Tinnitus and Cochlear Functions in Hearing Impaired and Normal Hearing Individuals

Background: In order to determine the pathophysiology of tinnitus and deciding on treatment, the function of peripheral hearing organs is very important. Objective: To evaluate the cochlear functions in tinnitus patients with or without hearing-loss(HL). Methods: Participants with tinnitus were divided into two groups; 16 participants with accompanying HL were included in the first study group (SG-I), and 15 participants without HL were included in the second group (SG-II). 21 normal-hearing subjects without tinnitus included as control group(CG). Tinnitus discomfort levels was determined with Tinnitus Handicap Inventory(THI). Besides pure-tone audiometry, Otoacoustic Emissions, to evaluate cochlear functions and to decide dead regions (DR), Threshold Equalizing Noise-(TEN) was used. Results: The threshold-shift was observed with TEN in subjects in SG-I and these levels were statistically different from SG-II and CG. There were both threshold-shift and DR in SG-II according to TEN. TEOAEs did not differ between SG-II and CG. The DPOAE results for SG-II showed significant decreases in emission amplitudes at 6 & 8 kHz. Conclusion: While Tinnitus patients with HL can be evaluated with conventional tests, evaluating patients with normal hearing tinnitus with additional tests such as OAE and TEN allows us to get more precise results on the functions of peripheral hearing organs

Tinnitus Incidence And Characteristics In Children With Hearing Loss

Objective: The objective of this study is to determine presence and prevalence of tinnitus in children with hearing loss under the age of eighteen in central Ankara. Materials and Methods All children were asked: "Do you hear any noises in your ears?" If they answered "yes" they were asked nine more questions. Associated symptoms, pitch, level and general descriptions were also noted. Results and Conclusion: Children with hearing loss had a high incidence of tinnitus. Even though they don't express, they have tinnitus and it effects their lives. By using a survey specific to tinnitus we can identify tinnitus in children with impaired hearing and develop new ways to manage their problems

Cochlear Implantation In Neurobrucellosis

Background: Neurobrucellosis is a disease consisting of a wide spectrum of complications such as peripheral neuropathy, cranial nerve involvement, ataxia, meningeal irritation, paraplegia, seizures, coma, and even death. The vestibulocochlear nerve seems to be the most commonly affected cranial nerve (10%). We present a patient with neurobrucellosis whose auditory perception and speech intelligibility skill performances improved after cochlear implantation. Case Report: A 35 year-old woman was admitted to another hospital 2 years ago with the symptoms of headache, nausea, and altered consciousness, who was finally diagnosed with neurobrucellosis. She developed bilateral profound sensorineural hearing loss during the following 6 months. There was no benefit of using hearing aids. After successful treatment of her illness, she was found to be suitable for cochlear implantation. After the operation, her auditory perception skills improved significantly with a Categories of Auditory Performance (CAP) score of 5. According to clinical observations and her family members' statements, her Speech Intelligibility Rating (SIR) score was 3. Her speech intelligibility skills are still improving. Conclusion: Our case report represents the second case of hearing rehabilitation with cochlear implantation after neurobrucellosis. Cochlear implantation is a cost-effective and time-proven successful intervention in post-lingual adult patients with sensorineural hearing loss. Early timing of the surgery after appropriate treatment of meningitis helps the patient to achieve better postoperative results. Keywords: Cochlear implantation, neurobrucellosis, sensorineural hearing lossWoSScopu

The Effect of National Pneumococcal Vaccination Program on Incidence of Postmeningitis Sensorineural Hearing Loss And Current Treatment Modalities

OBJECTIVES: The aim of the present study was to investigate the effect of the national pneumococcal vaccination program on postmeningitis sensorineural hearing loss (SNHL). MATERIALS and METHODS: Overall, 2751 patients (2615 cochlear implantation and 136 auditory brainstem implantation) who underwent cochlear implantation (CI) and auditory brainstem implantation (ABI) at a tertiary referral hospital otolaryngology clinic were retrospectively analyzed. One hundred sixteen patients with a history of meningitis were included in the study. Patients were evaluated for their age at the time of surgery, gender, computerized tomography (CT) and magnetic resonance imaging (MRI) findings, implant type, sidle, and incidence before and after the vaccination program. RESULTS: When patients with cochlear implants or ABI were examined, the incidence of meningitis-induced hearing loss was 6.2% in the pre-vaccination period and 0.6% in the post-vaccination period. There is a significant difference between them when compared by chi-square test (p<0.001). CONCLUSION:The most important finding of the present study is the dramatic decrease in the number of CI and ABI surgeries performed in patients with SNHL due to meningitis. This shows the effectivity of pneumococcal vaccination in this special group of patients. If total ossification is detected on CT of patients with postmeningitis, ABI should be prefer red to CI.WoSScopu

Accuracy of Turbo Spin-Echo Diffusion-Weighted Imaging Signal Intensity Measurements For The Diagnosis of Cholesteatoma

PURPOSE We aimed to evaluate the diagnostic accuracy of turbo spin-echo diffusion-weighted imaging (TSE-DWI) at 3 T, for cholesteatoma (CS) diagnosis, using qualitative and quantitative methods with numerical assessment of signal intensity (SI), signal intensity ratios (SIR), and apparent diffusion coefficient (ADC) values. METHODS In this retrospective study, two blinded observers independently evaluated the preoperative TSE-DWI images of 57 patients who were imaged with a presumed diagnosis of CS. Qualitative assessment with respect to the SI of the adjacent cortex and quantitative measurements of SI, SIR, and ADC values were performed. RESULTS Surgery with histopathologic examination revealed 30 CS patients and 27 patients with non-cholesteatoma (NCS) lesions including chronic inflammation and cholesterol granuloma. On TSEDWI, 96.7% of the CS lesions and none of the NCS lesions appeared hyperintense compared with the cortex. The mean SI and SIR indices of the CS group were significantly higher and the mean ADC values significantly lower compared with those of the NCS group (P < 0.001). Using specific cutoff values for SI (92.5) and SIR (0.9), CS could be diagnosed with 100% sensitivity and specificity. The use of quantitative imaging further increased the sensitivity of the TSE-DWI technique. CONCLUSION The quantitative indices of SI, SIR, and ADC of TSE-DWI appear to be highly accurate parameters that can be used to confirm the diagnosis of CS.Wo

Comparison Of Voice And Swallowing Parameters After Endoscopic Total And Partial Arytenoidectomy For Bilateral Abductor Vocal Fold Paralysis A Randomized Trial

IMPORTANCE Total arytenoidectomy is claimed to increase risk of aspiration and cause more voice loss than other operations performed for bilateral abductor vocal fold paralysis (BVFP). However, objective evidence for such a conclusion is lacking. There is no study comparing swallowing and voice after total and partial arytenoidectomy. OBJECTIVE To compare voice and swallowing parameters after endoscopic total and partial arytenoidectomy for BVFP. DESIGN, SETTING, AND PARTICIPANTS In this prospective, randomized, double-blind, case-control study conducted at a tertiary referral university, the study population comprised 20 patients with BVFP. INTERVENTIONS Endoscopic total and partial arytenoidectomy. MAIN OUTCOMES AND MEASURES Decannulation, duration of operation, Voice Handicap Index, acoustic and aerodynamic analysis, postoperative breathing ability, subjective comparison of preoperative and postoperative voice, speech intensity, and functional outcome swallowing scale. RESULTS Median duration of partial and total arytenoidectomies were 59 and 49 minutes, respectively. This difference was statistically significant (P = .04). Comparisons of preoperative and postoperative Voice Handicap Index, acoustic and aerodynamic measures, postoperative breathing ability, subjective comparison of preoperative and postoperative voice, speech intensity, and functional outcome swallowing scale were not statistically significantly different between both groups. CONCLUSIONS AND RELEVANCE Endoscopic total and partial arytenoidectomy are very successful static surgical options for BVFP. Partial takes longer than total arytenoidectomy. They both provide a comfortable airway, acceptable voice, and acceptable deglutition. It may be a sound practice to perform partial arytenoidectomy initially for primary BVFP cases and reserve total arytenoidectomy for revision cases.WoSScopu

Management of Acquired Atresia of the External Auditory Canal

OBJECTIVE: The aim was to evaluate surgical techniques and their relationship to postoperative success rate and hearing outcomes in acquired atresia of the external auditory canal. MATERIALS and METHODS: In this article, 24 patients with acquired atresia of the external auditory canal were retrospectively evaluated regarding their canal status, hearing, and postoperative success. RESULTS: Acquired stenosis occurs more commonly in males with a male: female ratio of 2-3:1; it seems to be a disorder affecting young adults. Previous ear surgery (13 patients, 54.2%) and external ear trauma (11 patients, 45.8%) were the main etiological factors of acquired ear canal stenosis. Mastoidectomy (12/13) and traffic accidents (8/11) comprise the majority of these etiological factors. Endaural incision is performed in 79.2% and postauricular incision for 20.8% of cases during the operation. As types of surgical approach, transcanal (70.8%), transmastoid (20.8%), and combined (8.4%) approaches are chosen. The atretic plate is generally located at the bony-cartilaginous junction (37.5%) and in the cartilaginous canal (33.3%); the bony canal is involved in a few cases only. Preserved healthy canal skin, split-or full-thickness skin grafts, or pre-or postauricular skin flaps are used to line the ear canal, but preserved healthy canal skin is preferred. CONCLUSION: The results of surgery are generally satisfactory, and complications are few if surgical principles are followed.WoSScopu

Transcanal Endoscopic Management of Middle Ear Paragangliomas

ObjectiveTo evaluate the clinical and audiological outcomes of transcanal endoscopic resection of middle ear paragangliomas.Study DesignRetrospective multicenter study.SettingTertiary referral center and private otology clinic.PatientsPatients who underwent transcanal endoscopic surgery between January 2015 and September 2020.Intervention(s)Transcanal endocope-assisted resection of middle ear paragangliomas.Main Outcome Measure(s)Demographic data.ResultsTwenty-three patients (2 men, 21 women) with a mean (standard deviation [SD]) age of 50.5 (11.8) years and stage 1 or 2 disease were included in the study. The mean follow-up time was 2.7 years (range, 1-5 yr). Preoperatively, the mean (SD) air-conduction threshold was 33.8 (17.9) dB, and the mean (SD) air-bone gap was 13.1 (13.9) dB. Postoperatively, the mean (SD) air-conduction threshold was 25.7 (10.2) dB, the mean (SD) air-bone gap was 6.3 (6.1) dB. The mean (SD) hospital stay was 27.7 (9.9) hours. No tumor regrowth was detected on magnetic resonance imaging during postoperative follow-up.ConclusionsEndoscopic transcanal tumor resection is effective and feasible in the treatment of stage 1 and 2 tumors and is associated with short operative time, low risk of perioperative and postoperative complications, and rapid discharge

Bimodal stimulation in children with inner ear malformation: One side cochlear implant and contralateral auditory brainstem implant

Objective: To determine audiological outcomes of children who use a cochlear implant (CI) in one ear and an auditory brainstem implant (ABI) in the contralateral ear. Design: Retrospective case review. Setting: Tertiary referral hospital. Participants: Twelve children followed with CI and contralateral auditory brainstem implant (ABI) by Hacettepe University Department of Otorhinolaryngology and Audiology in Turkey. All children were diagnosed with different inner ear malformations with cochlear nerve aplasia/hypoplasia. CI was planned in the ear with better sound detection during behavioural testing with inserted ear phones and with better CN as seen on MRI. Due to the limited auditory and speech progress with the cochlear implant, ABI was performed on the contralateral ear in all subjects. Main outcome measures: Audiological performance and auditory perception skills of children with cochlear nerve deficiency (CND) who use bimodal electrical stimulation with CI and contralateral ABI. Results: Mean age of the subjects was 84.00 ± 33.94 months. Age at CI surgery and ABI surgery was 25.00 ± 10.98 months and 41.50 ± 16.14 months, respectively. However, hearing thresholds only with CI and only with ABI did not reveal significant difference, and auditory perception scores improved with bimodal stimulation. The MAIS scores were significantly improved from unilateral CI to bimodal stimulation (P = .002). Pattern perception and word recognition scores were significantly higher with the bimodal condition when compared to CI only and ABI only conditions. Conclusion: Children with CND showed better performance with CI and contralateral ABI combined. Depending on the audiological and radiological results, bimodal stimulation should be advised for children with CND.Wo