Validation of Automatic Cochlear Measurements Using OTOPLAN® Software.

INTRODUCTION: Electrode length selection based on case-related cochlear parameters is becoming a standard pre-operative step for cochlear implantation. The manual measurement of the parameters is often time-consuming and may lead to inconsistencies. Our work aimed to evaluate a novel, automatic measurement method. MATERIALS AND METHODS: A retrospective evaluation of pre-operative HRCT images of 109 ears (56 patients) was conducted, using a development version of the OTOPLAN® software. Inter-rater (intraclass) reliability and execution time were assessed for manual (surgeons R1 and R2) vs. automatic (AUTO) results. The analysis included A-Value (Diameter), B-Value (Width), H-Value (Height), and CDLOC-length (Cochlear Duct Length at Organ of Corti/Basilar membrane). RESULTS: The measurement time was reduced from approximately 7 min ± 2 (min) (manual) to 1 min (AUTO). Cochlear parameters in mm (mean ± SD) for R1, R2 and AUTO, respectively, were A-value: 9.00 ± 0.40, 8.98 ± 0.40 and 9.16 ± 0.36; B-value: 6.81 ± 0.34, 6.71 ± 0.35 and 6.70 ± 0.40; H-value: 3.98 ± 0.25, 3.85 ± 0.25 and 3.76 ± 0.22; and the mean CDLoc-length: 35.64 ± 1.70, 35.20 ± 1.71 and 35.47 ± 1.87. AUTO CDLOC measurements were not significantly different compared to R1 and R2 (H0: Rx CDLOC = AUTO CDLOC: p = 0.831, p = 0.242, respectively), and the calculated intraclass correlation coefficient (ICC) for CDLOC was 0.9 (95% CI: 0.85, 0.932) for R1 vs. AUTO; 0.90 (95% CI: 0.85, 0.932) for R2 vs. AUTO; and 0.893 (95% CI: 0.809, 0.935) for R1 vs. R2. CONCLUSIONS: We observed excellent inter-rater reliability, a high agreement of outcomes, and reduced execution time using the AUTO method.

Actinomycotic Abscess of Thyroid Gland in a 3-Year-Old Child.

Actinomycosis is an atypical cause of infection in the head and neck area, especially in children. A rare incidence of actinomycosis, its nonspecific clinical signs that mimic other pathological conditions, as well as a complicated identification of microorganism lead to diagnostic delays in clinical practice. Besides an accurate diagnosis, it is of an utmost importance to pinpoint relevant predisposing factors, which might result in the infection. We present a clinical case of actinomycotic infection of the thyroid gland in the pediatric patient at our department.

Surgery or implantable hearing devices in children with congenital aural atresia: 25 years of our experience.

OBJECTIVES: Congenital aural atresia and ear deformities have been the subject of serious discussions for centuries. These malformations are associated with significant aesthetic and functional problems. Outcome of the surgical solution is rarely optimal. Despite the gradual improvement of surgical techniques the surgery still remains associated with very limited short-term and mainly long-term functional outcome. Therefore, the priority treatment in modern otology becomes implantable devices--BAHA, Bonebridge and active middle ear implants. METHODS: The functional and aesthetic outcomes of aural atresia reconstruction performed at Pediatric ENT Department of Children's University Hospital were retrospectively evaluated and compared with the results prospectively obtained from implantable hearing devices (BAHA, Vibrant Soundbridge, Bonebridge), which have been implanted in patients with aural atresia at Department of ORL HNS, University Hospital Bratislava. RESULTS: Aural atresia reconstruction has been performed in 34 patients during last 25 years. Results of the surgery could be viewed as excellent only in three patients (gain above 30 dB). Air conduction threshold has decreased after the surgery in seven patients, and in two cases total deafness occurred after the surgery. Patients gain on average 12 dB in auditory threshold after surgery. Hearing devices were implanted to the group of 11 children in order to improve their hearing. All of them were the patients with bilateral aural atresia. After implantation a significant improvement in hearing threshold occurred in all children (30-35 dB on average). Together with results of air conduction threshold in patient with aural atresia before and after surgery and implantation we also present a standard deviation. CONCLUSION: The functional outcome of implantable hearing devices in patients with bilateral aural atresia clearly dominates over the traditional reconstructive surgery. Aesthetic results in pinna deformity management remain a major concern for patients and parents. Implantable epithesis bring promising results. Since there is no universal solution to this disorder, the final selection of the treatment is upon the patient. Patients should opt for the most suitable solution through consultation with the surgeon, after clarifying the advantages and disadvantages of each option.