Measuring 3D Cochlear Duct Length on MRI: Is It Accurate and Reliable?

BACKGROUND AND PURPOSE: Prior studies have evaluated cochlear length using CT to select the most suitable cochlear implants and obtain patient-specific anatomy. This study aimed to test the accuracy and reliability of cochlear lateral wall length measurements using 3D MR imaging. MATERIALS AND METHODS: Two observers measured the cochlear lateral wall length of 35 patients (21 men) with postlingual hearing loss using CT and MR imaging. The intraclass correlation coefficient (with 95% confidence intervals) was used to evaluate intraobserver and interobserver reliability for the 3D cochlear measurements. RESULTS: The mean age of the participants was 39.85 (SD, 16.60) years. Observer 1 measured the mean lateral wall length as 41.52 (SD, 2.25) mm on CT and 41.44 (SD, 2.18) mm on MR imaging, with a mean difference of 0.08 mm (95% CI, -0.11 to 0.27 mm), while observer 2 measured the mean lateral wall length as 41.74 (SD, 2.69) mm on CT and 42.34 (SD, 2.53) mm on MR imaging, with a mean difference of -0.59 mm (95% CI, -1.00 to -0.20 mm). An intraclass correlation coefficient value of 0.90 (95% CI, 0.84-0.94) for CT and 0.69 (95% CI, 0.46-0.82) for MR imaging was obtained for the interobserver reliability for the full-turn cochlear lateral wall length. CONCLUSIONS: CT-based 3D cochlear measurements show excellent intraobserver and interobserver reliability, while MR imaging-based lateral wall length measurements have good-to-excellent intraobserver reliability and moderate interobserver reliability. These results corroborate the use of CT for 3D cochlear measurements as a reference method and demonstrate MR imaging to be an alternative acquisition technique with comparably reliable results.

Evaluation of the academic productivity of the top 100 worldwide physicians in the field of otorhinolaryngology and head and neck surgery using the Google Scholar h-index as the bibliometrics ranking system.

OBJECTIVE: The top 100 physicians of otorhinolaryngology and head and neck surgery worldwide were investigated using the Google Scholar h-index. METHOD: Although there are various bibliometrics ranking systems that present the academic quantity and quality of scientists' published articles, the h-index is the most popular and widely accepted. In this study, Google Scholar was used to search all the keywords involving all the subspecialties of otorhinolaryngology and head and neck surgery, with the aim of identifying as many physicians as possible. Obtaining the Google Scholar h-index and citations is not possible for scientists who do not have Google Scholar accounts. Thus, only those with Google Scholar accounts were included. RESULTS: The average h-index of all 100 physicians enrolled in the study was 37.83, with a range of 25-81. CONCLUSION: The current study details the academic impact of otorhinolaryngology and head and neck surgery physicians worldwide based on the Google Scholar h-index.

Does Nasal Septal Deviation Affect the Success of Tympanoplasty Surgery?

OBJECTIVE: This paper deals with the investigation of the effects of nasal septal deviation evaluated by acoustic rhinometry (ARM) in the success of tympanoplasty surgery. SUBJECT AND METHODS: All patients who underwent tympanoplasty surgery by the same surgeon were reviewed. The patients with nasopharyngeal or nasal masses, polyps, symptoms of allergic rhinitis or rhinosinusitis, or concha bullosa were excluded from the study. Forty patients who underwent tympanoplasty at least one year ago were included in the study. The patients were divided into two groups according to the graft success results. Acoustic rhinometry evaluations of the patients were performed. RESULTS: There were 25 and 15 cases in the intact graft (group A) and re-perforated group (group B), respectively. For the same side of the operated ear, ARM values of group A were 0.47 cm², at the first narrowest cross-sectional area (MCA 1), 0.43 cm² at the second narrowest cross-sectional area (MCA 2), 1.51 cm³ volume at the first 2 cm of the nasal cavity (Vol 1) and 3.33 cm³ volume between the second and fifth cm of the nasal cavity (Vol 2). Acoustic rhinometry values of group B were 0.50 cm², 0.47 cm², 1.60 cm³ and 3.19 cm³ for MCA 1, MCA 2, Vol 1 and Vol 2, respectively. CONCLUSION: The results of this study showed that nasal septal deviation may not affect the success of tympanoplasty surgery, and septoplasty may not be necessary before ear surgery.

Chronic otitis media surgery in the only hearing ear.

OBJECTIVES: The present study aimed to investigate how quality of life was impacted in patients who underwent surgery for chronic otitis media in their only remaining hearing ear (OHE). Such surgical treatment is controversial, and avoided by many surgeons due to the high risk of hearing loss due to surgery. However, if the patient is left untreated, hearing may further deteriorate over time, decreasing the patient's quality of life to an undesirable level. METHOD: We performed a retrospective single-institution study of a prospectively collected database in a tertiary university hospital. Twenty-three patients with OHE who underwent surgical treatment were retrospectively analyzed. The patients' age, sex, treated ear, indications, and preoperative and postoperative hearing levels were recorded. The data were statistically analyzed. RESULTS: Of the 23 patients with OHE, 15 regularly attended follow-up for at least two years. In all cases, the tympanic membrane perforations were closed and the ear drum became dry. An air-bone gap gain of ≥ 20 dB was measured in five patients, ≥ 10 dB in seven, and two patients showed no significant change (4-10 dB). One patient showed minimal hearing deterioration of -2 dB. CONCLUSION: Patients with OHE can be treated surgically to improve hearing levels and quality of life. Modern surgical techniques and instruments--especially in experienced hands--may reduce the possible surgical risks. If hearing deteriorates due to surgery, it may be improved, for example, with cochlear implantation surgery.

Does cerumen have a risk for transmission of HIV?

Human immunodeficiency virus (HIV) is mainly transmitted via sexual activity, mother-to-child transmission, and contact with body fluids, such as saliva and semen. Cerumen, however, has not been investigated for its capability to transmit HIV. The purpose of this study was to evaluate the potential of cerumen for transmission of HIV infection. This study was conducted among 42 treatment-naive HIV-infected patients with positive HIV RNA and 27 HIV-infected patients with negative HIV RNA receiving antiviral treatment. Simultaneous blood samples were studied as positive controls. Sixty-nine prospectively collected cerumen specimens were analyzed for the presence of HIV RNA by real-time polymerase chain reaction (PCR). None of the 69 cerumen specimens were positive for HIV RNA. These results conclude that cerumen in HIV-positive patients with or without antiretroviral therapy (ART) carry only an insignificant risk of transmission. However, standard infection control precautions should be applied carefully in all examinations and surgical operations of the ears.

Comparison between cartilage and fascia grafts in type 1 tympanoplasty.

OBJECTIVES: We retrospectively analysed long-term hearing results and graft take rates in our cases with both temporalis muscle fascia and the cartilage island technique. METHODOLOGY: Between September 2000 and October 2011, a total of 489 patients underwent cartilage tympanoplasty, while 318 patients had tympanoplasty using fascia. In this study we included patients with a follow-up period of at least 3 years. Exclusion criteria were ossicular chain defects, cholesteatoma, otorrhoea, middle ear granulation or effusion, and a history of middle ear surgery. RESULTS: The cartilage group consisted of 49 patients, with 28 patients being included in the fascia group. Both air conduction hearing thresholds and air bone gaps improved significantly in both groups. However, no statistical significance was found between the results for the two groups (p > 0.05). CONCLUSION: Our study concurs with many others in the literature, clearly indicating that cartilage produces hearing results that are comparable to temporalis muscle fascia grafts.

Is the pathological examination of routine tonsillectomy and adenoidectomy specimens necessary? A retrospective study of 559 adenoidectomy and 1132 tonsillectomy specimens and a literature review.

OBJECTIVE: There is still no consensus about the necessity of histopathological analysis of routine tonsillectomy and adenoidectomy specimens. In this study, our goal was to determine the incidence of unexpected pathological findings in routine tonsillectomy and adenoidectomy specimens. The results are discussed in the light of current literature. MATERIALS AND METHODS: The patient data were obtained from the archives of the departments of otorhinolaryngology and pathology. Between November 1992 and July 2006, chronic, recurrent infections or obstructive problems led to bilateral tonsillectomies, adenoidectomies, and adenoidectomies plus tonsillectomies being performed in 435, 502, and 770 patients respectively. Five hundred and fifty-nine of 1272 adenoidectomy specimens and 1132 of 2410 tonsillectomy specimens were sent to the department of pathology for histopathological examination. RESULTS: The histopathological results for all the adenoidectomy specimens reported chronic inflammatory processes. Only one of 1132 tonsillectomy specimens involved granulomatous inflammation, while 1131 were chronic inflammatory processes. CONCLUSION: On the basis of the result of our study and review of the published literature, the microscopic analysis of routine tonsillectomy and/or adenoidectomy specimens may not be necessary, especially in young patients with no clinically suspicious factors for malignancy. However, all patients must be carefully examined for evidence of malignancy before surgery.

Caffeic acid phenethyl ester ameliorated ototoxicity induced by cisplatin in rats.

Caffeic acid phenethyl ester (CAPE), an active component of propolis, exhibits antioxidant properties. This experimental study was designed to determine the effect of CAPE on ototoxicity induced with cisplatin. Twenty-four adult Wistar albino rats were divided into four groups: cisplatin (n=6), saline (n=6), CAPE (n=6), and cisplatin plus CAPE (n=6). Rats were tested before and 5 days after cisplatin treatment with or without chemo protection. The Distortion Product Otoacoustic Emissions (DPOAEs) were elicited from the control and experimental animals utilizing the standard commercial Otoacoustic Emission (OAEs) apparatus. The animals in all groups were sacrificed under general anesthesia on the fifth day following last OAE measurements. For biochemical investigations, the blood samples were drawn from inferior vena cava. On day 0, the initial baseline DPOAEs measurement results presented similar values while comparing the groups in drug free phase (p>0.05). On day 5, intrasubject measurement parameters of DPgrams and I/O functions of cisplatin group were significantly deteriorated (p<0.05). The second measurements of the other groups revealed no significant differences between their DPgrams and I/O functions in all frequencies (p>0.05). Among the biochemical parameters, plasma xanthine oxidase (XO) activity was found to be more elevated in the cisplatin group than the saline group (p<0.05). CAPE led to more decreased XO activity than cisplatin (p<0.05). The results of this study show that prophylactic administration of CAPE for cisplatin ototoxicity ameliorated hearing deterioration in rats.

Bilateral hearing loss during vincristine therapy: a case report.

Vincristine sulfate is a chemotherapeutic agent used in different cancer therapies. It is also the first choice of treatment for peripheral T-cell lymphoma with cyclophosphamide and adriamycin. Sudden hearing loss during vincristine therapy is a very rare event. This is a case of a 16-year old girl who developed sudden bilateral hearing loss related to vincristine therapy.

Detection of Alloiococcus otitidis in the nasopharynx and in the outer ear canal.

Alloiococcus otitidis has been recovered from the middle ear of children with otitis media with effusion, but its natural habitat is not known. To determine whether the nasopharynx and the outer ear canals are the natural habitats of A. otitidis, 145 swabs (50, nasopharynx; 95 outer ear canal) collected from 50 children were screened by polymerase chain reaction. A. otitidis DNA was detected in seven (4.8%) of the 145 specimens, of which four were nasopharynx, and three outer ear canal. These results indicate that the nasopharynx and outer ear canal may be the body sites for localization of A. otitidis.

Bacterial etiology of otitis media with effusion; focusing on the high positivity of Alloiococcus otitidis.

The etiology of otitis media with effusion (OME) is unclear. The bacterial analyses of middle ear effusion (MEE) in OME may reveal important information regarding its etiology. Alloiococcus otitidis, Heamophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis were investigated by using microbiologic culture and a multiplex PCR method in the middle ear fluid of 32 children (54 samples) with chronic OME. PCR yielded positive results in 18 (33.3%) middle ear effusions while culture resulted positive for 3 (5.6%). The PCR method detected A. otitidis in 10 (18.5%) specimens, H. influenzae in 7 (13%), M. catarrhalis in 4 (7.4%) and S. pneumoniae in 2 (3.7%) specimens. The multiplex PCR method enhances the detection rate significantly compared to that of the conventional culture method. A. otitidis is the most common detected pathogen in the MEE of the OME.

Cervical subcutaneous emphysema: an unusual complication of adenotonsillectomy.

Removal of the tonsils and adenoid tissue because of recurrent infection and/or respiratory obstruction is one of the most commonly performed operations. A rare complication during this intervention is subcutaneous surgical emphysema. The awareness of anaesthesiologists and otolaryngological surgeons will protect the patient from serious consequences. We report our experience with this complication and provide a review of the literature.