Advances in the Field of Bone Conduction Hearing Implants.
Authors: McLeod RWJ, Culling JF, Jiang D
Abstract
The number of marketed bone-conduction hearing implants (BCHIs) has been steadily growing, with multiple percutaneous devices and transcutaneous devices now available. However, studies assessing efficacy often have small sample sizes and employ different assessment methodologies. Thus, there is a paucity of evidence to guide clinicians to the most appropriate device for each patient. This paper outlines audiological guidelines for the latest devices, as well as research from the most up-to-date clinical trials. We also outline the evidence base for some pot...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Preliminaries.
Authors:
PMID: 29794424 [PubMed - in process] (Source: Advances in Oto-Rhino-Laryngology)
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Hearing Rehabilitation in Congenital Middle Ear Malformation.
In conclusion, hearing rehabilitation of congenital atresia should be performed as early as possible. This includes not only the bilateral but also the unilateral affected patients.
PMID: 29794426 [PubMed - in process] (Source: Advances in Oto-Rhino-Laryngology)
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Brain Plasticity and Rehabilitation with a Cochlear Implant.
Authors: McKay CM
Abstract
The functional changes that occur in the brain due to deafness may affect the way the auditory system processes sound after cochlear implantation. Brain plasticity plays a crucial role in the success of cochlear implantation to facilitate or develop spoken language in profoundly deaf individuals. The functional plasticity that occurs in postlingually deaf adults during periods of deafness can both support and hinder speech understanding with a cochlear implant, depending on the nature and degree of functional changes. Evidence so far suggests that the strategies people use to com...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Optimizing Ossicular Prosthesis Design and Placement.
Authors: Bance M
Abstract
Middle ear hearing reconstruction is unpredictable. Difficulties arise because of host factors, such as ventilation or scarring, surgical technique factors, such as prosthesis placement and stabilization, and design and mechanical factors influencing the properties of the prosthesis. Often there is a balancing act between choosing optimal stability, and maximizing the mechanical vibrations of the prosthesis. We review our and other investigators' work, in design and ideal placement of middle ear prostheses. Middle ear prostheses need to be rigid enough to deliver acoustic forces w...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Hearing Rehabilitation with Active Middle Ear Implants.
Authors: Donnelly NP, Pennings RJE
Abstract
Hearing implant technology is evolving at a rapid rate and more than ever patients with hearing loss are benefiting from these emerging hearing devices. Active middle ear implants are alternatives to hearing aids and bone conducting devices, offering patients an expanded range in improving their hearing. This chapter looks at the devices currently available, their indications and the literature regarding their outcomes.
PMID: 29794434 [PubMed - in process] (Source: Advances in Oto-Rhino-Laryngology)
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
New Imaging Modalities in Otology.
Authors: Bance M, Zarowski A, Adamson RA, Casselman JW
Abstract
Despite steady improvements in cross-sectional imaging of the ear, current technologies still have limitations in terms of resolution, diagnosis, functional assessment and safety. In this chapter, state-of-the-art imaging techniques in current clinical practice are presented including cone-beam computerized tomography, non-echo planar imaging magnetic resonance imaging, imaging for labyrinthine hydrops and imaging of the central auditory pathways. Potential future imaging modalities are also presented, including optical coherence tomography (O...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Intraoperative Auditory System Monitoring.
Authors: Miyazaki H, Caye-Thomasen P
Abstract
A new electrophysiological system for intraoperative, continuous, near-real time monitoring of cochlear nerve function through acoustic stimulation in the ear canal and recording of the evoked dorsal cochlear nucleus potentials (DNAPs) by a specially designed DNAP electrode placed directly on the brainstem is described. The system is denominated "(cerebellopontine angle) CPA Master" and is designed for hearing preservation surgery in the cerebello-pontine angle, through the retro-sigmoid or the retro-labyrinthine approach. As an additional novelty within the fi...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
The Future of Cochlear Implant Design.
Authors: Mitchell-Innes A, Saeed SR, Irving R
Abstract
This chapter discusses the multifaceted future of cochlear implant design. Current research is focused on novel strategies relating to the electrode array, aiming to improve the neuronal health and spatial selectivity, and reduce the power consumption. Future design iterations will most likely improve the neuronal health by reducing insertion trauma, minimizing the inflammatory pathway that follows electrode insertion or through the use of neurotrophins or stem cells. Improvements in spatial selectivity and in speech recognition in difficult listening ...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
The Role of the Eustachian Tube in Middle Ear Disease.
We describe the anatomy and physiology of the Eustachian tube, define ETD, discuss the methods for measuring ETD and describe recent advances in treatment.
PMID: 29794454 [PubMed - in process] (Source: Advances in Oto-Rhino-Laryngology)
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Diagnosis and Treatment of Perilymphatic Fistula.
Authors: Deveze A, Matsuda H, Elziere M, Ikezono T
Abstract
Perilymphatic fistula (PLF) is defined as an abnormal communication between the fluid (perilymph)-filled space of the inner ear and the air-filled space of the middle ear and mastoid, or cranial spaces. PLF is located in the round or oval window, fractured bony labyrinth, microfissures, anomalous footplate, and can occur after head trauma or barotrauma, chronic inflammation, or in otic capsule dehiscence. This clinical entity was initially proposed more than a century ago, yet it has remained a topic of controversy for more than 50 years. The diff...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Pharmacological Issues in Hearing Rehabilitation.
Authors: Bird PA, Bergin MJ
Abstract
Surgery aimed at hearing rehabilitation risks damaging residual inner ear function, especially cochlear implant surgery. Pharmacological intervention to reduce this risk has shown great promise in animal models. The challenge is to deliver medication to the appropriate part of the inner ear in appropriate concentrations for long enough to be effective. Barriers to achieving these goals include: the blood/labyrinth barrier, limiting systemic drug delivery to the inner ear, slow rates of diffusion from the base of the cochlea to the apex, limiting intratympanic delivery f...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Management of Cochlear Nerve Hypoplasia and Aplasia.
Authors: Freeman SR, Sennaroglu L
Abstract
Approximately 2% of congenital profound deafness cases are due to cochlear nerve (CN) deficiency. MRI is essential to confirm if the nerve is deficient, but because of limitations with resolution, especially when the internal auditory canal is narrowed, it is often unable to distinguish between hypoplasia and aplasia. A full audiometric test battery should always be performed, even if the MRI suggests CN aplasia, as there will sometimes be evidence of audition. Electrically evoked auditory brainstem response testing can be carried out transtympanically via the rou...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Hearing Rehabilitation in Neurofibromatosis Type 2.
Authors: North HJD, Lloyd SKW
Abstract
Bilateral vestibular schwannomas are almost pathognomonic of neurofibromatosis type 2 (NF2). As a result of these tumors, hearing loss is the presenting symptom in 60% of adults and 30% of children with NF2. It is often bilateral. The best means of preserving hearing in patients with NF2 is conservative management. Even so at least 28% of patients have progression of hearing loss following diagnosis. The likelihood of progression of hearing loss is, at least in part, determined by the type of mutation. Treatment of vestibular schwannomas often has a detrimental effect...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
Hearing Preservation Cochlear Implant Surgery.
Authors: Bruce IA, Todt I
Abstract
Cochlear implantation (CI), with attempted preservation of residual natural low-frequency hearing, is an increasingly accepted application of this technology, with potential benefits to the patient when listening in noise and in music appreciation. The full extent of the benefits of combining preserved natural hearing and electrical stimulation remain under evaluation. Various factors appear to influence the success of hearing preservation (HP) during CI, including electrode design, surgical approach, insertional trauma, steroid usage and patient factors. Currently, combi...
Source: Advances in Oto-Rhino-Laryngology - May 30, 2018 Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research
