Intra-operative neural response telemetry and acoustic reflex assessment using an advance-ln-stylet technique and modiolus-hugging a prospective cohort study

The development of cochlear implant [CI] electrode arrays has focused on the use of a minimally invasive technique involving a modiolus-hugging placement of the electrode. The aim of this study was to evaluate the [advance-in-stylet] [AIS] technique compared to the advance-off-stylet [AOS] technique recommended for the current cochlear Nucleus device. In the AIS technique, the stylet is not removed. We evaluated the electrical auditory thresholds measured when the stylet was removed [modiolus-hugging] compared to measurements taken with the stylet in place [lateral wall cochlea electrode placement]. In this prospective cohort study, 30 consecutive patients received unilateral Nucleus Freedom CIs using AIS insertion. Measurement of the acoustic reflex [AR] and neural response telemetry [NRT] were performed with the stylet in place [lateral wall placement of the electrodes] and then removed [perimodiolar placement], and the results compared. The responses were measured in the basal, middle and apical turns in both groups - with and without stylet. The AIS surgery was completed without complication in 30 patients [16 males and 14 females, age range 3-54 years [mean 11]]. Based on neural response telemetry, only apical electrodes showed statistically significant differences in thresholds, but the AR was not significantly different before or after stylet removal in any of the electrode groups tested. The effects of modiolus-hugging do not seem to result in a large difference in electrical stimulation thresholds so, in difficult cases, the stylet may be left in place without significantly changing the thresholds, except perhaps at the apical turn

Effect of interferon treatment on hearing of patients with chronic hepatitis C

Some reports in the literature have linked interferon therapy for the treatment of hepatitis C [HCV] with hearing loss. The aim of this study has been to examine the effects of interferon therapy on hearing of patients treated for HCV. Patients were recruited according to preset inclusion criteria from two centers. All patients received standard dose pegylated interferon [PEG-IFN alpha-2b or alpha-2a] plus ribavirin [RBV]. All patients had pure-tone audiometry [PTA], tympanogram and distortion-product otoacoustic emission [DPOAE] before treatment, three months after initiation of treatment, and three months after completion of treatment. Twenty one patients were prospectively recruited. The mean age was 45.7 years. The male to female ratio was 1.1:1. The mean PTA was 15.9 +/- 5.3 before treatment, 17.4 +/- 6.1 during treatment and 16.5 +/- 5.1 after treatment. The differences between pre and mid, pre and post, as well as mid and post were not significantly different [P>0.05] in all audiological assessments. Our results indicate that PEG-IFN/RBV therapy does not have any impact on the hearing thresholds of patients with HCV

Dangerous space emphysema after dental treatment

We report the case of an elderly female patient who presented with dangerous space emphysema occurring after a dental procedure. This case presented a diagnostic and management dilemma because of the development of an unusual complication of dental disease. In our review of the medical literature, we were unable to find any cases with similar manifestations and clinical courses

Prevalence of presbycusis in the elderly Saudi Arabian population

Hearing impairment has major financial, social, and psychological impacts on the greater community. No previous studies have been reported on the prevalence of hearing impairment in the elders of the Saudi population. The goal of this study is to ascertain the prevalence of hearing impairment and hearing complaints in the elders of the Saudi population. A cross-sectional study was conducted through a self-administered questionnaire. The questionnaire was supervised by medical professionals for 500 subjects with ages that spanned from 41 to 75. Participants in this study were screened by the Hearing Handicap Inventory for the Elderly using screening version HHIE-S. Results of the study indicated that out of the 386 eligible subjects, 17.35% [67 participants] had a diagnostic score of greater than 8 points in the HHIE-S screening with a slight male predominance compared to females [52% to 48%]. However, 3 participants [4.7%] between the ages of 41 to 45 had HHIE-S scores above 8. Indicating, the prevalence of hearing loss markedly increases with age [10.17% in subjects aged 46-50; 38.3% in subjects aged 71-75]. Findings from this cross-sectional, population-based study are consistent with the literature and suggest that environmental exposure may play a role in age-related hearing loss

Comorbid psychiatric conditions of benign paroxysmal positional vertigo

No studies have assessed psychopathology among benign paroxysmal positional vertigo [BPPV] patients. The General Health Questionnaire allows for distinguishing patients suffering from psychiatric problems from those in good mental health. To assess the psychiatric illness in Saudi patients with BPPV. The study was cross-sectional in nature. Institutional ethics committee approval and individual informed consent from study participants were obtained. Fifty patients with BPPV with unknown psychiatric illness were given the General Health Questionnaire-28 [GHQ-28] questionnaire to complete. Complete data were available for 50 patients. Thirty patients [60%] with BPPV scored above the conventional threshold. Their subgroups were: somatic complaints 28%, anxiety and insomnia 28%, social dysfunction 34%, and severe depression 10%. Greater attention needs to be paid to BPPV patients. Vulnerable female patients may have high levels of psychiatric symptomatology that may benefit from assessment and intervention

BAHA: Bone-Anchored Hearing Aid

Bone-Anchored Hearing Aid [BAHA] has proven performance and advantages for patients with aural atresia or chronic ear drainage who cannot wear air-conduction hearing aids. The BAHA has both cosmetic and acoustic advantages over most conventional hearing aids and hence is becoming increasingly popular. Moreover, BAHA improves the quality of life and has also significantly reduces ear discharge. This extensive review of the literature pertaining to BAHA discus the history, the indications, the advantages, the prediction of the outcome and the complications of this device as well as comparing it to the conventional hearing aids

BAHA: Bone-anchored hearing aid

Bone-Anchored Hearing Aid [BAHA] has proven performance and advantages for patients with aural atresia or chronic ear drainage who cannot wear air-conduction hearing aids. The BAHA has both cosmetic and acoustic advantages over most conventional hearing aids and hence is becoming increasingly popular. Moreover, BAHA improves the quality of life and has also significantly reduces ear discharge. This extensive review of the literature pertaining to BAHA discus the history, the indications, the advantages, the prediction of the outcome and the complications of this device as well as comparing it to the conventional hearing aids