Mild matters: trial learnings and importance of community engagement in research for early identified bilateral mild hearing loss.

Introduction: Early identification of mild hearing loss has resulted in early hearing amplification without adequate evidence of effectiveness. This paper describes learnings from a pilot trial, combined with a qualitative study, to highlight the importance of community engagement in designing research studies to determine whether early amplification benefits young children with bilateral mild hearing loss.

Methods: PART 1 of the study is a proof-of-concept non-blinded multi-centre randomised controlled trial (RCT) of hearing device fitting vs.

Electrocochleography triggered intervention successfully preserves residual hearing during cochlear implantation: Results of a randomised clinical trial.

Background: Preservation of natural hearing during cochlear implantation is associated with improved speech outcomes, however more than half of implant recipients lose this hearing. Real-time electrophysiological monitoring of cochlear output during implantation, made possible by recording electrocochleography using the electrodes on the cochlear implant, has shown promise in predicting hearing preservation. Sudden drops in the amplitude of the cochlear microphonic (CM) have been shown to predict more severe hearing losses.

Intraoperative Observational Real-time Electrocochleography as a Predictor of Hearing Loss After Cochlear Implantation: 3 and 12 Month Outcomes.

Objective: A decrease in intracochlear electrocochleographic (ECochG) amplitude during cochlear implantation has been associated with poorer postoperative hearing preservation in several short-term studies. Here, we relate the stability of ECochG during surgery to hearing preservation at 3- and 12-months.

Methods: Patients with hearing ≤80-dB HL at 500 Hz were implanted with a slim-straight electrode array.

Cochlear Patency After Translabyrinthine Vestibular Schwannoma Surgery.

Objectives: To determine the temporal occurrence of fluid signal changes on T2-weighted magnetic resonance imaging (T2MRI) that occur in the cochlear lumen after translabyrinthine surgery.

Study Design: Retrospective case control study.

Setting: Tertiary referral neurotology center.

Electrophysiological Evidence of the Basilar-Membrane Travelling Wave and Frequency Place Coding of Sound in Cochlear Implant Recipients.

Aim: To obtain direct evidence for the cochlear travelling wave in humans by performing electrocochleography from within the cochlea in subjects implanted with an auditory prosthesis.

Background: Sound induces a travelling wave that propagates along the basilar membrane, exhibiting cochleotopic tuning with a frequency-dependent phase delay. To date, evoked potentials and psychophysical experiments have supported the presence of the travelling wave in humans, but direct measurements have not been made.

Hearing Preservation Outcomes for 139 Cochlear Implant Recipients Using a Thin Straight Electrode Array.

Objective: To assess the hearing preservation outcomes in a large group of adult cochlear implant recipients implanted with a thin straight electrode array using atraumatic surgical techniques. Factors affecting hearing preservation will be investigated.

Study Design: Prospective cohort study undertaken at the Royal Victorian Eye and Ear Hospital in Melbourne, Australia from December 2010 to May 2015.

The effect of interdevice interval on speech perception performance among bilateral, pediatric cochlear implant recipients.

Objectives/hypothesis: To determine if prolongation of the interdevice interval in children receiving bilateral cochlear implants adversely affects speech perception outcomes.

Study Design: Retrospective chart review.

Methods: Retrospective review of our pediatric cochlear implant database was performed.

Intraoperative Real-time Cochlear Response Telemetry Predicts Hearing Preservation in Cochlear Implantation.

Aim: To monitor cochlear function during cochlear implantation and determine correlations with postoperative acoustic hearing.

Background: Cochlear response telemetry measures cochlear function directly from cochlear implant electrodes. We have adapted this system to provide real-time cochlear response telemetry (RT-CRT) monitoring of a patient's acoustic hearing as the cochlear implant electrode array is inserted.

Management of Children with Severe, Severe-profound, and Profound Sensorineural Hearing Loss.

Management of children with severe, severe-profound, and profound sensorineural hearing loss is best achieved using a family-centered approach by a team of health professionals, including audiologists, speech pathologists, otolaryngologists, pediatricians, genetic counselors, and early intervention programs. Early diagnosis and intervention offers the best chance for speech and language acquisition. Although hearing aids can provide some of the needed information, they are often not sufficient for spoken language development and a cochlear implant is needed.

Pre-operative simulation of pediatric mastoid surgery with 3D-printed temporal bone models.

Objectives: As the process of additive manufacturing, or three-dimensional (3D) printing, has become more practical and affordable, a number of applications for the technology in the field of pediatric otolaryngology have been considered. One area of promise is temporal bone surgical simulation. Having previously developed a model for temporal bone surgical training using 3D printing, we sought to produce a patient-specific model for pre-operative simulation in pediatric otologic surgery.

Effect of cochlear nerve electrocautery on the adult cochlear nucleus.

Hypothesis: Electrocauterization and subsequent transection of the cochlear nerve induce greater injury to the cochlear nucleus than sharp transection alone.

Background: Some studies show that neurofibromatosis Type 2 (NF2) patients fit with auditory brainstem implants (ABIs) fail to achieve speech perception abilities similar to ABI recipients without NF2. Reasons for these differences remain speculative.

Intraoperative round window electrocochleography and speech perception outcomes in pediatric cochlear implant recipients.

Objectives: The goal was to measure the magnitude of cochlear responses to sound in pediatric cochlear implant recipients at the time of implantation and to correlate this magnitude with subsequent speech perception outcomes.

Design: A longitudinal cohort study of pediatric cochlear implant recipients was undertaken. Intraoperative electrocochleographic (ECoG) recordings were obtained from the round window in response to a frequency series at 90 dB nHL in 77 children totaling 89 ears (12 were second side surgeries) just before device insertion.

Round window electrocochleography and speech perception outcomes in adult cochlear implant subjects: comparison with audiometric and biographical information.

Hypothesis: Intraoperative round window (RW) electrocochleography (ECoG) can help predict speech perception outcomes in adult cochlear implant (CI) recipients.

Background: Speech perception outcomes using CIs are highly variable. Recent data demonstrated that intraoperative ECoG could account for nearly half the variance in postoperative word scores.

Scala tympani cochleostomy survey: a follow-up study.

Objectives/hypothesis: To reassess cochleostomy techniques among North American cochlear implant surgeons after a 6-year period of widespread education and research on the topic.

Study Design: Prospective cohort study.

Methods: A multiple-choice survey of cochlear implant techniques was distributed to surgeons attending the William House Cochlear Implant Study Group in 2006 and 2012.

Intracochlear electrocochleography during cochlear implantation.

Objective: Electrophysiologic responses to acoustic stimuli are present in nearly all cochlear implant recipients when measured at the round window (RW). Intracochlear recording sites might provide an even larger signal and improve the sensitivity and the potential clinical utility of electrocochleography (ECoG). Thus, the goal of this study is to compare RW to intracochlear recording sites and to determine if such recordings can be used to monitor cochlear function during insertion of a cochlear implant.

Outcomes of intubation in difficult airways due to head and neck pathology.

The purpose of this study was to examine the impact of surgical pathology, anesthesiologist experience, and airway technique on surgically relevant outcomes in patients identified by preoperative laryngoscopy to have a difficult airway due to head and neck pathology. We prospectively recorded a series of 152 difficult airway cases due to head and neck pathology out of 2,145 direct laryngoscopies undertaken between November 2005 and June 2008. One of two senior anesthesiologists specializing in head and neck procedures intubated 101 (66.

Prophylactic neck dissection in early oral tongue squamous cell carcinoma 2.1 to 4.0 mm depth.

Objective: Regional recurrence is common following surgery for T1/T2 oral tongue squamous cell carcinoma (SCC). Tumor depth >4.0 mm is commonly assigned as an indication for prophylactic neck dissection to improve regional control.

Functional outcomes of fibula and osteocutaneous forearm free flap reconstruction for segmental mandibular defects.

Objective/hypothesis: To demonstrate that the osteocutaneous radial forearm free flap provides equivalent functional outcomes and improved morbidity compared to the fibular free flap in mandibular reconstruction.

Study Design: Retrospective review.

Methods: There were 168 patients requiring free flap reconstruction of segmental mandibular defects between January 2001 and December 2008.

Outcomes of static and dynamic facial nerve repair in head and neck cancer.

Objectives/hypothesis: Determine outcomes associated with nerve grafting versus static repair following facial nerve resection.

Study Design: Retrospective chart review.

Methods: Charts from 105 patients who underwent facial nerve reconstruction between January 1999 and January 2009 were reviewed.

Postoperative reirradiation for mucosal head and neck squamous cell carcinomas.

Objectives: To compare toxic effects and functional outcomes of reirradiation with and without salvage surgery for nonnasopharyngeal mucosal head and neck squamous cell carcinoma.

Design: Retrospective review.

Setting: Academic tertiary referral hospital.

Functional outcomes after transoral robotic surgery for head and neck cancer.

Objective: To evaluate functional outcomes following transoral robotic surgery for head and neck cancer.

Study Design: Case series with planned data collection.

Setting: Academic hospital.

A comparison of three methods of using transtympanic electrocochleography for the diagnosis of Meniere's disease: click summating potential measurements, tone burst summating potential amplitude measurements, and biasing of the summating potential using a low frequency tone.

Conclusion: Stimulus biasing modulated the amplitude of the tone burst evoked summating potential (SP) in ears affected by Meniere's disease less than in normal ears. A reduced SP bias ratio added diagnostic accuracy for the diagnosis of Meniere's disease.

Objectives: To evaluate the effect of stimulus biasing on the human tone burst SP, and to determine if stimulus biasing could contribute to the electrocochleography as a means of confirming the diagnosis of Meniere's disease.

Functional outcomes following secondary free flap reconstruction of the head and neck.

Objectives/hypothesis: To evaluate head and neck patients undergoing secondary (delayed) free flap reconstructions.

Study Design: Retrospective chart review.

Methods: Of the 523 free flaps between October 2004 and May 2008, 70 patients underwent 71 secondary free flaps.