Paddling Together: Water Trails as Innovative Public Health Strategies.

Background: Blueways can help improve health and quality-of-life by providing places for exercise, recreation, and community gatherings. The Rouge River Watershed is an industrialized region in Southeast Michigan with high rates of chronic disease and historic disinvestment in social and environmental conditions. The purpose of this article is to describe the process taken to develop an equitable, community-driven vision and approach for developing a water trail along the Lower Rouge River and to identify the key elements that emerged.

Novel candidate genes for cholesteatoma in chronic otitis media.

Cholesteatoma is a rare and benign disease, but its propensity to cause erosive damage through uninhibited growth can be detrimental to hearing and health. Prior reports indicated a genetic component to pathogenesis in at least a subset of patients. In this study, we aimed to identify rare DNA variants in affected patients.

The Outcome of Cochlear Implantations in Deaf-Blind Patients: A Multicenter Observational Study.

Objective: This multicenter study aimed to evaluate the auditory and speech outcomes of cochlear implantation (CI) in deaf-blind patients compared with deaf-only patients.

Study Design: Retrospective cohort study.

Setting: Multiple cochlear implant centers.

The Variant c.461G>A (p.Trp154*) Is Associated With Differentially Expressed Genes and Nasopharyngeal Microbiota Shifts in Patients With Otitis Media.

Otitis media (OM) is a leading cause of childhood hearing loss. Variants in , which encodes alpha-(1,2)-fucosyltransferase, were identified to increase susceptibility to OM, potentially through shifts in the middle ear (ME) or nasopharyngeal (NP) microbiotas as mediated by transcriptional changes. Greater knowledge of differences in relative abundance of otopathogens in carriers of pathogenic variants can help determine risk for OM in patients.

Round Window Stimulation of the Cochlea.

Mixed hearing loss associated with a sensorineural component and an impaired conductive mechanism for sound from the external ear canal to the cochlea represents a challenge for rehabilitation using either surgery or traditional hearing amplification. Direct stimulations of the ossicular chain and the round window (RW) membrane have allowed an improved hearing in this population. The authors review the developments in basic and clinical research that have allowed the exploration of new routes for inner ear stimulation.

Implantable Hearing Aids: Where are we in 2020?

Beginning in the late 20th century, implantable hearing aids were developed and used as an alternative for individuals who were unable to tolerate conventional hearing aids. Since that time, several devices have been developed, with four currently remaining on the international market (Med-el Vibrant Soundbridge, Envoy Esteem, Ototronix MAXUM, and Cochlear Carina). This review will briefly examine the history of middle ear implant development, describe current available devices, evaluate the benefits and limits of the technology, and consider the future directions of research in the field of implantable hearing aids.

Multi-omic studies on missense PLG variants in families with otitis media.

Otitis media (OM), a very common disease in young children, can result in hearing loss. In order to potentially replicate previously reported associations between OM and PLG, exome and Sanger sequencing, RNA-sequencing of saliva and middle ear samples, 16S rRNA sequencing, molecular modeling, and statistical analyses including transmission disequilibrium tests (TDT) were performed in a multi-ethnic cohort of 718 families and simplex cases with OM. We identified four rare PLG variants c.

Identification of Novel Genes and Biological Pathways That Overlap in Infectious and Nonallergic Diseases of the Upper and Lower Airways Using Network Analyses.

Previous genetic studies on susceptibility to otitis media and airway infections have focused on immune pathways acting within the local mucosal epithelium, and outside of allergic rhinitis and asthma, limited studies exist on the overlaps at the gene, pathway or network level between the upper and lower airways. In this report, we compared [1] pathways identified from network analysis using genes derived from published genome-wide family-based and association studies for otitis media, sinusitis, and lung phenotypes, to [2] pathways identified using differentially expressed genes from RNA-sequence data from lower airway, sinus, and middle ear tissues, in particular cholesteatoma tissue compared to middle ear mucosa. For otitis media, a large number of genes ( = 1,806) were identified as differentially expressed between cholesteatoma and middle ear mucosa, which in turn led to the identification of 68 pathways that are enriched in cholesteatoma.

A Comparison of Intracochlear Pressures During Ipsilateral and Contralateral Stimulation With a Bone Conduction Implant.

Objectives: To compare contralateral to ipsilateral stimulation with percutaneous and transcutaneous bone conduction implants.

Background: Bone conduction implants (BCIs) effectively treat conductive and mixed hearing losses. In some cases, such as in single-sided deafness, the BCI is implanted contralateral to the remaining healthy ear in an attempt to restore some of the benefits provided by binaural hearing.

A2ML1 and otitis media: novel variants, differential expression, and relevant pathways.

A genetic basis for otitis media is established, however, the role of rare variants in disease etiology is largely unknown. Previously a duplication variant within A2ML1 was identified as a significant risk factor for otitis media in an indigenous Filipino population and in US children. In this report exome and Sanger sequencing was performed using DNA samples from the indigenous Filipino population, Filipino cochlear implantees, US probands, Finnish, and Pakistani families with otitis media.

FUT2 Variants Confer Susceptibility to Familial Otitis Media.

Non-secretor status due to homozygosity for the common FUT2 variant c.461G>A (p.Trp154) is associated with either risk for autoimmune diseases or protection against viral diarrhea and HIV.

Air- and Bone-Conducted Sources of Feedback With an Active Middle Ear Implant.

Objectives: Active middle ear implants (AMEI) have been used to treat hearing loss in patients for whom conventional hearing aids are unsuccessful for varied biologic or personal reasons. Several studies have discussed feedback as a potential complication of AMEI usage, though the feedback pathway is not well understood. While reverse propagation of an acoustic signal through the ossicular chain and tympanic membrane constitutes an air-conducted source of feedback, the implanted nature of the device microphone near the mastoid cortex suggests that bone conduction pathways may potentially be another significant factor.

Intracochlear Pressures in Simulated Otitis Media With Effusion: A Temporal Bone Study.

Hypothesis: Simulated otitis media with effusion reduces intracochlear pressures comparable to umbo velocity.

Background: Otitis media with effusion is a common cause of temporary hearing loss, particularly in children, producing deficits of 30 to 40 dB. Previous studies measured the effects of simulated effusion on ossicular mechanics; however, no studies have measured cochlear stimulation directly.

Lateral Semicircular Canal Pressures During Cochlear Implant Electrode Insertion: a Possible Mechanism for Postoperative Vestibular Loss.

Hypothesis: Insertion of cochlear implant electrodes generates transient pressure spikes within the vestibular labyrinth equivalent to high-intensity acoustic stimuli.

Background: Though cochlear implant (CI) surgery is regarded as having low risk of impacting the vestibular system, several studies have documented changes in vestibular function after implantation. The mechanism of these changes is not understood.

Stapes displacement and intracochlear pressure in response to very high level, low frequency sounds.

The stapes is held in the oval window by the stapedial annular ligament (SAL), which restricts total peak-to-peak displacement of the stapes. Previous studies have suggested that for moderate (<130 dB SPL) sound levels intracochlear pressure (P), measured at the base of the cochlea far from the basilar membrane, increases directly proportionally with stapes displacement (D), thus a current model of impulse noise exposure (the Auditory Hazard Assessment Algorithm for Humans, or AHAAH) predicts that peak P will vary linearly with D up to some saturation point. However, no direct tests of D, or of the relationship with P during such motion, have been performed during acoustic stimulation of the human ear.

A Preliminary Investigation of the Air-Bone Gap: Changes in Intracochlear Sound Pressure With Air- and Bone-conducted Stimuli After Cochlear Implantation.

Hypothesis: A cochlear implant electrode within the cochlea contributes to the air-bone gap (ABG) component of postoperative changes in residual hearing after electrode insertion.

Background: Preservation of residual hearing after cochlear implantation has gained importance as simultaneous electric-acoustic stimulation allows for improved speech outcomes. Postoperative loss of residual hearing has previously been attributed to sensorineural changes; however, presence of increased postoperative ABG remains unexplained and could result in part from altered cochlear mechanics.

Long-Term Outcome Data in Patients following One Year's Use of a Fully Implantable Active Middle Ear Implant.

This study examined the safety and efficacy of a fully implantable active middle ear (AMEI) system. Outcome measures assessed AMEI performance compared with an optimally fitted conventional hearing aid (CHA). Fifty adults with stable, symmetric moderate-to-severe sensorineural hearing loss were implanted at 9 ambulatory settings.

Cochlear Implant Electrode Effect on Sound Energy Transfer Within the Cochlea During Acoustic Stimulation.

Hypothesis: Cochlear implants (CIs) designed for hearing preservation will not alter mechanical properties of the middle and inner ears as measured by intracochlear pressure (P(IC)) and stapes velocity (Vstap).

Background: CIs designed to provide combined electroacoustic stimulation are now available. To maintain functional acoustic hearing, it is important to know if a CI electrode can alter middle or inner ear mechanics because any alteration could contribute to elevated low-frequency thresholds in electroacoustic stimulation patients.

Effects of Skin Thickness on Cochlear Input Signal Using Transcutaneous Bone Conduction Implants.

Hypothesis: Intracochlear sound pressures (PIC) and velocity measurements of the stapes, round window, and promontory (VStap/RW/Prom) will show frequency-dependent attenuation using magnet-based transcutaneous bone conduction implants (TCBCIs) in comparison with direct-connect skin-penetrating implants (DCBCIs).

Background: TCBCIs have recently been introduced as alternatives to DCBCIs. Clinical studies have demonstrated elevated high-frequency thresholds for TCBCIs as compared with DCBCIs; however, little data exist examining the direct effect of skin thickness on the cochlear input signal using TCBCIs.

Retained dental needle migration across the skull base to the cochlea presenting as hearing loss.

Objectives: Long-term retained foreign bodies in the human body have been reported across many specialties, but relatively few exist in the ENT literature.

Patients: We present a case report of a patient with a broken dental needle fragment in the posterior oral cavity with subsequent migration to the cochlea over the course of 4 years, eventually leading to hearing loss. CT scan and middle ear exploration demonstrated a 4-cm metallic fragment abutting the base of the cochlea, immediately adjacent to the internal carotid artery.

Otologics active middle ear implants.

This article describes outcomes for the Otologics active middle ear implant for the semi-implantable and fully implantable (Carina, Otologics LLC, Boulder, CO) devices. Inclusion and exclusion criteria are reported in detail for surgical and audiologic management. Results from the clinical trial demonstrated no change for unaided air and bone conduction thresholds and no significant change in monosyllabic word scores or sentences in noise.

Sound location modulation of electrocochleographic responses in chinchilla with single-sided deafness and fitted with an osseointegrated bone-conducting hearing prosthesis.

Hypothesis: Bone-anchored hearing systems (BAHSs) provide sound location-dependent input to the normal ear for reducing the head shadow effect in the case of single-sided deafness (SSD).

Background: Patients with SSD can be fit with a BAHS positioned on the impaired side. Despite successful outcomes and some reports of spatial hearing capabilities, little data are available regarding the physiologic performance of BAHSs in response to free-field sounds.

Vibromechanical assessment of active middle ear implant stimulation in simulated middle ear effusion: a temporal bone study.

Hypothesis: Active middle ear implant (AMEI) generated vibromechanical stimulation of the ossicular chain (ossicular chain vibroplasty [OCV]) or the round window (round window vibroplasty [RWV]) is not significantly affected by simulated middle ear effusion in a human temporal bone model.

Background: OCV and RWV may be employed for sensorineural, mixed, and conductive hearing losses. Although middle ear effusions may be encountered across patient populations, little is known about how effusions may affect AMEI vibromechanical efficiency.

Techniques to improve the efficiency of a middle ear implant: effect of different methods of coupling to the ossicular chain.

Hypothesis: Coupling and placement of actuators onto the ossicular chain have a significant influence on active middle ear implant (AMEI) performance.

Background: AMEIs have proved to be effective in treating moderate-to-severe sensorineural hearing loss as well as mixed and conductive loss. Here, we assess the effect on performance of an AMEI prosthesis using 5 different methods of coupling to the ossicular chain in 6 temporal bones.

Third-window vibroplasty with an active middle ear implant: assessment of physiologic responses in a model of stapes fixation in Chinchilla lanigera.

Hypothesis: Mechanical stimulation through a cochlear third window into the scala tympani in a chinchilla model with normal and fixed stapes can generate cochlear responses equivalent to acoustic stimuli.

Background: Cochlear stimulation via the round window (RW) using active middle ear implants (AMEIs) can produce physiologic responses similar to acoustic stimulation including in a model of stapes fixation. However, pathologic conditions, such as advanced otosclerosis, can preclude delivery of sound energy to the cochlea through the oval window and/or the RW.