Immunoinflammatory and vascular inflammatory factors can be potential disease biomarkers of age-related hearing loss

Objectives: The relationship between age-related diseases and chronic inflammation associated with aging has recently been investigated. This study aimed to investigate how chronic inflammation is associated with age-related hearing loss (ARHL). Methods: Twenty ARHL patients aged ≥65 years were prospectively enrolled from July 1 to 31 December 2015. Audiological tests and serological tests, such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), immunoglobulin G (IgG), interleukin 6 (IL-6), white blood cell (WBC) counts, neutrophil counts, lymphocyte counts, and platelet counts, were performed. The patients were divided into two groups: mild hearing loss group (n = 7) and moderate to profound hearing loss group (n = 13). Results: Immunoinflammatory biomarkers, such as CRP, ESR, and IL-6, and vascular inflammatory biomarkers, such as neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, were higher in the moderate to profound hearing loss group. IgG, WBC counts, and neutrophil counts were similar in both groups. Conclusion: The present preliminary pilot study demonstrated that high levels of inflammatory biomarkers may be associated with ARHL. The results suggest a possible association between chronic inflammation and ARHL. Further well-designed studies of ARHL, based on a new perspective of chronic inflammation, should be performed.ope

Total Transcanal Endoscopic Facial Nerve Decompression for Traumatic Facial Nerve Palsy

A few approaches can be used to decompress traumatic facial nerve paralysis including the middle cranial fossa approach or transmastoid approach depending on the site of injury. In some specific situation of treating traumatic facial nerve palsy whose injured site was confined from the geniculate ganglion to the second genu, transcanal endoscopic approach for facial nerve decompression can be used. We performed two cases of total endoscopic transcanal facial nerve decompression in patients with traumatic facial nerve palsy. After a six month follow-up, both patients showed improvement in facial function by 2 grades according to House-Brackmann grade system. In terms of treatment outcomes, total transcanal endoscopic facial nerve decompression for traumatic facial nerve palsy is an alternative for lesions limited to the tympanic segment I, and has an advantages of being minimally invasive and is cosmetically acceptable without an external scar or bony depression due to drilling.ope

microRNA-183 is Essential for Hair Cell Regeneration after Neomycin Injury in Zebrafish

Purpose: microRNAs (miRNAs) are non-coding RNAs composed of 20 to 22 nucleotides that regulate development and differentiation in various organs by silencing specific RNAs and regulating gene expression. In the present study, we show that the microRNA (miR)-183 cluster is upregulated during hair cell regeneration and that its inhibition reduces hair cell regeneration following neomycin-induced ototoxicity in zebrafish. Materials and methods: miRNA expression patterns after neomycin exposure were analyzed using microarray chips. Quantitative polymerase chain reaction was performed to validate miR-183 cluster expression patterns following neomycin exposure (500 μM for 2 h). After injection of an antisense morpholino (MO) to miR-183 (MO-183) immediately after fertilization, hair cell regeneration after neomycin exposure in neuromast cells was evaluated by fluorescent staining (YO-PRO1). The MO-183 effect also was assessed in transgenic zebrafish larvae expressing green fluorescent protein (GFP) in inner ear hair cells. Results: Microarray analysis clearly showed that the miR-183 cluster (miR-96, miR-182, and miR-183) was upregulated after neomycin treatment. We also confirmed upregulated expression of the miR-183 cluster during hair cell regeneration after neomycin-induced ototoxicity. miR-183 inhibition using MO-183 reduced hair cell regeneration in both wild-type and GFP transgenic zebrafish larvae. Conclusion: Our work demonstrates that the miR-183 cluster is essential for the regeneration of hair cells following ototoxic injury in zebrafish larvae. Therefore, regulation of the miR-183 cluster can be a novel target for stimulation of hair cell regeneration.ope

Treatment of Hemorrhagic Vocal Polyps by Pulsed Dye Laser-Assisted Laryngomicrosurgery

OBJECTIVE: Conventional surgical techniques of laryngomicrosurgery (LMS) on hemorrhagic vocal polyps are often difficult due to obscuration of the surgical field by inadvertent bleeding from the lesion, and there are often significant amounts of mucosal epithelium loss. Here, we introduce our surgical technique using pulsed dye laser (PDL), which can effectively resect the polyp with vocal fold mucosa preservation. METHODS: Patients who were diagnosed with hemorrhagic vocal polyp and who were surgically managed using PDL from March 2013 to October 2014 were retrospectively reviewed. Preoperative and postoperative clinical outcomes and surgical findings were evaluated. RESULTS: A total of 39 patients were treated with PDL-assisted enucleation LMS. The average age was 43.7 years (range 20-73), and there were 20 males and 19 females (17 professional voice users). In all cases, the hemorrhagic polyp was successfully enucleated after application of PDL, thereby preserving the overlying epithelium. Postoperative voice outcomes were favorable with clear preservation of the vocal fold mucosal wave. CONCLUSION: PDL-assisted enucleation LMS for the treatment of hemorrhagic vocal polyps can be a safe and effective surgical technique. It can be considered a promising treatment option for hemorrhagic vocal polyps.ope

Simultaneous Translabyrinthine Tumor Removal and Cochlear Implantation in Vestibular Schwannoma Patients

Refinement of surgical techniques has allowed hearing preservation after tumor resection to be prioritized. Moreover, restoration of hearing after tumor removal can be attempted in patients with bilateral vestibular schwannomas or those with a schwannoma in the only-hearing ear. Cochlear implantation (CI) has emerged as a proper method of acoustic rehabilitation, provided that the cochlear nerve remains intact. Studies of electrical promontory stimulation in patients after vestibular schwannoma resection have demonstrated favorable results. We describe herein two cases of hearing rehabilitation via CI implemented at the time of vestibular schwannoma resection. Tumors were totally removed, and cochlear implant electrodes were successfully inserted in both cases. Also, post operative CI-aided hearing showed improved results.ope

Relationship between Hearing Loss and Dementia Differs According to the Underlying Mechanism

Background and purpose: The associations between hearing loss (HL) and the mechanisms underlying cognitive impairment (CI) remain unclear. We evaluated the effects of clinical factors, vascular magnetic resonance imaging (MRI) markers, and CI mechanisms on HL. Methods: In total, 112 patients with CI (59% demented) and subjective HL prospectively underwent MRI, amyloid positron-emission tomography (PET), hearing evaluations, and neuropsychological tests including a language comprehension test. Patients were categorized into pure-Alzheimer's disease-related CI (ADCI), pure-Lewy-body disease-related CI (LBCI), mixed-ADCI/LBCI, and non-ADCI/LBCI groups based on clinical features and PET biomarkers. Results: The risk of peripheral HL [defined as a pure-tone average (PTA) threshold >40 dB] was higher in the pure-LBCI group than in the pure-ADCI and mixed-ADCI/LBCI groups, and lower in the presence of ADCI. The non-ADCI/LBCI group had the most-severe vascular MRI markers and showed a higher risk of peripheral HL than did the pure-ADCI and mixed-ADCI/LBCI groups. While the pure-LBCI group had a higher risk of comprehension dysfunction than the pure-ADCI group regardless of the PTA and the score on the Korean version of the Mini Mental State Examination (K-MMSE), those in the pure-LBCI group even with a better K-MMSE score had a risk of comprehension dysfunction comparable to that in the mixed-ADCI/LBCI group due to a worse PTA. Conclusions: Peripheral HL could be associated with the absence of significant β-amyloid deposition in patients with CI and characteristic of the pure-LBCI and non-ADCI/LBCI groups.ope

Association between self-reported hearing impairment and cognitive function Korean longitudinal study of aging (2006-2014) data analysis

보건정책관리전공한국 사회가 고령화됨에 따라 노인의 질병 부담 또한 증가하고 있는데, 특히 인지기능 저하 및 치매의 질병 부담이 급격히 증가할 것으로 예상된다. 난청 또한 노인 인구에서 유병률이 높은데, 최근 난청이 인지기능 저하 및 치매의 발생과 연관이 있다는 연구 결과가 국외에서 보고된 바 있다. 그러나 아직 국내 자료를 이용한 연구는 부족한 실정이다. 향후 인지기능 저하 및 치매 발생을 예방하기 위해서는 난청의 영향을 파악할 필요가 있기 때문에, 이 연구에서는 한국 고령화 연구패널 조사 자료를 이용하여 주관적 난청과 인지기능의 관계를 살펴보고자 했다. 한국 고령화 연구패널 1차 조사에서 주관적 청력이 좋은 군과, Mini-Mental State Examination(MMSE) 점수가 24점 이상인 대상자를 선별하였으며, 뇌병변장애, 정신지체에 해당하는 대상자는 제외하였다. 이후 2-5차 조사까지 주관적 청력과 MMSE 점수 자료를 얻을 수 있는 대상자를 선별하였으며, 총 4,118명이 이 연구에 포함되었다. 인구 사회적 요인, 건강관련 요인들을 분석에 포함하였으며, 일반화 추정 방정식을 이용하여 분석을 수행하였다. 또한, 주관적 난청의 발생 시점과 유병 기간을 고려하여, 주관적 난청이 발생한 후 지속되는 군과, 청력이 지속적으로 좋은 군의 MMSE 점수를 일반화 추정 방정식을 이용하여 시간에 따라 비교 분석하였다. 인구 사회적 요인, 건강관련 요인들을 모두 통제하였을 때, 이전 조사에 비해 주관적 청력이 나빠진 경우 MMSE 점수가 유의하게 감소하였다(β= -0.609, p=0.005). 주관적 난청이 발생 후 지속되는 경우, 좋은 청력이 지속되는 경우에 비해 MMSE 점수가 급격히 감소하였으며(p=0.009), 6년 후 부터는 MMSE 점수가 경도 인지장애에 해당하는 24점 미만으로 감소하였다. 이 연구는 한국 고령화 연구패널 조사에서 얻을 수 있는 청력 정보가 주관적 청력 상태라는 한계점이 있으나, 국내 자료를 이용하여 주관적 난청과 인지기능 저하의 관계를 밝혔다는 점에서 의의가 있다. 또한, 주관적 난청의 발생 시기와 유병 기간을 고려하여 분석을 수행했으며, 시간이 지남에 따라 인지기능이 급격히 저하되는 양상을 밝힌 점에서 기존 국외 연구들과는 차별되는 점이 있다. 국외에서와 마찬가지로, 인지기능 저하를 예방하기 위해서는 주관적 난청에 대해 관심을 갖고 적극적으로 대응할 필요가 있다. 보청기를 비롯하여 최근 많이 시행되는 인공와우 수술이나 중이 임플란트 수술 등, 다양한 청각 재활 방법을 통해 난청을 해소하고 인지기능 저하 및 치매의 발생을 예방해야 한다.open석

Electrode Array Extrusion in Cochlear Implantation: Our Experience

ope

Facial reanimation using hypoglossal-facial nerve anastomosis after schwannoma removal

CONCLUSION: In this series, the split type hypoglossal-facial nerve anastomosis resulted in more favorable outcomes in terms of both facial function and tongue atrophy. OBJECTIVE: This study compared surgical techniques for hypoglossal-facial nerve anastomosis after schwannoma removal and evaluated which technique achieves better facial outcomes and less tongue morbidity. METHOD: This study included 14 patients who underwent hypoglossal-facial nerve anastomosis after schwannoma removal and were followed for more than 1 year. Three surgical techniques were performed: end-to-end, end-to-side, and split anastomoses. Facial palsy and tongue atrophy after anastomosis were evaluated using the scales suggested by House-Brackmann and Martins, respectively. Tumor volume and the time to surgery were also evaluated, and the effects on facial outcomes were analyzed. RESULTS: Overall, nine of 14 (64.3%) patients had favorable facial outcomes, and eight of 14 (57.1%) had favorable tongue outcomes. Regarding facial palsy, five of seven (71.4%) end-to-end, three of four (75%) split, and only one of three (33.3%) end-to-side patients had favorable facial function. Regarding tongue atrophy, all three (100%) end-to-side, three of four (75%) split, and two of seven (28.6%) end-to-end patients had favorable tongue outcomes. The effects of tumor volume and time to surgery on facial outcome were not significant.restrictio

Effects of self-reported hearing or vision impairment on depressive symptoms: a population-based longitudinal study

AIMS: The aims of this study were to investigate the effects of either hearing, vision or dual sensory impairment on depressive symptoms and to identify subgroups that are vulnerable and significantly affected. METHODS: Data from the 2006-2014 Korean Longitudinal Study of Aging (KLoSA) were used and a total of 5832 individuals were included in this study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D10) scale. Sensory impairment was assessed according to the levels of self-reported hearing or vision, which were categorised as either good (excellent, very good or good) or poor (fair or poor). The changes in hearing or vision from records of previous survey were investigated. Changes from good to poor, which indicates new onset, were defined as hearing impairment or vision impairment. Interactions of changes in hearing and vision were considered in the analysis. Dual sensory impairment was indicated when hearing impairment and vision impairment both developed at the same time. Demographic, socioeconomic and health-related factors were considered as potential confounders and were adjusted for in the generalised estimating equation model. RESULTS: Individuals with hearing impairment demonstrated significantly more severe depressive symptoms [β = 0.434, standard errors (s.e.) = 0.097, p < 0.001] than those who had good hearing. Those with vision impairment also showed significantly elevated depressive symptoms (β = 0.253, s.e. = 0.058, p < 0.001) than those with good vision. When the interactions between hearing and vision were considered, participants with dual sensory impairment showed significantly more severe depressive symptoms (β = 0.768, s.e. = 0.197, p < 0.001) than those with good hearing and vision. The effect of a single and dual sensory impairment on depressive symptoms was significant in both sexes and across age groups, except for vision impairment in male participants. CONCLUSIONS: Hearing, vision and dual sensory impairment are significantly associated with depressive symptoms. Our results suggest that treatment or rehabilitation of either hearing or vision impairment would help prevent depression.restrictio