Normal Contralateral Ear Research Articles

Parent-Reported Ease of Listening in Preschool-Aged Children With Bilateral and Unilateral Hearing Loss.

Evidence from school-aged children suggests that the ease with which children listen varies with the presence of hearing loss and the acoustic environment despite the use of devices like hearing aids. However, little is known about the ease of listening in preschool-aged children with hearing loss-an age at which rapid learning occurs and increased listening difficulty or effort may diminish the required capacity to learn new skills. To this end, the objectives of the present study were to (i) assess parent-reported aided ease of listening as a function of hearing loss configuration (hearing loss in one versus both ears) and device configuration among children with hearing loss in one ear (unilateral hearing loss), and (ii) investigate factors that influence children's ease of listening. Parents of 83 children with normal hearing, 54 aided children with bilateral hearing loss (hearing loss in both ears), and 139 children with unilateral hearing loss participated in the study. Of the 139 children with unilateral loss, 72 were unaided, 54 were aided with a device on the ear with hearing loss (direct aiding) and 13 were aided with a device that routed signals to the contralateral normal hearing ear (indirect aiding). Mean age of children was 40.2 months (1 SD = 2.5; range: 36 to 51). Parents completed the two subscales of the Parents' Evaluation of Aural/Oral Performance of Children+ (PEACH+) questionnaire, namely functional listening and ease of listening. Individual percent scores were computed for quiet and noisy situations. Linear mixed-effects models were used to assess the effect of hearing loss configuration and device configuration in children with unilateral hearing loss. Multiple regression was used to assess factors that influenced ease of listening. Factors included hearing thresholds, age at first device fit, consistency in device use, condition (quiet/noise), presence of developmental disabilities, and functional listening abilities. Children with direct aiding for their hearing loss, either unilateral or bilateral, had similarly lower functional listening skills and ease of listening than their normal hearing peers. Unaided children with unilateral hearing loss had lower functional listening skills and ease of listening than their normal hearing peers in noise but not in quiet. All aided children with unilateral hearing loss, irrespective of direct or indirect aiding had lower functional listening skills and ease of listening relative to normal hearing children in both quiet and noise. Furthermore, relative to unaided children with unilateral hearing loss, those with indirect aiding had lower functional listening and ease of listening. Regression analyses revealed functional listening as a significant predictor of ease of listening in all children with hearing loss. In addition, worse degrees of hearing loss and presence of noise reduced ease of listening in unaided children with unilateral hearing loss. Bilateral hearing loss is associated with poorer-than-typical ease of listening in preschoolers even when aided. The impact of unilateral hearing loss on ease of listening is similar to that observed in children with bilateral hearing loss, despite good hearing in one ear and aiding. Given increased difficulties experienced by children with unilateral loss, with or without a device, additional strategies to facilitate communication abilities in noise should be a priority.

New Strategies for Remnant Ear Treatment in Microtia Reconstruction Based on Morphometric Studies.

Given the lack of specific evaluation indices, it is difficult to determine whether to transpose or abandon remnant ears in lobule-type microtia reconstruction. The authors illuminate referable parameters beneficial for proper treatment of remnant ear in an efficient manner. A series of 359 lobule-type microtia patients underwent autogenous costal cartilage auricular reconstruction between 2016 and 2021. Fourteen measuring points and defined distances as well as six ratios of specific distances based on position, plumpness, similarity and the width-to-length ratio of the remnant ear have been described, and relevant tactics for appropriate treatments are introduced. Definite morphometric results contribute to attaining satisfactory contours of reconstructed auricles with harmonious earlobes, which exhibit highly similar dimensions and appearances compared to the contralateral normal ears. With the help of the proposed locating points and measuring approaches, the procedure of remnant ear treatment is systematically clarified. This technique ensures operation safety and contributes to the aesthetic contour of the auricle. IV Laryngoscope, 134:2741-2747, 2024.

Application of stereoscopic unequal S-plasty for reconstuction of the congenital hypoplastic ear lobe cleft associated with soft tissue deficiency

Objective: To explore the ideal way of using the stereoscopic unequal S-plasty in reconstruction of the congenital hypoplastic ear lobe cleft with soft tissue deficiency. Methods: Data of 10 patients with the congenital hypoplastic ear lobe cleft associated with soft tissue deficiency who were treated using the stereoscopic unequal S-plasty in the plastic cosmetic surgery of Xuzhou Central Hospital from Aug 2018 to Aug 2022 were retrospectively analyzed. Six patients were male, 4 were female. Their ages ranged from 6 years to 19 years old, with a mean age of 13 years. Lobe deficiency size ranged from 0.8 cm×0.5 cm to 1.2 cm×1.0 cm. Results: The post-operation flaps had no venous congestion, infection or necrosises. During 3 to 12 months of follow-up, the technique made the shape of the ear lobe smoother. The incisions left inconspicuous scars. The result was satisfactory in terms of matching the contralateral normal ear lobe in shape and symmetry. Doctors and patients were satisfied with the results. Conclusions: The stereoscopic unequal S-plasty is an effective way to correct the the severe congenital ear lobe deformity. The good result,simple manipulation and short operation time are the advantages of this method.

Effect of Drill Induced Noise on Contralateral Normal Ear Following Cortical Mastoidectomy.

Chronic suppurative otitis media (CSOM) is a long standing infection of the middle ear cleft. Mastoidectomy, with or without tympanoplasty, is the preferred treatment for CSOM. However, the drill used during ear surgery generates noise that may potentially cause hearing damage in both the operated and opposite inner ear, leading to temporary or permanent hearing loss. The study included patients diagnosed with CSOM who underwent surgeries in the Otorhinolaryngology department. Postoperatively, all patients were followed up on the 7th day and 1 month after the surgery. Pure Tone Audiometry (PTA) was performed to evaluate the hearing outcomes. A total of 61 patients were included in the study. The mean preoperative PTA of contralateral ear bone conduction among the study participants was 6.48. At the 7th day post-operation, the mean post-operative PTA of contralateral ear bone conduction for the same participants was 7.77. This difference was statistically significant according to the Paired T-test (P = 0.001).However, when evaluating the mean preoperative PTA of contralateral ear bone conduction (6.48) and the mean post-operative PTA at 1st month (6.02), the difference was not statistically significant (P = 0.208).Additionally, there was no statistical difference in air conduction and air-bone gap before and after surgery. The study suggests that mastoid drilling is associated with a significant temporary hearing loss in the contralateral ear immediately after surgery, which eventually recovers within a month. However, the hearing loss is considered negligible and not statistically significant in the long term. It is worth considering additional audiological investigations, such as otoacoustic emissions, to detect this type of hearing loss more accurately.

Matching the pitch perception of the cochlear implanted ear with the contralateral ear in patients with single-sided deafness: a novel approach.

Single-sided deaf patients following cochlear implantation often compare the sound quality of their implanted ear with normal hearing. The interaural differences can result in dissatisfaction with speech comprehension and reduced time of usage of the speech processor; hence, prolonging auditory adaptation time. The proposed calibration method presented in this study demonstrates how the frequency distribution of the cochlear implant can be set to adequately approximate the pitch perception of the contralateral normal hearing ear towards improving speech intelligibility in a noisy environment. In 12 postlingual single-sided deaf patients, subjective interaural pitch-matching was carried out to determine new central frequencies for the reallocation of the frequency bands of their speech processor (CP910, CP950 or CP1000, Cochlear, Australia). The patients were asked to compare the pitch of the tones presented to their normal hearing ear to the pitch of individual channels of their cochlear implant (CI522 or CI622, Cochlear, Australia). A third-degree polynomial curve was fit to the acquired matching frequencies to create the new frequency allocation table. Audiological measurements (free-field aided thresholds, speech reception thresholds, and monosyllabic word recognition score) in noise, together with a Speech, Spatial and Qualities of Hearing Scale (SSQ12) questionnaire (short version of the original SSQ) results were evaluated prior to the pitch-matching procedure, and again, 2 weeks later. The free-field aided thresholds of the patients showed no greater shift than ± 5dB following the procedure; however, their monosyllabic word recognition score in noise improved significantly (mean - 9.58%, SD 4.98%, matched pairs t test comparison: p < 0.001). The results of the SSQ12 questionnaire also showed significant improvement in speech intelligibility, sound localization, and sound quality (mean 0.96 points, SD 0.45 points, matched pairs t test comparison: p < 0.001). Matching the pitch perception of the implanted cochlea with the sensation of the normal hearing contralateral ear, resulted in significant changes in the quality of hearing in patients with single-sided deafness. It is plausible the procedure can usher positive results in bimodal patients or following sequential bilateral cochlear implantation.

A novel technique C-conchoplasty in canal wall down tympnomastoidectomy

Background Numerous methods for meatoplasty and conchoplasty have been introduced, but no clear V/S(the meatal cavity volume to the cross-sectional) was given and many patients have complained about poor cosmesis on follow-up. Aims To explore the proper size, and cosmetic shape of the external auditory meatus and auditory canal for canal wall-down tympnomastoidectomy (CWD). Material and Methods In this observational case series study 36 patients undergone CWD with C-conchoplasty that uses a C-shape skin incision on the concha were reviewed. S and V/S of the preoperative, postoperative and contralateral normal ears were observed. We analyzed the relationship between the epithelialization time and postoperative V/S. Long-term efficacy observation and the shape of the meatus after the operation were observed. Results C-conchoplasty could effectively enlarge S and reduce V/S. The postoperative V/S were closer to the normal ear than that if we didn’t do C-conchoplasty. The greater difference of V/S between the post-operative ears and the contralateral normal ears, the longer the epithelialization time will be. C-conchoplasty produced an excellent cosmetic result. No other complications were noted. Conclusions and Significance The C-conchoplasty, which is a novel and easy technique in CWD, offers good functional and excellent cosmetic results with minimal risk of complications.

Is Pattern of Acceptable Noise Level Growth for Apparently Normal Contralateral Ear Similar to Affected Ear in Unilateral Meniere’s Disease?

Background and Aim: The Acceptance Noise Level (ANL) which determines the tolerable noise level while listening to running speech, is related to factors such as hearing loss and speech presentation level. This study aims to investigate the effect of speech presentation level on the ANL in people with unilateral Meniere’s Disease (MD) compared to the normal-hearing people. Methods: In this study, 33 people aged 32–60 years with unilateral MD and 38 normal-hearing people aged 20–46 years participated. The ANL growth was evaluated unilaterally at four different speech presentation levels: Most Comfortable Level (MCL), –10 dB lower than the MCL, +10 dB higher than the MCL, and a range between MCL and uncomfortable level. Results: In MD patients, the ANL of the affected ear was significantly different from that of the contralateral ear (p&lt;0.010). Compared to the normal-hearing people, the pattern of ANL growth in MD patients was significantly different, but the ANL growth patterns were similar between the affected and contralateral ears. Conclusion: ANL and its growth pattern are different between the affected and contralateral ears of patients with unilateral MD, but are similar compared to normal-hearing people. Despite the apparently normal hearing thresholds, the performance of the contralateral ear in noise at various speech presentation levels in patients with unilateral MD seems to be similar to that of the affected ear. Keywords: Meniere disease; hearing loss; acceptable noise level

Does drilling affect the hearing of contralateral normal ear after mastoid surgery?

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic otitis media (COM) is a recurrent infection of the middle ear and/or mastoid air cells affecting 2-3% of global population. Mastoidectomy is the mainstay of the treatment of COM. Bone drilling during mastoidectomy procedure exposes both the ears to acoustic trauma leading to sensorineural hearing loss. The present study was conducted to assess the possible deleterious effect of drilling on hearing of contralateral normal ear by monitoring pre-operative and post-operative pure tone audibility (PTA) and otoacoustic emissions (OAE). Aims and objectives were to evaluate the effect of drill- generated noise on hearing in non-operated ear during mastoidectomy in terms of hearing loss, its nature and duration and recovery of hearing loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; An observational study was carried out in ENT department at SMS medical college and hospital, Jaipur. Total 40 patients were studied. Pre-operative and post-operative PTA and OAE were studied and compared. Mean drilling time during mastoid surgery was also studied.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of 40 subjects, maximum patients were 11-20 years of age group (37.5%) with female preponderance (57.5%). All had undergone mastiodectomy. Only 6 (15%) subjects had transient sensorineural hearing loss of contralateral normal ear as determined by comparing pre-operative and post-operative PTA and OAE. The mean recovery time was 2-3 days. The study had shown significant effect of drill generated noise on hearing of contralateral healthy ear following mastoidectomy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;: Drill-generated noise can’t be lowered to a great extent therefore drilling time should be minimized during mastoid surgeries.&lt;/p&gt;

Habituation of changed acoustics properties after canal wall down mastoidectomy

PurposeOur objective is to evaluate the effect of habituation on the altered ear canal acoustics after canal wall down mastoidectomy.MethodsA total of 11 participants with single sided dry cavities and normal contralateral ear canals with normal hearing thresholds were included in the study. Filtered sound fragments were created that simulate the different acoustic properties based on the participants Real Ear to Coupler Difference (RECD) of the cavity ear and the contralateral normal ear canal. These filtered sound fragments are presented to the cavity ear canal and the contralateral normal ear canal using inserts earphones. Participants performed a subjective quality assessment of the sound fragments using paired comparison with a seven-point scale (− 3 till + 3).ResultsMean assessment of sound quality revealed the following results; naturalness of sounds of the cavity ear canal is 0.29 (± 1.41; ns) in favour of the filtered sound fragment of the normal ear canal. Mean assessment of sharpness of sounds in the cavity ear canal is 1.55 (± 1.21, p = 0.55) in favour of the filtered sound fragment of the normal ear canal. Overall preference in the cavity ear canal was in favour of the normal ear canal acoustics 0.72 (SD ± 1.54 p = 0.224).ConclusionsPatients with cavity ear canals seem to habituate to their altered ear canal acoustics. Transforming the ear canal acoustics of the cavity ear to normal ear canal acoustics seem to sharpen the incoming sounds. Overall assessment of quality of sound of the normal ear canal acoustics is better than the cavity acoustics.

Otitis Media with Persistent Inflammation is a Common Cause of Sensorineural Hearing Loss

Objective: The purpose of the research was to determine the rate of sensorineural hearing loss that is associated with chronic otitis media. Study Design: A Descriptive Cross-sectional study Place and Duration: Frontier Medical College, Abbottabad, from June, 2021 to November, 2021. Methods: Total 87 patients of both genders had age 15-55 years were presented. All the included patients had chronic suppurative otitis media clinical symptoms. Patients were enrolled after getting informed written consent from the patients. Through the use of a pure tone audiogram, we were able to determine the mean threshold of voice frequencies for sick as well as normal contralateral ears. In sick ears, a mean of more than 25 dB was considered to represent a positive case of SNHL. SPSS 24.0 was used to analyze all data. Results: We found that 49 (56.9%) patients were males and 38 (43.1%) patients were females. 17 (19.5%) cases had age 15-25 years, 35 (40.2%) patients had age 26-35 years, 25 (28.7%) patients had age 36-45 years and 10 (11.5%) patients were aged between 46-55 years. Majority of the cases 51 (58.6%) were from urban areas. There were 50 (57.5%) cases had chronic otitis media duration &lt;10 months and remaining had disease duration &gt;10 months. Frequency of sensorineural hearing loss was found in 47 (54.02%) cases. Among 47 cases SNHL, 32 cases were aged between 31-55 years. Conclusion: We concluded in this study that patients with chronic otitis media had significantly higher number of sensorineural hearing loss, Among SBHL cases, patients were mostly aged between 31-55 years and disease duration was &gt;10months. Keywords: Otitis Media, Sensorineural Hearing Loss,

Cholesteatoma ear with increased bone conduction threshold should no more be missed - A prospective study

Background: Cholesteatoma is a collection of keratinized squamous epithelium in middle ear and pneumatic areas of temporal bone. It can be said as an invasive disease which is often associated with sensorineural hearing loss. It is seen that hearing loss varies with the location of disease, duration of disease, and extension of cholesteatoma. Aims and Objectives: The aim of this study is to see the association of cholesteatoma and bone conduction threshold difference as compared to contralateral normal ear. Materials and Methods: This study was done between August 2019 and December 2021 at our tertiary care center. It is a prospective study of 50 patients. Results: In our study, we saw that there is a considerable sensorineural hearing loss associated with cholesteatoma depending on which varies with location and extension. Conclusion: Our study shows that the more extensive the cholesteatoma more is the sensorineural hearing loss.

Symptom: Unilateral Hearing Loss

Symptom: Unilateral Hearing Loss

Posterior auricular artery free flap reconstruction of the retroauricular sulcus in microtia repair

Autologous repair using costal cartilage grafts remains the most widely accepted method of microtia reconstruction. A major complication of current techniques is loss of ear shape caused by scarring, contracture and cartilage absorption. We present a new surgical technique utilizing the posterior auricular artery free flap in microsurgical reconstruction of the retroauricular sulcus in microtia. Reconstruction is performed in two stages. In the first stage, a fabricated costal cartilage framework is inserted into a skin pocket as described by Nagata. In the second stage, the ear framework is elevated from the scalp and held by an additional cartilage wedge. Following indocyanine green angiography perforator mapping, a posterior auricular artery perforator flap is harvested from the contralateral (normal) ear and used to reconstruct the posterior auricular sulcus covering the cartilage framework and elevating wedge. The technique was applied to three patients aged 11-15 years with a follow-up time of 8 months to 3 years. The average flap artery diameter was 0.73 mm and the vein was 0.7 mm. Venous congestion occurred in one case and was resolved with a vein graft leading to complete flap recovery. Good ear shape, elevation, projection, skin color and texture were achieved in all the cases. Posterior auricular artery flap reconstruction of the retroauricular sulcus in microtia repair is a useful alternative to the current skin graft and tissue expander-based techniques. It provides the ideal skin color and texture match and may improve the overall results of microtia reconstruction by enhancing vascularity.

Extended high frequency hearing sensitivity in normal contralateral ears exposed to mastoid drill noise in patients undergoing mastoid surgery

&lt;p class="abstract"&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study aimed at evaluation of extended high frequency hearing in non operated normal ear in patients undergoing mastoid surgery using otological micro drill.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A hospital based prospective observational study was carried out. Patients up to 40 years of age with unilateral ear disease were recruited and divided into two groups- mastoidectomy group comprising 30 patients who underwent mastoid surgery using high speed microdrill and tympanoplasty group who underwent surgery without using microdrill. Pure tone audiometry (conventional and extended high frequency) was performed preoperatively, on 3rd and 10th postoperative day.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In mastoidectomy group, Air conduction thresholds in extended high frequency showed significant changes on 3rd postoperative day and showed recovery by 10th postoperative day. Recovery started by 3rd postoperative day and in majority of cases there was a complete recovery by 10th postoperative day.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Otological drilling has a significant effect on the extended high frequency hearing of normal contralateral ear. Extended high frequency audiometry till 16000 Hz is a sensitive modality for evaluation to monitor these cases on post-operative follow up.&lt;/p&gt;

Horizontal sound localisation and speech perception in Bonebridge-implanted single-sided deafness patients.

This study aimed to investigate the benefit of Bonebridge devices in patients with single-sided deafness. Five patients with single-sided deafness who were implanted with Bonebridge devices were recruited in a single-centre study. Participants' speech perception and horizontal sound localisation abilities were assessed at 6 and 12 months post-operatively. Speech intelligibility in noisy environments was measured in three different testing conditions (speech and noise presented from the front, speech and noise presented from the front and contralateral (normal ear) side separately, and speech presented from the ipsilateral (implanted Bonebridge) side and noise from the contralateral side). Sound localisation was evaluated in Bonebridge-aided and Bonebridge-unaided conditions at different stimuli levels (65, 70 and 75 dB SPL). All participants showed a better capacity for speech intelligibility in quiet environments with the Bonebridge device. The speech recognition threshold with the Bonebridge device was significantly decreased at both short- and long-term follow up in the speech presented from the ipsilateral (implanted Bonebridge) side and noise from the contralateral side condition (p < 0.05). Additionally, participants maintained similar levels of sound localisation between the Bonebridge-aided and unaided conditions (p > 0.05). However, the accuracy of localisation showed some improvement at 70 dB SPL and 75 dB SPL post-operatively. The Bonebridge device provides the benefit of improved speech perception performance in patients with single-sided deafness. Sound localisation abilities were neither improved nor worsened with Bonebridge implantation at the follow-up assessments.

Tiempo seguro para cambiar de altitud en post operatorio de Timpanoplastia

El objetivo de este estudio es evaluar si el cambio temprano de altitud y presión influye en el éxito de la timpanoplastia en población pediátrica. &#x0D; Estudio de cohorte descriptiva. Se revisaron historias clínicas de pacientes operados en el Hospital Universitario San Ignacio, entre septiembre de 2014 y noviembre de 2016. La tasa de éxito fue del 90%. El 52% de los pacientes (n=13) se trasladaron fuera de Bogotá, todos por vía terrestre. En dos pacientes no hubo integración del injerto. Observamos en nuestro grupo de pacientes, que el traslado temprano durante el postoperatorio de timpanoplastia no afecta negativamente la integración del injerto. Sin embargo, se requiere un mayor número de pacientes para lograr un resultado estadísticamente significativo.

Possible Effect of Chronic Otitis Media with and without Cholesteatoma on Bone Conduction Thresholds: Evaluation of the 112 Cases

Objective: The aim of this study is to evaluate any possible effects of chronic otitis media (COM), with or without accompanying cholesteatoma, on bone conduction thresholds (BCT). Methods : A total of 112 cases who underwent surgery for unilateral COM between 2006 and 2014 were enrolled in the study. Eighty cases had no cholesteatoma (Group 1). Thirty-two cases did have cholesteatoma (Group 2). Prior to surgery, the temporal bone was evaluated radiologically by use of high resolution computed tomography. The presence of a clinically and radiologically normal contralateral ear was the principal selection criterion for the cases. BCT at 0.5, 1, 2, 4 kHz and their averages were evaluated with pure tone audiogram (PTA) and the normal and diseased ears in each group were compared. This comparison was also made between the diseased ears in Groups 1 and 2. Results: There was a statistically significant difference observed between the mean BCT scores obtained by PTA for the normal/diseased ears in Group 1 (9.78±0.98/17.34±1.71 dB) and in Group 2 (9.10±0.99/17.58±2.59 dB). This statistically significant difference was observed for each of the four different frequencies (p<0.0001). However, there was no statistically significant difference observed between the mean BCT scores obtained by PTA for the diseased ears in Groups 1 and 2 (17.34±1.71/17.58±2.59 dB). Similarly, in the comparison between the diseased ears, the differences of BCT at all four different frequencies (0.5, 1, 2, 4 kHz) lacked statistical significance (p>0.05). Conclusion: As a result of this study, we can say that COM may lead to sensorineural hearing loss. However, we observed that the presence of cholesteatoma does not exert an additional negative effect on cochlear function.

Correlation Between Sensorineural Hearing Loss and Chronic Otorrhea.

Many studies have been trying to correlate chronic otorrhea, both in children and in adults, with the sensorineural hearing loss in the affected ear, but have been obtaining contradictory results. This loss might be due to the likely toxicity of the bacteria involved, effects of inflammatory cytokines, or constant use of ototoxic antibiotics. All the studies evaluated up to the present date compared the affected ear with the normal contralateral ear. From the digitized archive of otological surgery files of the Department of Otorhinolaryngology, the ears of patients with chronic otorrhea were evaluated visually and compared with the normal contralateral ears. Ears with otorrhea were also compared to ears with dry tympanic perforation of other patients. Ears with suppuration were evaluated for cholesteatoma. The duration of otorrhea was taken into account. The sensorineural hearing threshold was evaluated for the frequencies of 500, 1000, 2000, and 4000 Hz. A total of 98 patients with chronic otorrhea and 60 with dry tympanic membrane perforation were evaluated. From a statistical study, a correlation between sensorineural hearing loss and the chronic otorrhea was observed, in comparison both with contralateral normal ears and with dry perforated ears of other patients. There was no relationship with the duration of suppuration or with whether this was due to cholesteatoma. Sensorineural hearing loss occurs in ears with chronic otorrhea. The duration of otorrhea and the etiology of suppuration did not influence the hearing loss. The great majority of otorrhea cases begin during childhood.

Imaging findings in pediatric single-sided deafness and asymmetric hearing loss.

To examine the imaging findings on computer tomography (CT) and magnetic resonance imaging (MRI) in pediatric single-sided deafness (SSD) and asymmetric hearing loss (ASH). The medical records of 189 pediatric patients with SSD and ASH were retrospectively reviewed, and imaging findings were compared. SSD was defined as unilateral profound hearing loss and contralateral normal hearing ear. In the ASH group, ASHw was defined as the worse hearing ear with profound hearing loss, while ASHb was defined as the better hearing ear with mild-moderate hearing loss. There were 170 patients with SSD and 19 patients with ASH. In the SSD group, 83 patients (48.8%) had imaging findings associated with hearing loss. In the ASH group, such imaging findings were found in six (31.6%) of the ASHw and in five (26.3%) of the ASHb ears. The most common finding in the SSD group was cochlear nerve deficiency (50.6%), followed by cochlear dysplasia (39.8%) and enlarged vestibular aqueduct (26.5%). In the ASH groups, cochlear dysplasia was seen in three (50%) of ASHw ears and in two (40%) of the ASHb ears, and enlarged vestibular aqueduct was seen in three (50%) of ASHw ears and in two (40%) of the ASHb ears. Imaging studies identified the etiology in half of the cases of SSD and in one-third of ASH patients. Our findings strongly support the use of imaging studies in the evaluation of pediatric SSD and ASH. 4 Laryngoscope, 130:1007-1010, 2020.

Chronic Otitis Media and its Correlation with Unilateral Sensorineural Hearing Loss in a Tertiary Care Centre of North India.

Relation between chronic otitis media and sensorineural hearing loss is controversial. Otitis media can cause threshold shift in high frequency range. Also this correlation with patient's age, disease duration and normal ear is of importance for early prevention of hearing loss. The aim of this study was to evaluate relationship between sensorineural hearing loss and chronic otitis media. We also studied association of bone conduction between diseased ear and contralateral normal ear. In this study, 840 patients of unilateral COM were included. Audiometry was done and data analyzed. Majority of patients showing SNHL had COM for over a period of 5years. Squamosal disease showed early progression to SNHL than mucosal disease. Higher frequencies were found to be more affected and maximum bone gap was seen at 4000Hz. There was significant difference in mean bone conduction threshold between diseased ear and normal ear at all frequencies (p value < 0.001). Contradicting studies have emerged about association of SNHL with COM. Studies suggest that SNHL does not change with age but with duration. Bone conduction threshold tends to increase with increasing frequency. Few authors also pointed that this may be due to Carhart's effect and not due to disease damaging inner ear.