Preoperative determination of nerve of origin in patients with vestibular schwannoma.

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Preoperative determination of nerve of origin in patients with vestibular schwannoma.

HNO. 2017 Oct 27;:

Authors: Rahne T, Plößl S, Plontke SK, Strauss C

Abstract
BACKGROUND: Vestibular schwannoma (VS) is a benign tumor that develops in the internal auditory canal and the cerebellopontine angle, potentially diminishing hearing or balance. Most VS tumors arise from one of two vestibular branches: the superior or inferior vestibular nerve. Determining the specific nerve of origin could improve patient management in terms of preoperative counseling, treatment selection, and surgical decision-making and planning. The aim of this study was to introduce a novel scoring system that was designed to determine the nerve of origin.
METHODS: The nerve of origin was predicted based on video head impulse assessments of all semicircular channels, together with cervical/ocular vestibular-evoked myogenic potential tests. The acquired data were entered into a scoring system developed to allocate the tumor origin. Finally, the nerve of origin was definitively determined intraoperatively.
RESULTS: The novel scoring system was applied to five consecutive patients undergoing surgical VS treatment. In one case, no determination was possible. In all other cases, the preoperatively predicted tumor origin was the same as the origin determined during surgery.
CONCLUSION: The scoring system predicts the nerve of origin and will be evaluated in a larger prospective cohort study of VS patients in the near future.

PMID: 29079887 [PubMed - as supplied by publisher]

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Cannula-based drug delivery to the guinea pig round window causes a lasting hearing loss that may be temporarily mitigated by BDNF

Publication date: Available online 28 October 2017
Source:Hearing Research
Author(s): Phillip J.P. Sale, Aaron Uschakov, Tasfia Saief, David P. Rowe, Carla J. Abbott, Chi D. Luu, Amy J. Hampson, Stephen J. O'Leary, David J. Sly
Sustained local delivery of drugs to the inner ear may be required for future regenerative and protective strategies. The round window is surgically accessible and a promising delivery route. To be viable, a delivery system should not cause hearing loss. This study determined the effect on hearing of placing a drug-delivery microcatheter on to the round window, and delivering either artificial perilymph (AP) or brain-derived neurotrophic factor (BDNF) via this catheter with a mini-osmotic pump. Auditory brainstem responses (ABRs) were monitored for 4 months after surgery, while the AP or BDNF was administered for the first month. The presence of the microcatheter – whether dry or when delivering AP or BDNF for 4 weeks – was associated with an increase in ABR thresholds of up to 15 dB, 16 weeks after implantation. This threshold shift was, in part, delayed by the delivery of BDNF. We conclude that the chronic presence of a microcatheter in the round window niche causes hearing loss, and that this is exacerbated by delivery of AP, and ameliorated temporarily by delivery of BDNF.



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Cannula-based drug delivery to the guinea pig round window causes a lasting hearing loss that may be temporarily mitigated by BDNF

Publication date: Available online 28 October 2017
Source:Hearing Research
Author(s): Phillip J.P. Sale, Aaron Uschakov, Tasfia Saief, David P. Rowe, Carla J. Abbott, Chi D. Luu, Amy J. Hampson, Stephen J. O'Leary, David J. Sly
Sustained local delivery of drugs to the inner ear may be required for future regenerative and protective strategies. The round window is surgically accessible and a promising delivery route. To be viable, a delivery system should not cause hearing loss. This study determined the effect on hearing of placing a drug-delivery microcatheter on to the round window, and delivering either artificial perilymph (AP) or brain-derived neurotrophic factor (BDNF) via this catheter with a mini-osmotic pump. Auditory brainstem responses (ABRs) were monitored for 4 months after surgery, while the AP or BDNF was administered for the first month. The presence of the microcatheter – whether dry or when delivering AP or BDNF for 4 weeks – was associated with an increase in ABR thresholds of up to 15 dB, 16 weeks after implantation. This threshold shift was, in part, delayed by the delivery of BDNF. We conclude that the chronic presence of a microcatheter in the round window niche causes hearing loss, and that this is exacerbated by delivery of AP, and ameliorated temporarily by delivery of BDNF.



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Cannula-based drug delivery to the guinea pig round window causes a lasting hearing loss that may be temporarily mitigated by BDNF

Publication date: Available online 28 October 2017
Source:Hearing Research
Author(s): Phillip J.P. Sale, Aaron Uschakov, Tasfia Saief, David P. Rowe, Carla J. Abbott, Chi D. Luu, Amy J. Hampson, Stephen J. O'Leary, David J. Sly
Sustained local delivery of drugs to the inner ear may be required for future regenerative and protective strategies. The round window is surgically accessible and a promising delivery route. To be viable, a delivery system should not cause hearing loss. This study determined the effect on hearing of placing a drug-delivery microcatheter on to the round window, and delivering either artificial perilymph (AP) or brain-derived neurotrophic factor (BDNF) via this catheter with a mini-osmotic pump. Auditory brainstem responses (ABRs) were monitored for 4 months after surgery, while the AP or BDNF was administered for the first month. The presence of the microcatheter – whether dry or when delivering AP or BDNF for 4 weeks – was associated with an increase in ABR thresholds of up to 15 dB, 16 weeks after implantation. This threshold shift was, in part, delayed by the delivery of BDNF. We conclude that the chronic presence of a microcatheter in the round window niche causes hearing loss, and that this is exacerbated by delivery of AP, and ameliorated temporarily by delivery of BDNF.



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Modern Hearing Aids: Verification, Outcome Measures, and Follow-Up

No abstract available

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Improving the Efficiency of Speech-In-Noise Hearing Screening Tests

Objective: Speech-in-noise hearing screening tests have become increasingly popular. These tests follow an adaptive procedure with a fixed number of presentations to estimate the speech reception threshold. The speech reception threshold is compared with an established cutoff signal to noise ratio (SNR) for a pass result or refer result. A fixed SNR procedure was developed to improve the efficiency of speech-in-noise hearing screening tests. Design: The cutoff SNR is used for all presentations in the fixed-SNR procedure. After each response a reliable test result is given (pass/refer) or an extra stimulus is presented. The efficiency and pass/refer rates between the adaptive procedure and the fixed-SNR procedure were compared. Results: An average reduction of 67% in the number of presentations can be achieved (from 25 to an average of 8.3 presentations per test). Conclusions: The fixed-SNR procedure is superior in efficiency to the adaptive procedure while having nearly equal refer and pass rates.

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Hearing Threshold Shifts Among 11-to-35-Year-Olds With Early Hearing Impairment

No abstract available

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