Audiological Results Research Articles

Audiological Outcome of Tympanoplasty With Mastoidectomy in Middle-Aged and Younger Patients With Chronic Otitis Media

Audiological Outcome of Tympanoplasty With Mastoidectomy in Middle-Aged and Younger Patients With Chronic Otitis Media

Congenital Cytomegalovirus Infection and Hearing Loss: It's Time to Screen.

Congenital CMV infection is the leading nongenetic cause of sensorineural hearing loss worldwide, yet most parents have never heard of it. The majority of infected newborns have no clinical signs of infection, although a substantial proportion may have hearing loss at birth or develop it later in life. As antiviral treatment with ganciclovir or valganciclovir initiated in the first month of age improves audiologic outcomes, there is an urgent need for timely identification of infected neonates. A targeted approach that tests neonates who refer on the newborn hearing screen has been implemented in many states and hospital programs, but it fails to identify about 40% of children who experience CMV-related hearing loss. A universal screening approach is optimal given the prevalence of congenital CMV infection, its associated sequelae, the availability of a simple saliva screening tool, the available antiviral treatment, and the directed therapies for hearing impairment.

Split-Thickness Cartilage Graft Combined With Perichondrium for Endoscopic Repair of Total and Subtotal Drum Perforations.

This study aims to describe our new modification to cartilage tympanoplasty for endoscopic repair of total and subtotal tympanic membrane perforations and evaluate its outcomes. Retrospective case series. Multiple institutions. The study was conducted using records of patients who underwent tympanoplasty for subtotal and total perforations from January 2018 to June 2022. Utilizing an endoscopic transcanal approach, we employed a double graft consisting of outer tragal perichondrium supported by inner split-thickness tragal cartilage as separate layers, both placed in an underlay fashion lateral to the malleus, without the need to elevate a tympanomeatal flap. Anatomical success was defined as complete primary closure of the perforation, while functional success was defined as achieving an air-bone gap of ≤20 dB at 12 months postoperative. The series involved 64 patients, predominantly males (53%). The mean age was 30.8 years. 56.3% of patients had subtotal perforations. The anatomical success rate was 90.6% while the functional success rate was 87.5%. Postoperative speech discrimination scores significantly increased in all patients. Our modification provides effective anatomical and audiological outcomes. This technique reliably resists graft displacement and shrinkage before adequate healing. It avoids problems of elevating tympanomeatal flaps with comparable results to traditional approaches.

Revisions after prior stapes surgery: aspects on indication, intraoperative findings and surgical strategies.

Primary stapes surgery is considered a challenging intervention in ear surgery. Despite an risk of deafness in 0.5-1 percent, this procedure has still a good benefit-risk ratio due to the improvement in hearing and quality of life that is usually achieved. However, revision after prior stapes surgery is considered even more challenging. Revisions after stapes surgery are very heterogeneous procedures, both in terms of the indication and the surgical strategy and are generally considered to be significantly more demanding. Reasons for complications after prior stapes surgery as well as strategies for successful revisions are not well described in the literature. Retrospective cohort study, tertiary referral center. 124 cases of revisions after prior stapes surgery were identified between 2011-2022 and are analyzed based on biographic data, clinical, audiological, and intraoperative findings as well as the eventual therapy. Cases were analyzed regarding indication, intraoperative finding and the surgical strategy chosen. Acute, subacute, and long-term complications of the primary intervention as well as other incidental reasons such as progressive hearing loss can be identified as indication for revision surgery. Preoperative clinical findings were correlated to intraoperative findings and surgical strategies. Audiological results are discussed. Different recommendations for the indication of a surgical revision can be derived depending on the individual preoperative case history and findings. In addition, there are patterns regarding the chances of success of a revision, especially in cases of persistent conductive hearing loss chances of hearing improvement seem possible in more than 80% of cases.

Outcomes of Concurrent Balloon Eustachian Tuboplasty and Tympanostomy Tube Placement in Children.

Balloon dilation eustachian tuboplasty (BDET) has been proven to be a safe treatment option for children with eustachian tube dysfunction (ETD). This study aims to analyze the long-term outcomes of children who underwent concurrent BDET and tympanostomy tube (TT) placement. We hypothesize that patients who underwent simultaneous therapy have experienced a low overall rate of middle ear pathology and have consistent hearing quality at subsequent office visits. Retrospective chart review of 19 pediatric patients (36 ears) who previously underwent concurrent BDET and TT placement. Patient charts within the extended postoperative period were reviewed. Specific data points included need for reoperation, rates of middle ear pathology, audiological outcomes, and number of previous TT placements. Pediatric patients who underwent concurrent BDET and TT placement had long-term success in 34/36 ears (94.4%). All postoperative tympanograms and audiograms (100%) were normal when performed within 12 months after the procedure. Notably, 34/36 ears (94.4%) had history of tube placement in the past. Patients had an average of three sets of tympanostomy tubes prior to undergoing concurrent BDET and TT. Concurrent BDET and TT placement may be an effective treatment option for pediatric patients with persistent eustachian tube dysfunction. Specifically, BDET may be a useful adjunct tool in pediatric patients with refractory ETD despite having multiple sets of tympanostomy tubes. This study aims to strengthen the argument of performing multimodal therapy in pediatric patients with recurrent middle ear disease. 4 Laryngoscope, 134:4799-4802, 2024.

Outcomes with transcutaneous bone conduction implants in patients with mixed hearing loss

ObjectiveTo evaluate audiological outcomes of transcutaneous devices among individuals with mixed hearing loss (MHL) who underwent implantation with the Cochlear™ Osia® and Med-El Bonebridge™ devices. MethodsAdults with MHL in at least one ear, including a best bone conduction (BBC) threshold of 30 dB HL or poorer, and air-bone gaps of 15 dB HL or more at one or more frequencies were implanted with the Cochlear™ Osia® or Med-El Bonebridge™ devices for MHL. Four-frequency pure tone average (PTA) was calculated for aided thresholds and compared to preoperative PTAs for BBC thresholds. ResultsAmong the study participants, 11 were implanted with Osia, and 11 were implanted with Bonebridge. In the Osia group, the BBC PTA averaged 23.6 dB, which was not significantly different from the aided PTA of 27.0 dB (P = 0.2). In the Bonebridge group, the BBC PTA averaged 23.3 dB while the aided PTA was significantly poorer at 32.9 dB (P = 0.03). In both groups, aided sound field thresholds were worse than BBC thresholds overall except for a 7 dB improvement at 2000 Hz in the Osia group (P < 0.05). ConclusionWe highlight important limitations of current transcutaneous bone conduction systems for rehabilitation of MHL. Sound field outcomes for Osia and Bonebridge devices are limited by the BBC thresholds of either ear; these devices do not provide significant gain or “overclosure” beyond BBC thresholds. While both groups generally experienced declines in aided thresholds compared to best conduction thresholds, the Osia implant exhibited an exception of a 7 dB improvement at 2000 Hz.

Long-term outcomes of childhood otitis media and hearing loss: a systematic review

ABSTRACT Otitis media (OM) is a common childhood illness which can cause hearing loss and developmental delays. This is the first systematic review to investigate the long-term, longitudinal health and social outcomes of OM and hearing loss in childhood. The study was registered in PROSPERO (CRD42023396318). A structured search strategy identified literature in the following databases: CINAHL, Scopus, Medline, PsychInfo, and EmCare. Articles were independently dual-screened and extracted data were synthesised. From 2825 potential studies, 25 were selected for inclusion. These assessed broad outcomes: physical health, audiological health academic, behavioural, social function, service use, and housing. Overall, 28% of papers found no difference between those with a childhood history of OM and those without, 40% found poorer outcomes for those with a history of OM, and 32% found mixed results. This is the first study of its kind to explore the long-term effects of otitis media and resultant hearing loss in children. Trends of poor academic, behavioural, and audiological outcomes were identified in children with OM and hearing loss. Multiple gaps in the literature were identified including a paucity of recent research, studies extending into adulthood, and studies focusing on high-risk populations.

Follow-Up of Neonatal Hearing Screening in the Risk Factor Group for Hearing Loss: Results from a Tertiary Medical Center.

Universal newborn hearing screening has been successfully implemented in many places around the world, and it is recommended that cases with risk factors for hearing loss be followed-up regardless of hearing screening results. However, there is a need for clarity regarding the recommended rate of follow-up and which tests should be performed. The aim of this study was to assess the audiologic follow-up program for the group with risk factors. Our retrospective study involved children of various ages with a risk factor for hearing loss who passed the initial neonatal hearing test but were later diagnosed with hearing loss. Out of 113,708 children born at Hadassah University Medical Center during the years 2013-2021, 6763 were at risk of hearing loss, and their follow-up audiologic test results were studied. Audiologic testing including ABR, OAE, tympanometry and behavioral audiometry was performed in 1534 of 6763 (23%) of the risk factor group that returned to the hospital. In total, 73 children (4.7%) were diagnosed with hearing loss, 54 of whom failed the initial screening and 19 who had passed it. Further examination of the children that passed the initial screening and were later diagnosed with a hearing loss revealed that four cases had been missed in screening (one familial mild hearing loss, one familial progressive loss, one premature infant with a high tone loss, and one NICU graduate with CNS involvement). Another nine cases had late-onset hearing loss (three meningitis, five CMV, and one with a mitochondrial disease). An additional six cases were diagnosed late, and the age of onset of the hearing loss was unknown (two intubated, two with hydrocephalus, one with Cerebral Palsy, and one with general developmental delay). These results reveal the importance of implementing a refined protocol for monitoring hearing in the high-risk group of children that pass neonatal hearing screening with respect to which hearing tests should be conducted, at what age, and the duration of follow-up. Also, barriers to follow-up must be dealt with, and parents should be more involved in the monitoring process.

Risk factors for treatment-related sensorineural hearing loss and hearing aid use in medulloblastoma patients: an observational cohort study.

This study aimed to analyze treatment-related risk factors for sensorineural hearing loss (SNHL) and an indication for hearing aids (IHA) in medulloblastoma patients after craniospinal radiotherapy (CSRT) and platin-based chemotherapy (PCth). Atotal of 58patients (116 ears) with medulloblastoma and clinically non-relevant pre-treatment hearing thresholds were included. Cranial radiotherapy and PCth were applied sequentially according to the HIT 2000 study protocol or post-study recommendations, the NOA-07 protocol, or the PNET (primitive neuroectodermal tumor) 5MB therapy protocol. Audiological outcomes up to amaximum post-therapeutic follow-up of 4years were assessed. The incidence, post-treatment progression, and time-to-onset of SNHL, defined as Muenster classification grade ≥MS2b, were evaluated. Risk factors for IHA were analyzed separately. While 39patients received conventionally fractionated RT (CFRT; group1), 19patients received hyperfractionated RT (HFRT; group2). Over amedian follow-up of 40months, 69.2% of ears in group1 experienced SNHL ≥MS2b compared to 89.5% in group2 (p = 0.017). In multivariable Cox regressions analysis, younger age and increased mean cochlear radiation dose calculated as the equivalent dose in 2‑Gy fractions (EQD2) were associated with time-to-onset of SNHL ≥MS2b (p = 0.019 and p = 0.023, respectively) and IHA (p < 0.001 and p = 0.016, respectively). Tomotherapy and supine positioning were associated with alower risk for IHA in univariable modelling only (p = 0.048 and p = 0.027, respectively). Young age and cochlear EQD2 Dmean ≥40 Gy are significant risk factors for the incidence, degree, and time-to-event of SNHL as well as for IHA in medulloblastoma patients.

Audiological Outcomes following Middle Cranial Fossa Repair of Spontaneous CSF Leaks.

Audiological Outcomes following Middle Cranial Fossa Repair of Spontaneous CSF Leaks.

Associations Between Noise Exposure Level, Noise Kurtosis, and Distortion Product Otoacoustic Emissions in Young Workers With Normal Hearing.

Growing evidence has suggested that, in addition to noise exposure level, noise temporal structure (i.e., kurtosis) plays an important role in the development of noise-induced hearing loss, while most of the relevant research has been on the results of pure-tone audiometry. This study focuses on the combined effect of noise exposure level and noise kurtosis on distortion product otoacoustic emissions (DPOAEs) in young workers with normal hearing. A cross-sectional study among young workers in manufacturing industries was conducted in Zhejiang Province, China. Individual noise exposure measurements were performed on participants to obtain an A-weighted noise exposure level normalized to 8 hr (LAeq, 8hr), cumulative noise exposure (CNE), kurtosis, and kurtosis-adjusted CNE (CNE-K). The DPOAE test was performed on the participants and DPOAE levels were obtained. The relationships between noise exposure level, kurtosis, and DPOAE levels were explored by univariate analyses. Furthermore, multivariate regression models were conducted to estimate the combined effects of exposure level and kurtosis after adjusting for age, gender, and use of hearing protection devices. The overall DPOAE curves across frequency bands presented a fluctuating downward trend with increasing frequency. Both exposure level and kurtosis were found to be associated with decreases in DPOAE levels. The multivariate regression model including CNE-K as a joint indicator of complex noise showed an increased R2 compared with the model including CNE. After adjustment for age, gender, and the use of hearing protection devices, significant effects of CNE-K on DPOAE levels were observed at 3, 4, and 5 kHz frequencies, with maximum effect presented at 4 kHz. DPOAE is a sensitive test that can detect cochlear damage in limited areas that cannot be detected by conventional audiometry. The present study provided a more comprehensive understanding of the impact of complex noise on the DPOAE levels. It also suggested that CNE-K was an effective metric in assessing DPOAE levels associated with complex noise.

Study of malleus as a prognostic indicator on hearing outcomes after tympanomastoid surgery: A prospective observational study

Tympanomastoid surgery comprises a range of surgeries (cortical, radical, modified radical). Pre-operative auditory deficit in a patient with cholesteatoma may be correlated with ossicular chain status. The incus is often expected to be eroded, which may not be true for the malleus. The presence of malleus and it’s significance on the post-operative needs to be studied further. The purpose of our study is to determine the effect of intraoperative status of malleus on the post-operative hearing outcomes of patients undergoing canal wall-down mastoidectomy. A prospective observational study of 24 patients was conducted, where pre-operatively pure tone audiometry (PTA) was performed. Intraoperatively, the status of malleus was noted. Canal wall down mastoidectomy was done. Post-operative PTA was recorded after 3 months and both audiograms compared. An air bone gap (ABG) of less than 20dB post-operatively was considered significant functional improvement. In patients with a preserved malleus, mean improvement was 25.2dB (±9.8), whereas patients in whom malleus was remove had mean 16.8dB (±10.49) improvement. Similar results were found by Lu et al, Blom et al and Haberman et al. Haberman et al theorised the concentration of sound waves and preservation of middle ear volume as a contributing factor to the results. Hence it was concluded that relatively better post-operative audiological outcomes were obtained when malleus was present/preserved intraoperatively.

Prognostic Significance of Early Posttreatment Audiometry in Idiopathic Sudden Sensorineural Hearing Loss.

This study aimed to assess the prognostic value of early posttreatment initiation audiometry findings in patients with idiopathic sudden sensorineural hearing loss (ISSHL). A retrospective cohort study. The study was conducted at a single tertiary medical center. A review was conducted on 299 ISSHL patients treated between 2007 and 2023. Patients underwent audiometry on Days 2 to 3 and 5 to 7 posttreatment initiation. Data on demographics, medical history, audiometry results, and prognosis were collected. Prognosis was categorized based on hearing recovery at 1 year postdiagnosis. Older age, worse initial speech reception threshold (SRT), ischemic heart disease, cerebrovascular accidents/transient ischemic attacks, hypertension, and diabetes were associated with a poorer prognosis. Posttreatment initiation audiometry findings on Days 2 to 3 and 5 to 7 significantly correlated with prognosis. Patients with a ≥30% improvement had substantial or complete recovery in over 80% of cases, while those with <10% had <30% recovery. Multivariate analysis identified a significant improvement on days 5 to 7 as an independent predictor of complete recovery (odds ratio = 4.25 [95% confidence interval 1.96-9.23], P = .0002). Posttreatment initiation audiometry findings, particularly on Days 5 to 7, hold significant prognostic value in ISSHL patients. A substantial improvement during this timeframe is strongly associated with favorable outcomes. These findings emphasize the potential of posttreatment initiation audiometry as a valuable tool for clinicians in counseling patients with ISSHL.

The outcomes of an audiological management programme for neonates with hyperbilirubinaemia.

Hyperbilirubinaemia is a contributing condition to the prevalence of neonatal hearing loss. Because of its pathophysiology, the use of Otoacoustic Emissions (OAE) and Automated Auditory Brainstem Response (AABR) testing is essential in diagnosing hearing loss. Two-tier screening models are typically used in developing world contexts; however, a combined approach to testing (using both tests) should be used for early detection. Blood serum levels should also be monitored to determine how they impact audiological test results. To determine the outcomes of using a combined testing approach of both OAE and Auditory Brainstem Response (ABR) for both screening and diagnostic testing of neonates with hyperbilirubinaemia and studying the relationship between the test results and the serum bilirubin levels. A cross-sectional, comparative design was utilised. Forty neonates were tested (80 ears). Neonates underwent hearing screening and diagnostic testing (ABR and/or AABR and DPOAE tests). The study was conducted at a hospital in South Africa. One-third (32.5%) of the neonates had comorbidities. Screening results indicated that the AABR test could identify more cases of abnormalities than DPOAEs (p= 0.001). Participants with a serum level greater than 10 mg/dL presented with abnormal diagnostic ABR test results while passing the DPOAE test (p 0.001). Combined use of ABR and DPOAE testing yielded a greater identification of auditory pathology than using either test alone. Serum bilirubin levels can be used as an indicator for combination testing.Contribution:Combined use of ABR and DPOAE testing leads to greater identification of auditory pathology.

Assessment of Cochlear Implant Rehabilitation Success by Speech-Language Therapists Using International Classification of Functioning, Disability and Health Criteria.

This study aims to introduce an assessment questionnaire based on the International Classification of Functioning, Disability and Health (ICF) to enable quantifiable clinical documentation. The questionnaire assists speech-language therapists (SLTs) in evaluating both non-audiological and audiological rehabilitation outcomes of patients with cochlear implants (CIs). Six SLTs were recruited to evaluate the effectiveness of CI care using ICF criteria. We carefully selected 20 pertinent ICF criteria, and SLTs received thorough training in how to apply them uniformly. A cohort of 48 patients was evaluated at three distinct time points: presurgery, postsurgery, and 6 months post-initial CI fitting. Patients underwent dedicated speech-language therapy sessions throughout the treatment course. A total of 144 complete datasets were scrutinized using a two-factor analysis of variance for ranks. Following CI care, patients exhibited substantial improvements in auditory perception, characterized by enhanced sound recognition and speech discrimination. Additionally, patients demonstrated improved attentional focus, proficiency in daily tasks and increased conversational engagement over time. Environmental factors, particularly sound perception, improved markedly, correlating with reported reductions in stress levels. Minimal changes were noted in stress management and communication techniques. Articulatory function, speech functions, and pain perception exhibited the least alteration. The data extracted from the ICF-based assessments underscore the vital significance of incorporating speech therapy-based metrics to evaluate both non-audiological and audiological factors in assessing the success of CI care within the SLTs domain. This approach proves to be highly relevant both in terms of demonstration and clinical applicability.

Outcome Evaluation of BAHA Attract System Implantations.

Bone Anchored Hearing Aids (BAHAs) are currently well-utilized for treatment of hearing-impaired patients with unilateral or bilateral mixed and conductive hearing loss as well as patients with single sided deafness. The objective of this study is to evaluate outcome of BAHA Attract system in terms of surgical, functional,audiological and cosmetic results This is a prospective observational study of 15 consecutive patients of single sided deafness (SSD) who qualified for and underwent BAHA Attract surgery at a tertiary care hospital over a duration of two years. Parameters analysed were: (1) Surgery and wound healing, (2) Post-operative functional results (Bern Benefit for Single sided deafness questionnaire (BBSSQ)), (3) audiological results (free field speech in noise audiometry in two situations: with signal from implanted side and from contralateral side), (4) Cosmetic results (introduction of novel Three Points Scoring System (TPSS). Clinico-radiological planning of surgical site for implant is also described.Mean surgical time was 39 minutes and healing was uneventful in 73 % of patients. All patients reported improvement in all ten hearing situations with maximum improvement for sound localization. Significant improvement of speech in noise was seen especially when signal was presented from implanted side. All patient had full score in TPSS for cosmesis except one patient. This was the same patient in whom clinico-radiologically planned site was discarded intraoperatively due to overpneumatised temporal bone.BAHA Attract system is safeand effective solution for single sided deafness with acceptable cosmesis.

Cochlear implantation in otosclerosis: surgical and audiological outcomes between ossified and non-ossified cochlea.

To evaluate (1) Audiological and surgical outcomes in patients with otosclerosis following cochlear implantation. (2) surgical difficulties and outcomes between both groups. (3) Audiological outcomes between both groups. Retrospective study conducted at Otology and Skull Base Surgery Center. Data were analyzed from 111 patients with otosclerosis (114 ears) who underwent cochlear implant surgery using the cochlear implant database. Demographic characteristics (age, sex, and operated ear), auditory outcomes, and operative details (extent of cochlear ossification, surgical approach [posterior tympanotomy or subtotal petrosectomy], electrode insertion [partial/complete, scala tympani or vestibuli], and complications) were analyzed Auditory outcomes were assessed over at least one year follow-up period using pure tone audiometry and speech discrimination scores. Patients were divided into two groups (with and without cochlear ossification) to compare auditory outcomes and surgical outcomes. The mean age of patients with ossified and non-ossified cochlea was 60.04 and 62.22years respectively. Sixty-five of 114 ears had cochlear ossification, with complete round window involvement in 75.4% of these patients, while the rest had partial or complete basal turn ossification. Subtotal petrosectomy was performed in 63.1% and 28.6% of ossified and non-ossified cochlea respectively while the rest underwent cochlear implantation through posterior tympanotomy. Only one case had scala vestibuli insertion and four had incomplete electrode insertion. Six patients underwent re-implantation due to infection, device failure, and erosion of the posterior canal wall. Auditory outcomes among patients with ossified otosclerosis were slightly better than those without ossification but this difference was not statistically significant. Cochlear implantation for otosclerosis yields excellent auditory outcomes with a low rate of surgical complications, despite the high incidence of cochlear ossification.

Preoperative variables affecting outcome of cochlear implant

BackgroundCochlear implants made a great impact in the management of severe-to-profound hearing loss in both children and adults. Its greatest impact is in helping children born with a profound hearing loss and implanted early to attend mainstream education and using spoken language to communicate. However, the final outcome in pediatric implantation is not predictable as there are large number of factors which will affect the outcome of cochlear implantation. Studying these determinants increases the ability of clinicians to offer educated preoperative prognosis and might potentially allow for manipulation of variables in an attempt to achieve the best possible outcome.ObjectiveThe aim of this study was to assess the preoperative factors affecting the audiological, speech, and language outcomes achieved by the recipients of cochlear implants.MethodologyA total of 39 children with severe-to-profound sensory neural hearing loss were implanted with cochlear implants. Children had received their implants before age of 5 years. Tests of receptive, expressive language quotient, aided cortical auditory-evoked potential using speech stimulus, aided free field audiometry, and aided speech reception thresholds were administered. Characteristics of the child and the family (age before implant and duration of implant use, cause of hearing loss, preimplant use of hearing aids and language therapy, and sociodemographic characteristics of their families) were the preoperative variables. These variables were considered predictors of audiological and language outcomes achieved by children and were determined using statistical analysis by univariate and multivariate analyses.ResultsAge of the studied children at time of cochlear implantation was statistically significant predictor for CI outcome as regard receptive language quotient and also for N1 latency. Hearing age of the studied children was a statistically significant predictor for CI outcome as regards P1 latency.ConclusionBased on our findings, two most important factors affecting outcome of cochlear implantation were the age at implantation and the hearing age. Other factors were important but did not affect the outcome significantly.

The effect of percutaneous and transcutaneous BAHA on hearing and subjective auditory abilities: A comparative study.

Hearing loss significantly affects communication, social interactions, and the overall quality of life. The bone-anchored hearing aid (BAHA) is an implantable system that bypasses the outer and middle ear to directly stimulate the cochlea through bone conduction. This study aimed to compare hearing performance and subjective auditory ability improvements between transcutaneous and percutaneous BAHA devices using audiological assessments and Speech, Spatial and Qualities of Hearing Scale. This cross-sectional prospective study included 29 participants aged 14 to 69 years who had used BAHA for at least 6 months. Both Cochlear Baha System's percutaneous (connect) and transcutaneous (attract) implants were evaluated. Audiological assessments involved pure-tone audiometry, speech recognition threshold, and free-field (FF) audiometry, while subjective auditory ability was measured using the Turkish Speech, Spatial and Qualities of Hearing scale (Tr-SSQ). Significant improvements in FF audiometry averages and speech recognition thresholds were observed with BAHA compared to without BAHA (P < .001). Both implant types provided similar FF averages, speech audiometry results, and Tr-SSQ outcomes, with no significant differences between them. Tr-SSQ scores showed substantial satisfaction, indicating significant improvements in speech perception, spatial perception, and hearing quality with BAHA (P < .001). The findings align with previous research, demonstrating that BAHA is a reliable and effective solution for hearing rehabilitation. The study also emphasized the importance of using both audiological test results and daily hearing function scales to comprehensively evaluate the benefits of hearing rehabilitation in real-world environments. In conclusion, BAHA, regardless of the implant type, can provide predictable and lasting improvements in hearing thresholds and daily hearing abilities, making it a valuable option for patients with conductive hearing loss.

Cochlear Implantation in Post-Meningitis Deafness: Audiological, Imaging, and Postoperative Outcomes: A Systematic Review With Qualitative Synthesis.

Post-meningitis deafness (PMD) is a potentially devastating cause of hearing loss among pediatric and adult patients, for which hearing rehabilitation with cochlear implants (CIs) remains the standard of care. To date, there have been limited systematic studies on the impact of cochlear ossification (CO) and time-to-implantation (TTI) on audiological outcomes. An online database search was performed on the PubMed, Embase, and Scopus databases for articles within the past 20 years pertaining to audiological outcomes among pediatric and adult patients with PMD. Information on study characteristics, patient demographics, clinical outcomes, and postoperative complications was collected and analyzed. From 8,325 articles generated in the original search, 11 were included in the final analysis, representing 376 patients in total. Of the articles discussing TTI, the majority (3 of 4) found that a shorter TTI of 6 months on average led to improved audiological outcomes compared with control groups with a longer TTI. Of the articles that discussed the impact of preoperative CO, the majority (4 of 6) found that the presence of CO had a detrimental effect on postoperative audiological outcomes after CI. Finally, of the articles that discussed long-term audiological outcomes for PMD compared with the non-PMD control group after CI, the majority (4 of 7) found that PMD patients had inferior long-term outcomes. CI is a safe and effective treatment modality for PMD, with the majority of literature demonstrating improved long-term outcomes for patients without CO and a reduced TTI.