Otoacoustic emissions value in patients with idiopathic sudden sensorineural hearing loss.

Objectives: This study aimed to determine the prognostic value of otoacoustic emissions (OAEs) in idiopathic sudden sensorineural hearing loss patients. Methods: The study included 30 subjects with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). Each patient was evaluated four times: at baseline and after one week, one month, and three months of treatment. During each visit, each patient was subjected to full audiological history, otoscopic examination, basic audiological evaluations, and transiently evoked and distortion product otoacoustic emission (TEOAEs & DEOAEs). Results: The hearing thresholds (frequency range 250-8000 Hz) and word recognition scores of patients with detectable TEOAEs and DPOAEs improved significantly, whereas no significant improvements were observed in those with no response. Conclusion: Hearing improvement is better in patients with detectable TEOAEs and DPOAEs. As a result, TEOAEs and DPOAEs are recommended as routine tests in all SSNHL patients to predict outcomes and monitor treatment as TEOAEs and DPOAEs reflect the cochlear OHCs activity.

Electrode impedance changes over time in MED El cochlear implant children recipients: Relation to stimulation levels and behavioral measures.

Objective: Electrode impedance measures resistance encountered by electric current passing through wires, electrodes and biological tissue. This study was designed mainly to evaluate changes in electrode impedance values and psycho-electric parameters changes (i.e. threshold levels, comfortable levels, and dynamic range) in cochlear implant patients over time. Methods: It was a prospective study encompassing 20 patients implanted by MED-EL device programd using behavioral programs. Electrical stimulation levels and electrode impedance values were examined at 0, 1, 3 and 6 months after the first fitting session. Results: Electrode impedance values were reduced from the time of activation to the 6 months visit. Most comfortable levels increased and dynamic range widened until the 6 months visit. There was an inverse correlation between impedance values and most comfortable level as well as dynamic range, over time. Conclusion: Frequent monitoring of electrode impedance (for device and electrodes problems) and electric stimulation levels (for better performance, mapping and habituation) during the first 6 months of implant use is recommended.

Auditory profile and high resolution CT scan in autism spectrum disorders children with auditory hypersensitivity.

Autism is the third most common developmental disorder, following mental retardationand cerebral palsy. ASD children have been described more often as beingpreoccupied with or agitated by noise. The aim of this study was to evaluate theprevalence and clinical significance of semicircular canal dehiscence detected on CTimages in ASD children with intolerance to loud sounds in an attempt to find ananatomical correlate with hyperacusis.14 ASD children with auditory hypersensitivity and 15 ASD children without auditoryhypersensitivity as control group age and gender matched were submitted to historytaking, otological examination, tympanometry and acoustic reflex thresholdmeasurement. ABR was done to validate normal peripheral hearing and integrity ofauditory brain stem pathway. High resolution CT scan petrous and temporal boneimaging was performed to all participated children. All participants had normal hearingsensitivity in ABR testing. Absolute ABR peak waves of I and III showed no statisticallysignificant difference between the two groups, while absolute wave V peak andinterpeak latencies I-V and III-V were shorter in duration in study group whencompared to the control group. CT scans revealed SSCD in 4 out of 14 of the studygroup (29%), the dehiscence was bilateral in one patient and unilateral in threepatients. None of control group showed SSCD. In conclusion, we have reportedevidence that apparent hypersensitivity to auditory stimuli (short conduction time in ABR) despite the normal physiological measures in ASD children with auditoryhypersensitivity can provide a clinical clue of a possible SSCD.

Superior semicircular canal dehiscence syndrome as assessed by oVEMP and temporal bone computed tomography imaging.

To evaluate the role of oVEMP and multidetector CT scan in patients with superior canal dehiscence syndrome. Prospective study was conducted on nine patients with superior canal dehiscence syndrome (5 females, 4 males) age ranged 19-49 with mean age of 32.7 ± 9.3 years, complaining of intolerance to loud sounds and/or oscillopsia. The mean duration of illness was 18.7 ± 6.9 months, nine normal individuals as control (age and gender matched) were also included in the study. All of them underwent oVEMP and MDCT scan. Patients were of bilateral normal hearing sensitivity with no conductive impairment. All of the studied subjects (patients and controls) had identifiable contralateral oVEMP responses. MDCT scan showed dehiscence in all the patients. The dehiscence was unilateral (n = 7) and bilateral [n = 2 the other ear had a defect of 2 mm and thus was excluded from the study for fear or false diagnosis of Superior semicircular canal dehiscence syndrome (SCDS)]. Unlike the normal subject (nI = 0.94 µV ± 0.03 and pI = -0.42 µV ± 0.09), with stimulation of the affected side in SCDS, there were augmented amplitude responses (nI = 2.64 µV ± 0.35 and pI = -3.10 µV ± 0.44) in the eye contralateral to the stimulus "contralateral to the lesion". Mean oVEMP threshold for SCDS ears were 82.5 ± 7.55 dBnHL compared to 100 ± 5.77 dBnHL of the control ears. We concluded that combination of physiological and anatomical information from oVEMP and MDCT increased accuracy for diagnosis of dehiscence of superior semicircular canal.

SEN virus infection in Egyptian patients undergoing maintenance hemodialysis: prevalence and clinical importance.

BACKGROUND AND PURPOSE: SEN virus (SENV) is assumed to be responsible for post-transfusion non-A to -E hepatitis. Phylogenetic analysis of SENV has shown 9 different strains. Two strains, SENV-H and SENV-D, were described as possible candidates for post-transfusion hepatitis. This study examined the prevalence of SENV infection and its clinical importance for patients undergoing hemodialysis. METHODS: Serum samples were obtained from 63 long-term hemodialysis patients, and examined for SENV-H and SENV-D viremia by polymerase chain reaction. Serum samples were also obtained from 20 patients with chronic kidney diseases (CKD) who were not undergoing hemodialysis and from 20 apparently healthy blood donors to act as controls. For SENV screening, a primer pair was used for the conserved ORF1 region among all SENV genotypes from A to I. RESULTS: SENV infection was significantly more frequent among hemodialysis patients (33/63; 52.4%) and those with CKD (10/20; 50.0%) than among the control participants (2/20; 10.0%) [p = 0.003]. Twenty three of 33 hemodialysis patients had SENV-H or -D, 61% of whom were positive for SENV-H only, 4% were positive for SENV-D only, and 36% were positive for both SENV-H and SENV-D. SENV infection was not associated with age, sex, amount or duration of hemodialysis, or liver function test results. Elevated alanine aminotransferase was significantly associated with HCV viremia, but not with SENV infection. CONCLUSIONS: Egyptian hemodialysis patients and those with CKD are at higher risk for SENV transmission. SENV-H is more prevalent than SENV-D.