPLANTS\".","authors":"Orhan Ozturan, Alper Yenigun, Ramazan Bahadir Kucuk, Erol Senturk, Sabri Baki Eren, Fadlullah Aksoy","doi":"10.1097/MAO.0000000000004477","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004477","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586556","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":"Safety and Effectiveness of the Titanium mAXIS Stapes Prosthesis: Multicentric Short-Term Outcome.","authors":"Dirk Beutner, Nicholas Bevis, Benjamin Loader, Franz Windisch, Susan Arndt, Christian Offergeld, Wendelin Wolfram, Lisa Niederwanger, Paul Martin Zwittag, Nina Rubicz, Esther Schimanski, Christoph Arnoldner, Dominik Riss, Piotr H Skarżyński, Łukasz Plichta, Joachim Hornung, Lava Taha, Thomas Lenarz, Susan Busch, Astrid Magele, Georg Sprinzl","doi":"10.1097/MAO.0000000000004462","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004462","url":null,"abstract":"<p><strong>Objective: </strong>Otosclerosis leads to ossification of the stapes footplate and is responsible for a significant number of patients having hearing loss. Stapes surgery is a treatment for otosclerosis with excellent postoperative hearing outcomes. The aim of this retrospective study was to analyze the safety and effectiveness of the titanium mAXIS prosthesis in a multicentric setting.</p><p><strong>Methods: </strong>Ninety-four surgeries with implantation of the mAXIS stapes prosthesis took place in a multicenter study group. During follow-up at 59 (±48.1) days, pure-tone audiometry was performed. The pure-tone averages of 0.5, 1, 2, and 3 kHz (PTA-4) were determined.</p><p><strong>Results: </strong>No device-related adverse events were reported. There were 88 patients who reported for follow-up, at which pure-tone audiometry was performed. The PTA-4 air-bone gap (ABG) at follow-up was 8.8 (±6.0) dB. In 64.8% of the patients, the postoperative PTA-4 ABG was within 10 dB and in 94.3% it was within 20 dB. The postoperative PTA-4 thresholds for bone conduction were stable in 95.5% of cases.</p><p><strong>Conclusion: </strong>The results of this multicentric study demonstrate the safety of the mAXIS titanium stapes prosthesis. The prosthesis shows promising audiological outcomes. Future studies are needed to assess long-term efficacy.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586600","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":"RESPONSE TO LETTER TO THE EDITOR REGARDING: HEARING DEVICE COIL PLACEMENT LATERAL TO THE TEMPORALIS: AN ALTERNATIVE TO FLAP THINNING FOR COCHLEAR AND TRANSCUTANEOUS BONE-ANCHORED IMPLANTS.","authors":"Ashley M Nassiri, Cynthia A Hogan, Matthew L Carlson","doi":"10.1097/MAO.0000000000004478","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004478","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586592","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":"Reply to the Commentary on \"Effect of Non-ablative Medical Therapy on Progression of Hearing Loss in Menière's Disease: A Systematic Review and Meta-Analysis\".","authors":"Adam Thompson-Harvey, Madeline Pyle, Erin Harvey, Michael S Harris","doi":"10.1097/MAO.0000000000004465","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004465","url":null,"abstract":"","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586568","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":"Qualifying Cochlear Implant Candidates-Does it Matter How Patients Are Qualified?","authors":"David S Lee, Jacques A Herzog, Amit Walia, Miriam R Smetak, Cole Pavelchek, Nedim Durakovic, Cameron C Wick, Amanda J Ortmann, Craig A Buchman, Matthew A Shew","doi":"10.1097/MAO.0000000000004429","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004429","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate variable qualification criteria for cochlear implant (CI) recipients and 12-month speech perception outcomes.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>HERMES national database and nonoverlapping single-institution CI database.</p><p><strong>Patients: </strong>A total of 2,124 adult unilateral CI recipients categorized by qualifying status: AzBio in quiet (n = 1,239), +10 dB SNR (but not in quiet; n = 519), +5 dB SNR (but not in quiet or +10 dB SNR; n = 366); CNC ≤40% (n = 1,037), CNC 41% to 50% (n = 31), and CNC 51% to 60% (n = 20).</p><p><strong>Interventions: </strong>CI.</p><p><strong>Main outcome measures: </strong>Pre- and 12-month postoperative speech perception performance. Clinically significant improvement was defined as ≥15% gain.</p><p><strong>Results: </strong>Quiet qualifiers experienced improvement in all listening conditions, whereas +10 dB SNR and +5 dB SNR qualifiers only improved in their qualifying condition and implanted ear CNC. When stratified by expanded Medicare criteria (binaural AzBio ≤60% correct), patients that qualified in quiet experienced improvements regardless of qualifying threshold or background noise. However, those that qualified in noise and AzBio ≤60% experienced mixed results in quiet and limited gain in background noise. When ≤60% criteria was applied to CNC of the worse ear, ≤40% qualifiers experienced large improvements in all tested conditions, but those who qualified by 41% to 50% or 51% to 60% only demonstrated modest improvements in AzBio sentence testing.</p><p><strong>Conclusions: </strong>Quiet qualifiers improved in all testing conditions, while those qualifying in noise improved in their qualifying condition. Patients who qualified by expanded Medicare criteria (≤60%) showed improvement when qualifying with AzBio in quiet, but should be used with caution when qualifying patients in background noise or CNC due to more limited gains in performance.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449656","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 Association of Modified 5-Item Frailty Index on Perioperative Cochlear Implant Speech Perception.","authors":"David Fenton, Rose Dimitroyannis, Rachel Nordgren, Nour Asfour, Joshua Sevier, Terence Imbery","doi":"10.1097/MAO.0000000000004389","DOIUrl":"https://doi.org/10.1097/MAO.0000000000004389","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the potential association of perioperative hearing outcomes with frailty by Modified 5-Item Frailty Index (mFI-5).</p><p><strong>Design: </strong>Retrospective cross-sectional study.</p><p><strong>Setting: </strong>Single-institutional study conducted at a tertiary care hospital between January 2018 and January 2022.</p><p><strong>Patients: </strong>All adult patients older than 50 years who underwent cochlear implantation (CI).</p><p><strong>Interventions: </strong>Cochlear implantation.</p><p><strong>Main outcomes measures: </strong>Hearing outcomes were measured using pre-CI and longitudinal post-CI quiet AzBio scores. Frailty was determined by mFI-5 scores (0 = not frail, 1 = prefrail, and 2+ = frail). Univariable and multivariable linear regressions, ordinal logistic regressions, and time-to-event curves were used to determine perioperative speech perception and likelihood of high-performance hearing (defined as ≥70% on AzBio).</p><p><strong>Results: </strong>Of the 126 patients, the median age was 70 (63-77) years, 50% (63) were female, and 39% (49) identified as non-Hispanic Black, Hispanic, or other. By mFI-5 scoring, 38% (48) had no frailty, with 34% (43) and 28% (35) scoring 1 and 2+, respectively. When adjusting for age, sex, race, and BMI, scoring 1 point on mFI-5 was associated with significantly lower pre-implantation and post-implantation AzBio scores (pre: = -15 [-26, -3.4], p < 0.05; post: = -14 [-25, -3.0], p < 0.05). When controlling for all covariates, prefrailty and frailty were associated with significantly decreased likelihood of high-performance hearing (prefrailty OR: 0.22 [0.07, 0.63], p < 0.01; frailty OR: 0.31 [0.10, 0.92], p < 0.05). Time-to-event curves demonstrate significantly reduced likelihood of reaching high-performance hearing within 7 months after CI in patients with mFI-5 scores >0 (p < 0.05).</p><p><strong>Conclusion and relevance: </strong>Our findings suggest that prefrailty is associated with worse pre-CI and post-CI hearing and lower likelihood of high-performance hearing within 7 months post-CI. Preoperative frailty screening in adult CI candidates may better inform providers of patients' long-term risk-to-benefit.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":"46 2","pages":"140-147"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962360","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":"Is Vestibular Rehabilitation as Effective for Persistent Postural-Perceptual Dizziness as for Chronic Unilateral Vestibular Hypofunction?","authors":"Akiyuki Yamato, Chihiro Yagi, Akira Kimura, Ryota Kai, Meiko Kitazawa, Tatsuya Yamagishi, Shinsuke Ohshima, Shuji Izumi, Takao Imai, Hidenori Inohara, Arata Horii","doi":"10.1097/MAO.0000000000004397","DOIUrl":"10.1097/MAO.0000000000004397","url":null,"abstract":"<p><strong>Objective: </strong>To compare the feasibility and outcomes of vestibular rehabilitation (VR) for persistent postural-perceptual dizziness (PPPD) with those for chronic unilateral vestibular hypofunction (UVH).</p><p><strong>Study design: </strong>Prospective study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Nineteen consecutive patients with chronic UVH lasting for >3 months and 15 with PPPD.</p><p><strong>Interventions: </strong>The VR program consisted of gaze stabilization exercises, static or dynamic balance exercises and gait training, and habituation exercises that exposed patients to a provocative stimulus. Patients were asked to perform VR for at least 20 min a day.</p><p><strong>Main outcome measures: </strong>Status of VR (i.e., continuation/discontinuation) and outcomes were assessed 1 month after the introduction of VR using the Dizziness Handicap Inventory for handicaps in daily life due to dizziness, the Niigata PPPD Questionnaire (NPQ) for symptom exacerbations of PPPD, and the Hospital Anxiety and Depression Scale for anxiety and depression.</p><p><strong>Results: </strong>No patients in the chronic UVH group discontinued VR, whereas six patients in the PPPD group discontinued VR owing to symptom exacerbations, showing a significant difference. VR did not decrease any symptom scale, except for the NPQ-motion subscore, in patients with PPPD who continued VR, whereas it decreased all clinical symptom scales, except for the NPQ-motion subscore, in patients with chronic UVH.</p><p><strong>Conclusions: </strong>Patients with PPPD had a higher rate of VR discontinuation than those with chronic UVH, and VR was less effective in patients with PPPD who even continued treatment than in those with chronic UVH. Therefore, VR on PPPD should be optimized.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"170-175"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813739","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":"Prevalence and Intriguing Clinical Profiles of Autoimmune Inner Ear Diseases in Sudden Sensorineural Hearing Loss.","authors":"Thunyawarin Arunthanachaikul, Sornwit Osothsinlp, Saisuree Nivatwongs, Pongthorn Narongroeknawin","doi":"10.1097/MAO.0000000000004391","DOIUrl":"10.1097/MAO.0000000000004391","url":null,"abstract":"<p><strong>Introduction: </strong>Sudden sensorineural hearing loss (SSNHL) is idiopathic in 70-90% of cases with 10-30% linked to vascular injuries, viral infections, or autoimmune inner ear disease (AIED). AIED contributes to less than 1% of all hearing losses, categorized into primary, affecting only the inner ear, and secondary, associated with systemic autoimmune diseases (SAID). This study examines the prevalence and features of AIED in SSNHL in a tertiary referral center.</p><p><strong>Materials and methods: </strong>We conducted a prospective study from November 2021 to December 2022 including SSNHL patients who exhibited symptoms like hearing loss or tinnitus. Evaluations included tympanometry, pure tone audiometry, and blood tests, with suspected AIED cases further assessed by rheumatologists using Lobo's diagnostic criteria. Treatment responses were monitored through regular audiometry updates.</p><p><strong>Results: </strong>Out of 694 SSNHL patients, 43 (6.2%) were diagnosed with AIED, of which 36 (83.7%) had primary AIED and 7 (16.3%) had secondary AIED linked to conditions like Sjögren's syndrome and systemic lupus erythematosus. Treatment response was seen in 19.4% of primary and 42.9% of secondary AIED cases.</p><p><strong>Conclusion: </strong>The prevalence of AIED in SSNHL patients was found to be 6.2%, with a notable fraction also suffering from SAID. Responses to treatment were positive in about a third of these cases, highlighting the importance of interdisciplinary management for this rare yet significant cause of SSNHL.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":" ","pages":"215-220"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813762","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}