Objective: To analyze the surgical efficacy of patients with mixed hearing loss and otosclerosis with different air bone gap (ABG) before surgery, and to provide reference for the prognosis evaluation of otosclerosis surgery. Methods: The clinical data of 108 cases(116 ears) of otosclerosis who had undergone stapes fenestration technique artificial stapes implantation in Xiangya Hospital of Central South University from November 2013 to May 2020 and had mixed hearing loss before surgery were collected, including 71 women(76 ears)and 37 men (40 ears), with an average age of 38.5 years. According to preoperative pure tone audiometry ABG, they were divided into three groups: group S, 15 dB≤ABG<31 dB, a total of 39 ears; group M, 31 dB≤ABG<46 dB, a total of 58 ears; and group L, ABG≥46 dB, 19 ears in total. The hearing outcomes of three groups of patients at 6-12 months after surgery were compared and analyzed using SPSS 24.0 statistical software. Results: A total of 3 patients (group S: 2 cases; group L: 1 case) experienced severe sensorineural hearing loss after surgery and were not included in the statistical analysis. After surgery, the pure tone hearing threshold of patients with otosclerosis in each group was significantly improved compared to before surgery, with an average air conduction threshold improvement of(21.6±13.4) dB. The difference between before and after surgery was statistically significant(t=17.13, P<0.01). The average bone conduction threshold improved by(3.7±7.6) dB, and the difference was statistically significant before and after surgery(t=5.20, P<0.01). The postoperative ABG was(18.3±9.3) dB, which was significantly reduced compared to preoperative(36.2±8.6)dB. Among the three groups of patients, the L group had the highest improvement in air conduction threshold[(29.9±10.8)dB], while the S group had the lowest improvement[(15.7±11.4)dB]. There was no statistically significant difference in post operative pure tone hearing thresholds between the three groups(P>0.05). The postoperative ABG in group S was the smallest[(16.5±9.0)dB], while in group L, the postoperative ABG was the largest[(20.5±10.0)dB]. Compared with group S, group M and group L still had a large residual ABG at 2 000 Hz after surgery. The bone conduction threshold of both S and M groups improved to some extent after surgery compared to before (P<0.01). Conclusions: Surgery can benefit patients with mixed hearing loss and otosclerosis with different preoperative ABG. Patients with small preoperative ABG have better surgical results and ideal ABG closure at all frequencies after surgery. Patients with large preoperative ABG can significantly increase the gas conduction threshold during surgery, but certain frequencies of ABG may still be left behind after surgery. The improvement effect of surgery on bone conduction threshold is not significant. Patients should be informed of treatment methods such as hearing aids based on their actual situation for selection.
Male ; Humans ; Female ; Adult ; Bone Conduction ; Otosclerosis/surgery* ; Hearing Loss, Mixed Conductive-Sensorineural/surgery* ; Stapes Surgery/methods* ; Treatment Outcome ; Auditory Threshold ; Hearing ; Audiometry, Pure-Tone ; Deafness ; Retrospective Studies

Objective: To investigate the development of auditory speech perception and spatial hearing abilities within one year after cochlear implantation in preschool prelingual deaf children and the relationship between the two abilities. Methods: This retrospective study analyzed 31 preschool children with an average age of (2.3±1.2) years. All cases were assessed at pre-implant, 6 months and 12 months post-implant using the Infant-toddler Meaningful Auditory Integration Scale (IT-MAIS), the Meaningful Auditory Integration Scale (MAIS) and the Mandarin Early Speech Perception test (MESP) to evaluate their listening and speech perception abilities, and using the Speech,Spatial,and Other Qualities of Hearing Scale for Parents (SSQ-P) questionnaires to evaluate their speech perception and spatial hearing abilities. SPSS 23.0 was used for the statistical analysis. Results: All children performed better at 6 months and 12 months post-implant with IT-MAIS/MAIS, MESP than pre-implant, and the scoring rate continued to improve, with a significant difference (P<0.01). For the SSQ-P (Speech) and SSQ-P (Spatial) scores, the mean scores of pre-implant were (0.9±0.2) points and (0.8±0.3) points, those of 6 months post-implant were (4.6±0.2) and (2.6±0.3), and 12 months post-implant were (6.2±0.2) and (6.3±0.3), the scores of the two groups were significantly different at pre-implant, 6 months and 12 months post-implant (P<0.01). The growth rate of SSQ-P (Spatial) from pre-implant to 12 months post-implant was 675.3%, and the growth rate from 6 months post-implant to 12 months post-implant was 140.6%, the growth rate showed an significant increase compared with IT-MAIS/MAIS, MESP and SSQ-P (Speech).SSQ-P (Speech) and SSQ-P (Spatial) scores were moderate correlation at 12 months post-implant(r=0.465, P=0.008). Conclusions: Within one year after cochlear implantation, listening, speech perception and spatial hearing abilities of preschool prelingual deaf children could show a comprehensive, continuous and significant progress as the implantation time increasing. The growth rate of spatial hearing is greater than that of speech perception at 12 months post-implant, and the spatial hearing could still show rapid development characteristics after 6 months post-implant.
Auditory Perception ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Deafness/surgery* ; Hearing ; Humans ; Infant ; Retrospective Studies ; Speech ; Speech Perception

OBJECTIVE: Microvascular decompression (MVD) for hemifacial spasm (HFS) involving the vertebral artery (VA) can be technically challenging. We investigated the therapeutic effects of a bioglue-coated Teflon sling technique on the VA during MVD in 42 cases. METHODS: A bioglue-coated Teflon sling was crafted by the surgeon and applied to patients in whom neurovascular compression was caused by the VA. The radiologic data, intra-operative findings with detailed introduction of the procedure, and the clinical outcomes of each patient were reviewed and analyzed. RESULTS: The 42 patients included in the analysis consisted of 22 females and 20 males, with an average follow-up duration of 76 months (range 24–132 months). Intraoperative investigation revealed that an artery other than the VA was responsible for the neurovascular compression in all cases : posterior inferior cerebellar artery (PICA) in 23 patients (54.7%) and anterior inferior cerebellar artery (AICA) in 11 patients (26.2%). All patients became symptom-free after MVD. Neither recurrence nor postoperative neurological deficit was noted during the 2-year follow-up, except in one patient who developed permanent deafness. Cerebrospinal fluid (CSF) leak occurred in three patients, and one required dural repair. CONCLUSION: Transposition of the VA using a bioglue-coated Teflon sling is a safe and effective surgical technique for HFS involving the VA. A future prospective study to compare clinical outcomes between groups with and without use of this novel technique is required.
Arteries ; Cerebrospinal Fluid ; Deafness ; Female ; Follow-Up Studies ; Hemifacial Spasm* ; Humans ; Male ; Microvascular Decompression Surgery* ; Polytetrafluoroethylene* ; Prospective Studies ; Recurrence ; Therapeutic Uses ; Vertebral Artery*

BACKGROUNDThe auditory brainstem implants (ABIs) have been used to treat deafness for patients with neurofibromatosis Type 2 and nontumor patients. The lack of an appropriate animal model has limited the study of improving hearing rehabilitation by the device. This study aimed to establish an animal model of ABI in adult rhesus macaque monkey (Macaca mulatta).

METHODSSix adult rhesus macaque monkeys (M. mulatta) were included. Under general anesthesia, a multichannel ABI was implanted into the lateral recess of the fourth ventricle through the modified suboccipital-retrosigmoid (RS) approach. The electrical auditory brainstem response (EABR) waves were tested to ensure the optimal implant site. After the operation, the EABR and computed tomography (CT) were used to test and verify the effectiveness via electrophysiology and anatomy, respectively. The subjects underwent behavioral observation for 6 months, and the postoperative EABR was tested every two weeks from the 1 st month after implant surgery.

RESULTThe implant surgery lasted an average of 5.2 h, and no monkey died or sacrificed. The averaged latencies of peaks I, II and IV were 1.27, 2.34 and 3.98 ms, respectively in the ABR. One-peak EABR wave was elicited in the operation, and one- or two-peak waves were elicited during the postoperative period. The EABR wave latencies appeared to be constant under different stimulus intensities; however, the amplitudes increased as the stimulus increased within a certain scope.

CONCLUSIONSIt is feasible and safe to implant ABIs in rhesus macaque monkeys (M. mulatta) through a modified suboccipital RS approach, and EABR and CT are valid tools for animal model establishment. In addition, this model should be an appropriate animal model for the electrophysiological and behavioral study of rhesus macaque monkey with ABI.

Animals ; Auditory Brain Stem Implants ; Deafness ; surgery ; Evoked Potentials, Auditory, Brain Stem ; physiology ; Female ; Macaca mulatta ; Male

BACKGROUNDThe popularization and promotion of gene diagnosis technology makes it possible to detect deafness genes for children with congenital hearing impairment, and the proportion of gap junction protein beta 2 (GJB2) gene mutations in cochlear implant patients is 26.5%. We did follow-up evaluation on auditory rehabilitation effect for all 31 deaf children with GJB2 gene mutation after cochlear implantation to provide a reference for such patients.

METHODSApplication of "the genetic deafness gene chip detection kit" and "gene complete sequence analysis" were applied to conduct detection on common genetic deafness gene mutation hotspots of the hearing impaired children with cochlear implantation. To conduct auditory rehabilitation effect evaluation on all 31 cases of patients with GJB2 genetic deafness after 3, 6 and 12 months of the operation respectively. The single factor repeated measure analysis of variance (ANOVA) was applied to analysis whether there were significant difference among the results of initial consonant of a Chinese syllable recognition at 3 different stages after the operation, the results of vowel of a Chinese syllable recognition at 3 different stages after the operation, and the results of two-syllable recognition at 3 different stages after the operation.

RESULTSThe 235delC is the high-incidence mutational site in 31 cases of patients with GJB2 genetic deafness, and the total detection rate is up to 90.3% (28/31). There were significant differences in the initial consonant and the vowel of a Chinese syllable recognition rate, and the two-syllable recognition rates at 3, 6, and 12 months after the operation (P < 0.01).

CONCLUSIONCochlear implantation is a safe and effective measure for auditory reconstruction, enabling patients with GJB2 hereditary severe sensorineural deafness to achieve auditory speech recognition effectively.

Child, Preschool ; Cochlear Implantation ; adverse effects ; Connexins ; genetics ; Deafness ; genetics ; surgery ; Female ; Humans ; Male ; Mutation ; Treatment Outcome

OBJECTIVE: To evaluate the electrophysiological characteristics of electrically evoked auditory brainstem responses (EABR) and its application in cochlear implantation, especially in evaluating acoustic nerve survival. METHOD: An auditory evoked potential instrument was used to record responses and Cochlear Nucleus 24CA implants were used to generate electrical stimulation. We measured EABR in 23 patients with cochlear implants and compared EABR with behavioral measures and neural response telemetry (NRT). RESULT: EABR III-V waveforms were recognized in all of the 23 patients. The characteristics and origins of EABR waveforms were similar to those of ABR. The average EABR threshold was (172.61 +/- 14.61) CL. At 20 CL above threshold, the average latencies of Wave III, V were (2.93 +/- 0.18)ms, (4.80 +/- 0.28)ms which were 1-2 ms shorter than ABR latencies. But III-V intervals remained at (1.86 +/- 0.18)ms. EABR thresholds were strongly correlated with behavioral performance and NRT thresholds, while EABR input-output function is correlated with behavioral dynamic range (DR). CONCLUSION EABR is such an effective method to objectively evaluate the function of auditory pathway which can estimate residual spiral ganglion cell count. This is consistent with the foreign study leading to the conclusion that DR reflects spiral ganglion cell survival.
Auditory Threshold ; Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Nerve ; physiopathology ; Deafness ; physiopathology ; surgery ; Evoked Potentials, Auditory, Brain Stem ; physiology ; Female ; Humans ; Infant ; Male

Initially described in 1929, Warthin's tumor is a benign neoplasm predominantly found in the parotid gland of the salivary glands. Warthin's tumor is synonymous for cystadenoma lymphomatosum, adenolymphoma, and cystadenolymphoma. This tumor usually causes minimal pain, but the patient may complain of tinnitus, pain in the ear, or deafness. The tumor is treated with surgical excision, which is easily performed due to the superficial location of the tumor. In our case, a 69-year-old man visited our clinic primarily complaining of swelling in the left parotid gland area. Computed tomography revealed well-defined margins of the tumor in the superficial lobe of the left parotid gland and heterogeneous contrast enhancement. We performed superficial parotidectomy, with the pathological examination confirming Warthin's tumor. We report a typical case of Warthin's tumor and a literature review.
Adenolymphoma ; Cystadenoma ; Deafness ; Ear ; Humans ; Parotid Gland ; Salivary Glands ; Surgery, Oral ; Tinnitus

OBJECTIVE: To evaluate the auditory performance of infants with cochlear implants at the early stage after surgery, summarize the development of auditory ability, investigate the effect of age at cochlear implantation on auditory performance within the first year after surgery and provide a reference for their habilitation program. METHOD: A total of 272 infants with prelingually profound hearing loss participated in this study, ranging in age at cochlear implantation from 18 to 36 months. The mean age was 21 months with a standard deviation of 7 months. Infants with cochlear implants were divided into three groups according to their age at implantation. Infants in group A were implanted under 18 months of age. Infants in group B were implanted between 18 and 24 months of age. Infants in group C were implanted between 25 and 36 months of age. Categories of auditory performance (CAP) was used to evaluate the auditory performance, which rates auditory abilities in eight categories for a scale of 0 to 7. RESULT: The mean scores of CAP for all infants at each interval were significantly different after implantation. Significant differences were observed in mean scores of CAP among these three groups in 1 and 3 months after switch-on. However there were no significant differences in pre-operation, 6, 9 and 12 months after switch-on. CONCLUSION There is a significant improvement in auditory performance of infants with prelingually profound hearing loss within the first year after cochlear implantation. The age at cochlear implantation has no critical influence on the development of auditory capabilities at the early stage after surgery. CAP is a practical tool which can be used in clinic in China.
Age Factors ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Deafness ; surgery ; Female ; Hearing ; Humans ; Infant

OBJECTIVETo investigate the outcomes of prelingually deafened adolescents and young adults receiving cochlear implantation (CI).

METHODSThirty-three patients with prelingual deafness aged 7-33 years at the time of CI were followed up for 4 years. The Speech Discrimination Score (SDS) was tested using disyllabic words and short sentences with close-set and open-set, respectively.

RESULTSAfter appropriate mapping, sound field audiometry with warble tone showed that the warble tone threshold average (WTA) of the patients reached 25-41 dBHL, with a mean threshold of 28.62∓2.37 dBHL. At 1 year after the operation, the mean value of SDS was 70.03% in close-set word list with lip-reading and 61.18% without lip-reading, and was improved to 82.12% and 72.67% at 4 years, respectively. In open-set word list, the mean value of SDS was 77.94% with lip-reading and 67.85% without lip-reading. The safety and the benefits-cost evaluation of CI for prelingually deafened school age children and adolescents had been recognized by 90.9% of the families involved.

CONCLUSIONThese patients can obtain appropriate speech discrimination scores with improved quality of life after CI.

Adolescent ; Adult ; Child ; Cochlear Implantation ; rehabilitation ; Deafness ; surgery ; Female ; Humans ; Male ; Young Adult

OBJECTIVE: To evaluate preverbal communication skills in Chinese deaf children with cochlear implants, and to provide a basis for designing the habilitation program and establish a precursor for outcomes of habilitation. METHOD: Thirty children with cochlear implants participated in this study with a mean age of 32 months. They all had used the cochlear implant system within 12 months with a mean of 5. 8 months. All the children were diagnosed with prelingual profound hearing loss before cochlear implantation. Tait video analysis was used to analyze and assess the preverbal communication skills including turn-taking, autonomy, eye contact and auditory awareness. All statistical analyses were performed using the SPSS 13.0 statistical software package with a criterion of statistical significance set at P < 0.05. RESULT: The skill of turn-taking developed quickly within 12 months after cochlear implantation. The vocal turn developed in a similar pattern, and the score of gesture turn decreased slowly. The skills of autonomy and appropriate eye contact showed small changes over time at a lower level. The score of auditory awareness increased gradually after surgery. CONCLUSION Children established a vocal/auditory mode of early communicative behavior following cochlear implantation. They preferred to communicate with others in a more vocal style. Video analysis is a useful tool to assess preverbal communication skills in deaf children with cochlear implants in China.
Asian Continental Ancestry Group ; Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Deafness ; surgery ; Female ; Humans ; Infant ; Language Development ; Male