The latest medical research on Otolaryngology
The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about otolaryngology gathered by our medical AI research bot.
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Request AccessComparative executive function analysis: Cochlear implants and normal hearing in 7- to 11-year-old children from Iran.
Cochlear Implants InternationalThis study compares executive functioning in deaf children with cochlear implants and those with normal hearing. Individuals who lacked auditory stimulation during their early years might experience cognitive challenges that extend beyond just speech and language abilities.
The executive functioning abilities of a group of 32 children who were born deaf and received cochlear implants before the age of 7 were contrasted with those of 30 children with normal hearing. Both sets of children underwent assessments using the Tower of London, BRIEF, and Stroop tests.
The average score on the Tower of London task reveals that children who received cochlear implants (4.03 ± 2.53) achieved lower scores than typically hearing children (8.37 ± 2.79). This group also exhibited higher errors in the Stroop test and slightly longer response times Additionally, in terms of emotional control assessed by the BRIEF, a higher score was recorded. Notably, significant differences between the two groups were identified for organizing materials (t(62) = -4.204, p = 0.00). The tests measuring phonemic fluency, categorical fluency, and working memory also revealed significant differences.
The significant differences in data between both groups suggest the influence of cochlear implantation on cognitive functions. This emphasizes the importance of a holistic approach to supporting the overall development of these children.
Pneumatocoele after cochlear implantation with lateral petrosectomy: A minor complication?
Cochlear Implants InternationalTo illustrate the clinical features and management of pneumatocoele presenting with a trap-valve mechanism after cochlear implantation with lateral petrosectomy (LP) in comparison with literature.
Pneumatocoele is a rare complication of cochlear implant (CI) surgery, generally managed with conservative treatments.
We describe a progressively increasing pneumatocoele with a trap-valve mechanism occurring one year after CI with LP, successfully managed with revision surgery. Literature review was performed on this topic.
Our case was the second ever reported in literature. It appeared consequently to forceful nose-blowing in a patient with refractory nasal polyposis. Unlike the pneumatocoeles reported after standard CI, we advised revision surgery as well as in the case of pneumatocoele after staged LP and CI. In both the patients subcutaneous air collection occurred as a late complication and an insufficient Eustachian tube closure was disclosed, which is considered a complication of LP itself. Surgical management was necessary in consideration of the risk of ascending infections associated with Eustachian tube patency in LP with CI.
We consider surgical treatment mandatory in pneumatocoele after CI with LP, it is indeed the sentinel of the restoration of Eustachian tube patency and the potential prelude to major complications.
Paediatric percutaneous bone anchored hearing aid implant failures: Comparing the experience of a tertiary centre with a systematic review of the literature and meta-analysis.
Cochlear Implants InternationalDespite the proven audiological benefits of Percutaneous Bone Anchored Hearing Aids (BAHAs) in paediatric patients with conductive or mixed hearing loss, their adoption has been limited due to concerns over implant failure and associated complications. This paper conducts a systematic review and meta-analysis to assess the prevalence of implant failure in paediatric populations, combined with a case series from our tertiary referral centre.
A comprehensive literature search identified 562 articles, from which 34 were included in the review, covering 1599 implants in 1285 patients. Our retrospective case series included consecutive patients from our tertiary referral centre who underwent percutaneous BAHA implantation from 2003-2019.
Meta-analysis revealed an overall implant failure rate of 11%, predominantly attributed to traumatic extrusion. Our retrospective case series comprised 104 implantations in 76 patients, with a 4.8% failure rate.
Factors contributing to the lower-than-expected failure rates in the case series likely included consistent use of 4 mm fixtures from a single manufacturer and older age at implantation. The study underscores the need for standardised reporting formats in bone conduction implants research, given the systematic review's limitations in study design heterogeneity, especially with the expected rise in the adoption of novel active devices.
Comparative analysis of microstructures of narrative abilities in language-age-matched Tamil-speaking children with cochlear implants and typical hearing.
Cochlear Implants InternationalIn a unique exploration of narrative development among Tamil-speaking children, this study delves into the intricacies of linguistic expression, ex...
Awareness campaigns for cochlear implants: Are we making an impact?
Cochlear Implants InternationalThis study aimed to determine if the major public awareness campaign for cochlear implants 'International Cochlear Implant Day' influenced national and international public interest as measured by internet search activity.
Weekly search volume data in the United States, Canada, Australia, Germany, United Kingdom, Brazil, India, Japan, and a 'Worldwide' group for the search topic 'cochlear implant' was collected from Google Trends over a 5-year period (2017-2021). The 'Campaign' window was defined as 1 week before, the week of, and 2 weeks after International Cochlear Implant Day (February 25th). 'Non-Campaign' weeks were considered any data outside the 'Campaign' window.
Of the studied regions, the United States, United Kingdom, Australia, India, and 'Global' demonstrated a significant increase in internet search activity between 2017 and 2021. Although some individual years showed significant increases during the 'Campaign' period for Canada, Germany, Brazil, and Japan, none showed statistically significant increases over the 5-year period studied.
Public awareness campaigns are recognized crucial elements to delivering effective healthcare, but their success varies worldwide. While data from Google Trends suggests that cochlear implant awareness campaigns can translate into increased internet searches, greater efforts can be made in select countries to improve public interest.
Influence of cochlear implantation on the working ability of hearing-impaired patients: A prospective study on potential influencing factors.
Cochlear Implants InternationalThis study evaluates the effect of cochlear implantation (CI) on work ability. The influences of quality of life (QOL), age, mental health, and hearing were analyzed.
Seventy-nine patients undergoing CI surgery were evaluated preoperatively and 12 months postoperatively. Work ability was evaluated using the Work Ability Index (WAI). QOL was assessed with the Nijmegen Cochlear Implant Questionnaire (NCIQ) and the WHOQOL-BREF. Mental health was assessed with the Patient Health Questionnaire.
The WAI was unaffected by CI (Δ 0.8 ± 6.8, p = 0.42). No significant changes in WAI were observed for employees (Δ - 1.1 ± 5.7, p = 0.25) and pensioners (Δ -0.4 ± 7.8, p = 0.73). Patients without elevated depressiveness, stress, or somatoform symptoms had significantly better WAI.The multiple regression analyses show that WHOQOL-BREF (ß = 0.49, p ≤ 0.001), age (ß = -0.34, p ≤ 0.001), and depressiveness (ß = 0.33, p = 0.04) were significantly associated with WAI. In the employee group, the NCIQ (ß = 0.58, p = 0.008) had the strongest association with the WAI.
Age, mental health, and QOL are predictive factors for work ability. This should be considered in the consultation and the rehabilitation process.
More than 40 years of cochlear implant research: A bibliometric analysis.
Cochlear Implants InternationalCochlear implantation is the most effective treatment for patients with severe-to-profound sensorineural hearing loss. Much scientific work has been published since their inception. There is a need for a critical reflection on how and what we publish on cochlear implantation.
All Science Citation Index Expanded featured articles between 1980 and 2022 with the word 'cochlear implants' or 'cochlear implantation' were collected from the Web of Science database. Separate characteristics, such as the publication dates, the journals, the number of citations, the countries of origin, the authors, the institutions and co-occurring keywords, were assessed.
13,934 articles were included in the data analysis. The journals of of Otology and Neurotology, Ear and Hearing and of Pediatric Otorhinolaryngology represent the top three most publishing journals. Hannover Medical School, the University of Melbourne and the University of Northern Iowa represent the top three most publishing institutions.
The amount of scientific publications on cochlear implant technology has increased for the last 40 years. Besides the focus on speech perception, the research landscape on cochlear implantation is broad and diverse. The number of countries and institutions contributing to these publications is limited.
This bibliometric analysis serves as a quantitative overview of the research landscape on cochlear implantation.
Pure endoscopic transcanal revision cochlear implantation for a misplaced electrode array: A novel and minimally invasive approach.
Cochlear Implants InternationalMisplacement of the CI electrode array is one of the rarest complications of cochlear implant surgery. This condition can be noticed intraoperatively and diagnosed radiologically in the early postoperative period. To present a novel and minimally invasive revision approach for a misplaced cochlear implant (CI) electrode array.
In this case report, the authors present a previously undescribed alternative minimally invasive revision cochlear implantation approach for a patient with a misplaced CI electrode array in the right ear who underwent bilateral simultaneous cochlear implantation one and a half years ago at another center.
To correct CI electrode array misplacement, the endoscopic transcanal approach is a safe and effective alternative to the conventional approach.
Salvage of the cochlear implant in cases of skin breakdown over the receiver/stimulator in children.
Cochlear Implants InternationalSkin breakdown over receiver/stimulator (RS) after cochlear implantation poses a serious challenge. We report our experience using a one-stage reconstruction and implant salvage approach.
Between the years 2005 and 2017 five children, all females, with congenital- bilateral sensorineural hearing loss were identified. In all cases, a temporoparietal fascia flap (TPFF) and a large scalp flap were used to provide a two-layer coverage to the exposed RS. In the first three cases, a split-thickness skin graft was used to cover the donor site defect. In the latter two cases, a larger rotation flap was used, and a skin graft was not required. One case required revision due to the dehiscence of the wound and exposure of the RS. In another case, an accidental electrode array explantation occurred and the patient underwent a revision cochlear implantation. All patients had achieved complete healing and no change in hearing thresholds with the implants.
We demonstrate our one-stage salvage technique with TPFF that saves the implant and prevents a two-stage procedure. The success rate can be improved with special care at reconstruction and with better protection of the implant during the procedure.
Migration and other electrode complications following cochlear implantation.
Cochlear Implants InternationalTo investigate migration and other electrode-related complications in cochlear implant surgery.
Retrospective review of all patients (adult and paediatric) undergoing cochlear implantation at a tertiary referral centre in England, between April 2019 and December 2021. Split arrays and patients who did not have post-op imaging were excluded.
Two hundred and ninety-nine cochlear implants were performed including 90% primary and 10% revision surgeries. Two hundred and forty-eight (86%) of electrodes implanted were straight arrays.Twenty-seven (9%) demonstrated suboptimal position on post-operative imaging. Three (11%) were true migration, 4 (15%) possible migration, 15 (56%) had two or less extra-cochlear electrodes, 3 (11%) expected partial insertion and 2 (7%) demonstrated tip fold-overs. Twenty (74%) of arrays within the suboptimal insertion group were in primary surgeries. Six patients required re-implantation. The most common reason for re-implantation was migration.
Electrode migration after cochlear implantation may be more common than previously thought. We demonstrate rates of migration congruous with current literature; this is despite robust and varied fixation techniques. Notable in our series is that all true captured migrations were seen exclusively in straight arrays. The majority of patients in the possible and confirmed migration group had normal inner ear anatomy.
Suboptimal electrode position following cochlear implant surgery is a recognized complication and can affect implant performance. Reporting may increase with more widespread use of sophisticated post-operative imaging. Use of a pre-curved electrode and routine use of appropriate fixation techniques may reduce migration rates.
Cochlear-facial dehiscence - the most common cause of facial nerve stimulation from a cochlear implant? A case-control study.
Cochlear Implants InternationalTo investigate the prevalence of cochlear-facial dehiscence (CFD) and other radiographical pathologies in ears with facial nerve stimulation (FNS) from a cochlear implant (CI).
Retrospective case-control study of 27 patients with CI and FNS on either ear (study group) and 27 patients without FNS, matched for age, sex and type of electrode array (control group). Preoperative CT scans of all 108 ears were re-evaluated. Subanalyses included comparisons between the study and control groups and associations between FNS and radiographic pathologies.
CFDs were detected in 20 of 54 ears (37%) in the study group and in 3 of 54 ears (6%) in the control group (P < 0.001). The corresponding numbers of otosclerosis were 10 (18%) and 0 (P = 0.011) and of developmental anomalies 16 (30%) and 8 (15%) (not significant). FNS was present in 33 ears in the study group, of which 14 (42%) had a CFD. FNS was absent in six ears with CFD and CI, four of which contralateral to an ear with FNS. Eight of 14 ears with FNS and CFD had a lateral electrode array and six had a perimodiolar electrode array. We found no association between the presence of CFD and stimulation thresholds for FNS. The adjusted odds ratio for developing FNS in the presence of a CFD was 9.9 (95% CI 2.7-36.0).
CFD was the most common radiographic pathology in ears with FNS, with a 10-fold increased risk of FNS. To avoid CI-related FNS, preoperative CT scan and awareness of typical dehiscence symptoms are strongly recommended.
Factors that influence performance in pediatric cochlear implant recipients with cochlear nerve deficiency.
Cochlear Implants InternationalChildren with cochlear nerve deficiency (CND) have wide variability in outcomes with cochlear implant (CI) use. The current study aims to report a large cohort of pediatric CI recipients with CND and to evaluate for factors that may predict improved performance.
The current study is a retrospective review of pediatric CI recipients with CND at a tertiary academic hospital. Variables including cochlear nerve status (hypoplasia vs aplasia), age at implantation, cochleovestibular malformation, bony cochlear nerve aperture, internal auditory canal aperture, and cognitive delay were evaluated for predictors of postoperative performance. A stepwise multinomial regression analysis was performed.
Forty-seven CI recipients (54 ears) were included in the analysis. A majority (59%) showed auditory capabilities with their CI. Twenty percent of recipients achieved some level of open-set speech perception with their CI. The regression analysis identified cochlear nerve status and cognitive delay as predictors of performance. CI recipients with cochlear nerve hypoplasia had significantly improved performance compared to those with aplasia (p = 0.003). Recipients with cognitive delay had more limited benefit than those without cognitive delay (p = 0.033).
Children with CND can benefit from CI use, with outcomes spanning from non-use to development of spoken language. Predictive factors for improved performance include a lack of cognitive delay and cochlear hypoplasia rather than aplasia. These can be important considerations for parent counseling and decision making.
