Objective:This study aims to establish an economically viable and easily accessible adult animal model for optogenetic activation of auditory neurons using adeno-associated viruses(AAVs)carrying Ch R2(H134R)to explore...Objective:This study aims to establish an economically viable and easily accessible adult animal model for optogenetic activation of auditory neurons using adeno-associated viruses(AAVs)carrying Ch R2(H134R)to explore the potential of cochlear optogenetics as a hearing restoration technology.Methods:Healthy adult guinea pigs were used in the experiments.The viral vector AAV2/8-Ch R2(H134R)-h Syn-e YFP was administered to the right cochlea via the round window membrane.The confocal microscopy and reverse transcription polymerase chain reaction(RT-PCR)were utilized to analyze the Ch R2(H134R)expression localized to spiral ganglion neurons(SGNs).The auditory pathway activation was assessed by recording the optical compound action potential(oCAP)and acoustic compound action potential(a CAP)at various laser intensities.Results:The Ch R2(H134R)-e YFP expression was confirmed in 90%of the tested animals,localized to the SGNs of the injected ear.Higher m RNA levels of Ch R2(H134R)and e YFP were observed in the injected ear compared to the non-injected ear,while actin(Actb)m RNA levels were not significantly different.The o CAP was successfully elicited by a 470 nm blue light laser stimulus,with similar amplitudes and latency periods to those of a CAPs when the o CAP was evoked by 5.80 m W blue light and the a CAP was evoked by a 40 d B SPL click.The amplitudes of o CAPs increased with increasing laser intensity.Conclusion:This study demonstrates the viability of optogenetic activation of the auditory system in adult guinea pigs through the transduction of AAV-Ch R2(H134R)in SGNs.Cochlear optogenetics demonstrates potential as a hearing restoration technology,providing a basis for further clinical research and opening new avenues for investigation.展开更多
Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of deve...Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of developing a practical model that can accurately predict long-term vestibular function outcomes and identify associated risk factors.Methods:Clinical data,including imaging,vestibular evoked myogenic potentials(VEMPs),and auditory information,were collected from patients with sensorineural hearing loss(SNHL)before and after CI.The decision tree algorithm was employed to address missing values and screen pre-CI clinical features.Six machine learning methods were subsequently utilized to predict the relationships between the extracted features and post-CI vestibular dysfunction.The best-performing method determined the ranking of feature importance,which was regarded as risk factors for predicting symptoms and VEMPs results after CI.Results:Logistic regression models effectively predicted both post-CI vestibular dysfunction and abnormal cervical VEMP(c VEMP),with accuracies of 80%and 78%,respectively.The relative importance of the features,in descending order,was as follows:c VEMP latency,c VEMP amplitude,and residual hearing threshold.Moreover,the support vector machine(SVM)model attained an accuracy of 88%in predicting abnormal ocular VEMP(o VEMP)post-CI.For the SVM model,the feature importance ranking was as follows:o VEMP latency,o VEMP amplitude,and residual hearing threshold.Conclusions:This study successfully leverages machine learning techniques,specifically support vector machines(SVM)and logistic regression models,to predict the impact of CI on vestibular function.These predictive models provide valuable insights for presurgical planning and decision-making in CI procedures.Moreover,the findings highlight the critical risk factors associated with vestibular dysfunction,offering a robust reference for guiding vestibular rehabilitation strategies.展开更多
PurposeThe study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.MethodsThe Ear Outcome Survey-1...PurposeThe study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.MethodsThe Ear Outcome Survey-16(EOS-16),which assesses ear-specific symptoms and quality of life(QoL),was administered before and after cochlear implantation along with the post-operative administration of the 15D questionnaire that evaluates general HRQoL.The authors investigated post-implantation changes in the EOS-16 total scores and its category responses,examining their relationship with pre-and post-operative hearing levels,speech perception in noise,and the follow-up period length(time elapsed since cochlear implantation).ResultsThere were positive changes noted for the hearing,need for care,and QoL categories of the EOS-16 after implantation.The length of the follow-up period was a significant factor associated with improvements in subjective outcome measures.Changes in self-perceived hearing and HRQoL post-implantation seem independent of pre-and post-implantation hearing performance.ConclusionThese results suggest that while patients regain their hearing abilities shortly after implant activation,their subjective hearing-related benefits and QoL improve over time.展开更多
Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant ele...Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant electrodes in patients with inner ear malformations,and determine the value of 3D segmentation in predicting cochlear implant electrode insertion depth by simulating electrode implantation in a reconstructed 3D model.Methods:Data from 208 temporal bone CT scans of patients with a variety of inner ear malformations(including the CH,IP-Ⅰ,IP-Ⅱ,and IP-Ⅲtypes)who underwent cochlear implantation at our center were retrospectively analyzed.Preoperative temporal bone CT data were subjected to three-dimensional(3D)segmentation of the cochlea with a 3D slicer.Results:Cochlear malformation types,including IP typesⅠ(42 ears),Ⅱ(278ears),Ⅲ(20 ears),and CH(65 ears),were diagnosed and measured in 208 preoperative CT datasets.Cochlear anatomical parameters and electrode length were correlated,which partially explained the variations in electrode insertion angle.The mean angle of implantation among the enrolled patients was 564.33°,and the mean implantation angle prediction error in the 3D segmentation was|23.74|°.Conclusion:Three-dimensional segmentation from temporal bone CT is valuable for surgeons,especially in treating patients with inner ear malformation.Such insights will help surgeons understand overall anatomical variations,predict electrode implantation depth,and complete preoperative imaging assessments for cochlear implant insertion depth in patients with inner ear malformations.展开更多
This paper proposes a cochlear prosthetic system with an implanted digital signal processor （DSP）. This system transmits voice-band signals with a low data rate through the wireless link, free of the data-rate limit...This paper proposes a cochlear prosthetic system with an implanted digital signal processor （DSP）. This system transmits voice-band signals with a low data rate through the wireless link, free of the data-rate limitation and suitable for future development. By optimizing the speech processing algorithm and the DSP hardware design, the implanted DSP manages to execute the continuous interleaved sampling （CIS） algorithm at a clock frequency of 3MHz and a power consumption of only 1.91mW. With an analytic power-transmission efficiency of the wireless inductive link （40%）, the power overhead caused by the implanted DSP is derived as 2.87roW,which is trivial when compared with the power consumption of existing cochlear prosthetic systems （tens of milliwatts）. With the DSP implanted,this new system can.be easily developed into a fully implanted cochlear prosthesis.展开更多
Background： Currently, there is a significant lack of data concerning long-term outcomes following paediatric cochlear implantation in terms of quality of life. There is a need for a long-term, prospective study in t...Background： Currently, there is a significant lack of data concerning long-term outcomes following paediatric cochlear implantation in terms of quality of life. There is a need for a long-term, prospective study in this regard. This study aims at highlighting the preliminary results, one year post surgery of a five year prospective study. Methods： The CochlearTM Paediatric Implanted Recipient Observational Study （P-IROS） is a prospective, patient outcomes registry for routinely implanted children. The study collects data using questionnaires post-surgery and at regular intervals up to five years. Results： At our Centre, 159 cochlear implant surgery procedures were carried out between January 2014 and December 2014. Category of Auditory Performance II score increased from ‘0＇ to ‘3＇ at six months and to ‘5＇ at 12 months for children aged 0-3 years, although this was not statistically significant. However, the same trend was statistically significant for the age 3-6 year and age 6-10 year brackets. The quality of life of the child improved significantly. Analysis of communication mode revealed a statistically significant overall shift to the auditory-oral mode from total communication. Conclusion： Cochlear implantation is a life-changing intervention. The evidence in support of what it can achieve safely is clear. However, the costs associated with it raise the question if it will remain an effective option for life in all children. The Cochlear P-IROS is an attempt to answer the same over a five year period. Our study in New Delhi, so far concludes that cochlear implantation in a population with limited access to funds is very effective, one year after surgery.展开更多
Rehabilitation is a set of measures aimed at compensating or fully restoring the functions of the patient impaired by the disease. In the rehabilitation of children with a cochlear implant, a comprehensive, systematic...Rehabilitation is a set of measures aimed at compensating or fully restoring the functions of the patient impaired by the disease. In the rehabilitation of children with a cochlear implant, a comprehensive, systematic approach is essential in the work of doctors, teachers, sign language teachers, psychologists, and families. Rehabilitation and social adaptation of children with a cochlear implant depend not only on specialists but also on the ability of parents to help the child organize educational activities in an optimistic mood and the ability to provide emotional support. This means that the role of parents in the way to successful rehabilitation is high, and therefore this topic is especially relevant today. .展开更多
Cisplatin belongs to platinum-based drugs and is widely used in cancer chemotherapy.Ototoxicity is one of the major dose limiting side-effects of cisplatin.For toxicity to occur cisplatin must first be transported fro...Cisplatin belongs to platinum-based drugs and is widely used in cancer chemotherapy.Ototoxicity is one of the major dose limiting side-effects of cisplatin.For toxicity to occur cisplatin must first be transported from the bloodstream into cochlear cells.Three copper transporters are considered pathways for regulating the uptake and translocation of cisplatin into cells:Ctr1,ATP7A and ATP7B.Our recent study with cochlear organotypic cultures shows that cochlear hair cells can be destroyed by cisplatin at low concentrations from 10μm to 100μn.However,high doses of cisplatin cannot damage hair cells,maybe due to intrinsic feedback reactions that increase export of platinum by ATP7B when the platinum concentration is high in extracellular space.Cimitidine is a specific copper transporter inhibitor that can block the entrance of copper and platinum,and may prevent cisplatin-induced cochlear hair cell injury.To evaluate this hypothesis,we treated cochlear organotypic cultures with cisplatin (10 μm or 50 μm) alone,or cisplatin combined with cimitidine at concentrations ranging from 10-2000 μm for 48 hours.cisplatin at 10 μm damaged about 20% hair cells.In contrast,when cimitidine (10 μm,100 μm and 2000 μm) was added to the culture,near 100% cochlear hair cell survived.At higher concentration (50 μm),cisplatin destroyed about 80% of cochlear hair cells.However,100 μmcimitidine rescued about 50% hair cells from cisplatin damage,and 2000μm cimitidine protected about 80% hair cells.The data of western blot showed that CTR1 and ATP7B expressions were increased in cisplatin treated cochlear tissue,but cimitidine significantly reduced CTR1 and ATP7B.In addition,ATP7A expression was depressed a little after cisplatin treatment.Considering that Ctr1 is involved in copper and platinum influx,but the ATP7A and ATP7B are copper export transporters,the results suggest that cimitidine can effectively block the entrance by copper transporters and stop the influx of cisplatin.展开更多
Objectives:This study aimed to assess the effect of hearing and speech rehabilitation in patients with Nurotron■cochlear implants.Design:Ninety-eight paediatric patients with bilateral severe-to-profound sensorineura...Objectives:This study aimed to assess the effect of hearing and speech rehabilitation in patients with Nurotron■cochlear implants.Design:Ninety-eight paediatric patients with bilateral severe-to-profound sensorineural deafness who received cochlear implantation were divided into three groups according to age:group A(≤3 years),group B(4-7 years),and group C(8-16 years).All patients were followed up for one year for hearing and speech performance after the surgery.The comprehensive Auditory Perception Assessment,MAIS,CAP and SIR hearing and speech assessments and rating materials were used for assessment before the surgery and at 3,6,and 12 months after implant activation.Results:The scores of patients in the open-set speech assessment,Chinese Auditory Perception Assessment,MAIS,CAP and SIR significantly improved after cochlear implantation in all age groups.The younger the age at implantation,the better the results.Moreover,the hearing and speech performance of cochlear implant recipients gradually improved with the extension of rehabilitation time.Conclusions:Nurotron■Venus^TM cochlear implantation can improve the hearing and speech performance of patients with bilateral severe-to-profound sensorineural deafness.展开更多
Global demographic changes related to longevity are leading to increasing numbers of the elderly, for whom hearing loss is a significant cause of morbidity and disability. Once met with reticence, severely hearing imp...Global demographic changes related to longevity are leading to increasing numbers of the elderly, for whom hearing loss is a significant cause of morbidity and disability. Once met with reticence, severely hearing impaired older adults are increasingly being considered for cochlear implantation (CI). Significant data indicate that CI in the elderly population is safe, well-tolerated, and effective. Risks from CI surgery and anesthesia are low and generally comparable to rates in other age groups. Outcomes studies regarding CI in older adults have shown excellent improvements to speech perception, quality of life, and even cognition. Overall, currently available data suggests that advanced age should not, in itself, be considered a barrier to implantation. This review paper will highlight selected articles from recent medical literature regarding the safety and efficacy of CI in the elderly population. Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).展开更多
Objective: To report complications related to flap around implants after cochlear implantation, possible causes of such complications and treatments. Methods and material:We performed a retrospective analysis of child...Objective: To report complications related to flap around implants after cochlear implantation, possible causes of such complications and treatments. Methods and material:We performed a retrospective analysis of children in whom complications related to flap around implants occurred after undergoing cochlear implantation in our department from 2005 to 2016. Results:Complications among 1500 cochlear implantation (CI) recipients by the same surgeon included hematoma (n ? 20) and seroma around implants (n ? 15), of which most (n ? 10) recovered in 2 weeks after effective drainage, utility of antibiotics and pressure dressing, but 5 developed flap necrosis and had to undergo contralateral re-implantation. Four patients developed abscess around implants, of whom 2 recovered after 2 weeks of drainage, gentamicin irrigation and use of antibiotics, but 2 patients ended up with flap necrosis and had to receive contralateral reimplantation. Conclusions: Immediate drainage, pressure dressing and antibiotics can be used to effectively control seroma around implants. For seroma lasting for more than two weeks without improvement, surgical drainage may be need.展开更多
Objective: A common cavity deformity(CCD) is a deformed inner ear in which the cochlea and vestibule are confluent forming a common rudimentary cystic cavity that results in profound hearing loss. There are few studie...Objective: A common cavity deformity(CCD) is a deformed inner ear in which the cochlea and vestibule are confluent forming a common rudimentary cystic cavity that results in profound hearing loss. There are few studies paying attention to common cavity. Our group is engrossed in observing the improvement of auditory and verbal abilities in children who have received cochlear implantation(CI), and comparing these targets between children with common cavity and normal inner ear structure.Material and methods: A retrospective study was conducted in 12 patients with profound hearing loss that were divided into a common cavity group and a control group, six in each group matched in sex, age and time of implantation, based on inner ear structure. Categories of Auditory Performance(CAP) and speech intelligibility rating(SIR) scores and aided hearing thresholds were collected and compared between the two groups. All patients wore CI for more than 1 year at the Cochlear Center of Anhui Medical University from 2011 to 2015.Results: Postoperative CAP and SIR scores were higher than before operation in both groups(p < 0.05), although the scores were lower in the CCD group than in the control group(p < 0.05). The aided threshold was also lower in the control group than in the CCD group(p < 0.05).Conclusion: Even though audiological improvement in children with CCD was not as good as in those without CCD, CI provides benefits in auditory perception and communication skills in these children.展开更多
Tuberculous otitis media(TOM) is rare in ENT department,and is frequently misdiagnosed as otitis media.Thus early systemic treatment is very important for TOM.We reported a case report with TOM to highlight developmen...Tuberculous otitis media(TOM) is rare in ENT department,and is frequently misdiagnosed as otitis media.Thus early systemic treatment is very important for TOM.We reported a case report with TOM to highlight development of the disease and difficulties in clinical treatment in late stage of TOM.Implantation of ossified and eroded cochlea poses many unique challenges to both the surgeon and programming learn.With thorough preparation and complete knowledge about characters of specific issues,implantation would be performed successfully,and patients with ossified cochlear could benefit from cochlear implantation.展开更多
Currently, most people with modern multichannel cochlear implant systems can understand speech in qui-et environment very well. However, studies in recent decades reported a lack of satisfaction in music percep-tion w...Currently, most people with modern multichannel cochlear implant systems can understand speech in qui-et environment very well. However, studies in recent decades reported a lack of satisfaction in music percep-tion with cochlear implants. This article reviews the literature on music ability of cochlear implant users by presenting a systematic outline of the capabilities and limitations of cochlear implant recipients with regard to their music perception as well as production. The review also evaluates the similarities and differences be-tween electric hearing and acoustic hearing regarding music perception. We summarize the research results in terms of the individual components of music (e.g., rhythm, pitch, and timbre). Finally, we briefly intro-duce the vocal singing of prelingually-deafened children with cochlear implants as evaluated by acoustic measures.展开更多
Diabetes mellitus (DM) is a chronic systemic disease characterized by hyperglycemia, with various patho-genic mechanisms. From absolute or relative insulin deficiency, patients with DM often demonstrate vari-ous level...Diabetes mellitus (DM) is a chronic systemic disease characterized by hyperglycemia, with various patho-genic mechanisms. From absolute or relative insulin deficiency, patients with DM often demonstrate vari-ous levels of metabolic disorders. Major clinical manifestations of DM include metabolic disorders, vascu-lar lesions, circulatory disturbances and neurologic complications. Along with advances in DM research, re-ports of DM related tinnitus and hearing impairment have increased continuously. Research on DM related auditory system dysfunction has focused on cochlear microcirculation, cellular homeostasis, genetics and ag-ing. Cochlear microcirculation plays an important role in cochlear physiology and its disorders are associat-ed with many inner ear diseases. Ischemia and subsequent reperfusion seen in cochlear microcirculation dis-orders are important factors in hearing damage. Understanding cochlear microcirculation and structural as well as functional changes in DM patients with hearing loss and their causal factors will help reveal patho-genic mechanisms in diabetic hearing loss and provide new ideas in developing interventions and preventing damages caused by diabetes.展开更多
Objective:To evaluate the efficacy of using neural response telemetry(NRT)thresholds in predicting behavioural thresholds during programming of cochlear implant in prelingual children.Method:Prospective study of 28 co...Objective:To evaluate the efficacy of using neural response telemetry(NRT)thresholds in predicting behavioural thresholds during programming of cochlear implant in prelingual children.Method:Prospective study of 28 cochlear implants implanted with Nucleus 24 cochlear implant.We recorded NRT-thresholds on electrode numbers 1,6,11,16 and 22 of the electrode array in each patient,the neural response thresholds were correlated with the behavioural map after six months of programming the device.Results:The mean neural response telemetry level was significantly higher than the mean threshold level(T-level)but lower than the comfortable level(C-level)in all the electrodes tested.NRT levels could statistically significantly predict T behavioural levels and comfortable behavioural levels,p<0.01.There was a strong positive correlation between comfortable thresholds and neural response telemetry level measurements and behavioural threshold level and neural response telemetry threshold measurements.Conclusion:There is a useful role for neural response telemetry values in predicting the behavioural threshold and comfortable values in prelingual children.Combining the NRT values with behavioural observations can improve the programming of cochlear implants.展开更多
Objective:To review developments in sound processors over the past 30 years that have resulted in significant improvements in outcomes for Nucleus~ recipients.
Objective To report outcomes of cochlear implantation (CI) in a child with auditory neuropathy spectrum disorder (ANSD) and to provide preliminary clinical evidence of the efficacy of CI in ANSD patients.Methods A 4-y...Objective To report outcomes of cochlear implantation (CI) in a child with auditory neuropathy spectrum disorder (ANSD) and to provide preliminary clinical evidence of the efficacy of CI in ANSD patients.Methods A 4-year-old boy with diagnosed auditory neuropathy spectrum disorder (ANSD) received implantation of a Nucleus CI24R after an unsatisfactory trial of amplification.Post-implantation performance in both hearing sensitivity and speech recognition was assessed in different sessions.Aided hearing thresholds were tested by behavioral audiometry.Mandarin Early Speech Perception Test (MESP),Meaningful Auditory Integration Scale (MAIS),category of auditory performance (CAP) and Speech Intelligibility Rating (SIR) were used to assess the benefits in auditory skills or speech recognition the boy obtained from CI.The tests were administered before surgery and at 3 months and 7 months after opening.Results The boy demonstrated improved auditory sensitivity by using CI.Concerning speech recognition and communication,both speech audiometry and questionnaires showed an obvious benefit from CI.Conclusions CI has worked efficiently in this ANSD boy.But because of limited understanding of ANSD and rehabilitation effect by cochlear implantation in this condition,the clinical decision to implant should be cautious and only after a thorough evaluation.Meanwhile,well controlled and long term studies are needed to confirm the efficacy of cochlear implantation in patients with ANSD.展开更多
Objective:Vestibular dysfunction associated with cochlear implantation is rare.It is usually seen in patients with otosclerosis due to spread of electrical activity throughout the demineralized bone.A 17-year old fema...Objective:Vestibular dysfunction associated with cochlear implantation is rare.It is usually seen in patients with otosclerosis due to spread of electrical activity throughout the demineralized bone.A 17-year old female with progressive hearing loss 2 years after meningitis and vestibular dysfunction in the implanted ear is presented in this study.Findings:The patient had mild hearing loss in the right ear and total hearing loss on the left side because of complete ossification of the cochlea following meningitis.She had to have cochlear implantation in the right ear because of progression of hearing loss.She had successful implantation but she experienced vestibular dysfunction following activation of cochlear electrodes.Closure of two electrodes caused disruption of auditory programming.Then the patient was subjected to long term vestibular rehabilitation program.Conclusion:Timing for implantation before the completion of cochlear ossification is crucial not to miss the chance for hearing restoration.However,difficulties in hearing rehabilitation due to extensive ossification can be doubled by vestibular problems triggered by stimulation of the vestibular nerve by cochlear electrodes.Attempts to reduce the balance problem will complicate auditory programming.Vestibular rehabilitation for long term helps to carry on hearing progress.展开更多
Purpose:There is a growing interest in speech intelligibility and audito ry perception of deaf children.The aim of the present study was to compare speech intelligibility and auditory perception of pre-school children...Purpose:There is a growing interest in speech intelligibility and audito ry perception of deaf children.The aim of the present study was to compare speech intelligibility and auditory perception of pre-school children with Hearing Aid(HA),Cochlear Implant(Cl),and Typical Hearing(TH).Methods:The research design was descriptive-analytic and comparative.The participants comprised 75 male pre-school children aged 4-6 years in the 2017-2018 from Tehran,Iran.The participants were divided into three groups,and each group consisted of 25 children.The first and second groups were respectively selected from pre-school children with HA and CI using the convenience sampling method,while the third group was selected from pre-school children with TH by random sampling method.All children completed Speech Intelligibility Rating and Catego ries of Auditory Performance Questionnaires.Results:The findings indicated that the mean scores of speech intelligibility and auditory perception of the group with TH were significantly higher than those of the other groups(P<0.0001).The mean scores of speech intelligibility in the group with CI did not significantly differ from those of the group with HA(P<0.38).Also,the mean scores of auditory perception in the group with CI were significantly higher than those of the group with HA(P<0.002).Conclusion:The results showed that auditory perception in children with CI was significantly higher than children with HA.This finding highlights the importance of cochlear implantation at a younger age and its significant impact on auditory perception in deaf children.展开更多
基金supported by the Beijing Natural Science Foundation of China under Grant 7222185。
文摘Objective:This study aims to establish an economically viable and easily accessible adult animal model for optogenetic activation of auditory neurons using adeno-associated viruses(AAVs)carrying Ch R2(H134R)to explore the potential of cochlear optogenetics as a hearing restoration technology.Methods:Healthy adult guinea pigs were used in the experiments.The viral vector AAV2/8-Ch R2(H134R)-h Syn-e YFP was administered to the right cochlea via the round window membrane.The confocal microscopy and reverse transcription polymerase chain reaction(RT-PCR)were utilized to analyze the Ch R2(H134R)expression localized to spiral ganglion neurons(SGNs).The auditory pathway activation was assessed by recording the optical compound action potential(oCAP)and acoustic compound action potential(a CAP)at various laser intensities.Results:The Ch R2(H134R)-e YFP expression was confirmed in 90%of the tested animals,localized to the SGNs of the injected ear.Higher m RNA levels of Ch R2(H134R)and e YFP were observed in the injected ear compared to the non-injected ear,while actin(Actb)m RNA levels were not significantly different.The o CAP was successfully elicited by a 470 nm blue light laser stimulus,with similar amplitudes and latency periods to those of a CAPs when the o CAP was evoked by 5.80 m W blue light and the a CAP was evoked by a 40 d B SPL click.The amplitudes of o CAPs increased with increasing laser intensity.Conclusion:This study demonstrates the viability of optogenetic activation of the auditory system in adult guinea pigs through the transduction of AAV-Ch R2(H134R)in SGNs.Cochlear optogenetics demonstrates potential as a hearing restoration technology,providing a basis for further clinical research and opening new avenues for investigation.
基金a grant from the Beijing Hospitals Authority Youth Programme(grant:QML20230204)a grant from National Natural Science Foundation of China(No.82471179)a grant from the National Key Research and Development Plan(grant:2022YFC2402705)。
文摘Objective:To assess the effectiveness of machine learning in automating the prediction of vestibular abnormalities after cochlear implantation(CI)in patients with sensorineural hearing loss(SNHL),with the goal of developing a practical model that can accurately predict long-term vestibular function outcomes and identify associated risk factors.Methods:Clinical data,including imaging,vestibular evoked myogenic potentials(VEMPs),and auditory information,were collected from patients with sensorineural hearing loss(SNHL)before and after CI.The decision tree algorithm was employed to address missing values and screen pre-CI clinical features.Six machine learning methods were subsequently utilized to predict the relationships between the extracted features and post-CI vestibular dysfunction.The best-performing method determined the ranking of feature importance,which was regarded as risk factors for predicting symptoms and VEMPs results after CI.Results:Logistic regression models effectively predicted both post-CI vestibular dysfunction and abnormal cervical VEMP(c VEMP),with accuracies of 80%and 78%,respectively.The relative importance of the features,in descending order,was as follows:c VEMP latency,c VEMP amplitude,and residual hearing threshold.Moreover,the support vector machine(SVM)model attained an accuracy of 88%in predicting abnormal ocular VEMP(o VEMP)post-CI.For the SVM model,the feature importance ranking was as follows:o VEMP latency,o VEMP amplitude,and residual hearing threshold.Conclusions:This study successfully leverages machine learning techniques,specifically support vector machines(SVM)and logistic regression models,to predict the impact of CI on vestibular function.These predictive models provide valuable insights for presurgical planning and decision-making in CI procedures.Moreover,the findings highlight the critical risk factors associated with vestibular dysfunction,offering a robust reference for guiding vestibular rehabilitation strategies.
文摘PurposeThe study aimed to investigate the otology-specific and general health-related quality of life(HRQoL)after cochlear implantation,and scrutinize the variables associated with them.MethodsThe Ear Outcome Survey-16(EOS-16),which assesses ear-specific symptoms and quality of life(QoL),was administered before and after cochlear implantation along with the post-operative administration of the 15D questionnaire that evaluates general HRQoL.The authors investigated post-implantation changes in the EOS-16 total scores and its category responses,examining their relationship with pre-and post-operative hearing levels,speech perception in noise,and the follow-up period length(time elapsed since cochlear implantation).ResultsThere were positive changes noted for the hearing,need for care,and QoL categories of the EOS-16 after implantation.The length of the follow-up period was a significant factor associated with improvements in subjective outcome measures.Changes in self-perceived hearing and HRQoL post-implantation seem independent of pre-and post-implantation hearing performance.ConclusionThese results suggest that while patients regain their hearing abilities shortly after implant activation,their subjective hearing-related benefits and QoL improve over time.
基金supported by the National Key Research and Development Program of China(grant no.2022YFC2402705)National Municipal Natural Science Foundation(grant no.82471161)Beijing Municipal Natural Science Foundation(grant no.7244308)。
文摘Objective:The aims of this study were to investigate the clinical applicability of 3D segmentation in measuring cochlear anatomical parameters,explore factors that influence the insertion angle of cochlear implant electrodes in patients with inner ear malformations,and determine the value of 3D segmentation in predicting cochlear implant electrode insertion depth by simulating electrode implantation in a reconstructed 3D model.Methods:Data from 208 temporal bone CT scans of patients with a variety of inner ear malformations(including the CH,IP-Ⅰ,IP-Ⅱ,and IP-Ⅲtypes)who underwent cochlear implantation at our center were retrospectively analyzed.Preoperative temporal bone CT data were subjected to three-dimensional(3D)segmentation of the cochlea with a 3D slicer.Results:Cochlear malformation types,including IP typesⅠ(42 ears),Ⅱ(278ears),Ⅲ(20 ears),and CH(65 ears),were diagnosed and measured in 208 preoperative CT datasets.Cochlear anatomical parameters and electrode length were correlated,which partially explained the variations in electrode insertion angle.The mean angle of implantation among the enrolled patients was 564.33°,and the mean implantation angle prediction error in the 3D segmentation was|23.74|°.Conclusion:Three-dimensional segmentation from temporal bone CT is valuable for surgeons,especially in treating patients with inner ear malformation.Such insights will help surgeons understand overall anatomical variations,predict electrode implantation depth,and complete preoperative imaging assessments for cochlear implant insertion depth in patients with inner ear malformations.
基金the National Natural Science Foundation of China(No.60475018)~~
文摘This paper proposes a cochlear prosthetic system with an implanted digital signal processor （DSP）. This system transmits voice-band signals with a low data rate through the wireless link, free of the data-rate limitation and suitable for future development. By optimizing the speech processing algorithm and the DSP hardware design, the implanted DSP manages to execute the continuous interleaved sampling （CIS） algorithm at a clock frequency of 3MHz and a power consumption of only 1.91mW. With an analytic power-transmission efficiency of the wireless inductive link （40%）, the power overhead caused by the implanted DSP is derived as 2.87roW,which is trivial when compared with the power consumption of existing cochlear prosthetic systems （tens of milliwatts）. With the DSP implanted,this new system can.be easily developed into a fully implanted cochlear prosthesis.
文摘Background： Currently, there is a significant lack of data concerning long-term outcomes following paediatric cochlear implantation in terms of quality of life. There is a need for a long-term, prospective study in this regard. This study aims at highlighting the preliminary results, one year post surgery of a five year prospective study. Methods： The CochlearTM Paediatric Implanted Recipient Observational Study （P-IROS） is a prospective, patient outcomes registry for routinely implanted children. The study collects data using questionnaires post-surgery and at regular intervals up to five years. Results： At our Centre, 159 cochlear implant surgery procedures were carried out between January 2014 and December 2014. Category of Auditory Performance II score increased from ‘0＇ to ‘3＇ at six months and to ‘5＇ at 12 months for children aged 0-3 years, although this was not statistically significant. However, the same trend was statistically significant for the age 3-6 year and age 6-10 year brackets. The quality of life of the child improved significantly. Analysis of communication mode revealed a statistically significant overall shift to the auditory-oral mode from total communication. Conclusion： Cochlear implantation is a life-changing intervention. The evidence in support of what it can achieve safely is clear. However, the costs associated with it raise the question if it will remain an effective option for life in all children. The Cochlear P-IROS is an attempt to answer the same over a five year period. Our study in New Delhi, so far concludes that cochlear implantation in a population with limited access to funds is very effective, one year after surgery.
文摘Rehabilitation is a set of measures aimed at compensating or fully restoring the functions of the patient impaired by the disease. In the rehabilitation of children with a cochlear implant, a comprehensive, systematic approach is essential in the work of doctors, teachers, sign language teachers, psychologists, and families. Rehabilitation and social adaptation of children with a cochlear implant depend not only on specialists but also on the ability of parents to help the child organize educational activities in an optimistic mood and the ability to provide emotional support. This means that the role of parents in the way to successful rehabilitation is high, and therefore this topic is especially relevant today. .
文摘Cisplatin belongs to platinum-based drugs and is widely used in cancer chemotherapy.Ototoxicity is one of the major dose limiting side-effects of cisplatin.For toxicity to occur cisplatin must first be transported from the bloodstream into cochlear cells.Three copper transporters are considered pathways for regulating the uptake and translocation of cisplatin into cells:Ctr1,ATP7A and ATP7B.Our recent study with cochlear organotypic cultures shows that cochlear hair cells can be destroyed by cisplatin at low concentrations from 10μm to 100μn.However,high doses of cisplatin cannot damage hair cells,maybe due to intrinsic feedback reactions that increase export of platinum by ATP7B when the platinum concentration is high in extracellular space.Cimitidine is a specific copper transporter inhibitor that can block the entrance of copper and platinum,and may prevent cisplatin-induced cochlear hair cell injury.To evaluate this hypothesis,we treated cochlear organotypic cultures with cisplatin (10 μm or 50 μm) alone,or cisplatin combined with cimitidine at concentrations ranging from 10-2000 μm for 48 hours.cisplatin at 10 μm damaged about 20% hair cells.In contrast,when cimitidine (10 μm,100 μm and 2000 μm) was added to the culture,near 100% cochlear hair cell survived.At higher concentration (50 μm),cisplatin destroyed about 80% of cochlear hair cells.However,100 μmcimitidine rescued about 50% hair cells from cisplatin damage,and 2000μm cimitidine protected about 80% hair cells.The data of western blot showed that CTR1 and ATP7B expressions were increased in cisplatin treated cochlear tissue,but cimitidine significantly reduced CTR1 and ATP7B.In addition,ATP7A expression was depressed a little after cisplatin treatment.Considering that Ctr1 is involved in copper and platinum influx,but the ATP7A and ATP7B are copper export transporters,the results suggest that cimitidine can effectively block the entrance by copper transporters and stop the influx of cisplatin.
文摘Objectives:This study aimed to assess the effect of hearing and speech rehabilitation in patients with Nurotron■cochlear implants.Design:Ninety-eight paediatric patients with bilateral severe-to-profound sensorineural deafness who received cochlear implantation were divided into three groups according to age:group A(≤3 years),group B(4-7 years),and group C(8-16 years).All patients were followed up for one year for hearing and speech performance after the surgery.The comprehensive Auditory Perception Assessment,MAIS,CAP and SIR hearing and speech assessments and rating materials were used for assessment before the surgery and at 3,6,and 12 months after implant activation.Results:The scores of patients in the open-set speech assessment,Chinese Auditory Perception Assessment,MAIS,CAP and SIR significantly improved after cochlear implantation in all age groups.The younger the age at implantation,the better the results.Moreover,the hearing and speech performance of cochlear implant recipients gradually improved with the extension of rehabilitation time.Conclusions:Nurotron■Venus^TM cochlear implantation can improve the hearing and speech performance of patients with bilateral severe-to-profound sensorineural deafness.
文摘Global demographic changes related to longevity are leading to increasing numbers of the elderly, for whom hearing loss is a significant cause of morbidity and disability. Once met with reticence, severely hearing impaired older adults are increasingly being considered for cochlear implantation (CI). Significant data indicate that CI in the elderly population is safe, well-tolerated, and effective. Risks from CI surgery and anesthesia are low and generally comparable to rates in other age groups. Outcomes studies regarding CI in older adults have shown excellent improvements to speech perception, quality of life, and even cognition. Overall, currently available data suggests that advanced age should not, in itself, be considered a barrier to implantation. This review paper will highlight selected articles from recent medical literature regarding the safety and efficacy of CI in the elderly population. Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
文摘Objective: To report complications related to flap around implants after cochlear implantation, possible causes of such complications and treatments. Methods and material:We performed a retrospective analysis of children in whom complications related to flap around implants occurred after undergoing cochlear implantation in our department from 2005 to 2016. Results:Complications among 1500 cochlear implantation (CI) recipients by the same surgeon included hematoma (n ? 20) and seroma around implants (n ? 15), of which most (n ? 10) recovered in 2 weeks after effective drainage, utility of antibiotics and pressure dressing, but 5 developed flap necrosis and had to undergo contralateral re-implantation. Four patients developed abscess around implants, of whom 2 recovered after 2 weeks of drainage, gentamicin irrigation and use of antibiotics, but 2 patients ended up with flap necrosis and had to receive contralateral reimplantation. Conclusions: Immediate drainage, pressure dressing and antibiotics can be used to effectively control seroma around implants. For seroma lasting for more than two weeks without improvement, surgical drainage may be need.
文摘Objective: A common cavity deformity(CCD) is a deformed inner ear in which the cochlea and vestibule are confluent forming a common rudimentary cystic cavity that results in profound hearing loss. There are few studies paying attention to common cavity. Our group is engrossed in observing the improvement of auditory and verbal abilities in children who have received cochlear implantation(CI), and comparing these targets between children with common cavity and normal inner ear structure.Material and methods: A retrospective study was conducted in 12 patients with profound hearing loss that were divided into a common cavity group and a control group, six in each group matched in sex, age and time of implantation, based on inner ear structure. Categories of Auditory Performance(CAP) and speech intelligibility rating(SIR) scores and aided hearing thresholds were collected and compared between the two groups. All patients wore CI for more than 1 year at the Cochlear Center of Anhui Medical University from 2011 to 2015.Results: Postoperative CAP and SIR scores were higher than before operation in both groups(p < 0.05), although the scores were lower in the CCD group than in the control group(p < 0.05). The aided threshold was also lower in the control group than in the CCD group(p < 0.05).Conclusion: Even though audiological improvement in children with CCD was not as good as in those without CCD, CI provides benefits in auditory perception and communication skills in these children.
基金funded by Chinese National Scientifie Research Special-Purpose Project for Public Health Profession(No.200802070)National Program on Key Basic Research(2011CB504503)
文摘Tuberculous otitis media(TOM) is rare in ENT department,and is frequently misdiagnosed as otitis media.Thus early systemic treatment is very important for TOM.We reported a case report with TOM to highlight development of the disease and difficulties in clinical treatment in late stage of TOM.Implantation of ossified and eroded cochlea poses many unique challenges to both the surgeon and programming learn.With thorough preparation and complete knowledge about characters of specific issues,implantation would be performed successfully,and patients with ossified cochlear could benefit from cochlear implantation.
基金supported by Grant No.CX2012B101 from Scientific Innovation Fund of Hunan ProvinceGrant No.201206370106 from China State Scholarship Fund
文摘Currently, most people with modern multichannel cochlear implant systems can understand speech in qui-et environment very well. However, studies in recent decades reported a lack of satisfaction in music percep-tion with cochlear implants. This article reviews the literature on music ability of cochlear implant users by presenting a systematic outline of the capabilities and limitations of cochlear implant recipients with regard to their music perception as well as production. The review also evaluates the similarities and differences be-tween electric hearing and acoustic hearing regarding music perception. We summarize the research results in terms of the individual components of music (e.g., rhythm, pitch, and timbre). Finally, we briefly intro-duce the vocal singing of prelingually-deafened children with cochlear implants as evaluated by acoustic measures.
基金Projects of Hebei Provincial Administration of Traditional Chinese Medicine,No.2012068
文摘Diabetes mellitus (DM) is a chronic systemic disease characterized by hyperglycemia, with various patho-genic mechanisms. From absolute or relative insulin deficiency, patients with DM often demonstrate vari-ous levels of metabolic disorders. Major clinical manifestations of DM include metabolic disorders, vascu-lar lesions, circulatory disturbances and neurologic complications. Along with advances in DM research, re-ports of DM related tinnitus and hearing impairment have increased continuously. Research on DM related auditory system dysfunction has focused on cochlear microcirculation, cellular homeostasis, genetics and ag-ing. Cochlear microcirculation plays an important role in cochlear physiology and its disorders are associat-ed with many inner ear diseases. Ischemia and subsequent reperfusion seen in cochlear microcirculation dis-orders are important factors in hearing damage. Understanding cochlear microcirculation and structural as well as functional changes in DM patients with hearing loss and their causal factors will help reveal patho-genic mechanisms in diabetic hearing loss and provide new ideas in developing interventions and preventing damages caused by diabetes.
文摘Objective:To evaluate the efficacy of using neural response telemetry(NRT)thresholds in predicting behavioural thresholds during programming of cochlear implant in prelingual children.Method:Prospective study of 28 cochlear implants implanted with Nucleus 24 cochlear implant.We recorded NRT-thresholds on electrode numbers 1,6,11,16 and 22 of the electrode array in each patient,the neural response thresholds were correlated with the behavioural map after six months of programming the device.Results:The mean neural response telemetry level was significantly higher than the mean threshold level(T-level)but lower than the comfortable level(C-level)in all the electrodes tested.NRT levels could statistically significantly predict T behavioural levels and comfortable behavioural levels,p<0.01.There was a strong positive correlation between comfortable thresholds and neural response telemetry level measurements and behavioural threshold level and neural response telemetry threshold measurements.Conclusion:There is a useful role for neural response telemetry values in predicting the behavioural threshold and comfortable values in prelingual children.Combining the NRT values with behavioural observations can improve the programming of cochlear implants.
基金funded by Cochlear Limited,the manufacturer of Nucleus implant systems
文摘Objective:To review developments in sound processors over the past 30 years that have resulted in significant improvements in outcomes for Nucleus~ recipients.
基金supported by grants from the National Basic Research Program of China(973Program)(#2012CB9679002011CBA01000)National Hi-Tech Research and Development Program of China(863Program)(#2007AA02Z150)to SMYthe National Natural Science Foundation of China(NSFC)(#30730040)to Yang Shi-ming
文摘Objective To report outcomes of cochlear implantation (CI) in a child with auditory neuropathy spectrum disorder (ANSD) and to provide preliminary clinical evidence of the efficacy of CI in ANSD patients.Methods A 4-year-old boy with diagnosed auditory neuropathy spectrum disorder (ANSD) received implantation of a Nucleus CI24R after an unsatisfactory trial of amplification.Post-implantation performance in both hearing sensitivity and speech recognition was assessed in different sessions.Aided hearing thresholds were tested by behavioral audiometry.Mandarin Early Speech Perception Test (MESP),Meaningful Auditory Integration Scale (MAIS),category of auditory performance (CAP) and Speech Intelligibility Rating (SIR) were used to assess the benefits in auditory skills or speech recognition the boy obtained from CI.The tests were administered before surgery and at 3 months and 7 months after opening.Results The boy demonstrated improved auditory sensitivity by using CI.Concerning speech recognition and communication,both speech audiometry and questionnaires showed an obvious benefit from CI.Conclusions CI has worked efficiently in this ANSD boy.But because of limited understanding of ANSD and rehabilitation effect by cochlear implantation in this condition,the clinical decision to implant should be cautious and only after a thorough evaluation.Meanwhile,well controlled and long term studies are needed to confirm the efficacy of cochlear implantation in patients with ANSD.
文摘Objective:Vestibular dysfunction associated with cochlear implantation is rare.It is usually seen in patients with otosclerosis due to spread of electrical activity throughout the demineralized bone.A 17-year old female with progressive hearing loss 2 years after meningitis and vestibular dysfunction in the implanted ear is presented in this study.Findings:The patient had mild hearing loss in the right ear and total hearing loss on the left side because of complete ossification of the cochlea following meningitis.She had to have cochlear implantation in the right ear because of progression of hearing loss.She had successful implantation but she experienced vestibular dysfunction following activation of cochlear electrodes.Closure of two electrodes caused disruption of auditory programming.Then the patient was subjected to long term vestibular rehabilitation program.Conclusion:Timing for implantation before the completion of cochlear ossification is crucial not to miss the chance for hearing restoration.However,difficulties in hearing rehabilitation due to extensive ossification can be doubled by vestibular problems triggered by stimulation of the vestibular nerve by cochlear electrodes.Attempts to reduce the balance problem will complicate auditory programming.Vestibular rehabilitation for long term helps to carry on hearing progress.
文摘Purpose:There is a growing interest in speech intelligibility and audito ry perception of deaf children.The aim of the present study was to compare speech intelligibility and auditory perception of pre-school children with Hearing Aid(HA),Cochlear Implant(Cl),and Typical Hearing(TH).Methods:The research design was descriptive-analytic and comparative.The participants comprised 75 male pre-school children aged 4-6 years in the 2017-2018 from Tehran,Iran.The participants were divided into three groups,and each group consisted of 25 children.The first and second groups were respectively selected from pre-school children with HA and CI using the convenience sampling method,while the third group was selected from pre-school children with TH by random sampling method.All children completed Speech Intelligibility Rating and Catego ries of Auditory Performance Questionnaires.Results:The findings indicated that the mean scores of speech intelligibility and auditory perception of the group with TH were significantly higher than those of the other groups(P<0.0001).The mean scores of speech intelligibility in the group with CI did not significantly differ from those of the group with HA(P<0.38).Also,the mean scores of auditory perception in the group with CI were significantly higher than those of the group with HA(P<0.002).Conclusion:The results showed that auditory perception in children with CI was significantly higher than children with HA.This finding highlights the importance of cochlear implantation at a younger age and its significant impact on auditory perception in deaf children.
