The association between electrode impedance and short-term outcomes in cochlear implant recipients of slim modiolar and slim straight electrode arrays.

Objectives: Electrode impedance measurements from cochlear implants (CI) reflect the status of the electrode array as well as the surrounding cochlear environment, and could provide a clinical index of functional changes with the CI. The goals of this study were to examine (1) the impact of electrode array type on electrode impedance, and (2) the relationship between electrode impedance and short-term hearing preservation and speech recognition outcomes.

Methods: Retrospective study of 115 adult hearing preservation CI recipients of a slim modiolar or slim straight array.

The Effect of Aging on Auditory Nerve Function: Insights from Intraoperative eCAP Recordings in Cochlear Implant Users.

Background: Advanced age is associated with poorer speech perception outcomes in cochlear implant (CI) users. In an effort to improve our understanding of the basis for this decline, this study focused on the contributions from peripheral auditory processing, using the electrically evoked compound action potential (eCAP).

Objectives: To investigate the effect of aging on intraoperative, suprathreshold eCAP responses (amplitude growth function [AGF] slopes, eCAP maximum amplitudes, and N1 latencies) across the electrode array, in a large cohort of recipients of newer generation devices, who met hearing preservation criteria.

Radiation for Sporadic Vestibular Schwannoma: An Update on Modalities, Emphasizing Hearing Loss, Side Effects, and Tumor Control.

Stereotactic radiosurgery (SRS) is a valid option for most patients undergoing treatment of small- and medium-sized vestibular schwannoma. Predictors of hearing preservation are the same for observation or surgery: when pretreatment hearing is normal, the tumor is smaller, and when a cerebrospinal fluid fundal cap exists. Hearing outcomes are poor when hearing loss exists pre-treatment.

Intraoperative Electrically Evoked Compound Action Potential Growth and Maximum Amplitudes in Hearing Preservation Cochlear Implant Recipients.

Background: Electrically evoked compound action potentials (eCAPs) obtained from cochlear implant (CI) recipients reflect responsiveness of the auditory nerve to electrical stimulation. The recent use of atraumatic electrode arrays and expansion of CI candidacy to listeners with greater residual hearing may lead to increased clinical utility of intraoperative eCAP recordings.

Objectives: To examine the effect of electrode array (slim modiolar versus slim straight) on suprathreshold intraoperative eCAP recordings in hearing preservation CI recipients.

(Even Off-Label) Cochlear Implantation in Single-Sided Deafness and Asymmetric Hearing Loss Results in Measurable Objective and Subjective Benefit.

Objective: To quantify objective and subjective outcomes in cochlear implant (CI) recipients with asymmetric hearing loss, including single-sided deafness (SSD) whose candidacy was determined on an ear-specific basis when word recognition was 50% or less.

Study Design: Retrospective case review.

Setting: Tertiary referral center.

Mythbusters! The Truth about Common Misconceptions in Cochlear Implantation.

Cochlear implantation (CI) is the preferred method of hearing rehabilitation when patients cannot perform well with traditional amplification. Unfortunately, there are still significant misconceptions around this life-changing intervention. The goal of this article is to address some of the most common myths around CI surgery.

Optimizing Care Delivery by Applying an Innovative Shared Medical Appointment Model for Determination of Cochlear Implant Candidacy.

Objective: To develop and implement an innovative group appointment with the potential to improve access to cochlear implantation (CI) while maintaining patient satisfaction and experience.

Patients: Adult patients with advanced sensorineural hearing loss.

Interventions: Implementation of novel shared medical appointment (SMA) model.

Initial hearing preservation outcomes of cochlear implantation with a slim perimodiolar electrode array.

Objective: To assess the slim modiolar array as a hearing preservation electrode.

Methods: Retrospective chart review of adult, post-lingual CI recipients implanted with slim modiolar array Sept 2016 to July 2017 in a tertiary referral center. Baseline audiograms were obtained within six months of initial CI evaluation.

The Future of Telemedicine: Revolutionizing Health Care or Flash in the Pan?

The meteoric rise of telemedicine early in the COVID-19 pandemic might easily be mistaken for an ephemeral trend-one reaching its zenith in a moment of crisis. To the contrary, momentum has been mounting for telehealth over decades. The recent increase in telecare reveals its potential to deliver efficient, patient-centered, high-quality care in an increasingly technology-dependent landscape.

Slim Perimodiolar Arrays Are as Effective as Slim Lateral Wall Arrays for Functional Hearing Preservation After Cochlear Implantation.

Objective: To compare functional hearing preservation (HP) with a slim perimodiolar array (SPA) and a slim lateral wall array (SLW) in cochlear implantation (CI).

Study Design: Retrospective chart review.

Setting: Tertiary referral center.

Pediatric vestibular testing: Tolerability of test components in children.

Introduction: Objective of the study is to define rates of successful completion of components of pediatric vestibular testing (VT).

Methods: Retrospective review of VT performed on patients less than 18 years of age from 2004 to 2015.

Results: 188 pediatric patients (mean age: 13.

Ultra Long-Term Audiometric Outcomes in the Treatment of Vestibular Schwannoma With the Middle Cranial Fossa Approach.

Objective: Define the long-term audiometric outcomes of vestibular schwannomas treated using the middle cranial fossa (MCF) approach.

Study Design: Retrospective records review.

Setting: University-based tertiary referral center.

Utility of intraoperative and postoperative radiographs in pediatric cochlear implant surgery.

Objective: Routine plain film radiographs are often obtained to confirm proper placement of electrode after pediatric cochlear implant surgery. Objective is to evaluate necessity of routine radiographs in pediatric cochlear implant cases.

Study Design: Retrospective review.

A simple assessment tool for evaluation of cadaveric temporal bone dissection.

Educational Objective: Objective metrics in skilled-based educational courses allow trainees and instructors to assess performance and monitor progress. The objective is to validate a concise, easy-to-use instrument for assessment of resident skill during a timed cadaveric temporal-bone (CTB) dissection.

Study Design: Retrospective analysis.

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary.

The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue of Otolaryngology-Head and Neck Surgery featuring the updated Clinical Practice Guideline: Earwax (Cerumen Impaction). To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 11 recommendations emphasize proper ear hygiene, diagnosis of cerumen impaction, factors that modify management, evaluating the need for intervention, and proper treatment.

Clinical Practice Guideline (Update): Earwax (Cerumen Impaction).

Objective This update of the 2008 American Academy of Otolaryngology-Head and Neck Surgery Foundation cerumen impaction clinical practice guideline provides evidence-based recommendations on managing cerumen impaction. Cerumen impaction is defined as an accumulation of cerumen that causes symptoms, prevents assessment of the ear, or both. Changes from the prior guideline include a consumer added to the development group; new evidence (3 guidelines, 5 systematic reviews, and 6 randomized controlled trials); enhanced information on patient education and counseling; a new algorithm to clarify action statement relationships; expanded action statement profiles to explicitly state quality improvement opportunities, confidence in the evidence, intentional vagueness, and differences of opinion; an enhanced external review process to include public comment and journal peer review; and 3 new key action statements on managing cerumen impaction that focus on primary prevention, contraindicated intervention, and referral and coordination of care.

Safety of Monopolar Electrocautery in Patients With Cochlear Implants.

Objective: The outcomes of 2 patients with cochlear implants (CIs) who underwent adenotonsillectomy (AT) with inadvertent use of monopolar cautery are presented. The safety data regarding monopolar cautery use in CI recipients is also reviewed.

Study Design: This is a retrospective case series of 2 CI recipients that underwent AT with monopolar cautery and literature review of electrocautery safety in the setting of CI.

p75NTR is highly expressed in vestibular schwannomas and promotes cell survival by activating nuclear transcription factor κB.

Vestibular schwannomas (VSs) arise from Schwann cells (SCs) and result from the loss of function of merlin, the protein product of the NF2 tumor suppressor gene. In contrast to non-neoplastic SCs, VS cells survive long-term in the absence of axons. We find that p75(NTR) is overexpressed in VSs compared with normal nerves, both at the transcript and protein level, similar to the response of non-neoplastic SCs following axotomy.

Upper airway manifestations of granulomatosis with polyangiitis.

Upper airway manifestations, particularly sinonasal manifestations, are encountered frequently in granulomatosis with polyangiitis (GPA). Nasal endoscopy often reveals crusting, friable erythematous mucosa, and granulation. Up to 25% of patients may have a "saddle-nose" deformity as cartilage destruction worsens.

New frontiers in cochlear implantation: acoustic plus electric hearing, hearing preservation, and more.

As cochlear implant technology has changed, so have implantation criteria. In addition to profoundly deaf individuals, candidacy has expanded to include those with significant remaining acoustic hearing. This article describes the devices that are now in clinical trial, discusses the rationale as to why residual hearing preservation is important, details the surgical techniques for hearing preservation, and shares the clinical results of electric plus acoustic processing.