Antimicrobial resistance (AMR) is one of the most serious global public health threats that exert a significant burden in terms of patient morbidity and mortality and financial crises in many developing countr...
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Objective: Identify features on computed tomography (CT) that predict mastoidectomy conversion (MC) during transcanal endoscopic ear surgery (TEES). Study Design: Retrospective case-control. Setting: University otology practice. Patients: Consecutive patients with cholesteatoma. Intervention: TEES cholesteatoma dissection versus those requiring MC. Main Outcome Measures: Antrum opacification, depth of scutum involvement, and erosion of the mastoid trabeculae, ossicular...
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Objective: To prospectively evaluate opioid consumption following adult outpatient otologic surgery. Study Design: Prospective observational. Setting: Single-tertiary referral center. Patients: Patients scheduled for otologic surgery who did not have a history of chronic opioid use were recruited between February 2018 and February 2019. Interventions and Main Outcome Measures: Opioid consumption was queried using telephone or in-person surveys administered between postoperative...
Background: Individuals with Mal de Debarquement syndrome (MdDS) experience persistent oscillating vertigo lasting for months or years. Transcranial magnetic stimulation (TMS) can modulate the motion perception of MdDS. Materials and Methods: Twenty-six TMS naive individuals received single administrations of continuous theta burst stimulation (cTBS) over the occipital cortex, cerebellar vermis, and lateral cerebellar hemisphere, in randomized order. A 0–100 point Visual Analogue Scale was...
Objective: To compare the microbial flora of cholesteatoma and normal middle ears using gene-based sequencing analysis. Study Design: Controlled ex vivo human study. Setting: Academic, tertiary medical center. Subjects and Methods: Brush, swab, and tissue samples were each taken from cholesteatoma matrix and uninvolved tissue in patients with previously untreated, acquired cholesteatoma (n = 19) or middle ear mucosa from patients undergoing cochlear implantation with no history...
Hypothesis: The characteristics of auditory brainstem response (ABR), electrocochleogram (ECochG), and distortion product otoacoustic emissions (DPOAE) of different degrees of selective outer hair cells (OHCs) loss may be helpful for clinicians to evaluate the pathogeny, diagnosis, and rehabilitation of individuals’ hearing loss. Background: How many OHCs are necessary to maintain cochlear amplifier function remains unknown. The electrophysiologic characteristics may indicate different degrees...
Objective: To evaluate the clinical feasibility and auditory benefits of hearing rehabilitation using electroacoustic stimulation (EAS) after cochlear implantation (CI) and to identify the predictive factors for successful EAS rehabilitation in children with limited low-frequency hearing. Study Design: Retrospective case review. Setting: Tertiary referral hospital. Patients: Seventeen children (21 ears) under the age of 15 years with residual low-frequency hearing who underwent...
Objective: The etiology of sensorineural hearing loss (SNHL) in patients with jugular paraganglioma (JP) whose tumors lack inner ear fistulae or vestibulocochlear nerve involvement is unknown. Recent literature has proposed that occlusion of the inferior cochlear vein may be causative. Herein, we assess the association between radiologic involvement of the cochlear aqueduct (CA) and the development of SNHL. Study Design: Blinded, retrospective review of imaging and audiometry. Setting:...
Objectives: To conduct systematic review and meta-analyses of preclinical studies describing the efficacy of glucocorticoids administered via different routes for hearing preservation after cochlear implantation. Data Sources: A literature search was performed in PubMed to identify peer-reviewed articles published before December 31, 2017, with no language restrictions. Search components were “Cochlear implant,” “Glucocorticoids,” and “Hearing preservation.” The results were specified for...
Objective: To discuss an effect of transmastoid repair of superior semicircular canal dehiscence and its resolution using a mastoid titanium mesh plate. Patients: A 53-year-old woman with a history of superior canal dehiscence syndrome (SCDS) and subsequent transmastoid repair experienced dizziness and a loud, drum-like sound in her repaired ear when touching the ear. Palpating the skin over the mastoid defect reproduced the symptoms and could be observed on binocular microscopy as tympanic...
Hypothesis: Application of localized, mild therapeutic hypothermia during cochlear implantation (CI) surgery is feasible for residual hearing preservation. Background: CI surgery often results in a loss of residual hearing. In preclinical studies, local application of controlled, mild therapeutic hypothermia has shown promising results as a hearing preservation strategy. This study investigated a suitable surgical approach to deliver local hypothermia in patients utilizing anatomical and...
Objective.: The Dizziness Handicap Inventory (DHI) is a 25-item self-report questionnaire developed to measure the disabling and handicapping impact of dizziness. The present investigation was conducted in an effort to re-assess the factor structure of the DHI. Study Design.: Retrospective study. Setting.: Tertiary care center. Patients.: Subjects were 1,991 patients who were evaluated in the Mayo Clinic-Rochester Vestibular and Balance Laboratory. Main Outcome Measures.: Exploratory...
Objective: Characterize differences in adult cochlear implant outcomes and programming parameters for a straight (CI422/522) and a precurved (CI532) electrode array. Setting: Cochlear implant (CI) program at a tertiary otologic center. Patients: Fifty-eight adults were included in the study; 29 were implanted with CI422 or CI522 and 29 were implanted with CI532. Each CI532 recipient was matched to a CI422/522 recipient in terms of age and preoperative hearing thresholds for comparison...
Objectives: The aims of the study are to identify the limitations of the current newborn hearing screening (NHS) programs and provide recommendations for better protocols. Study Design: Retrospective analysis. Setting: Tertiary referral center. Patients: The study participants were 185 children who received cochlear implants (CIs) at ≤5 years of age. Interventions: Therapeutic and rehabilitative. Main Outcome Measures: The results of NHS, screening tools used, age, and...
Objective: To evaluate the impact of electrode length on hearing preservation (HP) in Partial Deafness Treatment–Electrical Complement (PDT-EC) subjects. Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: Twenty-three PDT-EC patients (with preoperative air-conduction thresholds ≤30 dB up to 500 Hz) were divided into two groups: Flex20 electrode (Med-EL GmbH, Innsbruck, Austria) (12 patients) and Flex24 electrode (Med-EL GmbH, Innsbruck, Austria)...
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Objective: To determine the correlation between speech perception performance between pediatric sibling pairs with severe to profound sensory hearing loss receiving cochlear implants, and in cases of discordance in performance, determine which variables negatively impacted performance. Study Design: Retrospective chart review. Setting: Tertiary academic referral center. Subjects: Eighty-nine pediatric subjects, 43 sibling groups, under the age of 18 with severe to profound sensory...
Objective: Throughout the history of vestibular research, the discovery of the vestibulo-ocular reflex in 1881 by Endre Hőgyes (1847–1906) is rarely mentioned. The aim of this study is to review Hőgyes’ vestibular research articles, all originally written in Hungarian and emphasize their epoch-making content. Main Data Sources: Hőgyes’ vestibular publications, originally written in Hungarian, which describe various eye movements of the rabbit in response to vestibular stimulation by rotation...
Objective: The role of magnetic resonance (MR) imaging in idiopathic sudden sensorineural hearing loss (ISSHL) is controversial due to the inhomogeneity of clinical and MR protocols. The aim of this work is to relate early MR findings obtained immediately after the admission, with the clinical presentation, the audiological findings, and the outcomes of treatment. Study Design: Prospective observational study. Setting: Tertiary referral university center. Patients: Forty-seven patients...
Objective: Metastatic lesions to the internal auditory meatus (IAM) and/or the cerebellopontine angle (CPA) are rare and may appear like a vestibular schwannoma (VS). We herein raise the issue of the diagnosis and treatment of nine malignant cases of the CPA and IAM among three referral centers in France and Japan. The aim of this study was 1) to report malignant lesions of the CPA, their diagnosis and treatment, 2) to review the literature, 3) to propose criteria of suspicion for malignant tumors...
Objective: Intratympanic (IT) steroid administration for sudden sensorineural hearing loss is offered as salvage to patients who failed systemic steroid treatment. Our objective was to study the audiometric and clinical outcomes of patients given salvage therapy with high-dose IT steroids instilled via ventilation tube. Study Design: Retrospective case review. Setting: Academic secondary medical center. Patients: One hundred three patients >18 years of age with sudden sensorineural...
Assessment of Health Care Utilization for Dizziness in Ambulatory Care Settings in the United States
Objective: Describe patient and physician characteristics, and physician recommendations for ambulatory care visits for dizziness in the US. Study Design: Cross-sectional analysis of visits for dizziness from the National Ambulatory Medical Care Survey (2013–2015). Setting: Ambulatory care clinics in the US. Patients: 20.6 million weighted adult visits [mean age 58.7 (1.0)] for dizziness, identified using ICD-9-CM codes (386.00–386.90, 780.40). Main Outcome Measures: Patient,...
Objective: The relationship between hearing loss and cognitive decline is of great importance with growing evidence of hearing loss as an independent modifiable risk factor for dementia. Our goal was to evaluate for differences in dementia neuropathology between subjective normal hearing and hearing loss subjects, as well as subjects who wore hearing aids. Study Design: Retrospective database. Setting: Tertiary academic center. Patients: Brain tissue analyzed from our Center on...
Objectives: To assess the audiological outcomes, practicalities, and impact on quality of life of a new, nonimplantable, adhesive retained bone conduction hearing aid in children. Study design: A prospective, single-subject repeat measure, cohort study. Setting: Community and in pediatric assessment center. Patients: Twenty-one children aged between 5 and 15 years with a conductive hearing loss of >/=25 dB HL in the better hearing ear. Intervention: Audiological comparisons...
Objective: Many tinnitus patients report cognitive deficits such as concentration and attention difficulties. The aim of this study was to comprehensively assess cognitive functioning in tinnitus patients using a standardized test battery, the repeatable battery for the assessment of neuropsychological status adjusted for hearing impaired individuals (RBANS-H). Study Design: Cross-sectional study. Setting: Tertiary referral center. Participants: Twenty-eight chronic tinnitus patients...
Objectives: This study aimed to evaluate the safety and efficacy of transvenous stent-assisted coil embolization for dehiscent high jugular bulb (HJB) with tinnitus and contralateral hypoplastic venous sinus. Study Design: Case series with chart review. Setting: Tertiary academic medical center. Methods: From September 2008 to October 2018, a series of patients with dehiscent HJB presenting with intractable pulsatile tinnitus abated only by ipsilateral jugular vein compression were...
Objective: Treatment effect in tinnitus research is commonly evaluated by use of self-report questionnaires. As this is a solely subjective assessment method, the need for an objective measurement is paramount to genuinely evaluate the effects of therapeutic interventions. The current study explores the value of event-related potentials (ERPs) in the evaluation of high-definition transcranial direct current stimulation (HD-tDCS) for tinnitus treatment. Study Design: Prospective exploratory...
Hypothesis: Objective physiologic changes measured using electrocochleography at the round window (ECOGRW) are observable during endolymphatic sac decompression and shunt surgery (ELS). Background: Limited effective treatment options are available to patients with Menière's disease (MD) who have failed conservative management, experience persistent vertigo symptoms, and have substantial residual hearing. ELS is a feasible therapeutic option for these patients. However, the efficacy of this...
Hypothesis: Intracochlear pressure (ICP) measurements during bone conduction (BC) stimulation may be affected by motion of the pressure sensor relative to the cochlear promontory bone, demonstrating the need to cement the sensor firmly to the cochlear bone. Background: ICP is a promising measurement tool for investigating the cochlear drive in BC transmission, but its use is not yet standardized. Previous ICP studies have reported artificially increased pressure due to motion of the sensor...
Objective: Previous research has shown that tumor growth during observation of small-to-medium sized sporadic vestibular schwannomas (VSs) occurs almost exclusively within 3 to 5 years following diagnosis. This has led some to consider ending surveillance after this interval. This study seeks to characterize a cohort of patients with tumors that exhibited late growth. Study Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: Adults with sporadic VSs...
Objective: This study aimed to evaluate the diagnostic accuracy of high-resolution T2-weighted magnetic resonance imaging (T2wi) in terms of detecting vestibular schwannoma compared with gadolinium-enhanced T1-weighted MRI (GdT1wi). Data Sources: Five databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database). Data Selection: Two authors independently searched five databases up to January 2019 on diagnosis of vestibular schwannomas via T2wi. Data Extraction:...
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Abstract Introduction Hybrid single photon emission computed tomography (SPECT) with CT (SPECT/CT) may improve diagnostic accuracy in suspected acute pulmonary embolism, but further research is needed. We evaluated whether the use of attenuation correction and/or the depiction of lung pathology with hybrid SPECT/CT could significantly reduce potentially false‐positive ventilation–perfusion (VQ) SPECT studies or obviate the need for a ventilation study. Methods Two specialists (S1 and S2)...
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Abstract Objectives The study evaluates the influence of two spacer settings and three resin luting materials on the marginal and internal fit of polymer-infiltrated ceramic network (PICN) material crowns manufactured using a complete digital workflow. Methods Optical impressions of fifty identical dies were performed using the 3M scanner (software version...
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Abstract Purpose To asses angiographic and computed tomographic success criteria during and after transcatheter arterial drug-eluting bead chemoembolization (DEB-TACE) in patients with hepatocellular carcinoma (HCC) and its impact on progression-free survival (PFS) and overall survival (OS). Methods In this retrospective single-center study,...
Abstract Endosalpingiosis rarely affects the appendix but can be mistaken for acute appendicitis or appendiceal tumors. The medical literature regarding appendiceal endosalpingiosis is sparse; consisting of only four case reports which are primarily focused on the histopathology but provide little radiologic correlation. Endosalpingiosis is a rare condition characterized by the presence of benign fallopian tubal-like glandular epithelium derived from Mullerian ducts, usually...
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