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Τρίτη 26 Οκτωβρίου 2021

Otology

EDITORIAL

The limitations of pure-tone audiometry (as the gold standard test of hearing) that are worthy of consideration [pg. 1]
Mohd Normani Zakaria
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ORIGINAL ARTICLES

Inner ear malformations in cochlear implant recipients [pg. 3]
Luan Viet Tran, Vu Anh Duong, Saim Lokman
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Anatomical variations of round window in different age groups and surgical difficulties associated with them during cochlear implantation [pg. 7]
Rabindra Bhakta Pradhananga, Bigyan Raj Gyawali, Pabina Rayamajhi, Bebek Bhattarai
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Validity of modified whisper test as hearing screening method in presbycusis patients [pg. 11]
Rizki Najoan, Nyilo Purnami
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Detection of two pathogenesis previously unreported myosin xva pathogenic variants in two large Iranian pedigrees with autosomal recessive nonsyndromic hearing loss [pg. 14]
Fatemeh Azadegan-Dehkordi, Korosh Ashrafi, Gholam Reza Mobini, Nasrin Yazdanpanahi, Maryam Shirzad, Effat Farrokhi, Morteza Hashemzadeh-Chaleshtori
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Chronic suppurative otitis media and microbial flora: Adult versus pediatric population [pg. 22]
Ashish Chandra Agarwal, Anitya Srivastava, Manodeep Sen
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Risk of hepatic toxicity and drug response in patients with chronic suppurative otitis media [pg. 26]
S M Tariq Rafi, Shafaque Mehboob, Mejabeen , Naila Tariq, Hurithmina Khan, Moona Mehboob
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Speech intelligibility enhancement in elderly with high-frequency hearing loss through visual speech perception [pg. 30]
Himanshu Chaurasiya
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Effectiveness of intratympanic dexamethasone as salvage therapy in treating sudden sensorineural hearing loss [pg. 36]
Bigyan Raj Gyawali, Rabindra Bhakta Pradhanaga, Pabina Rayamajhi
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Prospective study of use of Island of tragal cartilage in revision tympanoplasty [pg. 40]
Bhavika Verma, Naresh Dawat, Yogesh G Dabholkar, Sachin J Patil
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Antimicrobial susceptibility in patients with chronic suppurative otitis media in a North-Central secondary health facility in Nigeria [pg. 44]
Solomon Joseph Hassan, Yikawe Stephen Semen, Dabit Othniel Josep, Ekuma Otu Gabriel, Osisi Kingsley, Solomon Ndudiri Calista
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Conducting Fukuda stepping test in a noisy clinic and the effects of sound [pg. 47]
Carren Sui Lin Teh, Erica Anak Gima, Hani Binti Mamat, Meng Hon Lye, Sobani Bin Din, Narayanan Prepageran
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Transoral endoscopic vestibular approach Sistrunk procedure: First reported case series

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Abstract

Background

Standard of care for management of thyroglossal duct cysts (TGDCs) is a Sistrunk procedure performed through a transcervical incision. We describe the first series of Sistrunk procedures performed through a transoral endoscopic vestibular approach, eliminating a visible external scar.

Methods

The transoral endoscopic vestibular approach to the Sistrunk (TEVAS) was performed in patients with TGDCs meeting inclusion criteria who desired a scarless approach.

Results

Six patients (five females and one male) underwent TEVAS, with a mean age of 38 years (range 16–56 years) and a mean TGDC size of 1.8 cm (range 1.1–2.4 cm). Mean operative time was approximately 5 h (range 2–8 h). There were no surgical complications or recurrences.

Conclusions

For appropriately selected patients, the TEVAS is an alternative to open neck surgery that provides improved cosmesis while maintaining successful resection outcomes. More data on outcomes including complications and recurrences are needed as additional case information is collected.

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High expression of NFX1‐123 in HPV positive head and neck squamous cell carcinomas

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Abstract

Background

High-risk human papillomaviruses (HR HPV) cause nearly all cervical cancers and, in the United States, the majority of head and neck cancers (HNSCCs). NFX1-123 is overexpressed in cervical cancers, and NFX1-123 partners with the HR HPV type 16 E6 oncoprotein to affect multiple growth, differentiation, and immune response genes. However, neither the expression of NFX1-123 nor the levels of these genes have been investigated in HPV positive (HPV+) or negative (HPV−) HNSCCs.

Methods

The Cancer Genome Atlas Splicing Variants Database and HNSCC cell lines were used to quantify expression of NFX1-123 and cellular genes increased in cervical cancers.

Results

NFX1-123 was increased in HPV+ HNSCCs compared to HPV− HNSCCs. LCE1B, KRT16, SPRR2G, and FBN2 were highly expressed in HNSCCs compared to normal tissues. Notch1 and CCNB1IP1 had greater expression in HPV+ HNSCCs compared to HPV− HNSCCs.

Conclusion

NFX1-123 and a subset of its known targets were increased in HPV+ HNSCCs.

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Hyperintensity of integrin‐targeted fluorescence agent IntegriSense750 accurately predicts flap necrosis compared to Indocyanine green

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Abstract

Background

Flap necrosis is a feared complication of reconstructive surgery. Current methods of prediction using Indocyanine green (ICG) lack specificity. IntegriSense750 is a fluorescence agent that binds sites of vascular remodeling. We hypothesized that IntegriSense750 better predicts flap compromise compared to ICG.

Methods

Fifteen mice underwent lateral thoracic artery axial flap harvest. Mice received an injection of ICG (n = 7) or IntegriSense750 (n = 8) daily from postoperative days (POD) 0–3 and were imaged daily. Mean signal-to-background ratios quantified the change in fluorescence as necrosis progressed.

Results

Mean signal-to-background ratio was significantly higher for IntegriSense750 compared to ICG on POD0 (1.47 ± 0.17 vs. 0.86 ± 0.21, p = 0.01) and daily through POD3 (2.12 ± 0.70 vs. 0.96 ± 0.29, p < 0.001).

Conclusions

IntegriSense750 demonstrates increased signal-to-background ratio at areas of flap distress compared to ICG which may increase identification of flap necrosis and improve patient outcomes.

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Cortical auditory-evoked potential as a biomarker of central auditory maturation in term and preterm infants during the first 3 months

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Clinics (Sao Paulo). 2021 Oct 18;76:e2944. doi: 10.6061/clinics/2021/e2944. eCollection 2021.

ABSTRACT

OBJECTIVES: To analyze central auditory maturation in term and preterm infants during the first 3 months of life by comparing the latency and amplitude of cortical auditory-evoked potential at different frequencies.

METHODS: In this study, 17 term and 18 preterm infants were examined; all had tested positive on the neonatal hearing screening test. Cortical auditory potential was investigated during the first and third months of life. The response of the cortical auditory-evoked potential was investigated at frequencies of 500, 1000, 2000, and 4000 Hz. The latency and amplitude of the cortical response were automatically detected and manually analyzed by three researchers with experience in electrophysiology. The results were compared using analysis of variance and the Bonferroni test. A significance level of 5% was used for all analyse s.

RESULTS: Latency values of cortical auditory-evoked potential in the first month of birth were significantly higher than those in the third month, and latency values of the preterm group were higher than those of the term group, regardless of the frequency and time of evaluation. In general, the latency of the cortical auditory-evoked potential was higher at high frequencies. Amplitude values in the third month of life were significantly higher than those in the first month for term and preterm infants.

CONCLUSION: Central auditory maturation was observed in both groups but with different results between those born at term and preterm, with latencies of cortical auditory-evoked potential higher for the preterm group and at high frequencies.

PMID:34669874 | PMC:PMC8491591 | DOI:10.6061/clinics/2021/e2944

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Conducting Fukuda stepping test in a noisy clinic and the effects of sound

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Carren Sui Lin Teh, Erica Anak Gima, Hani Binti Mamat, Meng Hon Lye, Sobani Bin Din, Narayanan Prepageran

Indian Journal of Otology 2021 27(1):47-50

Context: The Fukuda stepping test (FST) is used to assess the labyrinthine function via the vestibulospinal reflex. The test is meant to be conducted in a quiet room, but in a busy clinic setting, it is often performed in the clinic itself, and individuals are exposed to environmental sounds. Aims: The aim of this study was to assess the effects of environmental sounds and the effects of fixed directional sound on the outcome of FST. Settings and Design: This is an observational study. Subjects and Methods: Thirty healthy participants performed the FST in the otorhinolaryngology clinic, in a sound-treated room, and then in a sound-treated room with the presence of a fixed directional sound where the angle of rotation, angle of displacement, and distance of displacement were compared. Statistical Analysis Used: Independent t-test and Chi-squared test were used for statistical analysis. Results: There was no statistical difference in the angle of rotation and angle of displacement in all three settings. Although the mean distance of displacement was above 50 cm in all three settings, there was a significant reduction between clinic versus sound-treated room (P = 0.016) and clinic versus room with sound-treated directional sound (P = 0.002). Fixed directional sound had no significant influence on the direction of rotation in all the participants. Conclusions: Performing FST in the standard clinic will not affect the results. Concurrently, we suggest omitting measurement of the distance of displacement in FST as it is not reproducible in our normal sample and is highly susceptible to auditory cues but to focus on the angle of rotation.
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Chronic suppurative otitis media and microbial flora: Adult versus pediatric population

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Ashish Chandra Agarwal, Anitya Srivastava, Manodeep Sen

Indian Journal of Otology 2021 27(1):22-25

Context: Chronic suppurative otitis media (CSOM) is an inflammatory condition of the middle ear which manifests as recurrent episodes of ear discharge. Due to the inappropriate use of antibiotics, the microbiological profile and the drug sensitivity pattern is changing, leading to either inadequate treatment or recurrence. Hence, there is a need to study the microbial profile and its sensitivity pattern in order to initiate the appropriate treatment. Aim: The study has been done to evaluate the microbiological profile of ear discharge in patients of CSOM and also to assess any difference in the microbiology in the adult and pediatric population. Setting and Design: A cross-sectional record-based study was conducted in a tertiary care hospital in North India on patients diagnosed to have tubotympanic type of CSOM. Materials and Methods: The study duration was 12 months. Sterile swabs were collected from the study individuals. The organisms were isolated using the standard microbiologi cal methods and antimicrobial susceptibility test was performed using diffusion method. Statistical Analysis: Descriptive statistics were used. Appropriate parametric and nonparametric tests were applied to assess the association between various variables. Results: Amongst children, the most common isolate was Staphylococcus aureus and this was followed by Proteus mirabilis and Pseudomonas aeruginosa. Among adults, the most common organism was P. aeruginosa and this was followed by S. aureus. Conclusion: Age, environmental, and geographical conditions of an individual affect the microbiological profile. Antibiotic therapy administered in accordance to the sensitivity pattern achieves best result.
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Prospective study of use of Island of tragal cartilage in revision tympanoplasty

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Bhavika Verma, Naresh Dawat, Yogesh G Dabholkar, Sachin J Patil

Indian Journal of Otology 2021 27(1):40-43

Background: Ideal graft material in revision tympanoplasty is a topic of much research. Cartilage being sturdy and stable even in negative pressure situations, is a viable option. Aims and Objectives: The aim of the present study was to evaluate graft uptake and hearing improvement using the technique of island of tragal cartilage as a graft material in revision tympanoplasty. Materials and Methods: This was a prospective study of total of 60 Type 1 revision tympanoplasty surgeries which were done using tragal cartilage island graft from December 2017 to December 2019 in our institute with a follow-up of 3 months. Results: Graft uptake in our study was found to be 93.33%. Four patients showed a re-perforation during follow-up. The mean preoperative air-bone gap (ABG) was 28.13 dB, while the postoperative mean ABG was 16.83 dB and the mean gain was 12.83 dB. Conclusion: It is thus worthwhile to consider island of tragal cartilage as a graft material in revision tympanoplasty.
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Detection of two pathogenesis previously unreported myosin xva pathogenic variants in two large Iranian pedigrees with autosomal recessive nonsyndromic hearing loss

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Fatemeh Azadegan-Dehkordi, Korosh Ashrafi, Gholam Reza Mobini, Nasrin Yazdanpanahi, Maryam Shirzad, Effat Farrokhi, Morteza Hashemzadeh-Chaleshtori

Indian Journal of Otology 2021 27(1):14-21

Purpose: Hearing loss (HL) is a genetically heterogeneous common neurosensory disorder. Among different ethnic groups, pathogenic variants of Myosin XVa (MYO15A) at the DFNB3 locus are the common causes of autosomal recessive nonsyndromic hearing loss (ARNSHL). The aim of this study was to determine the prevalence and the type of MYO15A pathogenic variants in a subset of Iranian pedigrees with ARNSHL. Materials and Methods: Thirty-eight Iranian pedigrees with no Gap junction beta-2 pathogenic variants were included in the study. For all pedigrees, linkage analysis was performed using five short tandem repeat markers of DFNB3 locus. The DNA sequencing was then applied to identify MYO15A pathogenic variants in linked pedigrees. Results: Altogether, two out of 38 (5.3%) pedigrees were linked to locus 3. After sequencing, five previously unreported MYO15A pathogenic variants (c.1775-1776insA, c.1766-1767insC, c.7694delA, c.611G > C (G204A), and c.6442T > A (W2148R)) were revealed i n homozygous and heterozygous state in the two pedigrees studied. Furthermore, the pathogenicity of pathogenic variants was confirmated by Insilco and cosegregation analysis in this study. Conclusions: Our findings support a relatively high prevalence and specificity of MYO15A pathogenic variant among Iranian ARNSHL patients. Molecular study of MYO15A may lead to elucidation of the population-specific pathogenic variant profile, which is of importance in molecular diagnostics of HL.
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Speech intelligibility enhancement in elderly with high-frequency hearing loss through visual speech perception

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Himanshu Chaurasiya

Indian Journal of Otology 2021 27(1):30-35

Background: Pathological and physiological disabilities of human auditory receptors reduce speech intelligibility under hearing loss (HL) at high frequencies. Objectives: The objective of the study is to investigate the speech-intelligibility-enhancement (SIE) in elderly with high-frequency HL (HFHL) through visual-speech-perception (VSP). The hypothesis is that the VSP of spondee words (two-syllable words with equal stress on both syllables) is properly recognized and reproduced with HFHL. Also; to decide the statistical relevance of the precise significant difference in speech discrimination (SD) with VSP on the subjected ear. Methods: Observational and descriptive studies of SIE with VSP on 12 elderly listeners (24 clear ears; without wax impaction) with progressive and bilateral HFHL were examined. The entire experimental records were checked for distribution with normal (Gaussian) using the Shapiro–Wilk's and paired Student's t-test (parametric test) had the 5% (0.05) signific ance level (α). Results: We analyzed, improved, and better performance in SIE with HFHL through VSP. The statistical P (probability) measure was calculated nothing, i.e., 0 (P < 0.05). Therefore, investigators strongly and carefully discarded the null hypothesis consideration. There was some significant value of statistical variation also exists with VSP. Moreover, with the help of the confidence-interval analysis, the same conclusion was achieved. Conclusions: In this study, it is concluded that the elderly-individuals of this experiment, whose mother tongue and official language is Hindi and English, respectively, they demonstrate the SIE with HFHL through VSP. This investigation also helps to improve the hearing sensitivity to some extent with VSP.
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Validity of modified whisper test as hearing screening method in presbycusis patients

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Rizki Najoan, Nyilo Purnami

Indian Journal of Otology 2021 27(1):11-13

Background: Presbycusis is a hearing loss due to the degeneration process which is found at the age of more than 65 years old, with decreased hearing sensitivity in both ears, asymmetrical bilateral sensorineural detection type. Objective: To identify the validity of modified whisper test by detecting the hearing level in presbycusis patients. Methods: The design of this study was comparative, cross-sectional, prospective study. Subjects were elderly undergoing hearing monitoring at URJ Geriatric and URJ Audiology Dr. Soetomo Hospital, in August–September 2018 and examined using whisper test and audiometry. The statistical analysis used 2 × 2 tables, sensitivity, specificity, positive predictive value, and negative predictive value. Results: The lowest sensitivity at frequencies > 41–55 dB was at 100%, the lowest specificity at 100%, lowest sensitivity at frequencies >56–70 dB was at 23.07% with specificity at 100%. The positive predictive value (NRP) at frequencies > ;25–40 dB was 88.46% while the negative predictive value (NPV) was of 100%. Conclusion: The modified whisper test can be used as early detection of hearing impairment.
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