12,730 research outputs found
Induced endolymphatic flow from the endolymphatic sac to the cochlea in Ménière's disease
No full textOBJECTIVE: The aim of the present study was to verify whether drugs injected into the endolymphatic sac (ES) can reach the cochlea and possibly treat inner ear disorders.
STUDY DESIGN: Prospective cohort study.
SETTING: Tertiary referral center, Otolaryngology Department, University of Verona.
SUBJECTS AND METHODS: Patients with Ménière's disease (MD) who were candidates for ES decompression were selected. Nineteen subjects received dexamethasone (DEX) via injection into the ES. To objectively define whether substances administered into the ES could reach the cochlea, we added gadolinium (GD) in three patients. All subjects had intraoperative electrocorticogram recordings and an audiologic follow-up. The three subjects who underwent injection of the DEX-GD solution were followed-up with magnetic resonance imaging. The audiological data are presented during a follow-up period of 12 months.
RESULTS: Intraoperative electrocochleography recordings revealed no changes in two patients and summating potentials and compound action potential latency and wave-form modifications in all the other subjects. GD distribution was observed from 48 hours to one week after ES injection into the cochlea of the three subjects injected with DEX-GD. GD-related enhancement of inner ear structures lasted more than two weeks in all subjects. Pure tone average results showed hearing improvement of at least 20 dB HL in 42 percent of patients (8 of 19) at the 12-month follow-up. Statistically significant differences emerged between the mean pure tone average of the ES procedure subjects at one and 12 months after surgery (P = 0.0096).
CONCLUSION: This novel approach might reveal new prospects for treating viral, metabolic, autoimmune, and genetic disorders of the cochlea
Auditory Brainstem Implant: Computer Tomography assessment of Electrodes Dislocation
No full textScientific Paper Session 16-06 Neuroradiology/Head and Neck (Temporal Bones
MABS validation through repeated execution and data mining analysis
No full textAgent Based Modelling is the most interesting and advanced approach for simulating a complex system: in a social context, the single parts and the whole are often very hard to describe in detail. Besides, there are agent based formalisms which allow to study the emergency of social behaviour with the creation and study of models, known as artificial societies. Thanks to the ever increasing computational power, it's been possible to use such models to create software, based on intelligent agents, which aggregate behaviour is complex and difficult to predict, and can be used in open and distributed systems. Data mining is born in the last decades in order to help users in finding useful knowledge from the otherwise overwhelming amount of data available nowadays from the web and the data collected every day by companies. Data Mining techniques can therefore be the keystone to reveal non-trivial knowledge expressed by the initial assumption used to build the micro-level of the model and the structure of the society of agents that emerged from the simulation
Endoscopic-assisted cochlear implant procedure in CHARGE syndrome: Preliminary report
No full textThe endoscopic approach demonstrated to be useful for cochlear implantations of children with CHARGE syndrome. It allows the surgeon to perform a direct ‘safe’ cochleostomy in difficult anatomical conditions. Three children with CHARGE syndrome underwent endoscopic-assisted cochlear implant surgery at the Tertiary University Referral Center of Modena and Verona between January 2014 and September 2015. A review of clinical data and videos from the operations was made. All procedures were re-analyzed and codified. Three children, all females (mean age 4.6 years; range: 3–7 years) underwent surgery. Two primary surgical procedures and one revision surgery, for secondary cholesteatoma, were performed. CT scans demonstrated complex malformations of middle and inner ear with anomalous course of the facial nerve. In all subjects, a transcanal endoscopic cochleostomy was performed; no immediate or late postoperative complications were observed. Discharge from hospital was the day post-surgery. The current mean follow-up is 12.5 months (range: 8–19 months)
To hear or not to hear: sound availability modulates sensory-motor integration.
No full textWhen we walk in place with our eyes closed after a few minutes of walking on a treadmill, we experience an unintentional forward body displacement (drift), called the sensory-motor aftereffect. Initially, this effect was thought to be due to the mismatch experienced during treadmill walking between the visual (absence of optic flow signaling body steadiness) and proprioceptive (muscle spindles firing signaling body displacement) information. Recently, the persistence of this effect has been shown even in the absence of vision, suggesting that other information, such as the sound of steps, could play a role. To test this hypothesis, six cochlear-implanted individuals were recruited and their forward drift was measured before (Control phase) and after (Post Exercise phase) walking on a treadmill while having their cochlear system turned on and turned off. The relevance in testing cochlear-implanted individuals was that when their system is turned off, they perceive total silence, even eliminating the sounds normally obtained from bone conduction. Results showed the absence of the aftereffect when the system was turned off, underlining the fundamental role played by sounds in the control of action and breaking new ground in the use of interactive sound feedback in motor learning and motor development
The floating mass transducer for external auditory canal and middle ear malformations.
No full textAbstract
OBJECTIVE: The indications for the Med-El Vibrant Soundbridge, currently limited to patients with sensorineural hearing loss and normal middle ear function, have been extended to include patients with conductive or mixed hearing loss because of severe acquired or congenital ossicular chain defects. Patients with congenital aural atresia have combined malformations of the external auditory canal and the middle ear, often accompanied by severe mixed hearing impairment. Long-term results of traditional surgical techniques for treatment of congenital aural atresia show a persistent air-bone gap in most patients, suggesting that new and better techniques for hearing rehabilitation in these patients would be of value. This study demonstrates that placement of the floating mass transducer of the Med-El Vibrant Soundbridge on the round window (RW) allows optimal amplification and enables the restoration of good hearing in these patients.
STUDY DESIGN: Retrospective case review.
SETTING: Tertiary referral center.
PATIENTS: The study population comprised 12 patients-5 adults and 7 children-with severe external auditory canal and middle ear malformations. The patients were either judged not to be candidates for air conduction hearing aids or declined bone conduction and Bone-Anchored Hearing Aids.
INTERVENTION: RW implantation.
MAIN OUTCOME MEASURES: Pure-tone threshold and speech understanding.
RESULTS: Significant improvements were observed in pure-tone threshold and speech understanding immediately after surgery and at follow-up intervals ranging from 12 to 48 months. No complications or instances of device extrusion were observed in these patients.
CONCLUSION: The results suggest that RW implantation offers a viable and improved treatment option for patients with severe mixed hearing loss and congenital malformation of the outer and middle ear
Imaging in 28 children with cochlear nerve aplasia
No full textCONCLUSION: Preoperative CT and MRI assessment of children with severe or profound sensorineural hearing loss (SNHL) is critical for determining implant candidacy. OBJECTIVES: There are a significant number of children who do not show any auditory development with a cochlear implant (CI), possibly due to cochlear nerve (CN) aplasia/hypoplasia. Regardless of the suspected etiology, if a CI is not providing auditory development the clinician should carefully evaluate the possibility of a CN malformation and re-evaluate the child with detailed neuroimaging studies. If the imaging evaluation shows severe cochlear malformation or CN aplasia there is some developmental urgency to consider auditory brainstem implant (ABI) surgery. SUBJECTS AND METHODS: Twenty-eight children affected by congenital SNHL were examined by CT and MRI. Evaluation of the cerebellopontine angle (CPA), internal auditory canal (IAC), cranial nerves, and membranous labyrinth was performed. Six children had been previously fitted elsewhere with a CI with no sound detection. RESULTS: Suspected congenital anomalies were confirmed by CT and MRI in all 28 children: 16 with associated labyrinthine malformations; 1 with outer, middle, and inner ear malformations; and 2 with associated monolateral facial nerve aplasia
Hearing Restoration During Vestibular Schwannoma Surgery With Transcanal Approach: Anatomical and Functional Preliminary Report
No full textObjective: Hearing restoration has always been a dream in vestibular schwannoma (VS) surgery. The aim of this study is to describe an endoscopic assisted transcanal retrocochlear approach to the internal auditory canal (IAC) with total removal of the VS; simultaneously we assessed the anatomical and functional aspects of hearing restoration with cochlear implant (CI). Study Design: A retrospective case series. Setting: Tertiary referral center. Patients: Six patients affected by VS involving the fundus of the IAC (Koos stage I–II) were included in this study. The patients already demonstrated symptoms of IAC involvement by the neuroma, with severe to profound hearing loss. Interventions: Transcanal microscopic, endoscopic assisted, approach was chosen for total tumor removal. Preoperative and intraoperative electrophysiological monitoring was performed using electrically evoked auditory brainstem responses (EABR) to evaluate preservation of cochlear function.Main Outcome and Measures: A retrospective evaluation of electrophysiological data collected during surgeries has been conducted; clinical outcomes, surgical complications, and postoperative radiological evaluations were also considered. Results: Total tumor removal was achieved in all patients with no major complications. One patient showed temporary facial palsy (HB stage II). We were able to preserve cochlear function in five out of six patients. In those patients intraoperative monitoring with EABR was performed after tumor removal with good responses. Conclusions: Transcanal retrocochlear approach for VS removal allows preservation of cochlea and cochlear nerve function. This is the first step towards developing an effective surgical technique for VS removal and hearing rehabilitation with CI
Bionic ear imaging
No full textPURPOSE: The aim of this study was to illustrate the different imaging features of middle and inner ear implants, brainstem implants and inferior colliculus implants. MATERIALS AND METHODS: We retrospectively reviewed the computed tomography (CT) images of 468 patients with congenital or acquired transmissive or neurosensory hearing loss who underwent surgery. The implants examined were: 22 Vibrant Soundbridge implants, 5 at the long limb of the incus and 17 at the round window, 350 cochlear implants, 95 brainstem implants and 1 implant at the inferior colliculus. All patients underwent a postoperative CT scan (single or multislice scanner) and/or a Dentomaxillofacial cone-beam CT scan (CBCT) (axial and multiplanar reconstruction), and/or a plain-film radiography to visualise the correct position of the implant. RESULTS: The CBCT scan depicts Vibrant site of implant better than plain-film radiography, with a lower radiation dose compared to CT. For cochlear implants, a single plain radiograph in the Stenvers projection can directly visualise the electrodes in the cochlea. All patients with brainstem or inferior colliculus implants underwent postoperative CT to exclude complications and the assess correct implantation, but the follow-up of these implants can be performed by plain radiography alone. CONCLUSIONS: CT and CBCT scans are reliable and relatively fast methods for precisely determining the location of middle ear implants. CBCT is preferable to CT because of the lower radiation dose administered; a single plain-film radiograph is enough to visualise and follow-up cochlear, brainstem and inferior colliculus implants
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