Cochlear implantation for rare Streptococcus suis meningitis with hearing loss.

OBJECTIVES: This study aimed to explore the diagnostic sensitivity of 3D heavily weighted T2-weighted MRI (T2MRI) and high-resolution computed tomography (HRCT) in patients with cochlear fibrosis associated with Streptococcus suis (S. suis) meningitis and the practicality of Cochlear implantation (CI) treatments. METHODS: Between January 2020 and December 2022, we enrolled four patients with rare cochlear S. suis meningitis with associated hearing loss despite aggressive or non-aggressive follow-up antibiotic treatment. Clinical imaging data, surgical performances and post-surgical-electrode impedance were evaluated. RESULTS: Combined with HRCT and T2MRI, the cochlea had varying degrees of fibrosis and ossification in different cases. However, the electrodes were successfully and wholly inserted after intraoperative removal of the ossified and fibrotic foci. Post-surgical electrode impedance values of MP1 + 2 mode were normal in all 4 cases at initial activation. CONCLUSION: In patients with S. suis meningitis and associated cochlear fibrosis, T2MRI examination of the inner ear was more sensitive than HRCT. This research highlights the feasibility of CI treatment in S. suis meningitis patients with severe cochlear fibrosis.

Relevant Research of Inflammatory Cytokines Spectrum in Peripheral Blood of Sudden Hearing Loss.

OBJECTIVE: To investigate whether there is a correlation between the inflammatory state and the pathogenesis and clinical features of sudden hearing loss (SHL) by studying the expression of inflammation-related cytokines in the peripheral blood of patients with SHL. METHODS: In this work, we analyzed the cytokine profiles of 48 analytes in 38 patients with SHL compared to 38 healthy donors using a multiplex immunoassay. This study used appropriate statistical methods to screen for inflammatory cytokines associated with the pathogenesis of SHL, to analyze their network correlation, and to analyze the relationship between clinical features of SHL and inflammatory cytokines. RESULTS: Several cytokines, including CTACK, Eotaxin, HGF, INF-α2, IFN-ß, IL-1ß, IL-1ra, IL-2Rα, IL-4, IL-7, IL-8, IL-9, IL-10, IL-12(p40), IL-13, MIG, ß-NGF, SCF, and TNF-α, exhibited significantly higher levels in the peripheral blood of the SHL group compared to the control group. An inflammatory network composed of multiple cytokines, including IL-1ß, is a risk factor for the development of SHL. CONCLUSION: This study identified several inflammatory cytokines with elevated expression, which may be linked with the onset of SHL. The results of this study also provide a basis for the theoretical hypothesis of inflammation in SHL. LEVEL OF EVIDENCE: III Laryngoscope, 2024.

Delayed-onset swelling around the implant after cochlear implantation: a series of 26 patients.

PURPOSE: We aimed to clarify the clinical features of delayed-onset swelling around cochlear implants (CI), and to present our experience on how to avoid and address this problem. METHODS: We performed a retrospective review of all CI cases at our institution between June 2001 and June 2020. Information on postoperative complications of swelling in the receiver area > 3 months after implantation were analyzed, and clinical data sheets were drawn. RESULTS: Twenty-six of 1425 patients (1.82%) with an age at implantation ranging from 1 to 9 years experienced delayed-onset swelling around the implant. Swelling episodes occurred as early as 4 months, and as late as 178 months after implantation (median, 79.7 months). The predisposing factor in 12 cases was unclear, 7 cases were caused by trauma at the implantation site, 5 cases were without predisposing factors, and 2 cases were related to infection. We found the frequency of delayed-onset swelling after cochlear implantation with different incision was statistically insignificant (P = 0.423). Nineteen patients (73.1%) were cured after one treatment, and five patients (19.2%) relapsed. Follow-up examinations at least 18 months after surgery revealed that all patients experienced a complete recovery. CONCLUSIONS: Delayed-onset swelling at the receiver site is a long term but not exactly uncommon complication after cochlear surgery and long-term follow-up is eagerly required. It can recur more than once, causing more complex treatment strategies in clinical practice. Conservative treatment first recommended, while needle aspiration should initially be considered in recurrent cases also when the effusion swelling is > 3 ml.

A Correlational Analysis between Audiometric Pure-tone Averages and Distortion Product Otoacoustic Emissions.

Hearing loss severely affects human speech communication and the quality of life, and efficient hearing screening can help hearing function diagnosis and subsequent hearing rehabilitation. Pure-tone audiometry test and distortion-product otoacoustic emission (DPOAE) measurement are two commonly-used clinical techniques for hearing loss diagnosis, and they were developed based on different mechanisms in a hearing process. Early work investigated the relation between audiometric thresholds and DPOAE measurements. The present work aimed to use a simple linear fitting to estimate audiometric pure-tone threshold averages (PTAs) from DPOAE signal-to-noise-ratio (SNR) measurements, i.e., DPOAE amplitude minus the mean noise floor. Audiometric PTA values and DPOAE SNRs were measured from both ears of 30 listeners with normal hearing or mild-to-moderate hearing loss. The DPOAE SNR measurements of 4 distortion products (i.e., 2fl-f2= 1, 2, 4 and 8 kHz) were combined with a linear prediction model, and correlated with the PTA values. Data analysis showed moderate high correlation coefficients (i.e., r=0.84 and 0.64) for the left and right ears, respectively. The results of the present work demonstrate the possibility to estimate the behavioral audiometric PTA values from the objective DPOAE SNR measurements for hearing loss diagnosis.

Cerebral Representation of Sound Localization Using Functional Near-Infrared Spectroscopy.

Sound localization is an essential part of auditory processing. However, the cortical representation of identifying the direction of sound sources presented in the sound field using functional near-infrared spectroscopy (fNIRS) is currently unknown. Therefore, in this study, we used fNIRS to investigate the cerebral representation of different sound sources. Twenty-five normal-hearing subjects (aged 26 ± 2.7, male 11, female 14) were included and actively took part in a block design task. The test setup for sound localization was composed of a seven-speaker array spanning a horizontal arc of 180° in front of the participants. Pink noise bursts with two intensity levels (48 dB/58 dB) were randomly applied via five loudspeakers (-90°/-30°/-0°/+30°/+90°). Sound localization task performances were collected, and simultaneous signals from auditory processing cortical fields were recorded for analysis by using a support vector machine (SVM). The results showed a classification accuracy of 73.60, 75.60, and 77.40% on average at -90°/0°, 0°/+90°, and -90°/+90° with high intensity, and 70.60, 73.6, and 78.6% with low intensity. The increase of oxyhemoglobin was observed in the bilateral non-primary auditory cortex (AC) and dorsolateral prefrontal cortex (dlPFC). In conclusion, the oxyhemoglobin (oxy-Hb) response showed different neural activity patterns between the lateral and front sources in the AC and dlPFC. Our results may serve as a basic contribution for further research on the use of fNIRS in spatial auditory studies.

A Neurophysiological Study of Musical Pitch Identification in Mandarin-Speaking Cochlear Implant Users.

Music perception in cochlear implant (CI) users is far from satisfactory, not only because of the technological limitations of current CI devices but also due to the neurophysiological alterations that generally accompany deafness. Early behavioral studies revealed that similar mechanisms underlie musical and lexical pitch perception in CI-based electric hearing. Although neurophysiological studies of the musical pitch perception of English-speaking CI users are actively ongoing, little such research has been conducted with Mandarin-speaking CI users; as Mandarin is a tonal language, these individuals require pitch information to understand speech. The aim of this work was to study the neurophysiological mechanisms accounting for the musical pitch identification abilities of Mandarin-speaking CI users and normal-hearing (NH) listeners. Behavioral and mismatch negativity (MMN) data were analyzed to examine musical pitch processing performance. Moreover, neurophysiological results from CI users with good and bad pitch discrimination performance (according to the just-noticeable differences (JND) and pitch-direction discrimination (PDD) tasks) were compared to identify cortical responses associated with musical pitch perception differences. The MMN experiment was conducted using a passive oddball paradigm, with musical tone C4 (262 Hz) presented as the standard and tones D4 (294 Hz), E4 (330 Hz), G#4 (415 Hz), and C5 (523 Hz) presented as deviants. CI users demonstrated worse musical pitch discrimination ability than did NH listeners, as reflected by larger JND and PDD thresholds for pitch identification, and significantly increased latencies and reduced amplitudes in MMN responses. Good CI performers had better MMN results than did bad performers. Consistent with findings for English-speaking CI users, the results of this work suggest that MMN is a viable marker of cortical pitch perception in Mandarin-speaking CI users.

Preparation, characterization and application research of a sustained dexamethasone releasing electrode coating for cochlear implantation.

Cochlear inflammatory response after cochlear implantation (CI) is an important mechanism for implantation trauma and hearing loss. The hearing loss was also caused by damage to auditory hair cells (HCs), whereas ion homeostasis within the cochlea can ensure survival of HCs. In our study, pure hyaluronic acid (HA) was crosslinked with 1, 4-butanediol diglycidyl ether (BDDE) and the successful preparation of the cross-linked hydrogel (CHA) was confirmed by rheological characteristics and FTIR spectra. Artificial perilymph (APL) was prepared to simulate the ion homeostasis microenvironment within scala tympani of human cochlear, and served as the major component of artificial perilymph soaked CHA (APL-CHA). The conductivity experiment indicated that APL-CHA is more suitable to the requirements of the electrical conductivity in scala tympani. The electrode coating process found that the extrusion coating method have advantages of controllable adhesive capacity of APL-CHA, uniform coating thickness and smooth surface as compared to common method. Due to CI surgery application requirement, optimization of coating process was selected as follows: extrusion coating method, degree of 3.6 vol%, pinhole diameter of 32G (110 µm), pressure of 200 ±â€¯15.81 Psi. Controlled dexamethasone 21-phosphate sodium salt (DSP) release of 20 days could be demonstrated using the hydrogel filled reservoir via a validated HPLC method. The morphological structure of CHA showed different sizes of porous structure among APL-CHA provided structural basis for drug delivery. L929 fibroblasts culture and Spiral Ganglion Neuron Explants culture results revealed that APL-CHA possesses fine biological compatibility. APL-CHA shows a promising application in CI surgery and has great potential in preventing hearing loss with well simulation of ion homeostasis within the cochlear, local DSP delivery for target anti-inflammatory, approximate conductivity within the scala tympani and optimization of electrode coating process.