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Otology
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Jameel Muzaffar, Chloe Swords, Adnan Darr, Karan Jolly, Manohar Bance, Sanjiv Bhimrao
Evidence: Meta-analysis: Jalali et al. Comparison of cartilage with temporalis fascia tympanoplasty: A meta-analysis of comparative studies. Laryngoscope 2017; 127(9): 2139–2148 Cartilage tympanoplasty favoured TF for integration rateHearing outcomes were the sameIn children: Depends on sxConventional wisdom has been that it is preferable to delay to age 10–12, but there is no statistical evidence to support this. However, it is potentially prudent to wait until the contralateral ear has normalised as this is associated with improved outcomes (Hardman et al. Tympanoplasty for chronic tympanic membrane perforation in children: systematic review and meta-analysis. Otology & Neurotology 2015; 36(5): 796–804) Improved ET functionHave to balance this with ages children keen to swim
Surgery for Childhood Hearing Loss
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
The role of the surgeon in managing children with permanent childhood hearing impairment is now largely focused on implantation otology, i.e. the use of implants to the skull or the ear to channel acoustic signals to the auditory nerve and auditory cortex. There have been enormous strides in this area in recent years with continuing improvements in technology and outcomes. Only the essential principles of the main varieties of implants are presented here.
Metabolic Bone Disease and Systemic Disorders of the Temporal Bone
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Victoria Alexander, Parag Patel
LCH is diagnosed based on positive immunohistochemistry (Langer CD 207 or CD1a) and histological examination demonstrating Birbeck granules on electron microscopy. Otologic symptoms are rare (<4%) but include otorrhea, soft tissue or postauricular swelling and often bilateral disease.
Cochlear implantation through intracochlear fibrosis: A comparison of surgical techniques
Published in Cochlear Implants International, 2023
Anne K. Maxwell, Jacob B. Kahane, Rahul Mehta, Moises A. Arriaga
Retrospective review of all patients who underwent cochlear implantation between 2009 and 2020 at a single University-based tertiary referral otology-neurotology practice was performed. Institutional Review Board approval (#19-971) was obtained as an exempt review. Patients found to have intracochlear fibrosis were identified. Those with bilateral profound SNHL met CI criteria with AzBio sentence testing in the best aided condition, while those with a unilateral profound SNHL met CI criteria for single-sided deafness with CNC word scores. Patient history, operative techniques, and type of implant used were examined. CT and MRI were performed preoperatively in all patients. Preoperative audiologic testing including pure tone average (PTA), speech reception threshold (SRT), and speech discrimination scores (SDS) were performed in the unaided condition. Postoperative audiologic testing was performed with the CI in place. PTA was calculated as an average of the air-conducted stimuli at 500-, 1000-, 2000-, and 4000-Hz. For calculations of means, when no response was obtained at a given frequency, 115 dB was substituted.
The case for intra-operative X-ray in cochlear implantation: Four illustrative cases and literature review
Published in Cochlear Implants International, 2022
Cheryl Yu, Sarah Debs, Rhea Singh, Sean Kastetter, Akilah Pierre-Louis, Daniel H. Coelho
The development of the cochlear implant (CI) has been a revolutionary milestone in the field of otology. Ever since its FDA approval, cochlear implantation has gained exponential worldwide popularity, becoming a well-established treatment option for those with moderate to profound sensorineural hearing loss (SNHL). The technology continues to evolve along with the development of new refined surgical techniques, leading to enhanced performance outcomes with decreasing complication rates. Despite decreasing complication rates (with overall complication rates cited as low as 3%), major complications, defined as those requiring surgical intervention, do still occur (Binnetoglu et al., 2020). The most commonly cited reasons for complications include device extrusion, wound infection, device failure, and electrode misplacement, which often require revision and reimplantation.
ICF domains covered by the Tinnitus Questionnaire and Tinnitus Functional Index
Published in Disability and Rehabilitation, 2022
Annemarie van der Wal, Sarah Michiels, Joke De Pauw, Laura Jacxsens, Antonios Chalimourdas, Annick Gilles, Marc Braem, Vincent van Rompaey, Paul Van de Heyning, Willem De Hertogh
In general, tinnitus can be divided into objective and subjective tinnitus [4]. When the tinnitus sound originates from an internal source within the patient’s body, the tinnitus is called “objective”. This form of tinnitus is rare (less than 5%) and can be caused by middle ear tumors, turbulent blood flow, or myoclonus of middle-ear palatal muscles [1]. In case of subjective tinnitus, no source can be found for the perceived sound, neither externally nor internally. The pathophysiological mechanism of subjective tinnitus is often multifactorial. The main risk factor for developing tinnitus is hearing loss, but other factors, diseases and malfunctions leading to tinnitus may be otologic (i.e., hearing loss, noise trauma, Meniere’s disease, acoustic neurinoma, and ototoxic medications or substances), neurologic (i.e., multiple sclerosis and head injury), metabolic (i.e., thyroid disorder, hyperlipidemia, and vitamin B12 deficiency), psychogenic (i.e., depression and anxiety), or somatogenic [1,4,5]. In case a patient’s tinnitus is influenced by altered somatosensory afference from the cervical spine or temporomandibular area, it is called somatic or somatosensory tinnitus [6]. In this type of tinnitus, dysfunctions in the cervical spine or temporomandibular area, such as restricted mobility or muscle tension, can change the tinnitus loudness and/or pitch or can even cause the tinnitus in some cases [6,7].