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Neuroglial Choristoma of the Middle Ear with Massive Tympanosclerosis: A Case Report and Literature Review.

Hyun Joon SHIM ; Yong Kyung KANG ; Yong Hwi AN ; Young Ok HONG

Journal of Audiology & Otology.2016;20(3):179-182. doi:10.7874/jao.2016.20.3.179

Neuroglialchoristoma is a rare cerebral heterotopia typically involving extracranial midline structures of the head and neck, including the nose, nasopharynx and oral cavity. It rarely involves non-midline structures, such as the middle ear, mastoid and orbit. We report the case of a 63-year-old woman with right-sided hearing loss and aural fullness who was diagnosed with neuroglialchoristoma of the middle ear and mastoid. To our knowledge, this is the first report on neuroglialchoristomawith massive tympanosclerosis. The presence of combination supported the inhalation theory of neuroglialchoristoma, given that tympanosclerosis is typically caused by Eustachian tube dysfunction.
Choristoma* ; Ear, Middle* ; Encephalocele ; Eustachian Tube ; Female ; Head ; Hearing Loss ; Humans ; Inhalation ; Mastoid ; Middle Aged ; Mouth ; Myringosclerosis* ; Nasopharynx ; Neck ; Neuroglia ; Nose ; Orbit

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Clinical Analysis of Dizzy Patients with High Levels of Depression and Anxiety.

Sung Kyun KIM ; Yong Bok KIM ; Il Seok PARK ; Seok Jin HONG ; Heejin KIM ; Seok Min HONG

Journal of Audiology & Otology.2016;20(3):174-178. doi:10.7874/jao.2016.20.3.174

BACKGROUND AND OBJECTIVES: Some patients experiencing dizziness also report psychological distress. However, the association between vestibular deficits and psychological symptoms remains controversial. Thus, the aim of this paper is to report the proportion of patients who complained of dizziness who also had high depression and anxiety indices. Also we investigated the severity of their dizziness and the distribution of the diseases underlying this symptom. SUBJECTS AND METHODS: We assessed the dizziness and psychological distress of 544 patients experiencing dizziness using the Korean versions of the Dizziness Handicap Inventory (DHI), the Beck Depression Inventory (BDI), and the Spielberger State-Trait Anxiety Inventory (STAI). We also reviewed the audio-vestibular symtoms of patients with high levels of depression and anxiety. RESULTS: The incidences of high depression and anxiety scores were 11% (60/544) and 18% (98/544), respectively. Patients with vestibular migraine were most likely to have high depression and anxiety indices. Patients in the high-BDI or high-STAI groups (117/544) obtained significantly higher DHI scores than those in neither the high-BDI nor the high-STAI group (427/544). We noticed that about 20% of the patients experiencing dizziness had high levels of psychological distress in this study; this group also suffered from various vestibular diseases and more symptoms of dizziness. CONCLUSIONS: The results of the study suggest that psychological evaluation should be considered when assessing patients with vertigo.
Anxiety* ; Depression* ; Dizziness ; Humans ; Incidence ; Migraine Disorders ; Vertigo ; Vestibular Diseases

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Clinical Aspects and Surgical Outcomes of Congenital Cholesteatoma in 93 Children: Increasing Trends of Congenital Cholesteatoma from 1997 through 2012.

Hyun Soo CHO ; Hak Geon KIM ; Da Jung JUNG ; Jeong Hun JANG ; Sang Heun LEE ; Kyu Yup LEE

Journal of Audiology & Otology.2016;20(3):168-173. doi:10.7874/jao.2016.20.3.168

BACKGROUND AND OBJECTIVES: The recent increase in the reported incidence of congenital cholesteatoma (CC) may be secondary to the widespread use of otoendoscopy as well as an increased awareness of these lesions among primary care physicians. However, little research about CC has been conducted in a large group of patients. This study aimed to analyze the clinical characteristics of CC including the annual number of patients, symptoms, age at diagnosis, stage and type of disease, surgical techniques, recurrence, and postoperative complications. SUBJECTS AND METHODS: Retrospective chart review was performed for patients who met the inclusion criteria between January 1997 and June 2012. RESULTS: Ninety-three patients underwent surgery for CC. The age at operation ranged from 12 months to 17 years (mean age, 6.1 years). The number of patients was less than 4 per year until 2005, but increased to more than 10 per year since 2008. CC was most commonly reported as an incidental finding (58.1%). The operative procedures included the transcanal myringotomy approach (46.2%), canal wall up mastoidectomy (37.6%), tympanoplasty (8.6%), and canal wall down mastoidectomy (7.5%). The recurrence rate was 20.4% and the complication rate was 12.9%. No patients with stage I CC had complications. CONCLUSIONS: This study showed that the incidence of CC has recently increased notably. Most patients with stage I and II CC were completely cured by transtympanic surgery, and complication and recurrence rates increased according to the extent of disease. Early detection of CC is important to facilitate minimally invasive surgery and to reduce complication and recurrence rates.
Child* ; Cholesteatoma* ; Diagnosis ; Humans ; Incidence ; Incidental Findings ; Minimally Invasive Surgical Procedures ; Physicians, Primary Care ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Tympanoplasty

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Audiological Profile of Adult Persons with Auditory Neuropathy Spectrum Disorders.

Pradeep YUVARAJ ; Mannarukrishnaiah JAYARAM

Journal of Audiology & Otology.2016;20(3):158-167. doi:10.7874/jao.2016.20.3.158

BACKGROUND AND OBJECTIVES: The auditory profile of a large number of persons with late onset auditory neuropathy spectrum disorder (ANSD) is recently described in the Indian context. The purpose of study was 1) to profile data on routine audiological parameters, cortical evoked potentials, and temporal processing, 2) to analyze the benefit from hearing aids for persons with ANSD, and 3) to understand the association between benefit from hearing aids and auditory profile. SUBJECTS AND METHODS: Thirty-eight adults with late onset ANSD and a matched group of 40 normally hearing adults participated in the study. Basic audiological tests, recording of cortical evoked potentials, and temporal processing tests were carried out on both groups of participant while only persons with ANSD were fitted with hearing aid. RESULTS: Subjects in the two groups were significantly different on all the audiological parameters. ANSD group seemed to benefit from hearing aids variably. The mean amplitude of N2 was significantly different between normally-hearing participants and patients with ANSD. CONCLUSIONS: Residual temporal processing, particularly amplitude modulation detection seems to be associated with benefit from hearing aids in patients with ANSD.
Adult* ; Evoked Potentials ; Hearing ; Hearing Aids ; Humans ; Research Design

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High Frequency Tympanometry (1,000 Hz) for Neonates with Normal and Abnormal Transient Evoked Otoacoustic Emissions.

Maryam EMADI ; Mohammad REZAEI ; Morteza Hamidi NAHRANI ; Masoud BOLANDI

Journal of Audiology & Otology.2016;20(3):153-157. doi:10.7874/jao.2016.20.3.153

BACKGROUND AND OBJECTIVES: This paper aimed at evaluating the characteristics of high-frequency (1,000 Hz) acoustic admittance (ya) for the neonates with transient evoked otoacoustic emissions (TEOAE) as either pass or refer group. SUBJECTS AND METHODS: Using a 1,000 Hz probe tone, 297neonates (152 male, 145 female aged 0–104 days old) were evaluated. Tympanometric parameters admittance value at +200 dapa, middle ear admittance, and tympanometric peak pressure were calculated for each tympanogram. RESULTS: The mean of ya was 0.9678 mmho in the TEOAE for the pass group and 0.7229 mmho in the refer group. The mean of acoustic admittance at +200 (y200) was 2.0657 in the TEOAE for the pass group and 1.7191 for the refer group. The mean of Tpp was 23/8591 in the TEOAE for the pass group and 59/7619 for the refer group. CONCLUSIONS: There were significant differences in the distribution of different types of tympanograms, the mean of ya, tympanic peak pressure, and y200 between the TEOAEs for the pass and the refer groups.
Acoustic Impedance Tests* ; Acoustics ; Ear, Middle ; Female ; Humans ; Infant, Newborn* ; Male

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Characteristics of Patients with Hearing Aids according to the Degree and Pattern of Hearing Loss.

Young Seok BYUN ; Sung Su KIM ; Sang Hyun PARK ; Eun Bin PARK ; Ho Joong KIM ; Sang Hoon KIM ; Seung Geun YEO

Journal of Audiology & Otology.2016;20(3):146-152. doi:10.7874/jao.2016.20.3.146

BACKGROUND AND OBJECTIVES: This study was designed to assess the characteristics of patients according to the degree and audiogram shape of hearing loss and the association of these characteristics with hearing aids (HA) choice, return rate, and cause of return. SUBJECTS AND METHODS: This study included 460 individuals who received HAs from 2011 to 2015. The relationships between type of HA and age, primary and accompanying symptoms, HA choice and return and cause of return were evaluated according to the degree and pattern of hearing loss. RESULTS: HA type did not differ significantly according to the degree and pattern of hearing loss. Intensity of hearing loss was greater in male than in female (p<0.05). Open and completely-in-canal types of HA decreased with age (p<0.05). As degree of hearing loss intensified, behind-the-ear and in-the-ear types increased and Open type decreased (p<0.05). The HA return rate was 9.7%, but was not associated with degree or pattern of hearing loss. The main causes of HA return were costs, psychological fears and adaptive failure. CONCLUSIONS: Choice of HA is affected by age, sex, and degree and pattern of hearing loss. HA for hearing rehabilitation in patients with hearing loss can be personalized according to each patient's characteristics and tendencies.
Female ; Hearing Aids* ; Hearing Loss* ; Hearing* ; Humans ; Male ; Rehabilitation

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Fibrinogen-Based Collagen Fleece Graft Myringoplasty for Traumatic Tympanic Membrane Perforation.

Seung Hyo CHOI ; Hyoung Yong SONG ; Chan Il SONG

Journal of Audiology & Otology.2016;20(3):139-145. doi:10.7874/jao.2016.20.3.139

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate how fibrinogen-based collagen fleece (Tachocomb®) graft myringoplasty (FCGM), performed under microscopic guidance, improves both hearing and tympanic membrane tissue repair in patients with traumatic tympanic membrane perforation (TMP). SUBJECTS AND METHODS: Between August 2009 and March 2015, a total of 52 patients with traumatic TMP visited the department of otorhinolaryngology at a secondary medical center. Twenty-nine of these underwent FCGM under microscopic guidance in our outpatient clinic. For each patient, we recorded the location and size of the perforation, the time elapsed from the onset of TMP until the myringoplasty, and the hearing level both before and after myringoplasty. RESULTS: The TMP closed completely in all cases (29 of 29 patients). After myringoplasty, the postoperative air-bone gap (ABG) differed significantly from the preoperative ABG. Three of the 29 patients (10.3%) experienced complications. Specifically, 2 presented with otorrhea after FCGM, but conservative management led to improvement without recurrence of perforation. One patient showed delayed facial palsy 1 week after the procedure. The condition of this patient also improved and the palsy was not permanent. CONCLUSIONS: FCGM may be an effective treatment option in case of traumatic TMP. The procedure requires no hospitalization, and can be used to avoid traditional tympanoplasty.
Ambulatory Care Facilities ; Collagen* ; Facial Paralysis ; Hearing ; Hearing Loss, Conductive ; Hospitalization ; Humans ; Myringoplasty* ; Otolaryngology ; Paralysis ; Recurrence ; Thymidine Monophosphate ; Transplants* ; Tympanic Membrane Perforation* ; Tympanic Membrane* ; Tympanoplasty

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MicroRNA-183 Family in Inner Ear: Hair Cell Development and Deafness.

Mohammad Reza MAHMOODIAN SANI ; Morteza HASHEMZADEH-CHALESHTORI ; Massoud SAIDIJAM ; Mohammad Saeid JAMI ; Payam GHASEMI-DEHKORDI ; Massoud SAIDIJAM ; Mohammad Saeid JAMI

Journal of Audiology & Otology.2016;20(3):131-138. doi:10.7874/jao.2016.20.3.131

miRNAs are essential factors of an extensively conserved post-transcriptional process controlling gene expression at mRNA level. Varoius biological processes such as growth and differentiation are regulated by miRNAs. Web of Science and PubMed databases were searched using the Endnote software for the publications about the role miRNA-183 family in inner ear: hair cell development and deafness published from 2000 to 2016. A triplet of these miRNAs particularly the miR-183 family is highly expressed in vertebrate hair cells, as with some of the peripheral neurosensory cells. Point mutations in one member of this family, miR-96, underlie DFNA50 autosomal deafness in humans and lead to abnormal hair cell development and survival in mice. In zebrafish, overexpression of the miR-183 family induces extra and ectopic hair cells, while knockdown decreases the number of hair cell. The miR-183 family (miR-183, miR-96 and miR-182) is expressed abundantly in some types of sensory cell in the eye, nose and inner ear. In the inner ear, mechanosensory hair cells have a robust expression level. Despite much similarity of these miRs sequences, small differences lead to distinct targeting of messenger RNAs targets. In the near future, miRNAs are likely to be explored as potential therapeutic agents to repair or regenerate hair cells, cell reprogramming and regenerative medicine applications in animal models because they can simultaneously down-regulate dozens or even hundreds of transcripts.
Animals ; Biological Processes ; Cellular Reprogramming ; Deafness* ; Ear, Inner* ; Gene Expression ; Hair* ; Hearing Loss ; Humans ; Mice ; MicroRNAs ; Models, Animal ; Nose ; Point Mutation ; Regenerative Medicine ; RNA, Messenger ; Triplets ; Vertebrates ; Zebrafish

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How do You Select an Anesthesia Method Prior to Tympanostomy Tube Insertion for a Child?.

Dong Hee LEE

Journal of Audiology & Otology.2016;20(3):127-130. doi:10.7874/jao.2016.20.3.127

The use of general (face-mask inhalation and intravenous) anesthesia has been the method of choice for tympanostomy tube insertion in children. However, there is no exact guideline for the choice of anesthesia method and there is no evidence to support the use of one anesthesia method over another. Clinically, the anesthesia method used to be decided by old customs and the surgeon's blind faith that children cannot bear tympanostomy tube insertion under local anesthesia. Clinicians should keep in mind that pediatric anesthesia has a potential risk. Despite infrequent serious complications, their seriousness necessitates that sedation or general anesthesia should be done by an anesthesiologist and thus children requiring tympanostomy tube insertion should be referred to secondary or tertiary hospitals, even if they have been followed by a primary care physician for a long time. Previous evidence showed that local anesthesia is appropriate for tympanostomy tube insertion in selected children, especially in children older than 5 years are older. Proper choice of anesthesia method is helpful for both patient and medical service provider. Local anesthesia can give psychological relief to children and their parent. It is easier for the medical service providers to schedule the operation and allocate the medical resources in their hospital. Local anesthesia can reduce individual, social, and national burdens for the health care services.
Anesthesia* ; Anesthesia, General ; Anesthesia, Local ; Appointments and Schedules ; Child* ; Delivery of Health Care ; Humans ; Inhalation ; Methods* ; Middle Ear Ventilation* ; Parents ; Physicians, Primary Care ; Tertiary Care Centers

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Speech Intelligibility in Persian Hearing Impaired Children with Cochlear Implants and Hearing Aids.

Mohammad REZAEI ; Maryam EMADI ; Peyman ZAMANI ; Farhad FARAHANI ; Gohar LOTFI

Journal of Audiology & Otology.2017;21(1):57-60. doi:10.7874/jao.2017.21.1.57

The aim of present study is to evaluate and compare speech intelligibility in hearing impaired children with cochlear implants (CI) and hearing aid (HA) users and children with normal hearing (NH). The sample consisted of 45 Persian-speaking children aged 3 to 5-years-old. They were divided into three groups, and each group had 15, children, children with CI and children using hearing aids in Hamadan. Participants was evaluated by the test of speech intelligibility level. Results of ANOVA on speech intelligibility test showed that NH children had significantly better reading performance than hearing impaired children with CI and HA. Post-hoc analysis, using Scheffe test, indicated that the mean score of speech intelligibility of normal children was higher than the HA and CI groups; but the difference was not significant between mean of speech intelligibility in children with hearing loss that use cochlear implant and those using HA. It is clear that even with remarkabkle advances in HA technology, many hearing impaired children continue to find speech production a challenging problem. Given that speech intelligibility is a key element in proper communication and social interaction, consequently, educational and rehabilitation programs are essential to improve speech intelligibility of children with hearing loss.
Child* ; Cochlear Implants* ; Hearing Aids* ; Hearing Loss ; Hearing* ; Humans ; Interpersonal Relations ; Rehabilitation ; Speech Intelligibility*

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