Translation and validation of the music-related quality of life questionnaire for adults with cochlear implant in Turkish language.

PURPOSE: It is important to assess the impact of music on cochlear implant (CI) users' quality of life. The aim of this study was to adapt and validate the music-related quality of life questionnaire into the Turkish language for adult CI users. METHODS: 161 CI users and 162 normal-hearing adults were included in the study. The final Turkish version of the questionnaire was prepared and evaluated for validity and reliability. The internal consistency of the questionnaire and test-retest reliability were evaluated by Cronbach's α and ICC index. Factor analysis and 'know-group' method was used to determine the construct validity. RESULTS: Sampling adequacy for execution of factor analysis was confirmed by the results of Kaiser-Meyer-Olkin (= 0.91) and Bartlett test (p < 0.05). 2 factors for each scale were identified from exploratory factor analysis. Confirmatory factor analysis confirmed the questionnaire met the criteria standards for adequacy of fit. The reliability coefficient was determined at least 0.80. Correlation between items indicated excellent (> .80) internal consistency. CONCLUSION: The Turkish version of the questionnaire has good validity and reliability and can be used to investigate the relationship between music and quality of life and as a diagnostic tool in identifying individuals who need music support and to guide and evaluate music rehabilitation.

The Effect of Blood Loss on the Hemodynamics of Pediatric Patients Undergoing Simultaneous Bilateral Cochlear Implantation.

OBJECTIVE: Our objectives were to find the mean blood loss volume and the mean hemoglobin decrease in patients undergoing simultaneous bilateral cochlear implant surgery, to determine whether they had clinical effects, and to calculate a minimum weight for pediatric patients that is independent of any age criteria. METHODS: A retrospective chart review of the pre- and post-operative hemoglobin concentrations and mean blood loss volumes were calculated for children between 12-24 months of age who underwent cochlear implant surgery. RESULTS: A postoperative decline in hemoglobin concentration was found in 67 cases (92%), with a mean difference between the pre- and post-operative values measuring 1.9 g/dL. Preoperative hemoglobin concentrations decreased from 13.4 g/dL to 11.5 g/dL. Mean blood loss volume was 82.3±12 cc. CONCLUSION: Although simultaneous bilateral cochlear implant surgery is reimbursed by the state for those who are greater than one year of age and who meet the appropriate audiological criteria, our findings suggest that these patients should weigh ≥10 kg to prevent hemodynamic instability due to blood loss during surgery.

The utilization of Chronic Otitis Media Questionnaire-12 in chronic otitis media with or without cholesteatoma.

OBJECTIVE: This study aimed to compare patients who had chronic otitis media with and without cholesteatoma in terms of the quality of life related to health. METHODS: The Turkish version of the Chronic Otitis Media Questionnaire-12 (COMQ-12) was completed by totally 100 healthy subjects and 100 patients who had chronic otitis media (COM). The COM group was divided into cholesteatoma and without cholesteatoma [dry tympanic membrane perforation (TMP) and draining ear] groups. RESULTS: COMQ-12 score = 3.6 for healthy people. The average scores of dry TMP, draining ear, and cholesteatoma groups were 32.90, 27.34, and 45.95, respectively. A significant difference was between the cholesteatoma and without cholesteatoma groups in total scores (p = 0.001). No difference was found between the groups in age (p = 0.518) and gender (p = 0.975). CONCLUSION: The COMQ-12 could be a useful tool to differentiate chronic otitis media with or without cholesteatoma.

Surgical complications of cochlear implantation: a 25-year retrospective analysis of cases in a tertiary academic center.

PURPOSE: Despite the advances made in cochlear implantation techniques, the associated complication rates are still high. Here, we aimed to analyze cases, with extensive follow-up data, associated with a large sample of patients to identify complications related to cochlear implants and to present our surgical experience and the technique that we used in order to follow surgical rules/medical purpose to avoid any complications. METHODS: We retrospectively examined cases involving 2597 patients (1342 males; 1255 females; age 1-88 years) who underwent cochlear implantation procedures between November 1995 and July 2019, and we classified complications as minor and major. RESULTS: The mean age at the time of implantation was 6.48 (Min: 1/Max: 88) years. The cause of deafness was congenital in 76.5% of the patients and acquired in 16.8%. The overall rate of complications in the study was 3.7% (n = 97). The minor and major complication rates were 3.0 and 0.7, respectively. Further, while the most common minor complication we encountered was vertigo, the most common major complication was implant extrusion. CONCLUSION: Fixing the cochlear implant receiver-stimulator with the bone-recess technique and sealing the posterior tympanotomy site with a piece of muscle in order to follow surgical rules/medical purpose to avoid any complications. Following the insertion of the electrode into the cochlea, the muscle closure of the cochleostomy site or the round window restores the original anatomy and in order to follow surgical rules/medical purpose to avoid any complications. We have developed this highly effective technique with years of experience and have not had a major surgical complication in 5 years.

Efficacy of balloon Eustachian tuboplasty on the quality of life in children with Eustachian tube dysfunction.

Background: Balloon Eustachian Tuboplasty (BET) is used as a second-line treatment in cases in which adenoidectomy, paracentesis, and VT have failed. However, studies have not investigated the efficacy of this procedure as a first-line treatment.Objectives: To evaluate the quality of life in children with chronic Eustachian tube dysfunction (ETD) after BET using the Otitis Media-6 (OM-6) questionnaire.Methods: We retrospectively evaluated the data of 62 children with chronic dysfunction ETD and divided patients into the following groups: 30 cases underwent BET (group 1), and 32 cases underwent ventilation tube (VT) insertion from July 2016 to April 2018. The children's parents were instructed to complete the OM-6 questionnaire preoperatively and at 6 weeks and 1 year postoperatively.Results:. The average preoperative scores were higher than the postoperative scores, and the average 6-week postoperative scores were higher than the average 1-year postoperative scores for both groups 1 and 2. Further, the average 6-week postoperative scores from patients in group 2 were significantly higher than those in group 1.Conclusion and significance: Our results demonstrate that BET may be a safe, first-line intervention that positively effects the quality of life in children with chronic ETD.

Bacterial cellulose tubes as a nerve conduit for repairing complete facial nerve transection in a rat model.

PURPOSE: Functionality of the facial nerve is cosmetically important. While many techniques have been investigated, early and effective treatment for traumatic facial nerve paralysis remains challenging. Here, we aim to examine bacterial cellulose (BC) as a new tubularization material for improving facial nerve regeneration. METHODS: Our study was performed on 40 female Sprague Dawley rats. Rats were randomly divided into four groups, with 10 rats per group. In all rats, the main trunk of the facial nerve was completely cut 8 mm before the branching point. For repairing the facial nerve, in group 1, the nerve was left to recover spontaneously (control group); in group 2, it was repaired by primary suturing (8.0 Ethilon sutures, Ethicon); in group 3, BC tubes alone were used to aid nerve repair; and in group 4, both BC tubes and primary sutures (8.0 Ethilon sutures) were used. After 10 weeks, the facial nerve regeneration was evaluated by the whisker movement test and electrophysiologically (nerve stimulation threshold and compound muscle action potential). Nerve regeneration was assessed by calculating the number of myelinated nerve fibers, and by microscopically evaluating the amount of regeneration and fibrosis. RESULTS: No significant difference was observed among the groups in terms of whisker movement and electrophysiological parameters (P > 0.05). We found that the numbers of regenerating myelinated fibers were significantly increased (P < 0.05) when BC tubes were used as a nerve conduit. CONCLUSIONS: BC can be easily shaped into a hollow tube that guides nerve axons, resulting in better nerve regeneration after transection.

The effect of canal diameter on audiologic results in patients with cochlear implantation with large vestibular aqueduct syndrome.

PURPOSE: To compare audiologic results according to vestibular aqueduct (VA) diameter in patients who have undergone cochlear implantation and were diagnosed with LVAS. METHODS: This was a retrospective study detailing the outcomes of 18 patients with LVAS and 18 patients undergone cochlear implants. VA diameter was assessed by magnetic resonance imaging and computed tomography. Categories of Auditory Perception (CAP) and Speech Intelligibility Rating (SIR) were assessed in all patients, and speech audiometry, including speech recognition thresholds (SRT) and word discrimination scores, was applied for all subjects who were able to perform these tests. All audiologic parameters were compared between patients with and without LVAS, and the relationship of these parameters with VA diameter was investigated. RESULTS: The control group consisted of 18 subjects (5 males, 13 females), ranging in age between 2 and 34 years (mean 13.17 ± 8.97 years). The research group consisted of 18 subjects (8 males, 10 females), ranging in age between 2 and 35 years (mean 13.28 ± 8.96 years). There was a statistically significant difference between the groups in terms of SIR and CAP pre-post differences (Mann-Whitney U test, p < 0.05), with higher averages in the LVAS group. No statistically significant correlations were found between VA diameter on computed tomography and magnetic resonance imaging and the audiologic variables collected. CONCLUSIONS: Patients with LVAS benefit from cochlear implant surgery and VA parameters do not affect audiologic parameters.

Outcomes of cochlear implantation in children with inner ear malformations.

PURPOSE: To evaluate the surgical experience and auditory functions and progress of speech development of cochlear implantation in malformed ears. MATERIALS AND METHODS: Between November 1995 and July 2017, thirty-seven patients (26 females and 11 males; mean age: 138.275 ± 96.24 months) with diverse anomalies of the inner ear were retrospectively examined for surgical and audiological results. Speech Intelligibility Rating (SIR), Categories of Auditory Perception (CAP), Pure Tone Average (PTA), Speech Intelligibility Rating (SRT), and Word Discrimination Score (WDS) were the audiological tests used to evaluate the efficacy of CI in the malformed inner ears. RESULTS: CSF gusher was experienced by six patients (three with LVA (large vestibular aqueduct), one with IP (incomplete partition) I, and two with both IP II Mondini malformations and LVA). Two patients had transient facial paresis after surgery. All patients fully recovered within 6 months. The postoperative PTA, SRT, and WDS test results showed significant differences between progressive and congenital sensorineural hearing loss (p values < 0.05 for all). On the other hand, the postoperative CAP and SIR test results revealed no significant differences between the two groups. According to etiology, the PTA and SRT values were significantly lower in common cavity patients than the LVA patients (p values < 0.01); no significant differences were found among the other etiological groups. CONCLUSIONS: Cochlear implantation is safe in children with inner ear malformations. However, the success rate is low compared to patients with normal anatomy in terms of audiological results; the most successful group of patients with inner ear malformation is large vestibular aqueduct.

Scar evaluation in subperiosteal temporal pocket versus the one-layer flap technique in cochlear implantation using the Patient and Observer Scar Assessment Scale.

PURPOSE: To compare the local and intracranial complications, migration of the IRS, surgical duration, and quality of life with the subperiosteal pocket technique and the one-layer flap (OLF) technique using the Patient and Observer Scar Assessment Scale (POSAS). METHODS: Eight patients who underwent cochlear implantation. The patients were applied subscales of the POSAS and were asked to respond to the questionnaire items via a telephone conservation conducted by a physician. Another researcher evaluated the patients' photographs using OSAS. POSAS was applied to the patients to compare the differences of scar assessment in subperiosteal pocket technique and the OLF technique. RESULTS: The surgical duration was 72.7 ± 12.3 min in the OLF group and 51.3 ± 11.7 min in the subperiosteal pocket group. The difference was statistically significant. No migration or intracranial complications were observed in either group. Patients in group 1 who underwent the subperiosteal technique were more satisfied than patients who received the OLF technique. However, there was no superiority between the two methods for the observer in scar assessment. CONCLUSION: Although the surgical time is longer, the lack of difference in terms of scar formation from smaller incisions, and few intra- and post-operative complications in experienced hands ensure that the OLF technique is a safe and reliable method in cochlear implantation surgery.

A Challenge for Cochlear Implantation: Duplicated Internal Auditory Canal.

Duplication of the internal auditory canal is an uncommon, congenital malformation that can be associated with sensorineural hearing loss owing to aplasia/hypoplasia of the vestibulocochlear nerve. Only 14 such cases have been reported to date. We report the case of a 13-month-old girl with bilateral, congenital, sensorineural hearing loss caused by narrow, duplicated internal auditory canals and discuss the challenges encountered in the diagnosis and treatment of this condition.

Cochlear implantation: is hearing preservation necessary in severe to profound hearing loss?

OBJECTIVES: The goal of the cochlear implant surgery is to place the electrode array with minimal damage to preserve the residual hearing. Round-window insertion can be performed in a manner that is potentially less traumatic than the standard cochleostomy. The purpose of the study was to investigate audiological results of the round-window approach using standard electrode. METHODS: A retrospective study was performed to evaluate our experience in patients with implanted through round window between January 2007 and March 2009. Sixty patients had undergone cochlear implant surgery through the round window with full insertion of a standard electrode array. Preoperative and postoperative pure-tone thresholds were measured for implanted ears in the range of 250 to 4000 Hz. RESULTS: Within these 60 cases, 31 patients had been evaluated. The population comprised 16 women and 15 men. The mean age was 15.96 years (range, 4-64 years). Follow-up times ranged from 6 to 26 months. Preservation of low-frequency hearing (250 and 500 Hz) was achieved in 27 (87%) of 31 patients. Complete hearing preservation (all frequencies) was accomplished in 11 patients (35.48%). No hearing could be determined postoperatively in 4 patients (12.9%), having preoperative thresholds of 120 dB at 250, 500, and 1000 Hz. CONCLUSIONS: Round-window approach has been widely used for preservation of residual hearing. In our patients with severe to profound hearing loss, we preserved residual hearing. Although the residual hearing cannot be sufficient for using additional acoustic stimulation, the preserved residual hearing means minimal damage and a more convenient cochlea, so this is promising for future development.

Cochlear implantation in patients with bilateral cochlear trauma.

PURPOSE: Temporal bone fracture, which involves the otic capsule, can lead to complete loss of auditory and vestibular functions, whereas the patients without fractures may experience profound sensorineural hearing loss due to cochlear concussion. Cochlear implant is indicated in profound sensorineural hearing loss due to cochlear trauma but who still have an intact auditory nerve. MATERIAL AND METHODS: This is a retrospective review study. We report 5 cases of postlingually deafened patients caused by cochlear trauma, who underwent cochlear implantation. Preoperative and postoperative hearing performance will be presented. These patients are cochlear implanted after the cochlear trauma in our department between 2001 and 2006. RESULTS: All patients performed very well with their implants, obtained open-set speech understanding. They all became good telephone users after implantation. Their performance in speech understanding was comparable to standard postlingual adult patients implanted. CONCLUSION: Cochlear implantation is an effective aural rehabilitation in profound sensorineural hearing loss caused by temporal bone trauma. Preoperative temporal bone computed tomography, magnetic resonance imaging, and promontorium stimulation testing are necessary to make decision for the surgery and to determine the side to be implanted. Surgery could be challenging and complicated because of anatomical irregularity. Moreover, fibrosis and partial or total ossification within the cochlea must be expected.

Cochlear implantation in chronic otitis media.

Chronic otitis media (COM) patients who had a multichannel device implanted were evaluated regarding surgical problems and technical modifications. In a multicentric study, implantees whose aetiology was COM were retrospectively evaluated. Patients were operated on and evaluated at three different tertiary referral centres: SSK Izmir Hospital Cochlear Implantation (CI) Center (32 cases), Istanbul Marmara University ENT Clinic (six cases), Eskisehir Anadolu University CI Center (one case). Thirty-nine implantees were evaluated with respect to surgical problems, technical modifications, complications and hearing results. All patients had lost their hearings as a result of COM. Three out of 39 cases were children. Thirty-seven of the patients either had a radical cavity or ear converted to radical at the first stage or concomittantly with the implantation. Patients were evaluated in order to find out the best possible surgical solutions to specific problems caused by COM. In seven cases electrode array disrupted the epithelial lining of the cavity despite specific measures. Five of those cases were re-implanted, passing the electrode array through a tunnel under the facial nerve. Seven recent cases were also implanted with the same subfacial route. In all patients but one, satisfactory hearing results were achieved one to five years after implantation (SDS scores with monosyllabic word list were between 59 and 89 per cent, median 67.4 per cent). CI in COM patients necessitates technical modifications. In radical cavities subfacial implantation seems to be a good solution for the protection of the electrode array.

The effects of topical agents of fluticasone propionate, oxymetazoline, and 3% and 0.9% sodium chloride solutions on mucociliary clearance in the therapy of acute bacterial rhinosinusitis in vivo.

OBJECTIVES: The aims of the study were to determine: 1) how mucociliary activity in acute bacterial rhinosinusitis is affected; 2) how this activity is changed by therapy; 3) the effects of topical agents on mucociliary clearance, and 4) the most appropriate topical agent(s) to be used in the therapy of sinusitis. STUDY DESIGN: Five groups of patients with acute bacterial rhinosinusitis were studied prospectively. METHODS: All patients had 500 mg oral amoxicillin and 125 mg oral clavulanic acid preparations given three times daily for 3 weeks. According to the topical agent applications, these groups included: group I (n = 12), no topical treatment was given; group II (n = 14), two puffs for each nostril once daily of 50 microg/100 mL fluticasone propionate was given; group III (n = 9), one puff for each nostril three times daily of 0.05% oxymetazoline was given; group IV (n =12), 3% sodium chloride (NaCl) (buffered to pH 6.5-7 at room temperature) was given; and group V (n =13), 10-mL solutions of 0.9% NaCl (buffered to pH 6.5--7 at room temperature) were given for nasal irrigations three times daily. All patients had medication for 3 weeks and were controlled each week. The saccharin method was used to measure nasal mucociliary clearance. To investigate the early effects of the topical agents for groups II to V, an additional test was repeated 20 minutes after the basal mucociliary clearance recordings. The test was repeated in the first, second, and third weeks of the treatment. RESULTS: The mucociliary clearance was significantly slower in the acute bacterial rhinosinusitis group than in the control group. There was no significant difference between the basal mucociliary clearance and the 20th minute mucociliary clearance of the fluticasone propionate and 0.9% NaCl solution groups. The mean values of the basal and the 20 minute's mucociliary clearance of the oxymetazoline group were 24.72 +/- 6.16 and 15.5 +/- 7.45 minutes, respectively, which were statistically significant. The mean values of the basal and the 20th minute mucociliary clearance of the 3% NaCl solution groups were 19.45 +/- 9.35 and 15.45 +/- 8.20 minutes, respectively, which were also statistically significant. In the first group (without topical treatment), the basal mucociliary clearance became significantly shorter after the second week of treatment. In the first and second weeks of the treatment of the oxymetazoline group, the mucociliary clearance did not change significantly, but after the third week the mucociliary clearance was significantly shorter. In the 3% NaCl solution group, significant improvement began from the first week and continued through the third week. Comparing the basal and the third weeks' mucociliary clearance values among the groups, the oxymetazoline and 3% NaCl solution groups revealed more significant improvement than the other groups, but this improvement was not different from the improvement of group I. There was still a statistically significant difference in the mucociliary clearance of the post-treatment sinusitis groups from the control group. CONCLUSIONS: The oxymetazoline and 3% NaCl solution groups seemed to be more effective in mucociliary clearance, but there was no significant difference in improvement among the groups. The improvement of acute bacterial rhinosinusitis takes more than 3 weeks, according to the mucociliary clearance values of the groups.