Objective: To determine the stage of middle ear cholesteatoma of patients who underwent middle ear surgery at the Southern Philippines Medical Center from January to December 2019, based on European Academy of Otology and Neurotology / Japan Otological Society (EAONO/JOS) system. Methods: Design: Case Series. Setting: Tertiary Government Hospital. Participants: A total of 42 charts were included in the study. Results: Of the 42 cases evaluated, congenital cholesteatoma was seen in 4 while acquired cholesteatoma was noted in 38, (further subdivided into 34 retraction pocket cholesteatoma and 4 non-retraction pocket/traumatic cholesteatoma). A majority (57%) had Stage II cholesteatoma (mass occupying at least two sub-sites in the middle ear) at the time of surgery. Eight (19%) had stage I cholesteatoma (confined to one sub-site), five (12%) had stage III cholesteatoma evidenced by extracranial complications such as subperiosteal abscess and erosion of the semi[1]circular canals. Stage IV cholesteatoma was seen in 5 (12%) presenting with intracranial abscess. Canal wall down mastoidectomy was the most common surgical approach performed. The sinus tympani (S2 ) was the most commonly involved difficult to access site across all classifications of middle ear cholesteatoma (60%). Conclusion Our study provided an initial profile of the stages and severity of middle ear cholesteatoma in our institution based on actual surgical approaches. Such a profile can be the nidus for a database that can help us to understand disease prevalence and compare local surgical practices with those in the international community.
Cholesteatoma ; Cholesteatoma ; Ear, Middle ; Cholesteatoma, Middle Ear

Objective: To determine the correlation between pre-operative in-house temporal bone CT scan readings and intraoperative findings during mastoidectomy for cholesteatoma in a tertiary government hospital from January 2018 to December 2019.

Methods:

Design: Review of Records

Setting: Tertiary Government Hospital

Participants: A total of 25 charts were included in the study. Surgical memoranda  containing intraoperative findings were scrutinized. Data on key structures or locations were  filled into a data gathering tool. Categorical descriptions were used for surgical findings:  "present" or "absent" for location, and "intact" or "eroded" for status of ossicles and critical structures. Radiological readings to describe location and extent of disease were recorded as either "involved" or "uninvolved," while "intact" or "eroded" were used to describe the status of ossicles and critical structures identified. Statistical correlations were computed using Cohen kappa coefficient. Sensitivity, specificity, and predictive values were also computed.

Results: No correlation between radiologic readings and surgical findings were found in terms of location and extent of cholesteatoma (? < 0). However, moderate agreement was noted in terms of status of the malleus (? = .42, 95% CI, .059 to .781, p<.05), substantial agreement noted for the incus status (? = 0.682, 95% CI, .267 to .875, p<.05), and fair agreement noted for the stapes status (? = .303, 95% CI, -.036 to .642, p>.05). Slight agreement was also noted in description of facial canal and labyrinth (? =.01, 95% CI, -.374 to .394, p>.05), while no correlation was noted for the status of the tegmen (? = 0, 95% CI, -.392 to .392, p<.05).

Conclusion: Our study shows the unreliability and shortcomings of CT scan readings in our institution in detecting and predicting surgical findings. An institutional policy needs to be considered to ensure that temporal bone CT scans be obtained using techniques that can appropriately describe the status of the middle ear and adjacent structures with better reliability.

Human ; Male ; Female ; Cholesteatoma ; Temporal Bone ; Tomography

Background: Establishing clinic-specific normative data for auditory brainstem response (ABR) tests is important due to variability in stimulus parameters and equipment. Objective: To establish normative values for ABR measurements in infants aged 3 to 6 months. Design: Descriptive study. Participants: 12 normal-hearing male and female infants, aged 3 to 6 months, who underwent ABR tests. Setting: Audiology Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Southern Philippines Medical Center, Davao City, January 2021 to December 2022. Main outcome measures: Absolute latency readings for waves I, III, and V, and interpeak latencies for waves I-III, III-V, and I-V using Interacoustics Eclipse EP15 apparatus with a RadioEar IP30 Insert Earphone transducer at a stimulus intensity of 60-90 dBnHL and a rate of 45.1 clicks/sec. Main results: All normative ABR ranges were computed with a threshold of ± 2 SD from the means. The computed means (normative ranges) for absolute latencies for waves I, III, and V were 1.49 ± 0.15 (1.19-1.78) msec, 4.45 ± 0.32 (3.81-5.10) msec, and 6.65 ± 0.26 (6.12-7.17) msec, respectively. The computed normative values for interpeak latencies for waves I-III, III-V, and I-V were 2.80 ± 0.22 (2.36-3.23) msec, 2.19 ± 0.21 (1.78-2.61) msec, and 4.99 ± 0.29 (4.41-5.57) msec, respectively. Conclusion In our study, we have established normative values for ABR test measurements for infants aged 3 to 6 months.
Hearing Loss ; Audiology

Background: The National Cochlear Implant Program (NCIP) is a national program to address the increasing prevalence of hearing loss, especially in the pediatric population here in the Philippines. In its pilot implementation, it included three tertiary hospitals to represent Luzon, Visayas, and Mindanao and was able to enroll 20 patients who successfully underwent cochlear implantation. Objectives: The aim of this study is to evaluate the auditory outcomes of the patients who underwent cochlear implantation under the NCIP using the Parents' Evaluation of Aural/Oral Performance of Children (PEACH) Questionnaire and Categories of Auditory Performance (CAP) score questionnaire. Methods: The study included all recipients of the cochlear implants, under NCIP from December 2019 to December 2021, except 1 with incomplete data during the course of his followup. The outcomes measured included the PEACH Questionnaire score and CAP Questionnaire score and were compared on various factors which included patient's sex and age, parents' socioeconomic status, duration of hearing aid use prior to CI, pre CI imaging findings and CI electrode placement using nonparametric statistical tests. Results: The mean PEACH score of the 19 patients was 53.59% ± 12.76% (range: 30% - 75%) while the mean CAP score was 3.16 ± 1.04 (range: 1 - 4.3). Parents of the included patients who have a higher educational background and those in which the electrode was located on the ideal location, scala tympani, have a statistically significant higher PEACH score (p-value of 0.017 and 0.012, respectively). In comparing the CAP scores, those who have unremarkable or normal preoperative imaging have a statistically significant higher score (p-value 0.013). Conclusion Patients who had normal preoperative imaging, proper placement of electrodes and those patients with parents belonging to a higher educational background had statistically significant better auditory outcomes after cochlear implantation. Patients who had the cochlear implantation before 36 months of age and hearing aid use of 7 to 18 months prior to cochlear implantation had higher PEACH and CAP scores, however these were not statistically significant. Further studies with a larger sample size is recommended.
cochlear implantation