ABSTRACT
INTRODUCTION: A narrow duplicated internal auditory canal (IAC) is an extremely rare anomaly, likely associated with congenital sensorineural hearing loss due to aplasia/hypoplasia of the vestibulocochlear nerve or the cochlear branch alone. We aimed to review our experience with IAC duplication, describe its clinical characteristics, and present a literature review. CASE PRESENTATION: Our Otology database was searched for children who showed duplication of the IAC. Clinical characteristics of two children with bilateral duplication of the IAC are described. Data regarding clinical history, auditory assessment, magnetic resonance imaging (MRI), and computed tomography (CT) were collected and analyzed. The separated, accessory bony canals were demonstrated on high-resolution CT scans, and the nerves were demonstrated on MRI. DISCUSSION: To date, a few cases of narrow duplicate IAC have been reported in the literature, Approximately 20% of patients with congenital SNHL are found to show inner-ear bony abnormalities on CT, but much uncertainty still exists about the mechanism underlying IAC stenosis.5 Imaging findings of the temporal bone in our case series demonstrated asymmetrical narrowing of both IACs, there is no clear evidence in the literature supporting the predominance of one side over the other. In our series, facial nerve function was intact bilaterally. As for our cases, both patients were enrolled in a single-sided deafness evaluation for a trial of options such as BAHA, CROS, cochlear implants, and other non-implantable hearing aids. Furthermore, addressing the important factors will optimize the outcomes including surgery at early age to optimize neural plasticity, with intense long-term therapy. CONCLUSION: Congenital duplication of the IAC likely convoying sensorineural hearing loss due to aplasia/hypoplasia of the vestibulocochlear nerve. Early diagnosis and intervention are essential to optimize patient outcomes.
ABSTRACT
Introduction Mood disorders, including anxiety and depression, are prevalent among patients with chronic kidney disease (CKD) who are on hemodialysis. Anxiety and\or depressive symptoms among those patients have been associated with early initiation of dialysis and adverse outcome. Aim The aim is to investigate the prevalence and factors associated with anxiety and depression among Saudi patients with CKD who are on hemodialysis. Methods This is a cross-sectional study. A total of 122 patients with CKD and on hemodialysis at King Fahad Hospital in Al-Madinah, Saudi Arabia, were included in the study during the period from November 2017 to August 2018. Data were collected using the Hospital Anxiety and Depression Scale questionnaire. Sociodemographic information, duration of illness, and duration of hemodialysis were determined. Results Of the 122 CKD patients, 24.6% had depression and 19.7% had anxiety symptoms. Anxiety symptoms were more prevalent among females than males (P = 0.04). Older age was significantly associated with depression (P = 0.003). Patients' depression and anxiety symptoms were insignificantly associated with their education level, employment status, duration of illness, and duration of hemodialysis. Conclusion Anxiety and depression are prevalent among CKD patients, particularly among females and older patients. Thus, this study suggests establishing a screening program to determine patients who are at risk of developing anxiety and depression. In addition, management to prevent the occurrence of depression and anxiety and improve patients' quality of life must be implemented.
