Digital Otoscopy With Computer-Aided Composite Image Generation: Impact on the Correct Diagnosis, Confidence, and Time.

Objective: This study investigated the comparative performance of ear, nose, and throat (ENT) physicians in correctly detecting ear abnormalities when reviewing digital otoscopy imaging using 3 different visualization methods, including computer-assisted composite images called "SelectStitch," single video frame "Still" images, and video clips. The study also explored clinicians' diagnostic confidence levels and the time to make a diagnosis.

Study Design: Clinician diagnostic reader study.

Intraoperative Electrocochleography in Subjects Affected by Vestibular Schwannoma and Ménière's Disease: Comparison of Results.

Objectives: Histologic reports of temporal bones of ears with vestibular schwannomas (VSs) have indicated findings of endolymphatic hydrops (ELH) in some cases. The main goal of this investigation was to test ears with VSs to determine if they exhibit electrophysiological characteristics similar to those of ears expected to experience ELH.

Design: Fifty-three subjects with surgically confirmed VS aged ≥18 and with normal middle ear status were included in this study.

Can an Imaging Marker of Consistency Predict Intraoperative Experience and Clinical Outcomes for Vestibular Schwannomas? A Retrospective Review.

 The main purpose of this article is to determine if vestibular schwannoma consistency as determined by tissue intensity on T2-weighted magnetic resonance imagings (MRIs) is predictive of intraoperative experience and postoperative clinical outcomes.  Retrospective chart review.  Tertiary referral center.

Vestibular Thresholds: A Review of Advances and Challenges in Clinical Applications.

Vestibular disorders pose a substantial burden on the healthcare system due to a high prevalence and the severity of symptoms. Currently, a large portion of patients experiencing vestibular symptoms receive an ambiguous diagnosis or one that is based solely on history, unconfirmed by any objective measures. As patients primarily experience perceptual symptoms (e.

Electrocochleography Observations in a Series of Cochlear Implant Electrode Tip Fold-Overs.

Objective: Tip fold-over is a rare but serious complication of cochlear implant (CI) surgery. The purpose of this study was to present intraoperative electrocochleography (ECochG) observations in a series of CI electrode tip fold-overs.

Patients: Five pediatric subjects undergoing CI surgery through a round window (RW) approach with a perimodiolar electrode array, who were diagnosed with either auditory neuropathy spectrum disorder or enlarged vestibular aqueduct.

Digital Otoscopy Videos Versus Composite Images: A Reader Study to Compare the Accuracy of ENT Physicians.

Objectives/hypothesis: With the increasing emphasis on developing effective telemedicine approaches in Otolaryngology, this study explored whether a single composite image stitched from a digital otoscopy video provides acceptable diagnostic information to make an accurate diagnosis, as compared with that provided by the full video.

Study Design: Diagnostic survey analysis.

Methods: Five Ear, Nose, and Throat (ENT) physicians reviewed the same set of 78 digital otoscope eardrum videos from four eardrum conditions: normal, effusion, retraction, and tympanosclerosis, along with the composite images generated by a SelectStitch method that selectively uses video frames with computer-assisted selection, as well as a Stitch method that incorporates all the video frames.

Intraoperative Electrocochleography of Posterior Fossa Tumors Producing Menière's Syndrome.

Objectives: Intraoperative electrocochleography (ECochG) has provided insight regarding inner ear pathophysiology during neurotologic procedures. In this study, intraoperative ECochG findings are reported in patients who presented with episodic aural and vestibular symptoms during resection of posterior fossa neoplasms.

Patients: Three patients with episodic vertigo who underwent resection of posterior fossa tumors.

Therapeutic challenges and clinical characteristics of single-sided deafness in children.

Introduction: The clinical implications of single-sided deafness (SSD) in children has historically been underappreciated by patients and providers alike, despite a large body of literature on the wide-ranging neurocognitive, language, scholastic, and functional impairments that occur. Conventional amplification options are marked by variable results and frequent loss of follow-up.

Methods: Retrospective case series for pediatric SSD from 2008 to 2018.

Electrocochleography and Cochlear Implantation: A Systematic Review.

Objective: Given the heterogeneity of papers about electrocochleography (ECochG) and cochlear implantation (CI) and the absence of a systematic review in the current literature, the aim of this work was to analyze the uses of ECochG in the different stages of CI.

Data Sources: A search of PubMed from inception to December 8, 2019, with cross-references, was executed. Keywords were: "Cochlear Implant" OR "Cochlear Implantation" AND "Electrocochleography" OR "ECochG.

Enlarged vestibular aqueduct: Intraoperative electrocochleography findings during cochlear implantation.

Enlarged vestibular aqueduct (EVA) is the most frequent inner ear abnormality found on computed tomography in children with sensorineural hearing loss. The effects EVA abnormalities have on electrocochleography (ECochG) are unknown. Positive deflections in summation potential evoked by tone bursts were observed in 3/5 subjects, while a large negative deflection, similar to endolymphatic hydrops (EH), was observed for 2/5 subjects.

Utilizing Electrocochleography as a Microphone for Fully Implantable Cochlear Implants.

Current cochlear implants (CIs) are semi-implantable devices with an externally worn sound processor that hosts the microphone and sound processor. A fully implantable device, however, would ultimately be desirable as it would be of great benefit to recipients. While some prototypes have been designed and used in a few select cases, one main stumbling block is the sound input.

Electrocochleography During Translabyrinthine Approach for Vestibular Schwannoma Removal.

Hypothesis: Intraoperative electrocochleography (ECochG) can differentiate hair cell and neural dysfunction caused by a vestibular schwannoma (VS) and help define the site of lesion as peripheral or central to the spiral ganglion.

Background: Hearing loss in patients with a VS can be caused by both sensory (cochlear) and neural dysfunction.

Methods: Round-window ECochG using low and high-frequency tone bursts was performed in 49 subjects with a VS.

Fibrous dysplasia mimicking a pediatric endolymphatic sac tumor.

A 15-year-old female presented for evaluation of progressive hearing loss over a year. Computed tomographic imaging revealed a 11 x 6 × 6 mm osseous lesion with 'groundglass' appearance within the left posterior petrous bone lateral to vestibular aqueduct suspicious for an endolymphatic sac tumor. Surgical excision revealed fibrous dysplasia on histological analysis.

Comparison of Opioid Prescription Patterns and Consumption Following Otologic Surgery.

Objective: To examine opioid prescribing patterns and consumption among patients undergoing common otologic surgeries.

Study Design: Retrospective cohort study with chart review and telephone survey.

Setting: Tertiary academic medical center.

Intraoperative Monitoring of Auditory Function During Lateral Skull Base Surgery.

Objective: We present a unique case of a patient with a jugular foramen tumor with serviceable hearing. This study discusses the audiometric results and intraoperative electrocochleographic (ECochG) findings recorded during tumor removal to illustrate the potential utility of this technique in skull base surgery.

Patients: A 22-year-old female patient presented with a jugular foramen schwannoma and associated symptoms of right-sided otalgia, mild hearing loss, and blurry vision.

Intraoperative Electrocochleography in Patients With Menière's Disease Undergoing Endolymphatic Sac Decompression and Shunt Surgery.

Hypothesis: Objective physiologic changes measured using electrocochleography at the round window (ECOG) are observable during endolymphatic sac decompression and shunt surgery (ELS).

Background: Limited effective treatment options are available to patients with Menière's disease (MD) who have failed conservative management, experience persistent vertigo symptoms, and have substantial residual hearing. ELS is a feasible therapeutic option for these patients.

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.

How Does Nonverbal Reasoning Affect Sentence Recognition in Adults with Cochlear Implants and Normal-Hearing Peers?

Background: Previous research has demonstrated an association of scores on a visual test of nonverbal reasoning, Raven's Progressive Matrices (RPM), with scores on open-set sentence recognition in quiet for adult cochlear implant (CI) users as well as for adults with normal hearing (NH) listening to noise-vocoded sentence materials. Moreover, in that study, CI users demonstrated poorer nonverbal reasoning when compared with NH peers. However, it remains unclear what underlying neurocognitive processes contributed to the association of nonverbal reasoning scores with sentence recognition, and to the poorer scores demonstrated by CI users.

Isolated malleus fixation: A pediatric case series.

Objectives: The goal of this review was to review our series of isolated malleus fixation in pediatric patients, a rare entity causing conductive hearing loss. Malleolar fixation is poorly described in this patient population.

Methods: A retrospective review of pediatric tympanoplasties by the senior author over a four-year period was performed.

Intracochlear Electrocochleography: Influence of Scalar Position of the Cochlear Implant Electrode on Postinsertion Results.

Hypothesis: Electrocochleography (ECochG) recorded during cochlear implant (CI) insertion from the apical electrode in conjunction with postinsertion ECochG can identify electrophysiologic differences that exist between groups with and without a translocation of the array from the scala tympani (ST) into the scala vestibuli (SV).

Background: Translocation of the CI electrode from ST into SV can limit performance postoperatively. ECochG markers of trauma may be able to aid in the ability to detect electrode array-induced trauma/scalar translocation intraoperatively.

Audiometric findings in children with unilateral enlarged vestibular aqueduct.

Objective: To evaluate the prevalence of bilateral hearing loss in children with unilateral enlarged vestibular aqueduct (EVA) at a single institution.

Methods: A retrospective case review was performed at a tertiary care pediatric referral center involving children with radiologic findings of unilateral EVA and normal labyrinthine anatomy of the contralateral ear diagnosed via CT and/or MRI. The main outcome measure of interest is the number of patients with unilateral EVA who were diagnosed with bilateral hearing loss.

Pediatric lateral graft tympanoplasty A review of 78 cases.

Objectives: The optimal timing and technique for repairing chronic tympanic membrane (TM) perforations in pediatric patients remains controversial. The objectives are to determine the surgical and hearing outcomes of pediatric lateral graft tympanoplasty at a tertiary teaching hospital.

Methods: A retrospective review was conducted for pediatric lateral graft tympanoplasties performed for chronic TM perforations by a single surgeon over a four-year period.

Neurocognitive Factors Contributing to Cochlear Implant Candidacy.

Hypothesis: Clinical adult cochlear implant (CI) candidacy evaluations rely heavily on measures of sentence recognition under the best-aided listening conditions. The hypothesis tested in this study was that nonauditory measures of neurocognitive processes would contribute to scores on preoperative sentence recognition for CI candidates, above and beyond hearing ability as assessed using pure-tone average (PTA). Support for this hypothesis would suggest that best-aided sentence recognition is not simply a measure of hearing ability; rather, neurocognitive functions contribute to performance and should be considered while counseling patients during CI candidacy evaluation about postoperative rehabilitative and outcome expectations.

Nonverbal Reasoning as a Contributor to Sentence Recognition Outcomes in Adults With Cochlear Implants.

Hypothesis: Significant variability in speech recognition persists among postlingually deafened adults with cochlear implants (CIs). We hypothesize that scores of nonverbal reasoning predict sentence recognition in adult CI users.

Background: Cognitive functions contribute to speech recognition outcomes in adults with hearing loss.

Intra-Cochlear Electrocochleography During Cochear Implant Electrode Insertion Is Predictive of Final Scalar Location.

Hypothesis: Electrocochleography (ECochG) patterns observed during cochlear implant (CI) electrode insertion may provide information about scalar location of the electrode array.

Background: Conventional CI surgery is performed without actively monitoring auditory function and potential damage to intracochlear structures. The central hypothesis of this study was that ECochG obtained directly through the CI may be used to estimate intracochlear electrode position and, ultimately, residual hearing preservation.