Journal of Clinical Medicine

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12 pages, 1932 KiB

Open AccessArticle

High Heterogeneity of Temporal Bone CT Aspects in Osteogenesis Imperfecta Is Not Linked to Hearing Loss

by Aïcha Ltaief-Boudrigua, Genevieve Lina-Granade, Eric Truy, Ruben Hermann and Guillaume Chevrel

J. Clin. Med. 2022, 11(8), 2171; https://doi.org/10.3390/jcm11082171 - 13 Apr 2022

Cited by 1 | Viewed by 1609

Abstract

Objectives: To determine whether temporal bone computed tomography (CT) features are linked to the presence and type of hearing loss in osteogenesis imperfecta (OI) when considering hearing-impaired OI patients and normally hearing (NH) OI ones. A secondary objective was to assess whether other [...] Read more.

Objectives: To determine whether temporal bone computed tomography (CT) features are linked to the presence and type of hearing loss in osteogenesis imperfecta (OI) when considering hearing-impaired OI patients and normally hearing (NH) OI ones. A secondary objective was to assess whether other factors influence CT features in a large sample: age, type of mutation, or bone mineral density (BMD). Methods: A total of 41 adults with OI underwent CTs and pure-tone audiometry in 82 ears. Hearing thresholds were normal in 64 out of 82 ears, and most had not been operated on for stapedectomy or stapedotomy. Ossicle density, footplates, oval and round windows, retrofenestral peri- and endolabyrinths, and temporal pneumatization were analyzed twice by an experienced radiologist. CT features were compared to hearing, age, collagen mutations, and bone mineral density. Results: Unexpectedly a high prevalence of footplate, ossicle, and otic capsule anomalies was observed, even in NH ears. Footplate hypodensity or thickening was mostly found in ears without conductive hearing loss. There were significantly more retrofenestral anomalies or window obstruction in ears with a sensorineural hearing loss component than in ears without. Age was significantly higher in ears with middle layer hypodensity than in ears without. Patients with mutations were expected to have reduced collagen quantity and had significantly more footplate or retrofenestral anomalies than those with qualitative mutations. BMD was significantly higher in ears without temporal hyperpneumatization. Conclusion: Temporal bone CT features in OI are present in a large proportion of patients, had they hearing loss or not, and might be determined more by collagen mutation type than by age or BMD. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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12 pages, 4578 KiB

Open AccessArticle

Analysis of Neural Interface When Using Modiolar Electrode Stimulation. Radiological Evaluation, Trans-Impedance Matrix Analysis and Effect on Listening Effort in Cochlear Implantation

by Angel Ramos-de-Miguel, Juan Carlos Falcón-González and Angel Ramos-Macias

J. Clin. Med. 2021, 10(17), 3962; https://doi.org/10.3390/jcm10173962 - 31 Aug 2021

Cited by 6 | Viewed by 2513

Abstract

Background: The proximity of the electrode to the modiolar wall may be of interest to investigate the effect of pitch discrimination. This research establishes the relation between these factors and whether perimodiolar positions may provide benefits regarding improved electrode discrimination. Methods: A prospective [...] Read more.

Background: The proximity of the electrode to the modiolar wall may be of interest to investigate the effect of pitch discrimination. This research establishes the relation between these factors and whether perimodiolar positions may provide benefits regarding improved electrode discrimination. Methods: A prospective randomized study including 24 post-lingual deaf adults was performed. A psychoacoustic study was done by using a psychoacoustic research platform. Radiological study, and a cone-beam computed tomography was used to assess post cochlear implantation electrodes’ position. Trans-impedance matrix (TIM) analysis was performed after cochlear implant insertion in all cases, and pupillometry test was also performed. Results: 12 patients received a slim perimodiolar electrode array, and 12 patients received a straight electrode array. Although all the patients showed similar speech test results after 12 months follow-up, those implanted with a perimodiolar electrode obtained better scores in electrode discrimination test and pupillometry test, and showed more homogenous TIM patterns. Conclusions: The better positioning of the electrode array seams to provide a better hearing resolution and less listening effort trans-impedance matrix seems to be a useful tool to analyze positioning of the perimodiolar array. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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18 pages, 4061 KiB

Open AccessArticle

Investigating Real-World Benefits of High-Frequency Gain in Bone-Anchored Users with Ecological Momentary Assessment and Real-Time Data Logging

by Arjan J. Bosman, Jeppe Høy Christensen, Tove Rosenbom, François Patou, Arno Janssen and Myrthe K. S. Hol

J. Clin. Med. 2021, 10(17), 3923; https://doi.org/10.3390/jcm10173923 - 30 Aug 2021

Cited by 7 | Viewed by 2016

Abstract

Purpose: To compare listening ability (speech reception thresholds) and real-life listening experience in users with a percutaneous bone conduction device (BCD) with two listening programs differing only in high-frequency gain. In situ real-life experiences were recorded with ecological momentary assessment (EMA) techniques combined [...] Read more.

Purpose: To compare listening ability (speech reception thresholds) and real-life listening experience in users with a percutaneous bone conduction device (BCD) with two listening programs differing only in high-frequency gain. In situ real-life experiences were recorded with ecological momentary assessment (EMA) techniques combined with real-time acoustical data logging and standard retrospective questionnaires. Methods: Nineteen experienced BCD users participated in this study. They all used a Ponto 4 BCD from Oticon Medical during a 4-week trial period. Environmental data and device parameters (i.e., device usage and volume control) were logged in real-time on an iPhone via a custom iOS research app. At the end of the trial period, subjects filled in APHAB, SSQ, and preference questionnaires. Listening abilities with the two programs were evaluated with speech reception threshold tests. Results: The APHAB and SSQ questionnaires did not reveal any differences between the two listening programs. The EMAs revealed group-level effects, indicating that in speech and noisy listening environments, subjects preferred the default listening program, and found the program with additional high-frequency gain too loud. This finding was corroborated by the volume log—subjects avoided the higher volume control setting and reacted more to changes in environmental sound pressure levels when using the high-frequency gain program. Finally, day-to-day changes in EMAs revealed acclimatization effects in the listening experience for ratings of “sound quality” and “program suitability” of the BCD, but not for ratings of “loudness perception” and “speech understanding”. The acclimatization effect did not differ among the listening programs. Conclusion: Adding custom high-frequency amplification to the BCD target-gain prescription improves speech reception in laboratory tests under quiet conditions, but results in poorer real-life listening experiences due to loudness. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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7 pages, 1551 KiB

Open AccessArticle

Prognostic Value of Trial Round Window Stimulation for Selection of Candidates for Cochlear Implantation as Treatment for Tinnitus

by Laure Poels, Andrzej Zarowski, Marc Leblans, Robby Vanspauwen, Joost van Dinther and Erwin Offeciers

J. Clin. Med. 2021, 10(17), 3793; https://doi.org/10.3390/jcm10173793 - 25 Aug 2021

Cited by 5 | Viewed by 1716

Abstract

Electrical stimulation with cochlear implants is able to significantly suppress the tinnitus sensations in 25–72% of implanted patients. Up to this point, no clear predictors for the effectiveness of tinnitus suppression with cochlear implants have been found and this substantially limits the possibility [...] Read more.

Electrical stimulation with cochlear implants is able to significantly suppress the tinnitus sensations in 25–72% of implanted patients. Up to this point, no clear predictors for the effectiveness of tinnitus suppression with cochlear implants have been found and this substantially limits the possibility of the application of cochlear implants for this purpose. The objective of the study was to investigate if a trial electrical round window stimulation (RWS) could be used as a diagnostic tool for identifying candidates in whom electrical stimulation would be successful as treatment for tinnitus. Thirty-four patients with unilateral severe tinnitus and ipsilateral moderate to severe sensorineural hearing loss underwent a trial RWS under local anesthesia. Thirteen patients received a cochlear implant. All patients qualified for cochlear implantation on the basis of the trial RWS showed tinnitus suppression with the implant switched on. Complete or almost complete tinnitus suppression was obtained in 77% and partial in 23%. The mean tinnitus loudness reduction was 68% (VAS score reduction from 7.7 to 2.5). False negative results are estimated not to exceed 10–15%. We conclude that significant tinnitus suppression achieved during trial RWS under local anesthesia is a simple procedure allowing the efficient identification of candidates in whom electrical stimulation with a cochlear implant would be successful as treatment for intractable tinnitus. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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13 pages, 2701 KiB

Open AccessArticle

Evaluation of the Efficacy of Dexamethasone-Eluting Electrode Array on the Post-Implant Cochlear Fibrotic Reaction by Three-Dimensional Immunofluorescence Analysis in Mongolian Gerbil Cochlea

by Philippine Toulemonde, Michaël Risoud, Pierre Emmanuel Lemesre, Cyril Beck, Jean Wattelet, Meryem Tardivel, Juergen Siepmann and Christophe Vincent

J. Clin. Med. 2021, 10(15), 3315; https://doi.org/10.3390/jcm10153315 - 28 Jul 2021

Cited by 10 | Viewed by 2867

Abstract

Cochlear implant is the method of choice for the rehabilitation of severe to profound sensorineural hearing loss. The study of the tissue response to cochlear implantation and the prevention of post-cochlear-implant damages are areas of interest in hearing protection research. The objective was [...] Read more.

Cochlear implant is the method of choice for the rehabilitation of severe to profound sensorineural hearing loss. The study of the tissue response to cochlear implantation and the prevention of post-cochlear-implant damages are areas of interest in hearing protection research. The objective was to assess the efficacy of dexamethasone-eluting electrode array on endo canal fibrosis formation by three-dimensional immunofluorescence analysis in implanted Mongolian gerbil cochlea. Two trials were conducted after surgery using Mongolian gerbil implanted with dexamethasone-eluting or non-eluting intracochlear electrode arrays. The animals were then euthanised 10 weeks after implantation. The cochleae were prepared (electrode array in place) according to a 29-day protocol with immunofluorescent labelling and tissue clearing. The acquisition was carried out using light-sheet microscopy. Imaris software was then used for three-dimensional analysis of the cochleae and quantification of the fibrotic volume. The analysis of 12 cochleae showed a significantly different mean volume of fibrosis (2.16 × 10⁸ μm³ ± 0.15 in the dexamethasone eluting group versus 3.17 × 10⁸ μm³ ± 0.54 in the non-eluting group) (p = 0.004). The cochlear implant used as a corticosteroid delivery system appears to be an encouraging device for the protection of the inner ear against fibrosis induced by implantation. Three-dimensional analysis of the cochlea by light-sheet microscopy was suitable for studying post-implantation tissue damage. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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11 pages, 1316 KiB

Open AccessArticle

Rates, Indications, and Speech Perception Outcomes of Revision Cochlear Implantations

by Doron Sagiv, Yifat Yaar-Soffer, Ziva Yakir, Yael Henkin and Yisgav Shapira

J. Clin. Med. 2021, 10(15), 3215; https://doi.org/10.3390/jcm10153215 - 21 Jul 2021

Cited by 6 | Viewed by 2206

Abstract

Revision cochlear implant (RCI) is a growing burden on cochlear implant programs. While reports on RCI rate are frequent, outcome measures are limited. The objectives of the current study were to: (1) evaluate RCI rate, (2) classify indications, (3) delineate the pre-RCI clinical [...] Read more.

Revision cochlear implant (RCI) is a growing burden on cochlear implant programs. While reports on RCI rate are frequent, outcome measures are limited. The objectives of the current study were to: (1) evaluate RCI rate, (2) classify indications, (3) delineate the pre-RCI clinical course, and (4) measure surgical and speech perception outcomes, in a large cohort of patients implanted in a tertiary referral center between 1989–2018. Retrospective data review was performed and included patient demographics, medical records, and audiologic outcomes. Results indicated that RCI rate was 11.7% (172/1465), with a trend of increased RCI load over the years. The main indications for RCI were device-related failures (soft-45.4%, hard-23.8%), medical failure (14%), trauma (8.1%), and surgical failure (6.4%). Success rate was 98.8%. Children comprised 78% (134) of the cohort and were more likely than adults to undergo RCI. Most (70%) of the RCIs were performed within 10 years from primary implantation. Speech perception outcome analysis revealed unchanged or improved performance in 85% of the cases and declined performance in 15%. Current findings confirm that RCI is a safe with high clinical efficacy; however, the non-negligible percentage of patients that exhibited declined performance post-RCI should be considered in decision-making processes regarding RCI. Routine follow-up during their first years post-implantation is warranted. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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12 pages, 1955 KiB

Open AccessArticle

Conductive Hearing Loss with Age—A Histologic and Audiometric Evaluation

by Ivo Dobrev, Daniel Dillinger, Letizia Meier, Dorothe Veraguth, Flurin Pfiffner, Rudolf Probst and Christof Röösli

J. Clin. Med. 2021, 10(11), 2341; https://doi.org/10.3390/jcm10112341 - 27 May 2021

Cited by 5 | Viewed by 2104

Abstract

A retrospective analysis to quantify age-related changes of the incudo-malleolar joint (IMJ) and incudo-stapedial joint (ISJ), and to analyse changes in the air-bone gap (ABG) with age, was performed. Defined histologic parameters of 153 IMJ and 106 ISJ from subjects aged from birth [...] Read more.

A retrospective analysis to quantify age-related changes of the incudo-malleolar joint (IMJ) and incudo-stapedial joint (ISJ), and to analyse changes in the air-bone gap (ABG) with age, was performed. Defined histologic parameters of 153 IMJ and 106 ISJ from subjects aged from birth to 70 years were correlated to age. Additionally, audiograms of 1760 ears of 974 other subjects aged 20 to 80 years were retrospectively analysed and the ABG was correlated to age. The joint space (age group from 0 to 10 compared to 61 to 70 years) became significantly wider with age (IMJ: from a mean of 44 µm to 100 µm, p < 0.001; ISJ: from a mean of 28 µm to 69 µm, p < 0.009. The thickness of cartilage of the incus decreased in the first 20 years of life (IMJ, from a mean of 88 µm to 65 µm, p < 0.01; ISJ: from a mean of 44 µm to 35 µm, p < 0.01). The ABGs of younger ears (20–40 years) was significantly larger at 500 Hz compared to older ears (60–80 years) by 2–4 dB, while it was significantly smaller by 3–5 dB at 4000 Hz (p < 0.0017). Interindividual variations in all age groups were large for both analyses. The increased joint spaces could potentially reduce the stiffness in the joints and explain the increase in ABG at 4000 Hz and the drop at 500 Hz. While the average change is small and of minimal clinical relevance, a larger increase of ABG with age is seen in some subjects. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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31 pages, 2197 KiB

Open AccessArticle

Rapid Assessment of Non-Verbal Auditory Perception in Normal-Hearing Participants and Cochlear Implant Users

by Agathe Pralus, Ruben Hermann, Fanny Cholvy, Pierre-Emmanuel Aguera, Annie Moulin, Pascal Barone, Nicolas Grimault, Eric Truy, Barbara Tillmann and Anne Caclin

J. Clin. Med. 2021, 10(10), 2093; https://doi.org/10.3390/jcm10102093 - 13 May 2021

Cited by 9 | Viewed by 3227

Abstract

In the case of hearing loss, cochlear implants (CI) allow for the restoration of hearing. Despite the advantages of CIs for speech perception, CI users still complain about their poor perception of their auditory environment. Aiming to assess non-verbal auditory perception in CI [...] Read more.

In the case of hearing loss, cochlear implants (CI) allow for the restoration of hearing. Despite the advantages of CIs for speech perception, CI users still complain about their poor perception of their auditory environment. Aiming to assess non-verbal auditory perception in CI users, we developed five listening tests. These tests measure pitch change detection, pitch direction identification, pitch short-term memory, auditory stream segregation, and emotional prosody recognition, along with perceived intensity ratings. In order to test the potential benefit of visual cues for pitch processing, the three pitch tests included half of the trials with visual indications to perform the task. We tested 10 normal-hearing (NH) participants with material being presented as original and vocoded sounds, and 10 post-lingually deaf CI users. With the vocoded sounds, the NH participants had reduced scores for the detection of small pitch differences, and reduced emotion recognition and streaming abilities compared to the original sounds. Similarly, the CI users had deficits for small differences in the pitch change detection task and emotion recognition, as well as a decreased streaming capacity. Overall, this assessment allows for the rapid detection of specific patterns of non-verbal auditory perception deficits. The current findings also open new perspectives about how to enhance pitch perception capacities using visual cues. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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8 pages, 524 KiB

Open AccessArticle

Association between Sudden Sensorineural Hearing Loss and Lyme Disease

by Klaudia Sowula, Joanna Szaleniec, Kamila Stolcman, Piotr Ceranowicz, Sebastian Kocoń and Jerzy Tomik

J. Clin. Med. 2021, 10(5), 1130; https://doi.org/10.3390/jcm10051130 - 8 Mar 2021

Cited by 8 | Viewed by 3019

Abstract

Objectives: Sudden sensorineural hearing loss (SSNHL) is defined as sensorineural hearing loss of 30 dB or more over at least three adjacent audiometric frequencies occurring within a 72-h period of time. One of the causes of SSNHL could be the progressive inflammatory state [...] Read more.

Objectives: Sudden sensorineural hearing loss (SSNHL) is defined as sensorineural hearing loss of 30 dB or more over at least three adjacent audiometric frequencies occurring within a 72-h period of time. One of the causes of SSNHL could be the progressive inflammatory state caused by an infection. The aim of this study was to assess the prevalence of SSNHL caused by various factors, most importantly those potentially related to Lyme disease. Material and Methods: The study includes a group of 86 patients between the ages of 20 and 70 who were hospitalized due to SSNHL between 2017 and 2018. All of these patients underwent a detailed medical interview and an otolaryngological examination, including audiological and diagnostic tests. Additionally, ELISA and Western blot tests were performed to confirm the diagnosis of Lyme disease. Results: In this group of 86 patients, nine patients presented with positive antibodies toward Borrelia burgdorferi sensu lato. This group was treated with antibiotics and experienced partial or complete regression of their deafness. This may suggest a relationship between SSNHL and Lyme disease. Conclusion: Infections caused by Borrelia burgdorferi may contribute to the development of inflammatory and angiopathic lesions, which are a possible cause of SSNHL. The longer the duration of the infection, the greater the likelihood of permanent and irreversible changes in the vessels of the cochlea or auditory nerve. Therefore, serological tests for Borrelia burgdorferi should be performed during the diagnosis of SSNHL as a possible cause of this illness. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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11 pages, 3310 KiB

Open AccessArticle

Otosurgery with the High-Definition Three-Dimensional (3D) Exoscope: Advantages and Disadvantages

by Małgorzata Wierzbicka, Witold Szyfter, Grażyna Greczka and Wojciech Gawęcki

J. Clin. Med. 2021, 10(4), 777; https://doi.org/10.3390/jcm10040777 - 16 Feb 2021

Cited by 16 | Viewed by 3315

Abstract

Background: The aim of the study was to describe our initial experience with the high-definition three-dimensional (3D) exoscope for middle ear surgery versus the operating microscope. Methods: The study included 60 randomly chosen patients diagnosed with otosclerosis (n = 30) or chronic [...] Read more.

Background: The aim of the study was to describe our initial experience with the high-definition three-dimensional (3D) exoscope for middle ear surgery versus the operating microscope. Methods: The study included 60 randomly chosen patients diagnosed with otosclerosis (n = 30) or chronic otitis media (n = 30) with a clinical indication for surgery. The primary measurement was the subjective estimation of quality of the visibility of the operating field provided by the 3D exoscope—VITOM-3D (Karl Storz, Tuttlingen, Germany) in comparison to the operating microscope. Results: All procedures, except for two (3.3%) converted to the microscope, were successfully completed using a 3D exoscope. In both stapedotomy and tympanoplasty, the exoscope was superior to the microscope during more superficial portions of the procedures. By contrast, in deeper areas of the middle ear, the exoscope provided significantly worse visibility, but usually not suboptimal. Both intraoperative bleeding and the narrow surgical field substantially reduced the visibility with the 3D exoscope in comparison to the microscope. Conclusions: Overall, our study shows that the 3D exoscope offers excellent, highly magnified, and well-illuminated high-definition images of the surgical field. However, our experience revealed several important limitations of this system, including decreased depth perception in deep areas of the tympanic cavity and reduced visibility in a difficult surgical field, with subsequent need to switch to an operating microscope in select cases. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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17 pages, 1785 KiB

Open AccessArticle

Word Recognition and Frequency Selectivity in Cochlear Implant Simulation: Effect of Channel Interaction

by Pierre-Antoine Cucis, Christian Berger-Vachon, Hung Thaï-Van, Ruben Hermann, Stéphane Gallego and Eric Truy

J. Clin. Med. 2021, 10(4), 679; https://doi.org/10.3390/jcm10040679 - 10 Feb 2021

Cited by 6 | Viewed by 3014

Abstract

In cochlear implants (CI), spread of neural excitation may produce channel interaction. Channel interaction disturbs the spectral resolution and, among other factors, seems to impair speech recognition, especially in noise. In this study, two tests were performed with 20 adult normal-hearing (NH) subjects [...] Read more.

In cochlear implants (CI), spread of neural excitation may produce channel interaction. Channel interaction disturbs the spectral resolution and, among other factors, seems to impair speech recognition, especially in noise. In this study, two tests were performed with 20 adult normal-hearing (NH) subjects under different vocoded simulations. First, there was a measurement of word recognition in noise while varying the number of selected channels (4, 8, 12 or 16 maxima out of 20) and the degree of simulated channel interaction (“Low”, “Medium” and “High”). Then, there was an evaluation of spectral resolution function of the degree of simulated channel interaction, reflected by the sharpness (Q10dB) of psychophysical tuning curves (PTCs). The results showed a significant effect of the simulated channel interaction on word recognition but did not find an effect of the number of selected channels. The intelligibility decreased significantly for the highest degree of channel interaction. Similarly, the highest simulated channel interaction impaired significantly the Q10dB. Additionally, a strong intra-individual correlation between frequency selectivity and word recognition in noise was observed. Lastly, the individual changes in frequency selectivity were positively correlated with the changes in word recognition when the degree of interaction went from “Low” to “High”. To conclude, the degradation seen for the highest degree of channel interaction suggests a threshold effect on frequency selectivity and word recognition. The correlation between frequency selectivity and intelligibility in noise supports the hypothesis that PTCs Q10dB can account for word recognition in certain conditions. Moreover, the individual variations of performances observed among subjects suggest that channel interaction does not have the same effect on each individual. Finally, these results highlight the importance of taking into account subjects’ individuality and to evaluate channel interaction through the speech processor. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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11 pages, 4842 KiB

Open AccessArticle

The Impact of Virtual Reality Training on the Quality of Real Antromastoidectomy Performance

by Wojciech Gawęcki, Magdalena Węgrzyniak, Patrycja Mickiewicz, Maria Bratumiła Gawłowska, Marcin Talar and Małgorzata Wierzbicka

J. Clin. Med. 2020, 9(10), 3197; https://doi.org/10.3390/jcm9103197 - 2 Oct 2020

Cited by 11 | Viewed by 2634

Abstract

Background: The aim of this paper is to analyze the results of virtual reality (VR) antromastoidectomy simulation training and the transferability of the obtained skills to real temporal bone surgery. Methods: The study was conducted prospectively on a group of 10 physicians, and [...] Read more.

Background: The aim of this paper is to analyze the results of virtual reality (VR) antromastoidectomy simulation training and the transferability of the obtained skills to real temporal bone surgery. Methods: The study was conducted prospectively on a group of 10 physicians, and was composed of five VR simulation training sessions followed by live temporal bone surgery. The quality of performance was evaluated with a Task-Based Checklist (TBC) prepared by John Hopkins Hospital. Additionally, during every VR session, the number and type of mistakes (complications) were noted. Results: The quality of performance measured by the TBC increased significantly during consecutive VR sessions. The mean scores for the first and fifth sessions were 1.84 and 4.27, respectively (p < 0.001). Furthermore, the number of mistakes in consecutive VR sessions was gradually reduced from 11 to 0. During supervised surgery, all the participants were able to perform at least part of an antromastoidectomy, and the mean TBC score was 3.57. There was a significant strong positive correlation between the individual results of the fifth VR session and the individual results of supervised surgery in the operating room (r_p = 0.89, p = 0.001). Conclusions: Virtual reality for temporal bone training makes it possible to acquire surgical skills in a safe environment before performing supervised surgery. Furthermore, the individual final score of virtual antromastoidectomy training allows a prediction of the quality of performance in real surgery. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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6 pages, 635 KiB

Open AccessBrief Report

On the Effect of Bimodal Rehabilitation in Asymmetric Hearing Loss

by Simonetta Monini, Chiara Filippi, Alessandra De Luca, Gerardo Salerno and Maurizio Barbara

J. Clin. Med. 2021, 10(17), 3927; https://doi.org/10.3390/jcm10173927 - 31 Aug 2021

Cited by 1 | Viewed by 1549

Abstract

Background: Bone conductive implants (BCI) have been reported to provide greater beneficial effects for the auditory and perceptual functions of the contralateral ear in patients presenting with asymmetric hearing loss (AHL) compared to those with single-sided deafness (SSD). The aim of the study [...] Read more.

Background: Bone conductive implants (BCI) have been reported to provide greater beneficial effects for the auditory and perceptual functions of the contralateral ear in patients presenting with asymmetric hearing loss (AHL) compared to those with single-sided deafness (SSD). The aim of the study was to assess the effects of wearing a conventional hearing aid in the contralateral ear on BCI in terms of an improved overall auditory performance. Methods: eleven AHL subjects wearing a BCI in their worse hearing ear underwent an auditory evaluation by pure tone and speech audiometry in free field. This study group was obtained by adding to the AHL patients those SSD subjects that, during the follow-up, showed deterioration of the hearing threshold of the contralateral ear, thus presenting with the features of AHL. Four different conditions were tested and compared: unaided, with BCI only, with contralateral hearing aid (CHA) only and with BCI combined with CHA. Results: all of the prosthetic conditions caused a significant improvement with respect to the unaided condition. When a CHA was adopted, its combination with the BCI showed significantly better auditory performances than those achieved with the BCI only. Conclusions: the present study suggests the beneficial role of a CHA in BCI-implanted AHL subjects in terms of overall auditory performance. Full article

(This article belongs to the Special Issue Intervention, Diagnosis and Treatment of Hearing Loss and Related Problems)

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