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PubMed2006

Mondini-like malformation mimicking otosclerosis and superior semicircular canal dehiscence.

In 2003, it was reported that superior semicircular canal dehiscence can mimic otosclerosis because of low-frequency bone conduction hearing gain and dissipation of air-conducted acoustic energy through the dehiscence. We report the case of a 17-year-old girl with left-sided combined hearing loss thought to be due to otosclerosis. Bone conduction thresholds were -10 dB at 250 and 500 Hz and she had a 40 dB air-bone gap at 250 Hz. When a tuning fork was placed at her ankle she heard it in her left ear. Acoustic reflexes and vestibular evoked myogenic potentials could be elicited bilaterally. Imaging of the temporal bones showed no otosclerosis, superior semicircular canal dehiscence or large vestibular aqueduct, but a left-sided, Mondini-like dysplasia of the cochlea with a modiolar deficiency could be seen. Mondini-like cochlear dysplasia should be added to the causes of inner-ear conductive hearing loss.

Adolescent↗
PubMed2000

[Some aspects of pure tone audiometry].

Masking procedure during hearing threshold measurement in air conduction mode, order of investigation of bone conduction perception are proposed. Range of application of broad band and narrow band masking noises is considered.

Adult↗
PubMed1998

Calcium channel blockers for prevention of noise trauma in otologic surgery.

One hundred patients were tested prior to otologic ear surgery in a prospective, randomized, double-blind study to assess the perioperative efficiacy of a calcium channel blocker (diltiazem) in preventing acoustical trauma during middle ear surgery. The patients were randomly divided into a therapy group (diltiazem), and a control group (placebo). Bone conduction hearing thresholds were examined preoperatively and followed at 1 day and 3 months postoperatively. Frequency-dependent changes in postoperative bone conduction and the number of patients with various degrees of postoperative hearing loss in both groups were statistically analyzed. The results indicated only a small postoperative hearing loss after ear surgery in both groups. There was a tendency for better results in the therapy group but this was not found to be statistically significant. Despite favorable results in animal trials utilizing different kinds of noise with the prophylactic application of diltiazem, further studies in humans will be needed to determine the role of calcium antagonist drugs in the prophylaxis or treatment of acoustical trauma.

Adolescent↗
PubMed2003

[Possible benefits of calcitonin in the treatment of otosclerosis].

This study shows the results obtained after treatment with intranasal calcitonin in 23 patients (36 ears) suffering from otosclerosis. 19.4% showed a hearing improvement upper of 10 dB. The gain was 32 dB in air conduction thresholds and 23 dB. In bone conduction. Tinnitus disappeared in 25% of cases suffering from tinnitus. Calcitonin tolerance was good, 8.7% of patients reported migraine. Authors recommended additional studies in order to evaluate the efficacy of this drug in the treatment of otosclerosis.

Adolescent↗
PubMed1997

The rehabilitation of conductive hearing impairment.

Conductive hearing loss (CHL) usually is amenable to surgical correction. At times, patients with CHL may not be candidates for surgical correction, or they may refuse to undergo the procedure. In such a situation, the patient should be encouraged to try hearing aids, either conventional or bone conduction, depending on the pathologic condition. After a discussion of bone-conduction implantable hearing aids, the article discusses congenital aural atresia, otosclerosis, and the management of CHL after infratemporal fossa approach and transtemporal approaches.

Bioprosthesis↗
PubMedDate not supplied

Use of an implantable hearing device.

PURPOSE: The purpose of this paper was to discuss our experiences with an implantable bone conduction hearing prosthesis, the XOMED Audiant Bone Conductor (Jacksonville, FL). PATIENTS AND METHODS: Twenty-four patients who had been implanted with the Audiant Bone Conductor were interviewed by telephone following implantation. Questions were asked regarding use of the device and subjective benefit. RESULTS: Eleven patients are using their devices, 12 patients are not using their devices, and one patient has been lost to follow-up. Patients using the device report satisfaction and prefer the Audiant to other amplification systems, whereas those not using the device indicate that insufficient amplification or weak magnetic attraction prevent its use. CONCLUSIONS: Analysis of failures has altered our criteria for implantation. With improvements that have been made by XOMED and stricter patient criteria, the Audiant should be considered a viable amplification alternative for certain hearing-impaired patients.

Adolescent↗
PubMed2001

Efficacy of evaluation of audiometric results after stapes surgery in otosclerosis. II. A method for reporting results from individual cases.

To standardize the reporting of hearing results after middle ear surgery, the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery proposed 2 levels of guidelines: level 1 for reporting summary data and level 2 for reporting raw data. The Committee encourages the reporting of raw data from each individual case. However, in studies in which the examined population is too large, this can yield difficulties. With respect to this point, we designed a method for a simple visual presentation of hearing results in an attempt to provide data from each individually operated ear in a patient group. In this method the relation between the preoperative and postoperative bone-conduction levels is evaluated to assess overclosure and iatrogenic cochlear damage, and the relation between postoperative gain in air conduction and the preoperative air-bone gap is evaluated as a measure of technical success rate. This results in 2 plots, which we called the Amsterdam Hearing Evaluation Plots. Audiometric data from 451 stapes operations were used to demonstrate the use of the Amsterdam Hearing Evaluation Plots.

Adult↗
PubMed1979

Middle-ear structures contribute little to auditory perception of microwaves.

The contribution of the ossicles (middle-ear bones) to auditory perception of microwaves was evaluated by the brain-stem evoked response (BER). Amplitude and latency of BERs were recorded from guinea pigs that were stimulated at various intensities by acoustic pulses coupled to the auditory canal or via bone conduction, and by microwave pulses. Blocking of the external ear, middle-ear damping, and middle-ear destruction produced little change in the BERs that were elicited by microwave pulses. Results indicate that activity in the central auditory pathway as induced by pulsed microwaves only requires stimulation of the cochlea. Conduction of pressure waves through the bones of the calvarium appears to be the mechanism responsible in perception of pulsed microwaves.

Animals↗
PubMed2004

Neurosensory deficits after myocardial infarction.

Cardiovascular diseases are extremely widespread and often cause vestibular system dysfunctions. They are related mainly to organic lesions of the brain. To investigate neurootological functional changes, we compared two samples from among our patients, of whom those in group A (42 persons: 92.86% male, 7.14% female) had experienced myocardial infarction within 1 year before our neurootometric investigation and those in group B had undergone infarction 1 year or more before examination (104 patients: 81.73% male, 18.27% female). Considering only the six most important vertigo symptoms experienced by patients, we found 1.48 symptoms per patient in group A and 2.02 symptoms per patient in group B. As regards acoustic symptoms, 45.24% of patients in group A experienced tinnitus and 52.38% reported hearing loss. In patients in group B, 48.08% were affected with tinnitus and 58.65% with hearing loss. Abnormalities in the neurootometric measurements were revealed as follows: in group A, butterfly calorigrams, 80.95%; stepping-test craniocorpography (CCG), 64.29%; and bone conduction audiometry on the right side, 40.48%, and on the left side, 52.38%; in group B, butterfly calorigrams, 78.85%; stepping-test CCG, 61.54%; bone conduction audiometry on the right side, 28.85%, and on the left side, 41.35%.

Audiometry, Pure-Tone↗
PubMed2002

Late radiation effects on hearing, vestibular function, and taste in brain tumor patients.

PURPOSE: To investigate late radiation effects on hearing, vestibular function, and taste after conventional radiotherapy in brain tumor patients. METHODS AND MATERIALS: Hearing, vestibular function, and taste were assessed in 33 brain tumor patients irradiated unilaterally to the tumor-bearing hemisphere and the temporal bone. Median observation time after completion of radiotherapy was 13 years; the fraction dose was 1.8 Gy, and mean radiation dose was 53.1 Gy. RESULTS: Deep ulceration in the external ear canal and osteoradionecrosis on the irradiated side was seen in three patients. Reduced hearing was found for air and bone conduction of the irradiated side compared to the opposite side (0.25-2 kHz: 6.1 dB, 4 kHz: 10.3 dB, 6 kHz: 15.6 dB, and 8 kHz: 16.5 dB). For bone conduction, the corresponding figures were 0.25-2 kHz: 5.5 dB and 4 kHz: 8.2 dB. Three patients had a canal paresis of the irradiated side, and three patients had affection of the chorda tympani. CONCLUSION: Irradiation of the temporal bone with doses usually given in the treatment of patients with brain tumors may cause osteoradionecrosis, sensorineural hearing loss, dysfunction of the vestibular inner ear, and loss of taste. Head-and-neck examination should be included in the follow-up of long-term survivors.

Adolescent↗
PubMed1994

Estimation of the benefit of bone-anchored hearing aids.

Implantable bone conduction hearing aids are a valuable alternative to conventional aids for those who cannot use a conventional air conduction aid or find it difficult to use because of an aural discharge, most commonly due to chronic otitis media. Previously reported series of the use of a bone-anchored hearing aid (BAHA) come from the originators of this device, and an independent report of their benefit and use, especially in previous air conduction aid users, would be of value. Twenty-three patients were evaluated at least 6 months after implantation of a BAHA. All 7 previous bone conduction aid users were delighted with their BAHA, reporting increased comfort and hearing benefit that was backed by audiometric evidence. Of the 16 individuals who previously used an air conduction aid, 11 (69%) were delighted users of their BAHA. Unfortunately, the other 5 (31%) reverted to solely using their air conduction aid. There was no obvious predictor as to how these individuals might have been identified prior to implantation. In particular, their pure tone thresholds, especially the bone conduction thresholds, were no different from those of the 11 BAHA users. However, in free field audiometry, the users gained superior benefit from their BAHA compared to their air conduction aid, whereas the nonusers did not. In conclusion, in all series to date, previous users of a conventional bone conduction aid have been delighted users of a BAHA and have gained superior audiometric benefit. This is not necessarily the case with previous air conduction aid users.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Early detection of the neurosensory component of hearing loss in patients with adhesive otitis media].

Thirty patients with adhesive otitis media and 10 otologically normal subjects were examined audiometrically in a wide frequency range according to Sagalovich. It was found that this kind of audiometry may help detect early symptoms of hearing impairment on a neurosensory basis which remain unobservable in conventional audiography. It was demonstrated that hearing threshold increments in a wide frequency range correlated with the shape of the curve of bone conductivity in conventional audiography. The hearing changes in a wide frequency range were dependent on the primary disease duration and were independent of the bone-air interval value in conventional audiography. Our investigations allow the conclusion that measurement of hearing sensitivity in a wide frequency range under the conditions of bone conductivity enlarges the capabilities of current tonal audiometry and opens up new perspectives for assessing the hearing level of patients with adhesive otitis media.

Adolescent↗
PubMed2006

The dynamic conduct of bone marrow-derived cells in the choroidal neovascularization microenvironment.

PURPOSE: Choroidal neovascularization (CNV) is one of the most frequent causes of severe and progressive vision loss. Prior studies have shown that bone marrow-derived cells (BMCs) play an important role in CNV, indicating that BMCs can be a potential target for inhibiting the development of CNV. It could be helpful for our understanding of CNV to study the dynamic conduct of BMCs in the CNV microenvironment. METHODS: Green fluorescent protein (gfp) chimeric mice were developed by transplanting bone marrow cells from gfp+/+ transgenic mice to adult C57BL/6J mice. The chimeric mice underwent laser rupture of Bruch's membrane to induce CNV and were killed at 1, 2, 3, and 4 weeks after laser injury. The eyes were enucleated and processed for immunofluorescence to detect markers for vascular smooth muscle cells (alpha smooth muscle actin, alpha SMA), endothelial cells (CD31), or macrophages (F4/80) on gfp+ cells. All sections were qualitatively and quantitatively assessed by confocal microscopy. RESULTS: Large number of gfp-labeled cells appeared in the lesions and integrated into CNV. Gfp+ cells, which were immunoreactive for alpha SMA, CD31, or F4/80, can be detected through the whole study. The constituent ratio of those three cell-types in total gfp+ cells in CNV altered as CNV developed. The maximal ratios of CD31-labeled cells and F4/80-labeled cells presented at 2 week, while the ratio of alpha SMA-labeled cells upgraded continuously. CONCLUSIONS: BMCs underwent a serial of changes in position and expression during the progression of CNV. Those changes may result from the interaction between BMCs and the CNV microenvironment.

Actins↗
PubMed2006

Evolution of the middle ear apparatus in Talpid moles.

The middle ear structures of eight species of mole in the family Talpidae (Mammalia: Eulipotyphla) were studied under light and electron microscopy. Neurotrichus, Parascalops, and Condylura have a simple middle ear cavity with a loose ectotympanic bone, ossicles of a "microtype" morphology, and they retain a small tensor tympani muscle. These characteristics are ancestral for talpid moles. Talpa, Scalopus, Scapanus, and Parascaptor species, on the other hand, have a looser articulation between malleus and ectotympanic bone and a reduced or absent orbicular apophysis. These species lack a tensor tympani muscle, possess complete bullae, and extensions of the middle ear cavity pneumatize the surrounding basicranial bones. The two middle ear cavities communicate in Talpa, Scapanus, and Parascaptor species. Parascaptor has a hypertrophied malleus, a feature shared with Scaptochirus but not found in any other talpid genus. Differences in middle ear morphology within members of the Talpidae are correlated with lifestyle. The species with middle ears closer to the ancestral type spend more time above ground, where they will be exposed to high-frequency sound: their middle ears appear suited for transmission of high frequencies. The species with derived middle ear morphologies are more exclusively subterranean. Some of the derived features of their middle ears potentially improve low-frequency hearing, while others may reduce the transmission of bone-conducted noise. By contrast, the unusual middle ear apparatus of Parascaptor, which exhibits striking similarities to that of golden moles, probably augments seismic sensitivity by inertial bone conduction.

Animals↗
PubMed1986

An implantable hearing device: osseointegration of a titanium-magnet temporal bone stimulator.

The use of bone conduction hearing devices has recently entered the realm of implantable prostheses and solid-state electronics, resulting in improved fidelity and applicability for a wider range of patients. One particular device, a temporal bone stimulator (TBS), consists of an external sound processor and implanted portion to cause vibration under the skin. An implantable temporal bone stimulator screw constructed of titanium alloy with a permanent magnet can be vibrated by inductive transcutaneous coupling. The safety and osseointegration of the TBS bone screw were tested in adult goats that were free-field stimulated at 75 dB with the TBS processor for 4 to 21 weeks. Histologic comparisons of the soft tissue and bone adjacent to active and passive screws revealed no remarkable differences between them with bone growing in the interstices of the threaded portion. Evidence for mild reorganization of bone was shown with Goldner's stain, which differentiated bone that was young and unmineralized from bone that was older and mineralized. Reorganization was evident in both the active and passive sites and there was no remarkable difference between the two in a blind study. Additional evidence for the integrity of the implant was obtained by subjecting a calvarium containing both screws to a 5000 gauss magnetic field for 10 minutes of a nuclear magnetic resonance head scan. The calvarium was first dissected free from overlying skin and connective tissue. The magnet-containing screws were not loosened. We conclude that the implanted screw portion of the TBS implantable hearing device is well-integrated into the temporal bone. Mild stimulation of new bone growth indicates a healthy long-term viable implant for bone conduction amplification of sound.

Animals↗
PubMed1995

Patients' opinions of bone-anchored vs conventional hearing aids.

OBJECTIVE: To evaluate patients' opinions of the bone-anchored hearing aid (BAHA) compared with a conventional hearing aid. DESIGN: Prospective study with two questionnaires. Questionnaire A consisted of questions that compared patients' previous hearing aid with the BAHA. Questionnaire B consisted of questions about the patients' experiences with the hearing aids. PATIENTS: Sixty-five consecutive patients who had used conventional hearing aids. SETTING: Tertiary referral center. INTERVENTION: A percutaneous titanium implant in the temporal bone for the BAHA. MAIN OUTCOME MEASURE: Qualitative descriptive results of questionnaire A and difference scores from questionnaire B comparing conventional hearing aids and the BAHA. RESULTS: Patients favored the BAHA to the conventional bone-conduction hearing aid. Patients with BAHA reported a significant improvement in speech recognition in quiet and in noise, in sound quality, and in comfort (P < .01). The results with the BAHA compared with the air-conduction hearing aid were ambiguous for speech recognition, but all the patients reported a decrease in ear infections. CONCLUSION: The BAHA is a good alternative for the conventional bone-conduction hearing aid if a patient can no longer use an air-conduction hearing aid.

Audiometry, Speech↗
PubMed2000

Sensorineural hearing loss caused by a high jugular bulb.

A 15-year-old female presented with sensorineural hearing loss related to a high jugular bulb. She noticed temporary worsening of her right hearing with mild dizziness when her neck was compressed whereas she noticed no change in her left hearing. An audiogram showed temporary worsening of low tone bone-conduction on such occasions. A large jugular bulb covering the right round window was observed through the perforation. Computed tomography (CT) revealed a large jugular bulb obliterating the round window niche. Deterioration of bone conduction during neck compression was thought to be caused by the protrusion of the jugular bulb into the inner ear via the round window. This case suggested the possibility of sensorineural hearing loss due to the jugular bulb. As in the present case, jugular bulb or vein-related ear disorders should be examined by neck compression.

Adolescent↗
PubMed2005

[Clinical application of incomplete tympanectomy for secretory otitis media in nasopharyngeal carcinoma after radiotherapy].

BACKGROUND & OBJECTIVE: Efficacy of previous treatments on secretory otitis media ears with severely damaged eustachian tube function after radiotherapy is limited. Tympan perforation can avoid relapse of secretory otitis media. This study was to explore clinical value of incomplete tympanectomy for secretory otitis media in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. METHODS: After confirmed severely damaged eustachian tube function through comprehensive examinations, 16 NPC patients (18 ears) with secretory otitis media after radiotherapy received incomplete tympanectomy. All patients were followed up for more than 6 months. RESULTS: After operation, 11 of 18 (61%) ears remained tympan perforation, audition was improved at large in these ears, the average air-bone conduction difference decreased from 30.1 dB to 16.0 dB, other symptoms, such as aural fullness, tinnitus, and headache, basically disappeared. After operation, tympans closed up in 7 (39%) ears,the average air-bone conduction difference decreased from 33.0 dB to 32.1 dB. CONCLUSION: Incomplete tympanectomy may have a long and definite effect on secretory otitis media without any injury on audition after healing of tympan.

Adult↗