Cochlear Implantation ; Ear, Inner/surgery* ; Hearing Loss, Sensorineural ; Humans

Ear, Inner ; physiopathology ; surgery ; Humans ; Vertigo ; surgery

Cerebellopontine Angle ; anatomy & histology ; Ear, Inner ; anatomy & histology ; Humans ; Microsurgery ; Neuroma, Acoustic ; surgery

Cerebellopontine Angle ; anatomy & histology ; Ear, Inner ; anatomy & histology ; Humans ; Microsurgery ; Neuroma, Acoustic ; surgery

OBJECTIVE: To review the classification of cochlear modiolus deficiency and decision on surgical approach for above case,in order to provide mastery for cochlear implant (CI) indication. METHOD: Basing on temporal bone HRCT pre-operation, CI subjects with modiolus deficiency were defined as following groups: (1) deficiency caused by cochlear dysplasia (Mondini malformation); (2) deficiency caused by dysplasia of cochlear and vestibule (Common cavity malformation); (3) deficiency caused by absence of internal acoustic meatus fundus (IP-III malformation). Three types of surgical approach were utilized: type I, electrode array was introduced through facial recess, enlarged the round window, type II, opened the surface of chchlea, electrode array was introduced through facial recess, fenestration on posterior promontory and then inserted around lateral wall of inner-cochlear cavity. type III, electrode array was introduce through fenestration of lateral semicircular canal and then placed close to the bony wall of common cavity. RESULT: One hundred and sixty-six cochlear modiolus deficiency cases were identified into 3 groups as following: 135 Mondini malformation cases into group a, 18 common cavity malformation cases into group b, and 13 IP-III malformation cases into group c. Surgical approach: type I were used in 136 cases (123 Mondini cases and 13 IP-III cases), while approach type II in 12 cases (12 Mondini cases), and approach type III in 18 cases (18 common cavity cases). Income post-operation of CI: For group a (Mondini malformation), post-activation mean hearing threshold in sound field was 65 dB, speech recognition score is 95% (single finals test) and 25% (signal initials test), while it was 80 dB, 60% and 0 for group b (Conmon cavity malformation), and it was 55 dB, 100% and 45% for group c (IP-III malformation). CONCLUSION The income of speech recognition score for cochlear modiolus deficiency was relatively poor, group b was worst and group c was best, while group a moderate.
Cochlea ; abnormalities ; surgery ; Cochlear Implantation ; methods ; Cochlear Implants ; Ear ; Ear, Inner ; abnormalities ; Female ; Humans ; Male ; Postoperative Period ; Round Window, Ear ; surgery ; Semicircular Canals ; surgery ; Speech Perception ; Temporal Bone ; Vestibule, Labyrinth ; abnormalities

OBJECTIVE: To discuss the surgical approach of cochlear implantation in patients with common cavity. METHOD: Seventeen patients with common cavity underwent cochlear implantations through facial recess approach or transmastoid lateral semicircular canal approach,according to the preoperative imaging and audiological evaluation. RESULT: Common cavity was opened and electrodes were inserted smoothly in all cases. Facial recess approach was used in 3 patients, while transmastoid lateral semicircular canal approach was used in the others. Intraoperative "gush" occurred in 4 cases. None of the cases developed intraoperative or postoperative complications, such as facial paralysis, meningitis and cerebrospinal fluid leakage. All cases had improvements in hearing. Atypical postoperative EABR responses were detected, the average free filed hearing threshold was 65 dB HL, the average speech recognition score of Chinese vowels was 75%, and the average speech recognition score of Chinese consonant was less than 10%. CONCLUSION (1) Selection of surgical approach for patients with common cavity: if the basal turn of cochlear could be distinguished at the posterior tympanum side of common cavity, the facial recess approach was used; if the cochlear,vestibule and the lateral semicircular canal merged to be a spherical cavity, the transmastoid lateral semicircular canal approach was used. (2) Surgical approach of cochlear implantation affected the postoperative outcomes. (3) Outcomes of cochlear implantation in common cavity patients were much poorer than normal cochlear cases.
Adolescent ; Child ; Child, Preschool ; Cochlea ; abnormalities ; Cochlear Implantation ; methods ; Cochlear Implants ; Ear Diseases ; surgery ; Ear, Inner ; abnormalities ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Semicircular Canals ; abnormalities ; Vestibule, Labyrinth ; abnormalities

OBJECTIVE: To investigate the intra-operative electrical evoked auditory brain stem response (EABR) characteristics and the hearing and speech rehabilitation effects of cochlear implantation (CI) in patients with internal auditory canal stenosis (IACS). METHOD: A retrospective study was performed on 16 patients with IACS (IACS group) matched with 16 implanted without IACS (control group), who received multi- channel CI because of pre-lingual sensorineural hearing loss. The integrity and functional status of the auditory pathway were assessed by EABR, recording waveforms, thresholds and dynamic ranges intra-operation before CI. Interviewed the implanted parents or teachers, asking them to rate the implanted hearing and speech ability according to Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). Paired T test was performed to compare scores of CAP and SIR between before and 1 year after CI, while Spearman test was performed to compare correlation between EABR grades and post-operative CAP scores. RESULT: Among the IACS group, 2 cases weren't recorded typical EABR waveforms and without auditory response 1 year after a successful CI. The EABR waveforms in the IACS group were poorer than that in the control group, their EABR thresholds higher than the control group, and their EABR dynamic ranges less than the control group. The hearing and speech rehabilitation after CI showed that the results of CAP and SIR values (3.47 +/- 1.09 and 1.62 +/- 0.50) scored significantly lower than the control group (5.06 +/- 0.79 and 2.59 +/- 0.58) (P < 0.05), but significantly increased compared with pre-operation. Intra-operative EABR grades and post-operative CAP scores showed significant correlation (r = 0.78 , P < 0.05). CONCLUSION Intra-operative EABR can accurately monitor the integrity and functional status of the auditory pathway, be of important clinical value in predicting whether patients can acquire auditory responses with the aid of CI. CI can help patients with IACS to improve the ability of hearing and speech with EABR to screen out compatible implanted.
Adolescent ; Auditory Pathways ; Child ; Child, Preschool ; Cochlear Implantation ; Constriction, Pathologic ; Ear, Inner ; surgery ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Infant ; Labyrinth Diseases ; physiopathology ; surgery ; Male ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the changes and determine the difference of electrode impedance and neural response telemetry ( NRT) value with cochlear implants in children with malformed inner ear and normal inner ear. METHOD: Eighty-eight children with multi-channel cochlear implants participated in this study. Children were divided into malformed inner ear group and normal inner ear group. To test the electrode impedance values and NRT value. RESULT: The changes of electrode impedance showed the similar changing pattern in two groups. There was not different in electrode impedance values between the two groups (P > 0.05). The changes of electrode neural response telemetry values showed the similar changing pattern in two groups. There was significantly different in electrode impedance values between the two groups (P < 0.05). The NRT were going up higher from electrode 22 to electrode 1. CONCLUSION The values vary are different programming sessions and electrodes during the first 3 months of cochlear implant use. To acquire better hearing frequent programming sessions are necessary.
Adolescent ; Case-Control Studies ; Child ; Child, Preschool ; Cochlear Implantation ; Cochlear Implants ; Cochlear Nerve ; Ear, Inner ; abnormalities ; physiopathology ; surgery ; Electric Impedance ; Electrodes ; Female ; Humans ; Infant ; Male

OBJECTIVE: To evaluate the clinical manifestation of Mondini dysplasia with cerebrospinal fluid leakage and investigate the effect of the surgical repair through trans-horizontal semicircular canal and vestibule approach. METHOD: Four cases which were operated by the approach of trans-horizontal semicircular canal and vestibule in our hospital were analyzed retrospectively. RESULT: The leakages were all stopped by the primary surgical closure after six-month follow up. CONCLUSION Mondini dysplasia should be considered in children or teenagers with recurrent bacterial meningitis whether or not with otorhinorrhea. Pure tone audiometry and a temporal bone CT or MRI will confirm the diagnosis. A trans-horizontal semicircular canal and vestibule approach is an effective and simple way for the treatment.
Adolescent ; Cerebrospinal Fluid Rhinorrhea ; complications ; surgery ; Child ; Child, Preschool ; Ear, Inner ; abnormalities ; Female ; Humans ; Male ; Retrospective Studies ; Semicircular Canals ; surgery ; Vestibule, Labyrinth ; surgery

To understand whether some amino acids in the medial vestibular nucleus (MVN) of conscious rats are involved in the regulation of blood pressure, microdialysis technique and high performance liquid chromatography (HPLC) were used to measure the changes of gamma-aminobutyric acid (GABA) and glycine (Gly) in this central area. Wistar rats (250-350 g) were randomly divided into three experimental groups: the control group with intact labyrinths; the ipsilateral MVN of unilateral labyrinthectomy (UL); contralateral MVN of the UL. Acute hypotension was induced by intravenous infusion of sodium nitroprusside (SNP). Unilateral chemical labyrinthectomy was performed 14 days before the start of the experiment to eliminate afferent signals from the peripheral vestibular receptors in the inner ear. Blood pressure decreased by 30% after SNP injection. In the control group, GABA and Gly release reduced to 43.53%+/-6.58% (P<0.01) and 62.24%+/-7.51% (P<0.01) respectively in the MVN following SNP-induced acute hypotension in conscious rats. In the contralateral MVN of UL, GABA and Gly release also reduced to 45.85%+/-17.27% (P<0.01) and 73.30%+/-3.00% (P<0.01) respectively following SNP-induced acute hypotension in conscious rats. In contrast, in the ipsilateral MVN of UL, GABA and Gly releases were not changed following SNP-induced acute hypotension in conscious rats. These results suggest that the SNP-induced acute hypotension may influence the activity of the neurons in the MVN by the afferent impulses from the peripheral vestibular organ, and that GABA and Gly may be involved in this process.
Acute Disease ; Animals ; Chromatography, High Pressure Liquid ; Ear, Inner ; physiology ; surgery ; Glycine ; metabolism ; Hypotension ; metabolism ; physiopathology ; Male ; Microdialysis ; Random Allocation ; Rats ; Rats, Wistar ; Vestibular Nuclei ; metabolism ; physiology ; gamma-Aminobutyric Acid ; metabolism