The latest medical research on Otolaryngology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about otolaryngology gathered by our medical AI research bot.

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Initial hearing preservation outcomes of cochlear implantation with a slim perimodiolar electrode array.

Cochlear Implants International

To assess the slim modiolar array as a hearing preservation electrode.

Retrospective chart review of adult, post-lingual CI recipients implanted with slim modiolar array Sept 2016 to July 2017 in a tertiary referral center. Baseline audiograms were obtained within six months of initial CI evaluation. Patients with low frequency pure tone average (LFPTA) (125, 250, 500 Hz) <80 dB were considered HP candidates. Postoperative audiograms were obtained within 48 h before activation. Successful HP was considered as (1) retention of LFPTA threshold <80 dB and (2) change in threshold from pre- to post-operative.

Sixty-three patients received the slim perimodiolar array and 42 were HP candidates. Post-operative audiograms were obtained for 39 of 42 patients an average of 28.92 days after surgery. 56.4% of HP candidates retainedLFPTA <80 dB. Mean ΔLFPTA was 24.15 dB (±16.14; p < 0.001). 56.4% of HP candidates experienced Δ LFPTA <20 dB; 69.2% <30 dB. Functional hearing preservation was more successful in lower frequencies where starting thresholds were better - 78% with LFPTA <50 dB retained serviceable hearing at activation. The postoperative change was similar in each low frequency (Δ125 Hz: mean 21.25 +/- 14.76 (N = 28); Δ250 Hz: 26.28 +/- 19.29 (N = 39); Δ500 Hz: 25.00 +/- 17.73 (N = 39)).

The slim perimodiolar array is moderately effective at immediate hearing preservation. In subjects with preoperative audiometric profiles similar to those in prior EAS trials, immediate HP is comparable.

The impact of unilateral, simultaneous, or sequential cochlear implantation on pediatric language outcomes.

Cochlear Implants International

The purpose of this study was to determine the impact of unilateral versus bilateral cochlear implantation on receptive and expressive spoken language outcomes. Secondary aims were to investigate factors timing of first and second implant placement and reliance on government funded health plans on language outcome.

This was a retrospective chart review of spoken language users with bilateral severe-to-profound hearing loss. A total of 204 children were included, 105 in the bilateral group and 99 in the unilateral group. Multiple regression analyses were completed to investigate factors that influence language outcomes at age 5.

Recipients who received bilateral CIs performed significantly higher on measures of receptive and expressive language than those with unilateral implants.

These results indicate that families should be counseled that language outcomes are better with bilateral cochlear implantation than unilateral implantation. Cochlear implant teams should continue to consider the impact of socioeconomic status on outcomes and explore new methods to reduce the impacts and barriers of poverty to language development.

Piloting the recording of electrode voltages (REVS) using surface electrodes as a test to identify cochlear implant electrode migration, extra-cochlear electrodes and basal electrodes causing discomfort.

Cochlear Implants International

To determine if Electrode Voltage (EV) measurements are potentially suitable as a test for detecting extra-cochlear electrodes in cochlear implants (CIs).

EV measurements were made using surface electrodes in live mode in 17 adult cochlear implant (CI) users. Repeatability, the effects of stimulation level, CI active electrode position, (active) recording electrode position and stimulation mode (for Nucleus devices) were investigated.

The test appears to be a viable approach to detect electrode migration and extra-cochlear electrodes in adult CI users and may also be sensitive to discomfort caused by current leakage from the basal end of the cochlea.

Slope of electrically evoked compound action potential amplitude growth function is site-dependent.

Cochlear Implants International

In human cochlear implant (CI) recipients, the slope of the electrically evoked compound action potential (ECAP) amplitude growth function (AGF) is not very well investigated, in comparison to the threshold derived from the AGF. This is despite the fact that it was shown in animal experiments that the slope correlates with the number of excitable neurons. The rationale of this study was to establish baseline data of the AGF slope for possible clinical applications, while investigating stability over time and dependence on cochlear site.

ECAP AGFs of 16 ears implanted with MED-EL CIs were recorded on all electrode contacts during the normal clinical routine at 4 different points in time.

Due to patient availability, not all 16 ears could be measured at all 4 points in time. A dependence of the slope on the electrode position was visible and statistically significant: At the three electrode contacts at the apical end of the array, the slope is greater compared to the medial and basal region of the cochlea.

The three most apical electrode contacts show greater slopes of ECAP AGF recordings. Our data of the cohort slopes show mild effects between the 4 different points in time.

A novel treatment for CI extrusion with vacuum-assisted closure device.

Cochlear Implants International

To assess if a vacuum-assisted closure device initially utilised as a temporising measure to dress a wound defect over a cochlear implant prior to definitive surgical intervention could instead be used to close the soft tissue and avoid surgery.

This is a case report describing the novel use of VAC (Vacuum-Assisted Closure Device) in the successful closure of a wound defect with cochlear implant hardware exposure post soft tissue infection during the Covid-19 pandemic.

While the VAC system was initiated for temporary wound coverage, it was observed at each dressing change to be successfully decreasing the soft tissue defect for our patient. This resulted in complete epithelisation of the soft tissue defect at Day 35 and avoidance of a surgical procedure. The patient was able to restart wearing her device on Day 50 and Cochlear MAPping performed on Day 58 showed minimal changes in patient's current requirements compared to her settings pre-infection.

The use of V.A.C dressing for a small soft tissue defect over an extruded cochlear implant seems promising as exemplified by our case study. However, due to the lack of literature, more studies should be done to prove its usefulness in such an application.

The role of computed tomography and magnetic resonance imaging for preoperative pediatric cochlear implantation work-up in academic institutions.

Cochlear Implants International

The goal of the study is to investigate the association of pertinent preoperative temporal bone computed tomography (CT) and brain magnetic resonance imaging (MRI) results and intraoperative surgical findings and complications of pediatric cochlear implantation reported in academic settings.

This is a retrospective review of cochlear implant patients who received a pre-operative temporal bone CT and MRI of the brain between 2005 and 2012 at academic pediatric otolaryngology practices within children's hospitals in the United States and France. Scans were reviewed in a double-blind fashion and compared to intraoperative findings.

91 children were analyzed (mean age 5.54 +/- 0.58 years). A small facial recess identified on CT was associated with difficult insertion of electrodes (P = 0.0003). A prominent sigmoid sinus noted on CT was associated of difficult insertion of electrodes (P = 0.01), iatrogenic tegmen dehiscence (P = 0.005), as well as difficult round window access (P = 0.025). No specific CT finding was found to be associated with external auditory canal injury, perilymphatic gusher, or iatrogenic facial nerve injury. MRI brain and internal auditory canal findings were not predictive of surgical outcomes.

Preoperative CT and MRI remain an important planning tool for pediatric cochlear implantation, particularly in academic institutions. The findings of our study demonstrate that a detailed assessment of both preoperative CT and MRI are valuable for teaching and surgical planning.

Facial nerve stimulation in a post-meningitic cochlear implant user: using computational modelling as a tool to probe mechanisms and progression of complications on a case-by-case basis.

Cochlear Implants International

Facial nerve stimulation (FNS) is a side-effect of cochlear implantation that can result in severe discomfort for the user and essentially limits t...

Use of auditory evoked potentials with electrical stimulation at the round window niche pre-operatively on a brain-injured patient: A case study.

Cochlear Implants International

To highlight the effectiveness of using PS testing in conjunction with electrically evoked auditory evoked potentials (eAEPs) to help guide treatment plans in patients with limited behavioural responses.

Case report on a 59-year-old male with traumatic brain injury. Electrophysiological measurements in conjunction with PS were performed.

eAEPs were obtained up to the thalamo-cortical region, supporting the viability of a CI in the non-implanted ear.

Use of PS in conjunction with electrically evoked auditory evoked potentials can provide valuable information to guide clinical decisions regarding implantation.

Hyrtl's fissures in cochlear implant surgery.

Cochlear Implants International

This case study presents a rare anatomical anomaly complicating cochlear implantation in the form of patent periotic ducts and Hyrtl's (tympanomeni...

Effects of longstanding degraded auditory signal on visuospatial, visuomotor, and visual attention skills in adults with hearing loss.

Cochlear Implants International

This study examined the consequences of long-term auditory deprivation on visuospatial functions, visuomotor functions, and visual attention skills in adults with early-onset hearing loss.

Fifteen adults with bilateral, early-onset (before age 3), severe-to-profound hearing loss who used spoken language participated in this study. Visuospatial (figure ground, form constancy, visual perception) and visuomotor functions (visuomotor integration, visual search) were examined using norm-referenced tests. Visual attention scales were examined using a computerized program, IVA plus continuous performance test.

As a group, participants performed in the average range on visuospatial and visuomotor functions when compared to normative data presented in the test instruments. However, participants demonstrated below average performance on sustained visual attention. Duration of cochlear implant use positively correlated with one of the visual attention scales, namely visual speed.

The findings of the current study suggest that adults with early-onset hearing loss may demonstrate difficulties in sustaining attention to visual information. Data also suggest that increased experience with cochlear implant may ameliorate deficits associated with visual attention. Future studies should explore challenges experienced by adults with early-onset hearing loss in their daily activities that may result from this deficit and intervention programs that may enhance visual attention skills.

Implications from cochlear implant insertion for cochlear mechanics.

Cochlear Implants International

It is usually thought that the displacements of the two inner ear windows induced by sound stimuli lead to pressure differences across the basilar ...

Presence of the spiral ganglion cell bodies beyond the basal turn of the human cochlea.

Cochlear Implants International

The purpose of this study was to obtain a better understanding of the number and distribution of spiral ganglion cell bodies (SGCB) in the central ...