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Infant, Maternal, and Hospital Factors' Role in Loss to Follow-Up After Failed Newborn Hearing Screening.
Acad Pediatr. 2017 May 23;:
Authors: Cunningham M, Thomson V, McKiever E, Dickinson LM, Furniss A, Allison MA
Abstract
BACKGROUND AND OBJECTIVES: Completion of newborn hearing screening (NBHS) is recommended by 1 month old. Delays and loss to follow-up and documentation (LTF/LTD) after failed NBHS are common. Committees of experts have established hospital guidelines to reduce LTF/LTD. We aimed to identify maternal and infant factors associated with LTF/LTD and determine if adherence to hospital guidelines is associated with timely completion of follow-up screening.
METHODS: We conducted a retrospective study of all infants born in Colorado hospitals who failed the newborn admission hearing screen from 2007-2012 and a cross-sectional survey of NBHS coordinators at Colorado birthing hospitals. NICU infants were excluded.
OUTCOMES: documented completion of the follow-up NBHS and completion by 1 month.
DATA SOURCES: Electronic Birth Record, Infant Hearing Integrated Data System, NBHS coordinator survey. Data were analyzed using logistic regression.
RESULTS: 13,904 newborns did not pass the newborn admission hearing screen from 2007-2012 and11,422 (82%) had documentation of a completed follow-up screen. 10,558 (76%) completed follow-up screening by 1 month. 100% of NBHS coordinators (n=53) completed the survey. Maternal age, education, smoking, and birth country; and payer, race, birth order, and population density were associated with completion of follow-up hearing screening. Maternal education, payer, population density, birth weight and cleft lip were associated with completion by 1 month of age. Only birth in a facility that charges a re-screening fee was associated with completion of follow-up screening.
CONCLUSIONS: Low income, rural, and minority infants are at risk for LTF. Further studies are needed to determine if adherence to guidelines can overcome barriers to follow-up.
PMID: 28549746 [PubMed - as supplied by publisher]
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Cochlear implantation in patients with otosclerosis of the otic capsule.
Am J Otolaryngol. 2017 May 19;:
Authors: Burmeister J, Rathgeb S, Herzog J
Abstract
OBJECTIVE: To evaluate outcomes of cochlear implantation of patients with otosclerosis of the otic capsule.
STUDY DESIGN: A retrospective case series of 6 patients (7 ears).
PATIENTS: 6 patients (7 ears), 5 patients with severe to profound sensorineural hearing loss; 1 patient with mild to profound sensorineural hearing loss, with radiologic evidence of otosclerosis. All patients were adult males, with or without history of stapes surgery.
INTERVENTION: Cochlear implantation of 7 ears. 5 patients with severe to profound sensorineural hearing loss received the Nucleus Contour Advance peri-modiolar electrode array with binaural implantation performed in one patient. One patient with mild to profound sensorineural hearing loss received a Cochlear® Nucleus Hybrid L24 device.
METHODS: Preoperative temporal bone CT, audiometric and speech perception testing scores were reviewed, confirming presence of otosclerosis of the cochlea as well as cochlear implant candidacy. Speech perception testing included CNC words, HINT sentences and AZ Bio scores to measure hearing outcomes post implantation.
RESULTS: All recipients of the contour advance device had a significant improvement in hearing at both 3 and 6month follow up.The hybrid device recipient experienced loss of residual hearing in the implanted ear without improvement at 3months and mild improvement at 6months.
CONCLUSION: Cochlear implantation has proven to be effective in the treatment of patients with sensorineural hearing loss, including those with otosclerosis of the cochlea.Hybrid candidacy in the setting of otosclerosis of the cochlea may require consideration of alternative electrode devices, most likely a peri-modiolar device.
PMID: 28549773 [PubMed - as supplied by publisher]
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Biocompatibility of Liposome Nanocarriers in the Rat Inner Ear After Intratympanic Administration.
Nanoscale Res Lett. 2017 Dec;12(1):372
Authors: Zou J, Feng H, Sood R, Kinnunen PKJ, Pyykko I
Abstract
Liposome nanocarriers (LPNs) are potentially the future of inner ear therapy due to their high drug loading capacity and efficient uptake in the inner ear after a minimally invasive intratympanic administration. However, information on the biocompatibility of LPNs in the inner ear is lacking. The aim of the present study is to document the biocompatibility of LPNs in the inner ear after intratympanic delivery. LPNs with or without gadolinium-tetra-azacyclo-dodecane-tetra-acetic acid (Gd-DOTA) were delivered to the rats through transtympanic injection. The distribution of the Gd-DOTA-containing LPNs in the middle and inner ear was tracked in vivo using MRI. The function of the middle and inner ear barriers was evaluated using gadolinium-enhanced MRI. The auditory function was measured using auditory brainstem response (ABR). The potential inflammatory response was investigated by analyzing glycosaminoglycan and hyaluronic acid secretion and CD44 and TLR2 expression in the inner ear. The potential apoptosis was analyzed using terminal transferase (TdT) to label the free 3'OH breaks in the DNA strands of apoptotic cells with TMR-dUTP (TUNEL staining). As a result, LPNs entered the inner ear efficiently after transtympanic injection. The transtympanic injection of LPNs with or without Gd-DOTA neither disrupted the function of the middle and inner ear barriers nor caused hearing impairment in rats. The critical inflammatory biological markers in the inner ear, including glycosaminoglycan and hyaluronic acid secretion and CD44 and TLR2 expression, were not influenced by the administration of LPNs. There was no significant cell death associated with the administration of LPNs. The transtympanic injection of LPNs is safe for the inner ear, and LPNs may be applied as a drug delivery matrix in the clinical therapy of sensorineural hearing loss.
PMID: 28549377 [PubMed - in process]
| Related Articles |
Cochlear implantation in patients with otosclerosis of the otic capsule.
Am J Otolaryngol. 2017 May 19;:
Authors: Burmeister J, Rathgeb S, Herzog J
Abstract
OBJECTIVE: To evaluate outcomes of cochlear implantation of patients with otosclerosis of the otic capsule.
STUDY DESIGN: A retrospective case series of 6 patients (7 ears).
PATIENTS: 6 patients (7 ears), 5 patients with severe to profound sensorineural hearing loss; 1 patient with mild to profound sensorineural hearing loss, with radiologic evidence of otosclerosis. All patients were adult males, with or without history of stapes surgery.
INTERVENTION: Cochlear implantation of 7 ears. 5 patients with severe to profound sensorineural hearing loss received the Nucleus Contour Advance peri-modiolar electrode array with binaural implantation performed in one patient. One patient with mild to profound sensorineural hearing loss received a Cochlear® Nucleus Hybrid L24 device.
METHODS: Preoperative temporal bone CT, audiometric and speech perception testing scores were reviewed, confirming presence of otosclerosis of the cochlea as well as cochlear implant candidacy. Speech perception testing included CNC words, HINT sentences and AZ Bio scores to measure hearing outcomes post implantation.
RESULTS: All recipients of the contour advance device had a significant improvement in hearing at both 3 and 6month follow up.The hybrid device recipient experienced loss of residual hearing in the implanted ear without improvement at 3months and mild improvement at 6months.
CONCLUSION: Cochlear implantation has proven to be effective in the treatment of patients with sensorineural hearing loss, including those with otosclerosis of the cochlea.Hybrid candidacy in the setting of otosclerosis of the cochlea may require consideration of alternative electrode devices, most likely a peri-modiolar device.
PMID: 28549773 [PubMed - as supplied by publisher]
| Related Articles |
Biocompatibility of Liposome Nanocarriers in the Rat Inner Ear After Intratympanic Administration.
Nanoscale Res Lett. 2017 Dec;12(1):372
Authors: Zou J, Feng H, Sood R, Kinnunen PKJ, Pyykko I
Abstract
Liposome nanocarriers (LPNs) are potentially the future of inner ear therapy due to their high drug loading capacity and efficient uptake in the inner ear after a minimally invasive intratympanic administration. However, information on the biocompatibility of LPNs in the inner ear is lacking. The aim of the present study is to document the biocompatibility of LPNs in the inner ear after intratympanic delivery. LPNs with or without gadolinium-tetra-azacyclo-dodecane-tetra-acetic acid (Gd-DOTA) were delivered to the rats through transtympanic injection. The distribution of the Gd-DOTA-containing LPNs in the middle and inner ear was tracked in vivo using MRI. The function of the middle and inner ear barriers was evaluated using gadolinium-enhanced MRI. The auditory function was measured using auditory brainstem response (ABR). The potential inflammatory response was investigated by analyzing glycosaminoglycan and hyaluronic acid secretion and CD44 and TLR2 expression in the inner ear. The potential apoptosis was analyzed using terminal transferase (TdT) to label the free 3'OH breaks in the DNA strands of apoptotic cells with TMR-dUTP (TUNEL staining). As a result, LPNs entered the inner ear efficiently after transtympanic injection. The transtympanic injection of LPNs with or without Gd-DOTA neither disrupted the function of the middle and inner ear barriers nor caused hearing impairment in rats. The critical inflammatory biological markers in the inner ear, including glycosaminoglycan and hyaluronic acid secretion and CD44 and TLR2 expression, were not influenced by the administration of LPNs. There was no significant cell death associated with the administration of LPNs. The transtympanic injection of LPNs is safe for the inner ear, and LPNs may be applied as a drug delivery matrix in the clinical therapy of sensorineural hearing loss.
PMID: 28549377 [PubMed - in process]
