This study aims to investigate the impact of middle ear effusion(MEE)on sound transmission in the human ear and its potential diagnostic significance.Firstly,the material properties of specific structures were adjuste...This study aims to investigate the impact of middle ear effusion(MEE)on sound transmission in the human ear and its potential diagnostic significance.Firstly,the material properties of specific structures were adjusted based on the existing human ear finite element(FE)model,and the accuracy of the model was validated using experimental data.Secondly,six FE models were developed to simulate varying degrees of MEE by systematically altering the material properties of the middle ear cavity(MEC)at different anatomical locations.Finally,the effects of these six FE models,representing varying degrees of MEE,on sound transmission characteristics and energy absorption(EA)rate in the human ear were systematically analyzed.When the degree of MEE is less than 50%of the MEC volume,its impact on the sound transmission characteristics of the human ear remains minimal,resulting in an estimated hearing loss of approximately 3 dB,with EA rate remaining close to normal levels.Once the effusion exceeds 50%of the MEC volume,a significant deterioration in acoustic transmission is observed,accompanied by a flattening of the EA curve and a drop in EA rates to below 20%.When the effusion completely fills the MEC,the maximum hearing loss reaches 46.47 dB,and the EA rate approaches zero across the entire frequency range.These findings provide theoretical insights into the biomechanical effects of MEE on human auditory transmission and offer a reference for clinical diagnosis and evaluation.展开更多
BACKGROUND Otitis media with effusion(OME),glue ear,serous otitis media,or secretory otitis media is a common paediatric condition.Two widely used surgical interventions for OME are myringotomy alone and myringotomy w...BACKGROUND Otitis media with effusion(OME),glue ear,serous otitis media,or secretory otitis media is a common paediatric condition.Two widely used surgical interventions for OME are myringotomy alone and myringotomy with tympanostomy tube.While both procedures aim to improve hearing outcomes,the efficacy of these approaches has been a subject of ongoing research and debate.AIM To compare the efficacy of myringotomy alone and myringotomy with tympa-nostomy tube.METHODS In this comparative study,66 patients diagnosed as OME meeting the inclusion criteria were selected via ear,nose and throat department.They were divided into two groups randomly,each of 33 patients.In the first group(Group A)myrin-gotomy alone was performed while in the second group(Group B)myringotomy with tympanostomy tube placement was performed.We observed hearing outcome by pure tone audiogram(PTA)pre operatively.Patients were followed up and re-assessed in outdoor patient department at 4th week postoperatively again by PTA.RESULTS The mean age of the patients in Group A was 10.96±2.76 SD but the mean age of the patients in Group B was 10.22±2.73 SD(P=0.1056).In Group A,males were 63.6%and females were 36.3%.Also in Group B,males were 63.6%and females were 36.3%(P=1.0).In group A,post operative hearing gain using pure tone audiometry at one month was 20.45±3.78 SD while in group B,post operative hearing gain using pure tone audiometry at one month was 23.84±3.69 SD(P=0.00005).However,ear discharge was noted in 3.03%cases in group A and 15.15%cases in group B(P=0.035).By applying independent t-test,the P<0.05 indicated that there is a significant association between Group B and hearing improvement at 4th week.CONCLUSION Our study concluded that myringotomy with tympanostomy tube seems to have better hearing results than myringotomy alone in treatment of OME.展开更多
ObjectiveTo develop a sustained-release codelivery system for intratympanic administration of dexamethasone(DEX)and lipoic acid(LA).MethodsDEX microcrystals(MCs)were prepared via precipitation,while LA-loaded porous P...ObjectiveTo develop a sustained-release codelivery system for intratympanic administration of dexamethasone(DEX)and lipoic acid(LA).MethodsDEX microcrystals(MCs)were prepared via precipitation,while LA-loaded porous PLGA microspheres(LPMPs)were fabricated using a double emulsion–solvent evaporation method.DEX MCs were physically perfused into LPMPs via negative pressure to form a combined system(DEX MCs+LPMPs).Physicochemical properties,in vitro drug release,pharmacokinetics,and biocompatibility were evaluated.Guinea pigs were used for intratympanic injections of DEX MCs,LPMPs,or DEX MCs+LPMPs.ResultsThe DEX MCs+LPMPs system enabled simultaneous release of both drugs,with DEX exhibiting superior pharmacokinetics(sustained perilymph concentrations up to 7 days)compared to DEX MCs alone.LA release from LPMPs demonstrated prolonged kinetics without burst release.SEM confirmed DEX MCs were localized within/on LPMPs and adhered to the round window membrane(RWM).Histological analysis revealed normal cochlear morphology and no inflammatory response,confirming biocompatibility.ConclusionsThis novel codelivery system combining microcrystals and porous microspheres achieves sustained dual-drug release,enhances therapeutic efficacy,and offers a promising strategy for managing hearing loss via intratympanic administration.展开更多
Background: Non-implantable bone anchored hearing devices (BCHDs) are utilized for patients with conductive or mixed hearing loss who are unsuitable for conventional hearing aids or have unresolved middle ear issues. ...Background: Non-implantable bone anchored hearing devices (BCHDs) are utilized for patients with conductive or mixed hearing loss who are unsuitable for conventional hearing aids or have unresolved middle ear issues. These devices can be surgically implanted or attached using adhesive plates, dental sticks, elastic headbands, or bone conduction spectacles. Optimal fitting of bone conduction spectacles requires appropriate frame selection and contact pressure in the temporal and mastoid areas. The ANSI S3.6 and DIN EN ISO 389-3 standards recommend a contact area of approximately 1.75 cm2 and a maximum force of 5.4 N for effective sound transmission and comfort. Methods: This study aimed to evaluate the technical fit and mechanical stability of universal bone conduction hearing spectacles compared to established systems. A Sen-Pressure 02 thin-film sensor connected to an Arduino Uno R3 board measured contact force in the temporal and mastoid areas. Several BCHDs were tested, including the Bruckhoff la belle BC D50/70, Radioear B71 headset, Radioear B71 elastic headband, Cochlear Baha SoundArc M, and Cochlear Baha elastic headband, on a PVC artificial head, with data analyzed using ANOVA and LSD post hoc tests. Results: The la belle BC D50/70 spectacles showed comparable contact force to established BCHDs, ensuring adequate sound transmission and comfort. Significant differences were observed between the systems, with the Radioear B71 headset exhibiting the highest forces. The la belle BC D50/70 had similar forces to the Radioear B71 elastic headband. Conclusion: The la belle BC D50/70 universal bone conduction hearing spectacles are a technically equivalent alternative to established BCHDs, maintaining pressure below 5.4 N. Future research should explore the impact of different contact forces on performance and comfort, and the integration of force control in modified spectacles. This study indicates that the la belle BC D50/70 is a viable alternative that meets audiological practice requirements.展开更多
Bone morphogenetic proteins(BMPs)are the largest subfamily of the transforming growth factor-βsuperfamily,and they play important roles in the development of numerous organs,including the inner ear.The inner ear is a...Bone morphogenetic proteins(BMPs)are the largest subfamily of the transforming growth factor-βsuperfamily,and they play important roles in the development of numerous organs,including the inner ear.The inner ear is a relatively small organ but has a highly complex structure and is involved in both hearing and balance.Here,we discuss BMPs and BMP signaling pathways and then focus on the role of BMP signal pathway regulation in the development of the inner ear and the implications this has for the treatment of human hearing loss and balance dysfunction.展开更多
Application of surgical endoscope, used alone or in combination with the surgical microscope, for the operative management of ear and temporal bone conditions may allow improved access and clearance of disease. Preser...Application of surgical endoscope, used alone or in combination with the surgical microscope, for the operative management of ear and temporal bone conditions may allow improved access and clearance of disease. Preservation of normal structures may also be improved.As the use of this tool is increasing, the need for better understanding of the anatomy of the ear is becoming evident. This is particularly so for endoscopic surgery aiming at removal of lesions involving the infra-cochlear corridor and/or petrous apex.Human temporal bone-derived labyrinth casts(molds), originally made for endolymphatic duct and sac analysis which genuinely represent the membranous labyrinth and its adjacent soft tissues, were morphometrically analyzed in terms of the anatomic relations between structures in and around the infra-cochlear corridor. The distance between the petrous carotid artery(PCA) and the basal turn of the cochlea, the distance between PCA and infra-cochlear vein(ICV)/cochlear aqueduct(CA), and the distance between the lower surface of basal cochlear turn and the point where the carotid artery and jugular vein(JV) meet close to the jugular foramen, were measured to be around 1.3 mm, 6 mm and 8 mm respectively, thus constituting an approximate 6?8 mm2 infra-cochlear corridor. This analysis and further study with larger samples might be helpful for operation via this corridor led to the petrous apex where cholesterol granuloma, cholesteatoma and other lesions are not uncommon.展开更多
The results from this study showed that the thresholds of brainstem auditory-evoked potentials peak following 10 successive days of intramuscular injection of Roman chickens with kanamycin, starting 3 days after birth...The results from this study showed that the thresholds of brainstem auditory-evoked potentials peak following 10 successive days of intramuscular injection of Roman chickens with kanamycin, starting 3 days after birth. Fluorescence immunohistochemistry analysis revealed few ganglion cells positively labeled for Ephrin A2 in the cochlea of experimental chickens from 2 days before until 7 days after the last kanamycin injection. The number of Ephrin A2-positive ganglion cell bodies was increased at 15 days after the last injection and was similar to that in normal chickens at 30 days following the cessation of kanamycin treatment. These experimental findings indicate that Ephrin A2 protein expression in the acoustic ganglia is synchronized with the connection damage and regeneration of cochlear hair cells after kanamycin exposure. Ephrin A2 may play an important role in the regeneration and plasticity of cochlear hair cells in the chick cochlea following kanamycin ototoxicity.展开更多
BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an id...BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.展开更多
Introduction: Hidden hearing loss (HHL) is a type of auditory disorder that affects the auditory neural processing and hearing sensitivity in subjects with normal hearing thresholds. Unlike central auditory processing...Introduction: Hidden hearing loss (HHL) is a type of auditory disorder that affects the auditory neural processing and hearing sensitivity in subjects with normal hearing thresholds. Unlike central auditory processing disorders, HHL happens when the cochlea (the peripheral auditory organ) is affected. There are several known risk factors to HHL which includes noise exposure, ototoxic drugs, and peripheral neuropathies, and age. Recent studies have shed light on this type of hearing loss, its etiology, prevalence, and how it can affect the auditory acuity in humans. Methods: This paper covers the current research regarding HHL, its causes, the different mechanisms involved in this disorder, and the diagnosis and potential treatments related to it. We will delve deeply into different researches concerning HHL. 4 articles from 285 were selected focusing on normal hearing individuals with bad speech intelligibility were discussed in this paper. In addition, articles discussing the effects of noise exposure on hearing impaired individuals were not considered as this study solely aims to focus on normal hearing sensitivity individuals with HHL, resulting in 4 articles from 285. Results: Numerous literatures over the decades have suggested that HHL is due to the degeneration of cochlear ribbon synapses, or hair cells synapses without hair cell damage. Their association with HHL was noted several times through this study, whether we were studying the effect of noise exposure, of age, or of ototoxicity. In all cases, no significant hair cell damage was observed, and normal thresholds were recovered. However, a decline in the amplitude of Auditory Brainstem Response (ABR) peak I from auditory nerve (AN) responses in noise exposed subjects and a decline in compound action potential (CAP) was measured when certain drugs were applied to the round window of Guinea pigs. Conclusion: Most studies, have proven that cochlear synaptophysin is the major contributor to noise induced, age, and ototoxic related HHL. There are several audiometric tests that were used to help identify HHL including Puretone audiometry in background noise, ABR, CAP, Distortion Product Otoacoustic Emission (DPOAE).展开更多
Integrity of the membranous labyrinth barrier system is of critical importance, which promotes inner ear homeostasis and maintains its features. The membranous labyrinth barrier system is divided into several subsets ...Integrity of the membranous labyrinth barrier system is of critical importance, which promotes inner ear homeostasis and maintains its features. The membranous labyrinth barrier system is divided into several subsets of barriers which, although independent from each other, are interrelated. The same substance may demonstrate different permeability characteristics through different barriers and under different conditions, while different substances can have different permeability features even in the same barrier under the same condition. All parts of the mem-branous labyrinth barrier structure, including their morphology, enzymes and channel proteins, and theirs permeability characteristics under various physiological and pathological conditions are reviewed in this paper. Infections, noise exposure, ototoxicity may all increase perme-ability of the barriers and lead to disturbances in inner ear homeostasis. Copyright ? 2015 The Authors. Production & hosting by Elsevier (Singapore) Pte Ltd On behalf of PLA General Hospital Department of Otolaryngology Head and Neck Surgery. 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
Profound sensorineural hearing loss (PSHL) is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous ...Profound sensorineural hearing loss (PSHL) is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous membranous structure and similar receptor cell ultrastructures, the cochlea and vestibule may be susceptible to the same harmful factors. Disorders of the inner ear may result in a variety of manifestations, including vertigo, spatial disorientation, blurred vision, impaired articulation, and hearing impairment. Considering the diversity of clinical symptoms associated with PSHL with otolithic dysfunction, it may be frequently misdiagnosed, and objective means of testing the function of otolithic organs should be recommended for hearing-impaired patients. Vestibular-evoked myogenic potentials (VEMPs) via air-conducted sound are of great importance for the diagnosis of otolithic function. Hearing devices such as cochlear implants are commonly accepted treatments for PSHL, and early identification and treatment of vestibular disorders may increase the success rate of cochlear implantation. Therefore, it is necessary to increase awareness of otolithic functional states in patients with PSHL.展开更多
Objectives:The main objective of the study was to ascertain the prevalence of chronic otitis media and determine the corresponding hearing loss in children from Nepal’s Himalayan region now residing in Buddhist Monas...Objectives:The main objective of the study was to ascertain the prevalence of chronic otitis media and determine the corresponding hearing loss in children from Nepal’s Himalayan region now residing in Buddhist Monastic schools of Nepal.Methods:The study was conducted among children at Buddhist monastic school in different parts of Nepal.A total of 3174 children aged between 5 and 15 years,who were originally from the Himalayan region of Nepal and were currently residing in monastic schools,were screened for ear problems and hearing loss.They were examined by otoscope to diagnose chronic otitis media.Hearing was evaluated by pure tone audiometer,and 0.5e4 kHz air conduction hearing threshold was measured and documented.Results:Of the total of 3174 children who were screened for ear diseases and hearing loss,monks constituted 76.21%(n?2419)and Nuns 23.78%(n?755).Chronic otitis media was the most common otoscopic finding during the screening,and it affected a total of 344(10.83%)children.Out of these 344,hearing loss of varying degrees was observed in 5.42%(n?172)children.Conclusion:There is high prevalence of chronic otitis media in children belonging to the Himalayan region of Nepal,and it is the main cause of avoidable hearing loss.Timely diagnosis and treatment of chronic otitis media could prevent unnecessary hearing loss in these children.展开更多
Objective:To investigate the effects of conductive hearing loss (CHL) on vestibular evoked myogenic potentials (VEMPs) using a simulated CHL model, and to provide the basis for future studies. Methods:Twenty-one healt...Objective:To investigate the effects of conductive hearing loss (CHL) on vestibular evoked myogenic potentials (VEMPs) using a simulated CHL model, and to provide the basis for future studies. Methods:Twenty-one healthy subjects were recruited in this study. We measured ocular VEMPs (oVEMPs) and cervical VEMPs (cVEMPs) in these subjects by air-conduction sound (ACS) stimulation. CHL was simulated later by blocking the right external auditory canal with a soundproof earplug to evaluate its impacts on VEMPs. Subjects' responses before simulated CHL served as the control, and were compared to their responses following simulated CHL. Results: oVEMPs following simulated CHL showed decreased response rate, elevated thresholds, attenuated amplitudes and prolonged N1 latencies compared with those before simulated CHL, and the differences were statistically significant. Similarly, cVEMPs following simulated CHL also showed decreased response rate, elevated thresholds and attenuated amplitudes, with prolonged P1 latencies compared with those before simulated CHL, although only differences in response rate, threshold and amplitude were significant. Conclusions:Conductive hearing loss affects the response rate and other response parameters in oVEMPs and cVEMPs.展开更多
Endoscopic ear surgery(EES) is an exciting, rapidly developing and innovative field of otologic surgery.Technically and conceptually, EES is a significant departure from traditional microscopic transcanal approaches t...Endoscopic ear surgery(EES) is an exciting, rapidly developing and innovative field of otologic surgery.Technically and conceptually, EES is a significant departure from traditional microscopic transcanal approaches to the middle ear and canal that has shown very positive results with respect to patient outcomes. This review serves as a primer for the otologist and otology resident embarking on EES and discusses the theory surrounding the learning process, the optical chain for endoscopic surgery as well as other important underlying principles.展开更多
Objective： To demonstrate the performance benefit of the Automatic Scene Classifier （SCAN） algorithm available in the Nucleus 6 （CP900 series） sound processor over the default processing algorithms of the previou...Objective： To demonstrate the performance benefit of the Automatic Scene Classifier （SCAN） algorithm available in the Nucleus 6 （CP900 series） sound processor over the default processing algorithms of the previous generation Nucleus 5 （CP810） and Freedom HybridTM sound processors. Methods： Eighty-two cochlear implant recipients （40 Nucleus 5 processor users and 42 Freedom Hybrid processor users） listened to and repeated AzBio sentences in noise with their current processor and with the Nucleus 6 processor. Results： The SCAN algorithm when enabled yielded statistically significant non-inferior and superior performance when compared to the Nucleus 5 and Freedom Hybrid sound processors programmed with ASC ＋ ADRO. Conclusion： The results of these studies demonstrate the superior performance and clinical utility of the SCAN algorithm in the Nucleus 6 processor over the Nucleus 5 and Freedom Hybrid processors.展开更多
Objectives:To document the frequency of occurrence and types of symptoms experienced in the contralateral ear in patients with unilateral physical non-explosive(UPN)ear trauma and to compare the audio metric and tympa...Objectives:To document the frequency of occurrence and types of symptoms experienced in the contralateral ear in patients with unilateral physical non-explosive(UPN)ear trauma and to compare the audio metric and tympano metric parameters between asymptomatic and symptomatic contralateral ears.Design:Prospective analytical clinical study Setting:Specialized(Ear,Nose,and Throat)clinic of a tertiary health institution.Participants:Patients with UPN ear trauma who presented within the first week of the incident.Main outcome measures:Otologic symptoms in the contralateral ear in UPN ear trauma Results:Eighteen out of 53 patients(34.0%)experienced symptoms in the contralateral ear.The symptoms were tinnitus in 77.8%(14/18),hearing loss in 66.7%(12/18),and ear blockage in 27.8%(5/18).There was hearing loss in 38/53(71.7%)of contralateral ears.Hearing loss type and PTAv at the low frequencies were not significantly different(p=0.142),but other audiometric parameters were significantly different between asymptomatic and symptomatic contralateral ears(p<0.05 in all).Type C tympanogram was more prominent in the symptomatic contralateral ear.There was a statistically-significant difference in the type of tympanogram between the two categories of patients(p=0.018).There was no difference in acoustic reflex between the two categories of patients(p=0.095).Conclusions:The contralateral ear may be affected in up to one-third of patients with UPN ear trauma,and experience otologic symptoms similar to those of the traumatized ears.Audiologic and audiometric parameters were abnormal in most of the contralateral ears.The two ears must be assessed thoroughly in cases of UPN ear trauma.展开更多
Voltage-gated sodium channels(VGSCs)are transiently expressed in cochlear hair cells before hearing onset and play an indispensable role in shaping spontaneous activity.In this study,we showed that Na^+currents shaped...Voltage-gated sodium channels(VGSCs)are transiently expressed in cochlear hair cells before hearing onset and play an indispensable role in shaping spontaneous activity.In this study,we showed that Na^+currents shaped the spontaneous action potentials in developing mouse inner hair cells(IHCs)by decreasing the time required for the membrane potential to reach the action-potential threshold.In immature IHCs,we identified 9 known VGSC subtypes(Navl.la-l.9ot),among which Navl.7a was the most highly expressed subtype and the main contributor to Na+currents in developing hair cells.Electrophysiological recordings of two cochlea-specific Navi.7 variants(CbmNavl.7a and CbmNavl.7b)revealed a novel loss-of-function mutation(C934R)at the extracellular linker between segments 5 and 6 of domain II.In addition,post-transcriptional modification events,such as alternative splicing and RNA editing,amended the gating properties and kinetic features of CbmNavl.7a(C934).These results provide molecular and functional characteristics of VGSCs in mammalian IHCs and their contributions to spontaneous physiological activity during cochlear maturation.展开更多
Purpose An important outcome measure of patient care is the impact on the patient’s health-related quality of life(HRQoL).Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different ...Purpose An important outcome measure of patient care is the impact on the patient’s health-related quality of life(HRQoL).Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different subdivisions such as symptoms,hearing problems,psychosocial impact,and the need for care.The optimal length of the recall period has not been studied.For these reasons,a new survey is needed that would cover most chronic ear diseases.Methods A preliminary 24-item survey(EOS-24)was created.Untreated adult patients(included n=186)with one of seven different chronic otologic conditions from all university hospitals in Finland were recruited to respond to EOS-24 and the 15D general HRQoL instrument.The recruiting otologists evaluated the severity of the disease and the disability caused by it.A control group was recruited.Based on the patients’responses in different diagnosis groups,the items were reduced according to pre-defined criteria.The resulting survey was validated using a thorough statistical analysis.Results The relevance and necessity of the original 24 items were thoroughly investigated,leading to the exclusion of 8 items and the modification of 1.The remaining 16 items were well-balanced between subdivisions and were useful in all seven diagnosis groups,thus constituting the final instrument,EOS-16.The most suitable recall period was three months.Conclusions EOS-16 has been created according to the HRQoL survey guidelines with a versatile nationwide patient population.The survey has been validated and can be used for a wide range of chronic ear diseases as a HRQoL instrument.展开更多
Background: Self-cleaning of ears with different objects is a common practice among school children with scanty report in literature. Aim: The aim of this study was to determine the prevalence and profile of self-ear ...Background: Self-cleaning of ears with different objects is a common practice among school children with scanty report in literature. Aim: The aim of this study was to determine the prevalence and profile of self-ear cleaning among school children. Methods: It was a cross-sectional institutional-based study which was carried out among school children in Ekiti, south western Nigeria from January 2017, to March 2017. Results: A total of 174 students participated in this study. Their age ranged between 13 and 17 years. The highest number of participant was found at the age of 15 years. One hundred and eighteen (67.8%) of them had carried out self ear cleaning. Personal hygiene was the commonest reason for self ear cleaning in 28.8% of the students. Cotton buds were mostly used by the respondents in 51.7% of them. Injury to the external auditory canal (EAC) was the most recorded complications. Conclusion: The outcome of this study shows that self-ear cleaning practices were common among school children with a prevalence of 67.8%. Cotton buds were the commonest objects used. Avoidable complications were reported among respondents. There is a need to intensify efforts on public enlightenment programme and the establishment of school health programme in our various schools.展开更多
Objective: Cochlear implantation is the emerging treatment of choice for severe and profound sensorineural hearing loss, yet there are conflicting data on outcomes in adults. There is significant variability in the li...Objective: Cochlear implantation is the emerging treatment of choice for severe and profound sensorineural hearing loss, yet there are conflicting data on outcomes in adults. There is significant variability in the literature concerning the exact effect of age on cochlear implant outcomes. We sought to evaluate the outcomes of cochlear implant performance stratified by age. Study Design: Retrospective review. Methods: Audiologic preoperative and postoperative evaluation consisted of word recognition scores (Consonant-Nucleus-Consonant). Complications were retrospectively collected after each cochlear implantation. A sub-analysis was performed comparing patients implanted at a younger (21 - 64 years) and older (65 and above) age. Results: A total of 240 patients were evaluated. Patients experienced a significant improvement in audiologic performance as seen with word recognition scores (p < 0.00001). The mean post-implant score was 44.6% (at 3 months) and 53.5% (at 24 months) at 50 dB compared to average pre-implantation aided score of 6%. There was no significant difference between postoperative performances in younger versus older patient groups. Multiple regressions showed no correlation with duration of deafness at time of implantation or age and performance. There was no significant difference in performance based on side of implantation. Conclusion: This is one of the largest series to date on hearing outcomes in adults who receive a cochlear implant. No statistical differences were noted between the younger and older groups or based on side of implantation. The audiologic benefit in the adult population is clearly demonstrated.展开更多
基金supported by the National Natural Science Foundation of China(52275296)the Priority Academic Program Development of Jiangsu Higher Education Institutions.
文摘This study aims to investigate the impact of middle ear effusion(MEE)on sound transmission in the human ear and its potential diagnostic significance.Firstly,the material properties of specific structures were adjusted based on the existing human ear finite element(FE)model,and the accuracy of the model was validated using experimental data.Secondly,six FE models were developed to simulate varying degrees of MEE by systematically altering the material properties of the middle ear cavity(MEC)at different anatomical locations.Finally,the effects of these six FE models,representing varying degrees of MEE,on sound transmission characteristics and energy absorption(EA)rate in the human ear were systematically analyzed.When the degree of MEE is less than 50%of the MEC volume,its impact on the sound transmission characteristics of the human ear remains minimal,resulting in an estimated hearing loss of approximately 3 dB,with EA rate remaining close to normal levels.Once the effusion exceeds 50%of the MEC volume,a significant deterioration in acoustic transmission is observed,accompanied by a flattening of the EA curve and a drop in EA rates to below 20%.When the effusion completely fills the MEC,the maximum hearing loss reaches 46.47 dB,and the EA rate approaches zero across the entire frequency range.These findings provide theoretical insights into the biomechanical effects of MEE on human auditory transmission and offer a reference for clinical diagnosis and evaluation.
文摘BACKGROUND Otitis media with effusion(OME),glue ear,serous otitis media,or secretory otitis media is a common paediatric condition.Two widely used surgical interventions for OME are myringotomy alone and myringotomy with tympanostomy tube.While both procedures aim to improve hearing outcomes,the efficacy of these approaches has been a subject of ongoing research and debate.AIM To compare the efficacy of myringotomy alone and myringotomy with tympa-nostomy tube.METHODS In this comparative study,66 patients diagnosed as OME meeting the inclusion criteria were selected via ear,nose and throat department.They were divided into two groups randomly,each of 33 patients.In the first group(Group A)myrin-gotomy alone was performed while in the second group(Group B)myringotomy with tympanostomy tube placement was performed.We observed hearing outcome by pure tone audiogram(PTA)pre operatively.Patients were followed up and re-assessed in outdoor patient department at 4th week postoperatively again by PTA.RESULTS The mean age of the patients in Group A was 10.96±2.76 SD but the mean age of the patients in Group B was 10.22±2.73 SD(P=0.1056).In Group A,males were 63.6%and females were 36.3%.Also in Group B,males were 63.6%and females were 36.3%(P=1.0).In group A,post operative hearing gain using pure tone audiometry at one month was 20.45±3.78 SD while in group B,post operative hearing gain using pure tone audiometry at one month was 23.84±3.69 SD(P=0.00005).However,ear discharge was noted in 3.03%cases in group A and 15.15%cases in group B(P=0.035).By applying independent t-test,the P<0.05 indicated that there is a significant association between Group B and hearing improvement at 4th week.CONCLUSION Our study concluded that myringotomy with tympanostomy tube seems to have better hearing results than myringotomy alone in treatment of OME.
基金supported by Capital’s Funds for Health Improvement and Research(CFH:2022-2-5072)the Tianjin Natural Science Foundation for Jingjinji Collaboration(23JCZXJC00240)+1 种基金Beijing Natural Science Foundation(J230006)the CAMS Innovation Fund for Medical Science(2021-I2M-1-052).
文摘ObjectiveTo develop a sustained-release codelivery system for intratympanic administration of dexamethasone(DEX)and lipoic acid(LA).MethodsDEX microcrystals(MCs)were prepared via precipitation,while LA-loaded porous PLGA microspheres(LPMPs)were fabricated using a double emulsion–solvent evaporation method.DEX MCs were physically perfused into LPMPs via negative pressure to form a combined system(DEX MCs+LPMPs).Physicochemical properties,in vitro drug release,pharmacokinetics,and biocompatibility were evaluated.Guinea pigs were used for intratympanic injections of DEX MCs,LPMPs,or DEX MCs+LPMPs.ResultsThe DEX MCs+LPMPs system enabled simultaneous release of both drugs,with DEX exhibiting superior pharmacokinetics(sustained perilymph concentrations up to 7 days)compared to DEX MCs alone.LA release from LPMPs demonstrated prolonged kinetics without burst release.SEM confirmed DEX MCs were localized within/on LPMPs and adhered to the round window membrane(RWM).Histological analysis revealed normal cochlear morphology and no inflammatory response,confirming biocompatibility.ConclusionsThis novel codelivery system combining microcrystals and porous microspheres achieves sustained dual-drug release,enhances therapeutic efficacy,and offers a promising strategy for managing hearing loss via intratympanic administration.
文摘Background: Non-implantable bone anchored hearing devices (BCHDs) are utilized for patients with conductive or mixed hearing loss who are unsuitable for conventional hearing aids or have unresolved middle ear issues. These devices can be surgically implanted or attached using adhesive plates, dental sticks, elastic headbands, or bone conduction spectacles. Optimal fitting of bone conduction spectacles requires appropriate frame selection and contact pressure in the temporal and mastoid areas. The ANSI S3.6 and DIN EN ISO 389-3 standards recommend a contact area of approximately 1.75 cm2 and a maximum force of 5.4 N for effective sound transmission and comfort. Methods: This study aimed to evaluate the technical fit and mechanical stability of universal bone conduction hearing spectacles compared to established systems. A Sen-Pressure 02 thin-film sensor connected to an Arduino Uno R3 board measured contact force in the temporal and mastoid areas. Several BCHDs were tested, including the Bruckhoff la belle BC D50/70, Radioear B71 headset, Radioear B71 elastic headband, Cochlear Baha SoundArc M, and Cochlear Baha elastic headband, on a PVC artificial head, with data analyzed using ANOVA and LSD post hoc tests. Results: The la belle BC D50/70 spectacles showed comparable contact force to established BCHDs, ensuring adequate sound transmission and comfort. Significant differences were observed between the systems, with the Radioear B71 headset exhibiting the highest forces. The la belle BC D50/70 had similar forces to the Radioear B71 elastic headband. Conclusion: The la belle BC D50/70 universal bone conduction hearing spectacles are a technically equivalent alternative to established BCHDs, maintaining pressure below 5.4 N. Future research should explore the impact of different contact forces on performance and comfort, and the integration of force control in modified spectacles. This study indicates that the la belle BC D50/70 is a viable alternative that meets audiological practice requirements.
基金Project Project supported by the National Key Technologies R&D Program of China(Nos.2017YFA0103900 and 2016YFC0905200)the National Natural Science Foundation of China(Nos.81620108005,8177040802,and 81622013)the Shanghaigng Talents Plan(No.18PJ1401700),China
文摘Bone morphogenetic proteins(BMPs)are the largest subfamily of the transforming growth factor-βsuperfamily,and they play important roles in the development of numerous organs,including the inner ear.The inner ear is a relatively small organ but has a highly complex structure and is involved in both hearing and balance.Here,we discuss BMPs and BMP signaling pathways and then focus on the role of BMP signal pathway regulation in the development of the inner ear and the implications this has for the treatment of human hearing loss and balance dysfunction.
文摘Application of surgical endoscope, used alone or in combination with the surgical microscope, for the operative management of ear and temporal bone conditions may allow improved access and clearance of disease. Preservation of normal structures may also be improved.As the use of this tool is increasing, the need for better understanding of the anatomy of the ear is becoming evident. This is particularly so for endoscopic surgery aiming at removal of lesions involving the infra-cochlear corridor and/or petrous apex.Human temporal bone-derived labyrinth casts(molds), originally made for endolymphatic duct and sac analysis which genuinely represent the membranous labyrinth and its adjacent soft tissues, were morphometrically analyzed in terms of the anatomic relations between structures in and around the infra-cochlear corridor. The distance between the petrous carotid artery(PCA) and the basal turn of the cochlea, the distance between PCA and infra-cochlear vein(ICV)/cochlear aqueduct(CA), and the distance between the lower surface of basal cochlear turn and the point where the carotid artery and jugular vein(JV) meet close to the jugular foramen, were measured to be around 1.3 mm, 6 mm and 8 mm respectively, thus constituting an approximate 6?8 mm2 infra-cochlear corridor. This analysis and further study with larger samples might be helpful for operation via this corridor led to the petrous apex where cholesterol granuloma, cholesteatoma and other lesions are not uncommon.
基金supported by the Natural Science Foundation of Shanghai,No.08ZR1414900 and 11ZR1423600
文摘The results from this study showed that the thresholds of brainstem auditory-evoked potentials peak following 10 successive days of intramuscular injection of Roman chickens with kanamycin, starting 3 days after birth. Fluorescence immunohistochemistry analysis revealed few ganglion cells positively labeled for Ephrin A2 in the cochlea of experimental chickens from 2 days before until 7 days after the last kanamycin injection. The number of Ephrin A2-positive ganglion cell bodies was increased at 15 days after the last injection and was similar to that in normal chickens at 30 days following the cessation of kanamycin treatment. These experimental findings indicate that Ephrin A2 protein expression in the acoustic ganglia is synchronized with the connection damage and regeneration of cochlear hair cells after kanamycin exposure. Ephrin A2 may play an important role in the regeneration and plasticity of cochlear hair cells in the chick cochlea following kanamycin ototoxicity.
文摘BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.
文摘Introduction: Hidden hearing loss (HHL) is a type of auditory disorder that affects the auditory neural processing and hearing sensitivity in subjects with normal hearing thresholds. Unlike central auditory processing disorders, HHL happens when the cochlea (the peripheral auditory organ) is affected. There are several known risk factors to HHL which includes noise exposure, ototoxic drugs, and peripheral neuropathies, and age. Recent studies have shed light on this type of hearing loss, its etiology, prevalence, and how it can affect the auditory acuity in humans. Methods: This paper covers the current research regarding HHL, its causes, the different mechanisms involved in this disorder, and the diagnosis and potential treatments related to it. We will delve deeply into different researches concerning HHL. 4 articles from 285 were selected focusing on normal hearing individuals with bad speech intelligibility were discussed in this paper. In addition, articles discussing the effects of noise exposure on hearing impaired individuals were not considered as this study solely aims to focus on normal hearing sensitivity individuals with HHL, resulting in 4 articles from 285. Results: Numerous literatures over the decades have suggested that HHL is due to the degeneration of cochlear ribbon synapses, or hair cells synapses without hair cell damage. Their association with HHL was noted several times through this study, whether we were studying the effect of noise exposure, of age, or of ototoxicity. In all cases, no significant hair cell damage was observed, and normal thresholds were recovered. However, a decline in the amplitude of Auditory Brainstem Response (ABR) peak I from auditory nerve (AN) responses in noise exposed subjects and a decline in compound action potential (CAP) was measured when certain drugs were applied to the round window of Guinea pigs. Conclusion: Most studies, have proven that cochlear synaptophysin is the major contributor to noise induced, age, and ototoxic related HHL. There are several audiometric tests that were used to help identify HHL including Puretone audiometry in background noise, ABR, CAP, Distortion Product Otoacoustic Emission (DPOAE).
文摘Integrity of the membranous labyrinth barrier system is of critical importance, which promotes inner ear homeostasis and maintains its features. The membranous labyrinth barrier system is divided into several subsets of barriers which, although independent from each other, are interrelated. The same substance may demonstrate different permeability characteristics through different barriers and under different conditions, while different substances can have different permeability features even in the same barrier under the same condition. All parts of the mem-branous labyrinth barrier structure, including their morphology, enzymes and channel proteins, and theirs permeability characteristics under various physiological and pathological conditions are reviewed in this paper. Infections, noise exposure, ototoxicity may all increase perme-ability of the barriers and lead to disturbances in inner ear homeostasis. Copyright ? 2015 The Authors. Production & hosting by Elsevier (Singapore) Pte Ltd On behalf of PLA General Hospital Department of Otolaryngology Head and Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
文摘Profound sensorineural hearing loss (PSHL) is not uncommonly encountered in otology. In clinics, there is a high incidence of otolithic damage in patients with PSHL, but relevant reports are few. Sharing a continuous membranous structure and similar receptor cell ultrastructures, the cochlea and vestibule may be susceptible to the same harmful factors. Disorders of the inner ear may result in a variety of manifestations, including vertigo, spatial disorientation, blurred vision, impaired articulation, and hearing impairment. Considering the diversity of clinical symptoms associated with PSHL with otolithic dysfunction, it may be frequently misdiagnosed, and objective means of testing the function of otolithic organs should be recommended for hearing-impaired patients. Vestibular-evoked myogenic potentials (VEMPs) via air-conducted sound are of great importance for the diagnosis of otolithic function. Hearing devices such as cochlear implants are commonly accepted treatments for PSHL, and early identification and treatment of vestibular disorders may increase the success rate of cochlear implantation. Therefore, it is necessary to increase awareness of otolithic functional states in patients with PSHL.
文摘Objectives:The main objective of the study was to ascertain the prevalence of chronic otitis media and determine the corresponding hearing loss in children from Nepal’s Himalayan region now residing in Buddhist Monastic schools of Nepal.Methods:The study was conducted among children at Buddhist monastic school in different parts of Nepal.A total of 3174 children aged between 5 and 15 years,who were originally from the Himalayan region of Nepal and were currently residing in monastic schools,were screened for ear problems and hearing loss.They were examined by otoscope to diagnose chronic otitis media.Hearing was evaluated by pure tone audiometer,and 0.5e4 kHz air conduction hearing threshold was measured and documented.Results:Of the total of 3174 children who were screened for ear diseases and hearing loss,monks constituted 76.21%(n?2419)and Nuns 23.78%(n?755).Chronic otitis media was the most common otoscopic finding during the screening,and it affected a total of 344(10.83%)children.Out of these 344,hearing loss of varying degrees was observed in 5.42%(n?172)children.Conclusion:There is high prevalence of chronic otitis media in children belonging to the Himalayan region of Nepal,and it is the main cause of avoidable hearing loss.Timely diagnosis and treatment of chronic otitis media could prevent unnecessary hearing loss in these children.
基金supported by grants from the National Natural Science Foundation of China, China (No. 81670945, 81541040)Fundamental Research Funds for the Central Universities, China (No. 2012jdhz13)+1 种基金Shaanxi Major International Cooperative Project, China (No. 2013KW-28)Key Science and Technology Program of Xi'an, China (No. SF1315(1))
文摘Objective:To investigate the effects of conductive hearing loss (CHL) on vestibular evoked myogenic potentials (VEMPs) using a simulated CHL model, and to provide the basis for future studies. Methods:Twenty-one healthy subjects were recruited in this study. We measured ocular VEMPs (oVEMPs) and cervical VEMPs (cVEMPs) in these subjects by air-conduction sound (ACS) stimulation. CHL was simulated later by blocking the right external auditory canal with a soundproof earplug to evaluate its impacts on VEMPs. Subjects' responses before simulated CHL served as the control, and were compared to their responses following simulated CHL. Results: oVEMPs following simulated CHL showed decreased response rate, elevated thresholds, attenuated amplitudes and prolonged N1 latencies compared with those before simulated CHL, and the differences were statistically significant. Similarly, cVEMPs following simulated CHL also showed decreased response rate, elevated thresholds and attenuated amplitudes, with prolonged P1 latencies compared with those before simulated CHL, although only differences in response rate, threshold and amplitude were significant. Conclusions:Conductive hearing loss affects the response rate and other response parameters in oVEMPs and cVEMPs.
文摘Endoscopic ear surgery(EES) is an exciting, rapidly developing and innovative field of otologic surgery.Technically and conceptually, EES is a significant departure from traditional microscopic transcanal approaches to the middle ear and canal that has shown very positive results with respect to patient outcomes. This review serves as a primer for the otologist and otology resident embarking on EES and discusses the theory surrounding the learning process, the optical chain for endoscopic surgery as well as other important underlying principles.
文摘Objective： To demonstrate the performance benefit of the Automatic Scene Classifier （SCAN） algorithm available in the Nucleus 6 （CP900 series） sound processor over the default processing algorithms of the previous generation Nucleus 5 （CP810） and Freedom HybridTM sound processors. Methods： Eighty-two cochlear implant recipients （40 Nucleus 5 processor users and 42 Freedom Hybrid processor users） listened to and repeated AzBio sentences in noise with their current processor and with the Nucleus 6 processor. Results： The SCAN algorithm when enabled yielded statistically significant non-inferior and superior performance when compared to the Nucleus 5 and Freedom Hybrid sound processors programmed with ASC ＋ ADRO. Conclusion： The results of these studies demonstrate the superior performance and clinical utility of the SCAN algorithm in the Nucleus 6 processor over the Nucleus 5 and Freedom Hybrid processors.
文摘Objectives:To document the frequency of occurrence and types of symptoms experienced in the contralateral ear in patients with unilateral physical non-explosive(UPN)ear trauma and to compare the audio metric and tympano metric parameters between asymptomatic and symptomatic contralateral ears.Design:Prospective analytical clinical study Setting:Specialized(Ear,Nose,and Throat)clinic of a tertiary health institution.Participants:Patients with UPN ear trauma who presented within the first week of the incident.Main outcome measures:Otologic symptoms in the contralateral ear in UPN ear trauma Results:Eighteen out of 53 patients(34.0%)experienced symptoms in the contralateral ear.The symptoms were tinnitus in 77.8%(14/18),hearing loss in 66.7%(12/18),and ear blockage in 27.8%(5/18).There was hearing loss in 38/53(71.7%)of contralateral ears.Hearing loss type and PTAv at the low frequencies were not significantly different(p=0.142),but other audiometric parameters were significantly different between asymptomatic and symptomatic contralateral ears(p<0.05 in all).Type C tympanogram was more prominent in the symptomatic contralateral ear.There was a statistically-significant difference in the type of tympanogram between the two categories of patients(p=0.018).There was no difference in acoustic reflex between the two categories of patients(p=0.095).Conclusions:The contralateral ear may be affected in up to one-third of patients with UPN ear trauma,and experience otologic symptoms similar to those of the traumatized ears.Audiologic and audiometric parameters were abnormal in most of the contralateral ears.The two ears must be assessed thoroughly in cases of UPN ear trauma.
基金We thank Prof.Lin Chen(University of Science and Technology of China)and Dr.Juanmei Yang(Eye and ENT Hospital of Fudan University)for valuable help with cochlear microscopic anatomy.This work was supported by the National Natural Science Foundation of China(31571032,31771191.81730028)the National Basic Research Development Program of China(SQ2017YFSF080012)the Postdoctoral Science Foundation of China(2018M640407).
文摘Voltage-gated sodium channels(VGSCs)are transiently expressed in cochlear hair cells before hearing onset and play an indispensable role in shaping spontaneous activity.In this study,we showed that Na^+currents shaped the spontaneous action potentials in developing mouse inner hair cells(IHCs)by decreasing the time required for the membrane potential to reach the action-potential threshold.In immature IHCs,we identified 9 known VGSC subtypes(Navl.la-l.9ot),among which Navl.7a was the most highly expressed subtype and the main contributor to Na+currents in developing hair cells.Electrophysiological recordings of two cochlea-specific Navi.7 variants(CbmNavl.7a and CbmNavl.7b)revealed a novel loss-of-function mutation(C934R)at the extracellular linker between segments 5 and 6 of domain II.In addition,post-transcriptional modification events,such as alternative splicing and RNA editing,amended the gating properties and kinetic features of CbmNavl.7a(C934).These results provide molecular and functional characteristics of VGSCs in mammalian IHCs and their contributions to spontaneous physiological activity during cochlear maturation.
文摘Purpose An important outcome measure of patient care is the impact on the patient’s health-related quality of life(HRQoL).Current ear-specific HRQoL instruments are designed for one diagnosis and emphasize different subdivisions such as symptoms,hearing problems,psychosocial impact,and the need for care.The optimal length of the recall period has not been studied.For these reasons,a new survey is needed that would cover most chronic ear diseases.Methods A preliminary 24-item survey(EOS-24)was created.Untreated adult patients(included n=186)with one of seven different chronic otologic conditions from all university hospitals in Finland were recruited to respond to EOS-24 and the 15D general HRQoL instrument.The recruiting otologists evaluated the severity of the disease and the disability caused by it.A control group was recruited.Based on the patients’responses in different diagnosis groups,the items were reduced according to pre-defined criteria.The resulting survey was validated using a thorough statistical analysis.Results The relevance and necessity of the original 24 items were thoroughly investigated,leading to the exclusion of 8 items and the modification of 1.The remaining 16 items were well-balanced between subdivisions and were useful in all seven diagnosis groups,thus constituting the final instrument,EOS-16.The most suitable recall period was three months.Conclusions EOS-16 has been created according to the HRQoL survey guidelines with a versatile nationwide patient population.The survey has been validated and can be used for a wide range of chronic ear diseases as a HRQoL instrument.
文摘Background: Self-cleaning of ears with different objects is a common practice among school children with scanty report in literature. Aim: The aim of this study was to determine the prevalence and profile of self-ear cleaning among school children. Methods: It was a cross-sectional institutional-based study which was carried out among school children in Ekiti, south western Nigeria from January 2017, to March 2017. Results: A total of 174 students participated in this study. Their age ranged between 13 and 17 years. The highest number of participant was found at the age of 15 years. One hundred and eighteen (67.8%) of them had carried out self ear cleaning. Personal hygiene was the commonest reason for self ear cleaning in 28.8% of the students. Cotton buds were mostly used by the respondents in 51.7% of them. Injury to the external auditory canal (EAC) was the most recorded complications. Conclusion: The outcome of this study shows that self-ear cleaning practices were common among school children with a prevalence of 67.8%. Cotton buds were the commonest objects used. Avoidable complications were reported among respondents. There is a need to intensify efforts on public enlightenment programme and the establishment of school health programme in our various schools.
文摘Objective: Cochlear implantation is the emerging treatment of choice for severe and profound sensorineural hearing loss, yet there are conflicting data on outcomes in adults. There is significant variability in the literature concerning the exact effect of age on cochlear implant outcomes. We sought to evaluate the outcomes of cochlear implant performance stratified by age. Study Design: Retrospective review. Methods: Audiologic preoperative and postoperative evaluation consisted of word recognition scores (Consonant-Nucleus-Consonant). Complications were retrospectively collected after each cochlear implantation. A sub-analysis was performed comparing patients implanted at a younger (21 - 64 years) and older (65 and above) age. Results: A total of 240 patients were evaluated. Patients experienced a significant improvement in audiologic performance as seen with word recognition scores (p < 0.00001). The mean post-implant score was 44.6% (at 3 months) and 53.5% (at 24 months) at 50 dB compared to average pre-implantation aided score of 6%. There was no significant difference between postoperative performances in younger versus older patient groups. Multiple regressions showed no correlation with duration of deafness at time of implantation or age and performance. There was no significant difference in performance based on side of implantation. Conclusion: This is one of the largest series to date on hearing outcomes in adults who receive a cochlear implant. No statistical differences were noted between the younger and older groups or based on side of implantation. The audiologic benefit in the adult population is clearly demonstrated.
