Publications by authors named "Ana H Kim"

Objective: Electrode array design may impact hearing outcomes in patients who receive cochlear implants. The goal of this work was to assess differences in post operative speech perception among patients who received cochlear implants of differing designs and lengths.

Study Design: Retrospective chart review.

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Purpose: In cochlear implantation (CI) surgery, there are a wide variety of intraoperative tests available. However, no clear guide exists on which tests must be performed as the minimum intraoperative testing battery. Toward this end, we studied the usage patterns, recommendations, and attitudes of practitioners toward intraoperative testing.

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Objectives: A wide variety of intraoperative tests are available in cochlear implantation. However, no consensus exists on which tests constitute the minimum necessary battery. We assembled an international panel of clinical experts to develop, refine, and vote upon a set of core consensus statements.

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Objective: Age-related hearing loss (ARHL) is a prevalent but often underdiagnosed and undertreated condition among individuals aged 50 and above. It is associated with various sociodemographic factors and health risks including dementia, depression, cardiovascular disease, and falls. While the causes of ARHL and its downstream effects are well defined, there is a lack of priority placed by clinicians as well as guidance regarding the identification, education, and management of this condition.

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Article Synopsis
  • - Age-related hearing loss (ARHL) is common but often goes undiagnosed in people over 50, leading to risks like dementia and falls, and there is a significant need for improved clinical focus on this issue.
  • - The clinical practice guideline aims to improve the identification and management of ARHL by providing evidence-based recommendations for clinicians, targeting individuals aged 50 and older.
  • - Key action statements emphasize the importance of screening for hearing loss, obtaining audiograms, offering appropriately fitted amplification, and evaluating candidates for cochlear implants.
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SBO is a life-threatening disease that requires a high index of suspicion based on these patients complex underlying medical co-morbidities and clinician's acumen. Once a diagnosis is made, is it critical to communicate and work closely with other multidisciplinary teams (neuroradiology for appropriate choice of imaging study and interpretation; infectious disease for appropriate medical treatment and duration; internist to properly manage their underlying medical co-morbidities). Despite advances in imaging, the diagnosis is first made based on clinical judgment, appropriate culture, and tissue biopsy.

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Article Synopsis
  • The study investigates the occurrence of ear-related symptoms, including sudden sensorineural hearing loss (SSNHL), after COVID-19 vaccination among patients in an otology clinic.
  • Out of 500 patients screened, 420 were vaccinated, with 61 (14.5%) reporting otologic symptoms like hearing loss, tinnitus, dizziness, and vertigo within four weeks of vaccination.
  • The findings suggest that the reported incidence of SSNHL is similar to that in a typical otology patient population, indicating the need for further research to explore these symptoms' causes and relationships with vaccination.
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Objective: Idiopathic sudden sensorineural hearing loss (ISSNHL) affects 66,000 patients per year in the United States. Genetic mutations have been associated with progressive hearing loss; however, genetic mutations associated with ISSNHL have not been identified.

Methods: A prospective cohort study of adults older than 18 years presenting with ISSNHL at a tertiary academic medical center.

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The COVID-19 pandemic led to a temporary lapse in the development of otolaryngology trainee operative skills due to the cancellation of elective procedures and redeployment of trainees and attendings to COVID-19 units. Although transient, this disruption provided an opportunity for otolaryngology programs to develop contingency plans and formalize nascent simulation training curricula. Integration of formal simulation training alongside current didactic and surgical education may offset lost exposure during surgically lean times while providing the framework and resources for enhanced baseline training.

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Objectives: Accumulating evidence suggests that hearing loss (HL) treatment may benefit depressive symptoms among older adults with Major Depressive Disorder (MDD), but the specific individual characteristics of those who stand to improve most are unknown.

Methods: N = 37 patients ≥60 years with HL and MDD received either active or sham hearing aids in this 12-week double-blind randomized controlled trial. A combined moderator approach was utilized in the analysis in order to examine multiple different pretreatment individual characteristics to determine the specific qualities that predicted the best depressive symptom response to hearing aids.

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Objective: This executive summary of the guideline update provides evidence-based recommendations for patient selection and surgical indications for managing tympanostomy tubes in children. The summary and guideline are intended for any clinician involved in managing children aged 6 months to 12 years with tympanostomy tubes or children being considered for tympanostomy tubes in any care setting as an intervention for otitis media of any type. The target audience includes specialists, primary care clinicians, and allied health professionals.

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Objective: Insertion of tympanostomy tubes is the most common ambulatory surgery performed on children in the United States. Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy. All these conditions are encompassed by the term (middle ear inflammation).

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Objectives: Recent research has revealed important neural and psychiatric consequences of hearing loss (HL) in older adults. This pilot study examined the neural effects of HL and the impact of hearing aids on neuropsychiatric outcomes in major depressive disorder (MDD).

Design: Twelve-week, double-blind, randomized controlled trial.

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Objective: The physical shape of cochlear implant (CI) arrays may impact hearing outcomes. The goal of this study was to compare post-operative speech and melody perception between patients with lateral wall (LW) and perimodiolar (PM) electrode arrays across a range of lengths and manufacturers.

Study Design: Retrospective chart review.

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Article Synopsis
  • The study aimed to determine if using two cochlear implants (bilateral) enhances speech perception more than using one cochlear implant and one hearing aid (bimodal).
  • Researchers compared speech perception in 50 pediatric and adult participants who received a second implant to those who only used bimodal listening, assessing performance at 1-year post-implant under various sound conditions.
  • Results showed significant improvements in speech perception for pediatric users with bilateral implants across all conditions, while adults saw less significant benefits, particularly at lower sound levels.
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Objectives: Age-related hearing loss (ARHL) is a prevalent condition associated with increased risk for depression and cognitive decline. This 12-week prospective, double-blind pilot randomized controlled trial (RCT) of hearing aids (HAs) for depressed older adults with ARHL evaluated the feasibility of a novel research design.

Methods/design: N = 13 individuals aged ≥60 years with Major Depressive Disorder or Persistent Depressive Disorder and at least mild hearing loss (pure tone average ≥ 30 dB) were randomized to receive full- (active) vs low-amplification (sham) HAs added to psychiatric treatment as usual.

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Objective: Our objective was to compare outcomes in speech and quality of life in those undergoing cochlear implantation for single-sided deafness (SSD), with the aim to characterize the clinical impact of underlying diagnosis in the affected ear and pre-operative hearing status.

Study Design: Prospective case series.

Setting: Academic Cochlear Implant Center.

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Objective: To assess whether the relationship between hearing and depressive symptoms is present among older adults classified as normal hearing (≤25 dB).

Design: Cross-sectional epidemiologic study (Hispanic Community Health Study).

Setting: US multicentered.

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Objective: To describe histologic and radiographic findings associated with insertion of a new lateral wall electrode in human temporal bones, as well as quantify the ease of insertion as characterized by multiple cochlear implant surgeons.

Setting: Multi-institutional cadaveric study.

Methods: The Slim J electrode was inserted in cadaveric temporal bones via a standard mastoidectomy and facial recess approach.

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Electroacoustic Stimulation.

Otolaryngol Clin North Am

April 2019

Electric acoustic stimulation (EAS), also known as hybrid stimulation, is indicated for individuals with intact low-frequency hearing and profound high-frequency hearing loss. Although low frequencies contribute to speech perception, these individuals are usually only able to detect vowels, but few or no consonants, and thus have difficulty with word understanding and hearing in noise. EAS uses the cochlear implant electrode array to stimulate the high frequencies within the basal turn of the cochlea coupled with a hearing aid to convey the low frequencies at the apical turn in the same ear.

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Importance: Age-related hearing loss is highly prevalent and has recently been associated with numerous morbid conditions of aging. Late-life depression is also prevalent and can be resistant to available treatments. Preliminary studies examining the association between hearing loss and late-life depression have been limited by subjective hearing measures, small sample sizes, and primarily white populations.

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Neuro-otologists rely on the expertise and judgment of a skilled neuroradiologist to identify radiographic abnormalities in the complicated regional anatomy of the temporal bone and middle and posterior fossa, and more importantly, to alert the surgeon to potential operative pitfalls. This article highlights some of the common otologic surgical procedures that stress this important dynamic. The surgical perspective on quick and effective clinical decision-making pearls to keep in mind during a thorough radiographic analysis of the ear and lateral skull base is presented.

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Recent research has linked age-related hearing loss to impaired performance across cognitive domains and increased risk for dementia diagnosis. The data linking hearing impairment to incident late-life depression are more mixed but suggest that diminished hearing does increase risk for depression. Behavioral mechanisms may explain these associations, such as the withdrawal of older adults from situations in which they may have difficulty hearing and communicating, which may contribute to the development of social isolation, loneliness, and consequent cognitive decline and depression.

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