ABSTRACT
Objectives: Exoscopes represent a promising alternative to conventional binocular microscopes (OM) in otology offering potential advantages such as enhanced ergonomics and a more compact device design. While previous research has demonstrated the effectiveness of exoscopes in various surgical specialties, their objective assessment in the field of otology remains limited. Therefore, this investigation aims to assess task-based efficiency associated with exoscopes in the field of otology by use of simulated surgical models. Methods: A prospective cross-over study design was used to compare an OM to an exoscope in otolaryngology residents and medical students. Participants performed five tasks on 3D-printed ear models using both the exoscope and OM. Data collection included completion time, frequency of predefined errors, mental effort, and user experience. Subgroup analysis was performed based on level of experience. Results: Fourteen students and fifteen residents participated. Participants completed four of five tasks faster with the OM and there was no difference in number of errors committed. When separated by surgical experience, residents performed four of five tasks faster using the OM while students completed one of five tasks faster with the OM. Students committed more errors with the exoscope for one task with no difference in errors for residents. There was no difference in perceived difficulty performing tasks with either visualization system. Exit survey results showed more favorable opinions of the OM among residents and more favorable opinions of the exoscope among students. Conclusions: The exoscope permits successful performance in simulated otologic tasks. Task performance and user experience between operative microscopes and exoscopes differ based on level of surgical experience. Level of Evidence: 2.
ABSTRACT
Objective: To determine the circadian influence on sound sensitivity produced by temporal hearing deprivation in healthy normal human subjects. Design: Participants underwent bilateral earplugging before completion of anthropometry, the author's developed questionnaire, the Hamilton Anxiety and Depression Inventory, pure tone audiometry (PTA), stapedial reflex thresholds (SRT), distortion products otoacoustic emissions input/output (DPOAE-I/O), and uncomfortable loudness levels (ULLs). Afterward, the participants were randomly divided into group A, starting at 8:00 a.m. and finishing at 8:00 p.m., and group B, starting at 4:00 p.m. and ending at 4:00 a.m. Serum cortisol levels and audiological test results were obtained at the beginning and end of the session and 24-h free urinary cortisol levels were measured. Study sample: Thirty healthy volunteers. Results: PTA was 2.68 and 3.33 dB HL in groups A and B, respectively, with no statistical difference between them. ULLs were significantly lower in group A compared to group B, with an average of 8.1 dB SPL in group A and 3.3 dB SPL in group B (p < 0.0001). A SRT shift was observed in group A, with no difference in group B, and a night shift in DPOAE-I/O in group B. Conclusions: Reduced loudness tolerance is demonstrated during daytime hearing deprivation in contrast to nighttime; this may be due to increased central gain in the awake cortex.
ABSTRACT
The benefits of Cochlear implant (CI) technology depend among other factors on the proximity of the electrode array to the spiral ganglion neurons. Laminin, a component of the extracellular matrix, regulates Schwann cell proliferation and survival as well as reorganization of actin fibers within their cytoskeleton, which is necessary for myelination of peripheral axons. In this study we explore the effectiveness of laminin-coated electrodes in promoting neuritic outgrowth from auditory neurons towards the electrode array and the ability to reduce acoustic and electric auditory brainstem response (i.e. aABR and eABR) thresholds. In vitro: Schwann cells and neurites are attracted towards laminin-coated surfaces with longer neuritic processes in laminin-coated dishes compared to uncoated dishes. In vivo: Animals implanted with laminin-coated electrodes experience significant decreases in eABR and aABR thresholds at selected frequencies compared to the results from the uncoated electrodes group. At 1 month post implantation there were a greater number of spiral ganglion neurons and neuritic processes projecting into the scala tympani of animals implanted with laminin-coated electrodes compared to animals with uncoated electrodes. These data suggest that Schwann cells are attracted towards laminin-coated electrodes and promote neuritic outgrowth/ guidance and promote the survival of spiral ganglion neurons following electrode insertion trauma.
Subject(s)
Cochlear Implants/standards , Laminin/administration & dosage , Neurons/physiology , Organ of Corti/physiology , Animals , Animals, Newborn , Cell Survival/physiology , Cells, Cultured , Electrodes, Implanted/standards , Laminin/chemistry , Male , Organ of Corti/cytology , Random Allocation , Rats , Rats, Inbred BN , Rats, Sprague-DawleyABSTRACT
Se presentan los resultados de potenciales evocados auditivos de tallo cerebral y emisiones otoacústicas en 35 recién nacidos sanos en edades de 8-120 días de nacidos. Se concluye que los potenciales evocados auditivos de tallo cerebral y las emisiones otoacústicas son procedimientos diagnósticos confiables en al determinación de función auditiva en la población neonatal
Subject(s)
Infant, Newborn , Humans , Male , Female , Hearing/physiology , Cerebrum/anatomy & histology , Deafness/classification , Neonatology , Otolaryngology/classificationABSTRACT
La electronistagmografía es un procedimiento que se ha venido utilizando en las últimas tres (3) décadas con exelente confiabilidad, en lo que respecta a la función vestibular central y periférica. Presentamos los resultados de la exploración electronistagmográfica computarizada en 9 pacientes con lesiones de fosa posterior, provenientes del servicio de Otorrinolaringología del Hospital Universiatrio de Caracas y del laboratorio de Otoneurología del Instituto de Diagnóstico de Caracas. Se muestran todos los procedimientos sistemáticamente realizados con un equipo Janus Atac V.100, comparándolos con los estudios audiológicos y de resonancia magnética. Concluimos que la electronistagmografía computarizada nos permite un análisis minucioso de los registros obtenidos y aporta datos en el diagnóstico otoneurológico de las lesiones de fosa posterior
