Audiological Results Research Articles

Clinical experience with the Nurotron™ cochlear implant in a Spanish-speaking postlingual population: Clinical safety and audiological results

Objectiveto assess clinical safety and postoperative audiological outcomes in postlingual deafness Spanish speaking patients, who underwent surgery with Nurotron™ cochlear implant. Material and methodsRetrospective descriptive case series study. We performed follow-up of complications and audiological measurements before and after cochlear implantation. Patients with bilateral severe to profound sensorineural hearing loss or patients with unilateral deafness with/without tinnitus were included. Repeated-measures within-subjects for assess pure tone thresholds and speech performance (bilingual test) with a detailed monitoring to establish security or adverse effects were performed. Analysis of variance tests, repetitive measures, were used for statistical analysis. Results31 patients were included, 17 (54.8%) men and 14 (45.2%) women. Mean age at the time of surgery was 49.82 ± 18.8 years. The mean follow-up of the group was 31.56 ± 9.57 months (minimum = 19.6 months and maximum = 52.50 months). As major complication one patient (3.23%) had a hard failure that required removal and re-implantation. 25.8% of the patients presented minor complications, the most frequent being vertigo/unsteadiness in 22.6%.The mean of language discrimination (free field at 65 dB SPL) was 62.19% ± 16.66; being 69.82% ± 7.35 in the group of severe to profound bilateral sensorineural hearing loss. A statistically significant reduction was observed in patients with tinnitus, assessed using the visual analogue scale, preoperative = 7.2 ± 1,6 vs postoperative (18months postoperative) = 1.7 ± 1.3 (p < .001). ConclusionsThe Nurotron™ cochlear implant shows satisfactory audiological results, in accordance with what has been reported in the literature. Minor complications were similar to previous studies, but the percentage of hard failure should continue to be observed, which was higher than other reports with comparable follow-up.

Redefining endoscopic stapedotomy: a detailed exploration of endoscopic principles and surgical techniques

Objective: Our aim was to investigate the practicality, safety, and effectiveness of endoscopic stapedotomy (ES) for otosclerosis. To assess audiological outcomes and any complications that arose during our experience at the hospital. Methods: A Case Series of 42 patients underwent ES at our hospital between January 2021 and December 2023. Patients were carefully selected based on a confirmed diagnosis of otosclerosis, age (18 years or older), and no history of prior ear surgery or chronic middle ear issues. We diligently collected data on patient characteristics, surgical specifics, hearing outcomes, and any complications encountered and then analyzed this data to see how ES affected patients’ hearing and how safe it was. Results: Significant improvement in air conduction (AC), bone conduction (BC), and the air-bone gap (ABG) after surgery (p &lt; 0.0001 for all). On average, the surgery took 31 min to perform. Complications were rare, with only a few patients experiencing mild vertigo. Notably, we had no cases of taste disturbance (dysgeusia) or eardrum perforation. As the surgeon gained more experience with ES, we noticed a trend toward shorter operating times and fewer complications. Conclusion: Our experience with ES suggests that it is a feasible, effectual, and the safest technique for treating otosclerosis. It offers significant benefits in terms of better visualization and less invasive surgery, but it does require specialized training. It is clear that a surgeon’s experience with this technique plays a significant role in achieving the best possible outcomes for patients.

Preservation of Residual Hearing: Long-Term Results With a Mid-Scala Electrode.

The long-term preservation of residual hearing after cochlear implantation has become a major goal over the past few years. The aim of the present study was to evaluate residual hearing in the long-term follow-up using mid-scala electrodes. In this retrospective, single-center study, we collected data from 27 patients who were implanted between 2014 and 2015 with residual hearing in the low-frequency range using a mid-scala electrode. Measurements of the hearing thresholds were carried out directly postoperatively (day 1 after surgery) and in the long-term follow-up 43.7 ± 6.9 months. The calculation of the extent of audiological hearing preservation was determined using the HEARRING group formula by Skarsynski. Postoperative preservation of residual hearing was achieved in 69.2% of the cases in the low-frequency range between 250 Hz and 1 kHz, of which 89.5% of the patients had frequencies that suggested using electroacoustic stimulation (EAS). In the long-term follow-up, 30.8% of the patients showed residual hearing; however, 57.1% had apparently benefited from EAS. Preservation of residual hearing is feasible in the long term using mid-scala electrodes. Postoperatively, there is over the half of patients who benefit from an EAS strategy. The long-term follow-up shows a certain decrease in residual hearing. However, these results are comparable to studies relating to other types of electrodes. Further research should be conducted in future to better evaluate hearing loss in long-term follow-up, compared to direct postoperative audiological results.

The Implementation of the K-Medoid Clustering for Grouping Hearing Loss Function on Excessive Smartphone Use

During the current pandemic, smartphones have become a means of learning for all students in Indonesia, including high school students. Students use smartphones to send assignments, learn via video calls, and conduct online exams. The prolonged use of smartphones, from the beginning of learning hours in the morning to study hours in the evening, has a terrible impact on the ear health of high school students in Padang. Excessive smartphone use caused a decrease in the student's hearing function. Therefore, this study aims to group the audiometry results of high school students in Padang who have a hearing loss function. The audiogram result is only performed as the result of a frequency test of the subject's hearing in both the left and right ear. Conventionally, an otolaryngologist concluded the final decision of hearing loss ability. This research proposed an automatic classification of audiometry results using machine learning methods. The K-Medoids clustering was selected to classify the audiometry data in this research. Of 210 audiometry data, 91 data is confirmed by an otolaryngologist as valid data. By using the K-Medoids clustering, 93 data is classified into Normal hearing, Mild Hearing loss, and Moderate Hearing loss. The proposed model successfully grouped the audiometry data into three categories. The confusion matrix is applied to measure the model performance, which has 28,3% accuracy, 64,3% precision, and 21,4% recall.

The Implementation of the K-Medoid Clustering for Grouping Hearing Loss Function on Excessive Smartphone Use

During the current pandemic, smartphones have become a means of learning for all students in Indonesia, including high school students. Students use smartphones to send assignments, learn via video calls, and conduct online exams. The prolonged use of smartphones, from the beginning of learning hours in the morning to study hours in the evening, has a terrible impact on the ear health of high school students in Padang. Excessive smartphone use caused a decrease in the student's hearing function. Therefore, this study aims to group the audiometry results of high school students in Padang who have a hearing loss function. The audiogram result is only performed as the result of a frequency test of the subject's hearing in both the left and right ear. Conventionally, an otolaryngologist concluded the final decision of hearing loss ability. This research proposed an automatic classification of audiometry results using machine learning methods. The K-Medoids clustering was selected to classify the audiometry data in this research. Of 210 audiometry data, 91 data is confirmed by an otolaryngologist as valid data. By using the K-Medoids clustering, 93 data is classified into Normal hearing, Mild Hearing loss, and Moderate Hearing loss. The proposed model successfully grouped the audiometry data into three categories. The confusion matrix is applied to measure the model performance, which has 28,3% accuracy, 64,3% precision, and 21,4% recall.

The Implementation of the K-Medoid Clustering for Grouping Hearing Loss Function on Excessive Smartphone Use

During the current pandemic, smartphones have become a means of learning for all students in Indonesia, including high school students. Students use smartphones to send assignments, learn via video calls, and conduct online exams. The prolonged use of smartphones, from the beginning of learning hours in the morning to study hours in the evening, has a terrible impact on the ear health of high school students in Padang. Excessive smartphone use caused a decrease in the student's hearing function. Therefore, this study aims to group the audiometry results of high school students in Padang who have a hearing loss function. The audiogram result is only performed as the result of a frequency test of the subject's hearing in both the left and right ear. Conventionally, an otolaryngologist concluded the final decision of hearing loss ability. This research proposed an automatic classification of audiometry results using machine learning methods. The K-Medoids clustering was selected to classify the audiometry data in this research. Of 210 audiometry data, 91 data is confirmed by an otolaryngologist as valid data. By using the K-Medoids clustering, 93 data is classified into Normal hearing, Mild Hearing loss, and Moderate Hearing loss. The proposed model successfully grouped the audiometry data into three categories. The confusion matrix is applied to measure the model performance, which has 28,3% accuracy, 64,3% precision, and 21,4% recall.

A comparison between endoscopic and microscopic approaches for stapes surgery: experience of a tertiary referral center.

Otosclerosis is a common ear disease causing ankylosis of the stapedio-vestibular joint and conductive hearing loss. Stapedoplasty is the most advisable surgical solution. The restoration of hearing depends on the condition of the patient and the surgery itself. The aim of our work was to compare the surgical and audiological results of stapedoplasty performed with endoscopic versus microscopic technique. This is a retrospective study of 254 patients treated with stapedoplasty with a microscopic approach (91/254) or with an endoscopic approach (163/254) between 2014 and 2021 at our tertiary referral center. Statistical significance of differences between the two methods was determined using the Mann-Whitney test for quantitative variables and the Wilcoxon matched-pairs signed-rank test for repeated measures. Categorical variables were assessed with Fisher's exact test. Both techniques improved the hearing status of patients, with no statistically significant difference between them. There was also no statistically significant difference in reported complications between the two techniques. There is a statistical difference (p < 0.001) in operating time between the two techniques: the endoscopic technique had a mean operating time of 39min versus 45min for the microscopic technique. The two techniques are comparable in terms of results and the choice depends on the surgeon's preferences and experience.

Endoscopic Transcanal Stapes Surgery: Our Audiological and Surgical Results

Endoscopic Transcanal Stapes Surgery: Our Audiological and Surgical Results&#x0D; Adem Bora, Tuğberk Salık&#x0D; Sivas Republic University Health Services Application and Research Hospital, Ear Nose Throat Clinic, Sivas, Turkey&#x0D; &#x0D; ABSTRACT&#x0D; Aim: The aim of this study is to investigate the intraoperative and postoperative results of endoscopic stapes surgery performed at our institution.&#x0D; &#x0D; Methods: A total of 25 patients with 28 ears (14 right, 14 left ears) who underwent endoscopic stapes surgery between 2018 and 2022 were analyzed for postoperative hearing outcomes and surgical complications at the 6-month follow-up.&#x0D; &#x0D; Results: The average age of the patients was 43.16 years (range, 24-63 years), and 64.0% of the patients were female. The median preoperative air-bone gap decreased from 30.36 dB hearing level (HL) to 18.95 dB HL after surgery (P &lt; 0.001). The postoperative air-bone gap was 10 dB or lower in 8 patients (28.6%), 11-20 dB in 10 patients (35.7%), and more than 20 dB in 6 patients (21.4%). Intraoperative complications included only tympanic membrane ruptures in one patient, which resolved during the initial follow-up. Postoperatively, 10.7% of the subjects complained of changes in taste sensation. One patient developed facial paralysis responsive to steroid treatment one week after surgery.&#x0D; &#x0D; Conclusion: Endoscopic surgery is particularly suitable for stapedial disorders. Endoscopic stapes surgery is minimally invasive and suitable for surgical training, as surgical anatomy can be easily understood, and both the surgeon and assistant can observe the procedure from the same monitor. The operation should only be performed by experienced surgeons due to the need for single-handed operation and the lack of stereoscopic vision.&#x0D; &#x0D; Keywords: Stapes; Stapedectomy; Outcomes; Endoscopic ear surgery

Аудиометрия: значение графического представления результатов

The purpose of the work is to analyze the possibility and significance of graphical presentation of audiometry results, which is one of the key methods for diagnosing human hearing impairment. During the study, the following tasks were set and solved: 1) familiarization with the content of the audiometry method and its varieties; 2) studying the procedure for presenting the results of speech audiometry in graphic form; 3) analysis of examples of audiograms and other graphs reflecting the progress of treatment of a patient with asymmetric hearing.

PENGARUH PAPARAN KEBISINGAN WEAVING MACHINE TERHADAP RESIKO TERJADINYA HEARING IMPAREMENT PADA KARYAWAN PT. KECUBUNG MOJOGEDANG

Noise-induced hearing loss is a sensorineural type of hearing loss caused by exposure to loud enough noise over a long period of time. Hearing loss due to noise has an impact on life. The diagnosis of noise-induced hearing loss was obtained from a hearing examination, pure tone audiometry and audiometric examination results. The impact of noise-induced hearing loss is in several aspects, namely functional, social and emotional aspects, as well as economic aspects. This study aims to determine the effect of the duration of exposure to weaving machine noise on the risk of hearing imparement on employees of PT. Kecubung Mojogedang. This research is a quantitative research using a cross sectional design. The sampling technique is Total Sampling. The sample used was 40 people. The data collected will be analyzed by univariate and bivariate, the data analysis technique in this study uses the contingency coefficient test. The results of the bivariate analysis using the Contingency C coefficient test obtained a value of 0.367 with a significance (p) of 0.013. The significance value (p) is smaller than = 0.05, meaning that Ho is rejected and Ha is accepted, which means that there is an effect of the duration of noise exposure with the risk of hearing loss in employees who work at PT. Kecubung Mojogedang

Detailed analysis of inner ear malformations in CHARGE syndrome patients – correlation with audiological results and proposal for computed tomography scans evaluation methodology

ObjectivesThe aim was to describe the spectrum of inner ear malformations in CHARGE syndrome and propose a Computed Tomography (CT) detailed scan evaluation methodology. The secondary aim was to correlate the CT findings with hearing thresholds. MethodsTwenty ears of ten patients diagnosed with CHARGE syndrome were subjected to CT analysis focusing on the inner ear and internal acoustic canal. The protocol used is presented in detail. ASSR results were analyzed and correlated with inner ear malformations. ResultsCochlear hypoplasia type III was the most common malformation found in 12 ears (60%). Cochlear hypoplasia type II, aplasia with a dilated vestibule, and rudimentary otocyst were also identified. In 20%, no cochlear anomaly was found. The lateral Semicircular Canal (SCC) absence affected 100% of ears, the absence of the posterior SCC 95%, and the superior SCC 65%. Better development of cochlea structures and IAC correlated significantly with the lower hearing thresholds. ConclusionThis study demonstrated that rudimentary SCC or a complete absence of these SCCs was universally observed in all patients diagnosed with CHARGE syndrome. This finding supports the idea that inner ear anomalies are a hallmark feature of the CHARGE, contributing to its distinct clinical profile. The presence of inner ear malformations has substantial clinical implications. Audiological assessments are crucial for CHARGE syndrome, as hearing loss is common. Early detection of these malformations can guide appropriate interventions, such as hearing aids or cochlear implants, which may significantly improve developmental outcomes and communication for affected individuals. Recognizing inner ear malformations as a diagnostic criterion presents implications beyond clinical diagnosis. A better understanding of these malformations can advance the knowledge of CHARGE pathophysiology. It may also help guide future research into targeted therapies to mitigate the impact of inner ear anomalies on hearing and balance function. Level of evidence4.

Short-term safety and effectiveness of the mCLIP partial prosthesis

PurposeThis multicentric, retrospective study aimed to analyze the short-term safety and effectiveness of the mCLIP Partial Prosthesis.MethodsPatients underwent tympanoplasty with implantation of a mCLIP Partial Prosthesis. Follow-up examination included ear microscopy and pure-tone audiometry to determine the post-operative pure tone average of the frequencies 0.5, 1, 2 and 3 kHz (PTA4). The post-operative PTA4 air bone gap (ABG) was used to evaluate the audiological outcome. A post-operative minimum and maximum follow-up period was not defined. Thus, the follow-up times of each study center were different, which resulted in different follow-up times for the audiological analysis and for adverse events (AE).Results72 (66 adults, 6 children) patients were implanted with the mCLIP Partial Prosthesis. 68 (62 adults, 6 children) patients underwent audiological examination; all 72 patients were examined for adverse events. All patients (N = 68): 72.1% of the patients showed a PTA4 ABG of ≤ 20 dB. Individual post-operative bone conduction (BC) PTA4 thresholds were stable in 67 patients. The mean post-operative follow-up time was 78 ± 46 days. Children (N = 6): 5 out of 6 children showed a PTA4 ABG of ≤ 20 dB. None of the children reported a BC PTA4 deterioration of > 10 dB HL after the implantation. The mean post-operative follow-up time was 101 ± 45 days. Adverse events (all patients, N = 72): 15 (14 adults, 1 child) patients had AEs (27 AEs and 2 Follow-Ups). The mean post-operative follow-up time was 375 days.ConclusionClinical data show satisfactory audiological parameters after implantation of the mCLIP Partial Prosthesis. The prosthesis is safe and effective for implantation in children and adults.Trial registration numberNCT05565339, 09 September 2022, retrospectively registered.

DESIGN AND IMPLEMENTATION OF THE ACHIEVE HEARING INTERVENTION

Abstract The ACHIEVE trial required the development of a manualized best-practice hearing intervention designed to meet the needs of older adults with mild-moderate hearing loss. The hearing intervention (HI) was developed using an iterative process including input from a diverse professional panel and a feasibility study to confirm that expected outcomes from a best-practices, evidence-based HI would be obtained. The HI involves use of hearing aids and related technologies along with counselling, coaching and education to support self-management of hearing loss. The HI is delivered in four sessions after the completion of a comprehensive hearing evaluation. Individualized goals are developed using the Client Oriented Scale of Improvement (COSI), which guides selection of hearing aids and other technologies to meet prioritized listening needs and assessment of how well those needs are met. The most frequent COSI listening goal categories included: Conversation in Noise (n= 413; 29%), Conversations in Quiet (n= 296; 21%), and TV/Radio at Normal Volume (n= 280; 20%). Three levels of hearing aid technology differing by the number of signal processing approaches included were: Basic (n=223, 20%), Advanced (n=662, 56%), and Premium (n=283, 24%). Additional hearing assistive technologies included streaming devices, TV connectors, and remote microphones were provided. We discuss how the baseline audiological results and individualized goal setting informed delivery of the HI and how the use of manualization allowed us to maintain excellent treatment fidelity throughout the clinical trial.

Analysis of audiological outcomes of children referred from a universal newborn hearing screening program over 9 years in Beijing, China

Universal newborn hearing screening (UNHS) and audiological diagnosis are crucial for children with congenital hearing loss (HL). The objective of this study was to analyze hearing screening techniques, audiological outcomes and risk factors among children referred from a UNHS program in Beijing. A retrospective analysis was performed in children who were referred to our hospital after failing UNHS during a 9-year period. A series of audiological diagnostic tests were administered to each case, to confirm and determine the type and degree of HL. Risk factors for HL were collected. Of 1839 cases, 53.0% were referred after only transient evoked otoacoustic emission (TEOAE) testing, 46.1% were screened by a combination of TEOAE and automatic auditory brainstem response (AABR) testing, and 1.0% were referred after only AABR testing. HL was confirmed in 55.7% of cases. Ears with screening results that led to referral experienced a more severe degree of HL than those with results that passed. Risk factors for HL were identified in 113 (6.1%) cases. The main risk factors included craniofacial anomalies (2.7%), length of stay in the neonatal intensive care unit longer than 5 days (2.4%) and birth weight less than 1500 g (0.8%). The statistical data showed that age (P < 0.001) and risk factors, including craniofacial anomalies (P < 0.001) and low birth weight (P = 0.048), were associated with the presence of HL. This study suggested that hearing screening plays an important role in the early detection of HL and that children with risk factors should be closely monitored.

To detach or not to detach the umbo in type I tympanoplasty: functional results.

To compare the audiological outcomes, tympanic membrane (TM) healing rates and complication rates in patients undergoing endoscopic underlay and over-under tympanoplasty type I (TTI). The study includes 95 patients who underwent endoscopic TTI in the period between 2018 and 2023: 56% of the patients had the underlay technique and 41% had the over-under technique. Data regarding pre- and postoperative hearing, perforation characteristics, surgical procedures, graft types and complications were retrospectively analyzed. Audiometrical assessment included air conduction (AC) and bone conduction (BC) pure tone averages (PTA) and air-bone gap (ABG), pre- and postoperatively. Both underlay and over-under techniques significant improved AC PTA, with a mean ABG improvements of 5.9 dB and 7.2 dB, respectively. There was no significant difference in BC PTA between pre- and post-operative, indicating no inner ear damage in both techniques. The over-under technique showed a significantly higher TM closure rate (94.4%) compared to the underlay technique (80.6%). Complications were rare, with only one case of TM lateralization requiring revision surgery. Endoscopic TTI is an effective treatment in improving auditory function in chronic middle ear diseases. In our cohort, the detachment of the umbo does not negatively influence the postoperative hearing results and does not increase rate of complications. Moreover, the over-under technique demonstrates superior TM closure rates, making it a valuable option for specific cases. However, future prospective studies with larger sample sizes and longer term follow-up are needed to validate these findings and provide more comprehensive insights.

Incidence of audiologic or otolaryngologic evaluation in patients with external ear anomalies

PurposeThe relationship between specific external ear anomalies (EEA) and hearing loss has been previously described. However, there is no literature regarding the appropriate evaluation of patients with EEA by audiology or otolaryngology. The objective of this study was to determine the incidence of audiologic or otolaryngologic evaluation of patients with EEA. Materials and methodsA retrospective review of charts was conducted following approval from the institutional review board at Boston Medical Center. Charts of patients younger than 18 years old with EEA, identified using International Classification of Diseases (ICD)-9 codes 380–380.99, 744, and 744.4 and ICD-10 codes H61.90–92, Q16.0–16.9, Q17.0–17.9, Q18.0–18.2, from January 2012 to January 2019 were reviewed. Primary variables included incidence of audiologic and otolaryngologic evaluation, newborn hearing screen and audiometry results, and completion of surgical intervention. Binary logistic regressions were conducted for each group for diagnostic, procedural, and demographic characteristics. ResultsA total of 723 patients were diagnosed with EEA from January 2012 to January 2019. Of these patients, 327 (45.2 %) were evaluated by audiology and 327 (45.2 %) were evaluated by otolaryngology. Of the 364 patients who obtained audiograms, 63 (17.3 %) demonstrated hearing loss. Surgical procedures were performed on 119 (16.5 %) patients, with the most common procedure being excision of the EEA (n = 79, 66.4 %). A total of 468 patients had a documented newborn hearing screen. Failure of newborn hearing screen and presence of microtia were associated with increased otolaryngologic and audiologic evaluation. ConclusionsA majority of patients with EEAs do not obtain audiologic or otolaryngologic evaluation.

Benefits of unilateral cochlear implantation in adults with asymmetric hearing loss: Audiologic and patient-related outcome measures

PurposeTo investigate the benefits of cochlear implantation in adults with single-sided deafness (SSD) and asymmetric hearing loss (AHL). Study designProspective within-subjects repeated-measures. SettingTwo tertiary cochlear implant centers. PatientsFourteen adults with severe-to-profound sensorineural hearing loss in the worse hearing ear and up to moderate SNHL in the better hearing ear. InterventionCochlear implantation in the worse hearing ear. Main outcome measuresConsonant-nucleus-consonant (CNC) test, AzBio sentence test in noise, and lateralization testing were conducted preoperatively and at 3-, 6-, and 12-months post-activation. Patient-related outcomes were measured using the Speech, Spatial, and Qualities of Hearing Scale and Glasgow Benefit Inventory. Tinnitus Handicap Inventory was administered to subjects with tinnitus. ResultsMean length of hearing loss in the worse hearing ear was 3.5 years. The mean CNC change scores from baseline were 54.8, 55.9, and 58.9 percentage points at 3-, 6-, and 12-months (p < 0.001). AzBio sentence test in noise demonstrated improved scores in all spatial configurations, although statistically significant in S0N0 (speech front, noise front) only. Lateralization testing showed significant improvement of 22.9, 24.5, and 24.0 percentage points at 3-, 6-, and 12 months post-activation (p = 0.002). All patient-related outcome measures revealed significant improvement. ConclusionThis study demonstrates improved speech perception in noise, sound lateralization, quality of life, and reduction in tinnitus perception in adults with SSD/AHL who undergo cochlear implantation. Our results add to the growing body of evidence that cochlear implant should be offered to this population.

Combination Therapy of Choline Alfoscerate With Ginkgo biloba Monotherapy in Age-Related Hearing Loss: Effects and Outcomes.

Ginkgo biloba and choline alfoscerate are used as adjuvant treatment for presbycusis, but studies on how the monotherapy differs from the combination therapy are lacking. Therefore, this study aimed to compare the audiologic outcomes between Ginkgo biloba monotherapy and Ginkgo biloba and choline alfoscerate combination therapy. Subjects and. The study groups are divided into three: negative control, monotherapy, and combination therapy groups. All groups' pure tone audiometry was measured by dividing the study period into Initial, 3-6, 6-9, 9-12, 12-15 months, and checked whether differences between groups were present. The combination therapy showed less gradient gap than the monotherapy, indicating less hearing loss rate than the monotherapy. Based on the Kaplan-Meier curve, the combination therapy showed better results in terms of survival time of hearing. As a pharmacological treatment for presbycusis, combination therapy shows better results than monotherapy.

Wideband frequency impedance for diagnosis of ossicular chain abnormality

Background The accurate estimation of the ossicular chain abnormalities using existing functional examinations has been difficult. Aims/Objectives This study aimed to verify the accuracy of preoperative diagnosis of ossicular chain abnormalities using a wideband frequency impedance (WFI) meter, which can measure the dynamic characteristics of the middle ear. Material and Methods Retrospective cohort study. Fourteen ears of patients with ossicular chain abnormalities that were definitively diagnosed surgically were included in this study. The following data were collected for each participant: sound pressure level (SPL) curve measured using the WFI meter and a sweep frequency impedance (SFI) meter, WFI measurements plotted on the resonance frequency (RF)-ΔSPL plane, distribution map of the dynamic characteristics of the middle ear, preoperative audiometry results, and the definitive surgical diagnosis. Results The SPL curve obtained using the WFI meter had lesser noise than that obtained using the SFI meter. The distribution map revealed that the ossicular chain separation range and ossicular chain fixation range were completely separated. The hearing data tended to be poor in cases with small ΔSPL. Conclusions and Significance WFI can potentially enhance the accuracy of SFI. In addition, it can also be used for the classification of ossicular chain separation and fixation as well as the quantification of fixation in cases of ossicular chain anomalies that cannot be diagnosed using conventional tests.

Exoscope-Assisted Stapedotomy: Evaluation of Safety and Efficacy.

Evaluate the safety and efficacy of exoscope-assisted stapedotomy. Retrospective chart review. Tertiary care neurotology clinic. Adult patients with otosclerosis undergoing stapedotomy. Primary stapedotomy. Evaluation of audiologic outcomes, including pure-tone average, bone-conduction thresholds, word recognition score, and air-bone gap. Complications, need for scutum removal, and length of surgery were also evaluated. A total of 47 patients were identified, and 24 patients underwent surgery with the microscope and 22 with the exoscope. There were significant improvements in pure-tone average, mean bone-conduction thresholds, and air-bone gap for both groups. There was no difference in preoperative or postoperative audiologic status for either group. There was no difference in rates of dysgeusia, chorda tympani nerve damage, dizziness, or facial paresis in either group. This study indicates similar audiologic outcomes, complication profiles, and visualization when comparing exoscopic and microscopic stapedotomy. Demonstrated here, exoscopic stapedotomy can be safely performed in a transcanal manner.