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Hearing-preserving approaches to the internal auditory canal: feasibility assessment from an endoscope's perspective.

World Neurosurg 2022 Jan 10. Epub 2022 Jan 10.

Department of Otolaryngology Head and Neck Surgery, Inselspital University Hospital and University of Bern, Bern, Switzerland; Hearing Research Laboratory, ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland.

Objective: To date, minimally invasive transcanal transpromontorial endoscopic approaches to the internal auditory canal sacrifice the cochlea. Two hearing-preserving approaches, the exclusively endoscopic transcanal infracochlear approach and the endoscope-assisted transmastoid retrolabyrinthine approach, are being controversially discussed in the literature. In this study, we examine the feasibility of these two approaches by means of 3D surface models, a population-based analysis of the available surgical space, and dissections in human whole head specimens. Read More

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January 2022

Pharmacokinetics and biodistribution of supraparticle-delivered neurotrophin 3 in the guinea pig cochlea.

J Control Release 2022 Jan 6;342:295-307. Epub 2022 Jan 6.

Bionics Institute, Melbourne, Australia; Medical Bionics Department, University of Melbourne, Australia; Department of Surgery (Otolaryngology), University of Melbourne, Australia. Electronic address:

Hearing loss is the most prevalent sensory disorder affecting nearly half a billion people worldwide. Aside from devices to assist hearing, such as hearing aids and cochlear implants, a drug treatment for hearing loss has yet to be developed. The neurotrophin family of growth factors has long been established as a potential therapy, however delivery of these factors into the inner ear at therapeutic levels over a sustained period of time has remained a challenge restricting clinical translation. Read More

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January 2022

Round window membrane rupture following blunt force trauma.

Ann R Coll Surg Engl 2022 Jan;104(1):e12-e13

The Ear Centre, Green Pastures Hospital, Nepal.

Round window rupture following barotrauma such as diving and air travel is well documented. However, we describe a case of round window rupture following a slap to the ear, which has not been described previously. A 12-year-old boy was slapped by his teacher in rural Nepal over his left ear and immediately noted hearing loss. Read More

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January 2022

Acoustic streaming resulting from compression of the cochlear bony capsule.

J Acoust Soc Am 2021 Dec;150(6):4548

Center for Advanced Computation and Telecommunications, University of Massachusetts Lowell, 1 University Ave., Lowell, Massachusetts 01854, USA.

Acoustic streaming resulting from the time-harmonic compression of the cochlear capsule is examined in this paper. The cochlear pressure is expressed as an integral equation in the cochlear partition velocity. Rapid spatial variation in the velocity of the cochlear partition requires one to treat high-order fluid modes within the cochlear fluid. Read More

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December 2021

Role of the endoscope in cochlear implantation: A systematic review.

Clin Otolaryngol 2021 Dec 31. Epub 2021 Dec 31.

Department of Otorhinolaryngology-Head and Neck Surgery, 'G. Papanikolaou' General Hospital, Thessaloniki, Greece.

Objective: To review the role of the endoscope in cochlear implantation (CI).

Methods: MEDLINE, ScienceDirect, Google Scholar and the Cochrane Library databases, as well as other sources, were searched by two independent reviewers. Studies including patients undergoing either exclusively endoscopic or endoscopically assisted CI were eligible for inclusion. Read More

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December 2021

Round Window Stimulation of the Cochlea.

Front Neurol 2021 14;12:777010. Epub 2021 Dec 14.

Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, United States.

Mixed hearing loss associated with a sensorineural component and an impaired conductive mechanism for sound from the external ear canal to the cochlea represents a challenge for rehabilitation using either surgery or traditional hearing amplification. Direct stimulations of the ossicular chain and the round window (RW) membrane have allowed an improved hearing in this population. The authors review the developments in basic and clinical research that have allowed the exploration of new routes for inner ear stimulation. Read More

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December 2021

Surgical treatments of superior semicircular canal dehiscence: A single-centre experience in 63 cases.

Laryngoscope Investig Otolaryngol 2021 Dec 24;6(6):1414-1420. Epub 2021 Nov 24.

Service d'ORL, Otoneurologie et ORL Pédiatrique CHU Toulouse Purpan Toulouse France.

Objective: Different procedures have been described to treat superior canal dehiscence. The present study aims to describe the results obtained with middle fossa approach, transmastoid approach, and round window reinforcement in a large series of patients.

Methods And Design: In this single-center retrospective study, we report the results of the procedures performed between 2006 and 2019 using the three main surgical approaches, middle fossa approach (MFA), transmastoid approach (TMA), and round window reinforcement (RWR). Read More

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December 2021

Herniation of the Mastoid Segment of the Facial Nerve During Cochlear Implantation Surgery.

Ear Nose Throat J 2021 Dec 18:1455613211051655. Epub 2021 Dec 18.

Division of Neurology, Department of Internal Medicine, Faculty of Medicine, 251087Damascus University, Damascus, Syria.

Background: We aim to report a rare case of a herniated mastoid segment of the facial nerve that was accidently discovered during cochlear implantation surgery and how altering the surgery plan could achieve the implantation while preserving the nerve.

Case Presentation: A four-year-old girl presented with profound bilateral sensorineural hearing loss that did not completely resolve after 2 years of using hearing aids was scheduled for cochlear implantation surgery in the right ear. During surgery, a herniated mastoid segment of the facial nerve took an anterior course and obstructed the access to the round window. Read More

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December 2021

[Analysis of the imaging characteristics of otosclerosis based on 10 μm otology CT].

Zhonghua Yi Xue Za Zhi 2021 Dec;101(47):3885-3889

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

To evaluate the imaging features of otosclerosis based on10 μm otology CT. Data of 27 patients with otosclerosis (51 sides) in Beijing Friendship Hospital, Capital Medical University from October 2020 to July 2021 were retrospectively collected, including 9 males and 18 females age ffrom 22 to 70 (42±12) years. All patients underwent 10 μm otology CT examination and surgical treatment. Read More

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December 2021

Image-Based Planning of Minimally Traumatic Inner Ear Access for Robotic Cochlear Implantation.

Front Surg 2021 25;8:761217. Epub 2021 Nov 25.

Department of Otorhinolaryngology, Head and Neck Surgery, Vrije Universiteit Brussel, Brussels, Belgium.

During robotic cochlear implantation, an image-guided robotic system provides keyhole access to the scala tympani of the cochlea to allow insertion of the cochlear implant array. To standardize minimally traumatic robotic access to the cochlea, additional hard and soft constraints for inner ear access were proposed during trajectory planning. This extension of the planning strategy aims to provide a trajectory that preserves the anatomical and functional integrity of critical intra-cochlear structures during robotic execution and allows implantation with minimal insertion angles and risk of scala deviation. Read More

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November 2021

Genome-wide Association Study for Carcass Primal Cut Yields Using Single-step Bayesian Approach in Hanwoo Cattle.

Front Genet 2021 26;12:752424. Epub 2021 Nov 26.

Animal Breeding and Genetics Division, National Institute of Animal Science, Cheonan-si, South Korea.

The importance of meat and carcass quality is growing in beef cattle production to meet both producer and consumer demands. Primal cut yields, which reflect the body compositions of carcass, could determine the carcass grade and, consequently, command premium prices. Despite its importance, there have been few genome-wide association studies on these traits. Read More

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November 2021

Staged surgical management of idiopathic sudden sensorineural hearing loss refractory to medical treatment

Orv Hetil 2021 12 19;162(51):2055-2060. Epub 2021 Dec 19.

1 Pécsi Tudományegyetem, Általános Orvostudományi Kar, Klinikai Központ, Fül- Orr-Gégészeti és Fej-Nyaksebészeti Klinika Pécs, Munkácsy M. u. 2., 7621.

Összefoglaló. A hirtelen halláscsökkenés patofiziológiája még nagyrészt tisztázatlan, így oki terápia nem lehetséges. Az elsődleges kezelést a helyileg vagy szisztémásan adott kortikoszteroid jelenti, egységes protokoll azonban nem áll rendelkezésre. Read More

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December 2021

The posterior ligament of the incus ("white dot"): A reliable surgical landmark for the facial recess.

Am J Otolaryngol 2021 Dec 3;43(2):103304. Epub 2021 Dec 3.

Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN 55905, USA; Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA. Electronic address:

Objective: There is a void in the literature describing reliable surgical landmarks that aid in the dissection of the facial recess in the absence of skeletonizing the mastoid segment of the facial nerve. The posterior ligament of the incus is a readily distinguishable "white dot" along the incus buttress that has been used to guide dissection in a safe and efficient manner. The goal of our study is to describe a surgical approach that utilizes this surgical landmark to drill the facial recess and to take anatomical measurements demonstrating the safety and reliability of this approach. Read More

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December 2021

Evaluating cochlear insertion trauma and hearing preservation after cochlear implantation (CIPRES): a study protocol for a randomized single-blind controlled trial.

Trials 2021 Dec 9;22(1):895. Epub 2021 Dec 9.

Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht University, P.O. Box 85500, 3508, GA, Utrecht, the Netherlands.

Background: In order to preserve residual hearing in patients with sensorineural hearing loss (SNHL) who receive a cochlear implant (CI), insertion trauma to the delicate structures of the cochlea needs to be minimized. The surgical approach comprises the conventional mastoidectomy-posterior tympanotomy (MPT) to arrive at the middle ear, followed by either a cochleostomy (CO) or the round window (RW) approach. Both techniques have their benefits and disadvantages. Read More

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December 2021

[Round window implantation of vibrant soundbridge through a retrofacial approach].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Nov;35(11):1023-1027

Department of Otolarygology Head and Neck Surgery,Beijing Tongren Hospital,the Key Laboratory of Otolaryngology Head and Neck Surgery,Capital Medical University.

To investigate the specific retrofacial approach for application of vibrant soundbridge (VSB) to the round window (RW) in patients with complex congenital ear malformation. The clinical information of four patients with congenital ear malformation were retrospectively analyzed. VSB were implanted unilaterally in these four patients via a retrofacial approach. Read More

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November 2021

Effect of Dexamethasone Combination with Gentamicin in Chemical Labyrinthectomy on Hearing Preservation and Vertigo Control in Patients with Unilateral Meniere's Disease: A Randomized Controlled Clinical Trial.

J Clin Med 2021 Nov 27;10(23). Epub 2021 Nov 27.

Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul 03722, Korea.

Chemical labyrinthectomy using gentamicin is a popular method for treating intractable vertigo attacks in Meniere's disease. However, the risk of hearing loss remains a major concern for clinicians. We investigated the effect of simultaneous dexamethasone and gentamicin application on hearing preservation and vertigo control in patients with intractable unilateral Meniere's disease. Read More

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November 2021

Do children in India grow well into adolescents? Longitudinal analysis of growth transitions from Young Lives panel survey in India.

Public Health 2022 Jan 4;202:18-25. Epub 2021 Dec 4.

Department of Biostatistics, National Institute of Mental Health and Neuro Sciences, Bangalore, India.

Objectives: Studies that examined the growth during late childhood and early adolescence beyond 8 years of age are very limited. Further, most studies have used dichotomized classification of stunting, thereby limiting the understanding of moderate stunting in childhood growth trajectory. We aimed to examine the course of stunting from childhood to adolescence by undertaking robust analyses of the Young Lives Survey (YLS) longitudinal data from India using multilevel categorization of stunting. Read More

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January 2022

Ultra-High-Resolution CT to Detect Intracochlear New Bone Formation after Cochlear Implantation.

Radiology 2021 Dec 7:211400. Epub 2021 Dec 7.

From the Departments of Otorhinolaryngology (F.H., T.M.K., W.J.H., E.A.M.M.) and Radiology (W.J.v.d.W., B.M.V.), Radboud University Medical Center, Philips van Leydenlaan 16, Route 377, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (F.H., T.M.K., W.J.H., E.A.M.M.); Department of Radiology, Civil Hospital, Vigevano, Italy (F.L.); and Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands (B.M.V.).

Background Histopathologic studies reported that cochlear implantation, a well-established means to treat severe-to-profound sensorineural hearing loss, may induce inflammation, fibrosis, and new bone formation (NBF) with possible impact on loss of residual hearing and hearing outcome. Purpose To assess NBF in vivo after cochlear implantation with ultra-high-spatial-resolution (UHSR) CT and its implication on long-term residual hearing outcome. Materials and Methods In a secondary analysis of a prospective single-center cross-sectional study, conducted between December 2016 and January 2018, patients with at least 1 year of cochlear implantation experience underwent temporal bone UHSR CT and residual hearing assessment. Read More

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December 2021

Effects of Calcitonin-Gene-Related-Peptide on Auditory Nerve Activity.

Front Cell Dev Biol 2021 12;9:752963. Epub 2021 Nov 12.

Department of Otolaryngology, University of Michigan, Ann Arbor, MI, United States.

Calcitonin-gene-related peptide (CGRP) is a lateral olivocochlear (LOC) efferent neurotransmitter. Depression of sound-driven auditory brainstem response amplitude in CGRP-null mice suggests the potential for endogenous CGRP release to upregulate spontaneous and/or sound-driven auditory nerve (AN) activity. We chronically infused CGRP into the guinea pig cochlea and evaluated changes in AN activity as well as outer hair cell (OHC) function. Read More

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November 2021

Triamcinolone acetonide can be detected in cerebrospinal fluid after intratympanic injection.

Eur J Pharm Biopharm 2022 Jan 2;170:52-58. Epub 2021 Dec 2.

Medical University of Vienna, Vienna, Austria, Department of Otorhinolaryngology, Head and Neck Surgery, Austria. Electronic address:

Intratympanically applied treatments are of increasing interest to the otologic community to treat sudden sensorineural hearing loss or vestibular disorders but also to deliver gene therapy agents, or biologics to the inner ear. Further diversion from the middle ear and perilymph to blood circulation and cerebrospinal fluid via the cochlear aqueduct are one of the limiting factors and so far not understood well enough. In this study, intratympanically applied triamcinolone acetonide was determined in cerebrospinal fluid. Read More

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January 2022

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study.

Surg Radiol Anat 2021 Nov 24. Epub 2021 Nov 24.

Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Banacha 1a Street, 02-202, Warsaw, Poland.

Purpose: Sinus tympani is the space in the retrotympanum, with variable morphology. Computed tomography is a common tool to investigate sinus tympani anatomy. During cochlear implantation or tympanoplasty, electrocochleography can be used for hearing monitoring. Read More

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November 2021

Permeation of polyethylene glycols across the tympanic membrane.

Giant (Oxf) 2021 Jun 8;6. Epub 2021 Apr 8.

Laboratory for Biomaterials and Drug Delivery, The Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, United States.

Localized and non-invasive delivery of therapeutics across barriers in the body is challenging. Examples include the flux of drugs across the tympanic membrane (TM) for the treatment of middle ear infections, and across the round window to treat inner ear disease. With the emergence of macromolecular therapies, the question arises as to whether such delivery can be achieved with macromolecules. Read More

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Endolymphatic Hydrops is a Marker of Synaptopathy Following Traumatic Noise Exposure.

Front Cell Dev Biol 2021 5;9:747870. Epub 2021 Nov 5.

Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States.

After acoustic trauma, there can be loss of synaptic connections between inner hair cells and auditory neurons in the cochlea, which may lead to hearing abnormalities including speech-in-noise difficulties, tinnitus, and hyperacusis. We have previously studied mice with blast-induced cochlear synaptopathy and found that they also developed a build-up of endolymph, termed endolymphatic hydrops. In this study, we used optical coherence tomography to measure endolymph volume in live CBA/CaJ mice exposed to various noise intensities. Read More

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November 2021

Drug Delivery across Barriers to the Middle and Inner Ear.

Adv Funct Mater 2021 Oct 4;31(44). Epub 2020 Dec 4.

Laboratory for Biomaterials and Drug Delivery, Department of Anesthesiology, Division of Critical Care Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.

The prevalence of ear disorders has spurred efforts to develop drug delivery systems to treat these conditions. Here, recent advances in drug delivery systems that access the ear through the tympanic membrane (TM) are reviewed. Such methods are either non-invasive (placed on the surface of the TM), or invasive (placed in the middle ear, ideally on the round window [RW]). Read More

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October 2021

[A case of obliteration of a round window in otosclerosis].

Vestn Otorinolaringol 2021 ;86(5):75-81

Pirogov Russian National Research Medical University, Moscow, Russia.

The article presents a brief review of the literature on the anatomy and physiology of the round window (RW) niche, the causes of occlusion, the diagnosis of this pathology, the features of auditory disorders and tactics when it is detected in patients with otosclerosis (OS). A clinical case of diagnosis and effective surgical treatment for obliteration of RW in a patient with advanced OS, which occurred in 2019 in 0.7% of cases, is described. Read More

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November 2021

[The significance of microanatomy of the round window in terms of cochlear implantation].

Vestn Otorinolaringol 2021 ;86(5):42-47

St. Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia.

Sensoneural hearing loss is a polyetiological disease, which is often a secondary reflection of systemic pathology and is associated with damage of the cochlea and auditory nerve receptors. An important point in the surgical stage of cochlear implantation is the introduction of an implant active electrode into the cochleostomy spiral channel through the cochleostoma or round window. However, the issue of intra-cochlear structures surgical trauma in such surgical intervention seems to be very important, as it may reduce the success of subsequent rehabilitation. Read More

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November 2021

Inner hair cell stereocilia displacement in response to focal stimulation of the basilar membrane in the ex vivo gerbil cochlea.

Hear Res 2021 Dec 22;412:108372. Epub 2021 Oct 22.

Hearing Research Center, Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, 02215, MA, United States.

The inner hair cells in the mammalian cochlea transduce mechanical signals to electrical signals that provide input to the auditory nerve. The spatial-temporal displacement of the inner hair cell stereocilia (IHCsc) relative to basilar membrane (BM) displacement is central to characterizing the transduction process. This study specifically focuses on measuring displacement of the stereocilia hair bundles in the radial dimensions where they are most sensitive. Read More

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December 2021

Salicylate-induced changes in organ of Corti vibrations.

Hear Res 2021 Nov 2:108389. Epub 2021 Nov 2.

Columbia University, Department of Otolaryngology 630 West 168th Street New York, NY 10032 USA; Columbia University, Department of Biomedical Engineering 1210 Amsterdam Avenue New York, NY 10027 USA.

Intra organ of Corti (OC) vibrations differ from those measured at the basilar membrane (BM), with higher amplitudes and a wide-band nonlinearity extending well below a region's best frequency. The vibrations are boosted by the cochlear amplifier, the active processes within the mammalian hearing organ, and are thus sensitive to metabolic or pharmacological manipulation. We introduced salicylate, a known blocker of outer hair cell (OHC) based electromotility, into the perilymphatic space by applying sodium salicylate onto the round window membrane. Read More

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November 2021

Residual hearing preservation for cochlear implantation surgery.

Tzu Chi Med J 2021 Oct-Dec;33(4):359-364. Epub 2021 Feb 6.

Department of Otolaryngology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.

Cochlear implantation (CI) has developed for more than four decades. Initially, CI was used for profound bilateral hearing impairment. However, the indications for CI have expanded in recent years to include children with symptomatic partial deafness. Read More

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February 2021

Combined Endoscopic/Microscopic Cochlear Implantation Through the Oval Window.

Authors:
Italo Cantore

J Audiol Otol 2021 Nov 9. Epub 2021 Nov 9.

Cochlear Implants Regional Center, San Carlo Regional Hospital, Potenza, Italy.

Standard round window (RW) cochlear implantation is a well-described technique. Implantation might be difficult in patients with inner and middle ear anomalies, in some cases because of not achieving adequate exposure to the RW, with a related higher risk of complications such as facial nerve injury. It is proposed a combined microscopic/endoscopic oval window approach in a 63 year old man affected by bilateral Menière disease, with bilateral severe sensorineural hearing loss, speech discrimination score for bysillabic words under 40% and a hidden RW by anomalous facial nerve course. Read More

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November 2021