Ufuk Derinsu

Cochlear implantation in patients with bilateral cochlear trauma

PURPOSE Temporal bone fracture, which involves the otic capsule, can lead to complete loss of auditory and vestibular functions, whereas the patients without fractures may experience profound sensorineural hearing loss due to cochlear concussion. Cochlear implant is indicated in profound sensorineural hearing loss due to cochlear trauma but who still have an intact auditory nerve. MATERIAL AND METHODS This is a retrospective review study. We report 5 cases of postlingually deafened patients caused by cochlear trauma, who underwent cochlear implantation. Preoperative and postoperative hearing performance will be presented. These patients are cochlear implanted after the cochlear trauma in our department between 2001 and 2006. RESULTS All patients performed very well with their implants, obtained open-set speech understanding. They all became good telephone users after implantation. Their performance in speech understanding was comparable to standard postlingual adult patients implanted. CONCLUSION Cochlear implantation is an effective aural rehabilitation in profound sensorineural hearing loss caused by temporal bone trauma. Preoperative temporal bone computed tomography, magnetic resonance imaging, and promontorium stimulation testing are necessary to make decision for the surgery and to determine the side to be implanted. Surgery could be challenging and complicated because of anatomical irregularity. Moreover, fibrosis and partial or total ossification within the cochlea must be expected.

Cochlear implantation: is hearing preservation necessary in severe to profound hearing loss?

Objectives: The goal of the cochlear implant surgery is to place the electrode array with minimal damage to preserve the residual hearing. Round-window insertion can be performed in a manner that is potentially less traumatic than the standard cochleostomy. The purpose of the study was to investigate audiological results of the round-window approach using standard electrode. Methods: A retrospective study was performed to evaluate our experience in patients with implanted through round window between January 2007 and March 2009. Sixty patients had undergone cochlear implant surgery through the round window with full insertion of a standard electrode array. Preoperative and postoperative pure-tone thresholds were measured for implanted ears in the range of 250 to 4000 Hz. Results: Within these 60 cases, 31 patients had been evaluated. The population comprised 16 women and 15 men. The mean age was 15.96 years (range, 4-64 years). Follow-up times ranged from 6 to 26 months. Preservation of low-frequency hearing (250 and 500 Hz) was achieved in 27 (87%) of 31 patients. Complete hearing preservation (all frequencies) was accomplished in 11 patients (35.48%). No hearing could be determined postoperatively in 4 patients (12.9%), having preoperative thresholds of 120 dB at 250, 500, and 1000 Hz. Conclusions: Round-window approach has been widely used for preservation of residual hearing. In our patients with severe to profound hearing loss, we preserved residual hearing. Although the residual hearing cannot be sufficient for using additional acoustic stimulation, the preserved residual hearing means minimal damage and a more convenient cochlea, so this is promising for future development.

[Publication rates of audiology master and doctoral theses in peer-reviewed journals].

OBJECTIVES Theses are the prime indicators of the scientific productivity of a country and one of the main and strongest resources for the emergence of scientific articles. This study aims to examine, by using the survey method, how many of the audiology master and/or doctoral theses in Turkey were turned into a scientific work. PATIENTS AND METHODS Individuals who received a masters degree in audiology were surveyed whether their theses had been reviewed as a paper or publication. RESULTS Forty-five of the 230 audiology specialists and 22 audiologists with a doctorate degree working in Turkey participated in the study by answering the survey questions. In general, while 45.4% of master theses were presented orally or as a poster presentation in a national convention, 20.4% were presented orally or as a poster presentation in an international convention. While 18.1% of theses were published as an article in a national journal, 15.9% were published as an article in an international SCI or SCI-E journal. The distribution of the doctoral theses is 26.6%, 33.3%, 13.3% and 26.6%, respectively. CONCLUSION We found the rate of theses in audiology turning into a scientific article to be below the desired level, as in other fields. The reasons for this should be emphasized and efforts should be made to raise these rates to the desired level.

Effects of residual speech and auditory deprivation on speech perception of adult cochlear implant recipients

OBJECTIVE Possible predictive factors of cochlear implant (CI) outcomes have been extensively reported in literature for different user groups such as prelingual pediatric or postlingual adult users. However, there remains unexplained outcome variability among adult CI users; therefore, research concerning these patients continues and many different variables have been reported. This study aimed at evaluating the relationship between preoperative speech reception capacity, residual hearing, duration of deafness, age of implantation, and postoperative monosyllabic word recognition scores (WRSs) in postlingual CI users. METHODS Effect of onset age of hearing loss, duration of hearing loss, cochlear implantation age, pre CI speech reception thresholds (SRT) and pre CI WRS on the post-CI WRS of 76 adults were analyzed. RESULTS There are statistically significant relationships between hearing loss duration, pre-CI WRS, residual hearing and the post CI WRS. We observed that patients with shorter auditory deprivation with measurable speech perceptions and residual hearing might perform better with CI. CONCLUSION Ear selection in cases of unilateral CI should be considered on an individual basis with respect to the speech perception abilities.

Association between Family History and Idiopathic Sudden Sensorineural Hearing Loss.

OBJECTIVE Sudden sensorineural hearing loss (SSNHL) is defined as hearing loss of at least 30 dB occurring within three days over at least three contiguous frequencies. The etiology of SSNHL cannot always be precisely determined; in such cases, this condition is termed idiopathic SSNHL (ISSNHL). This unique study investigates the relationship between ISSNHL and positive family history for ISSNHL. MATERIALS AND METHODS In total, 125 patients diagnosed with ISSNHL were retrospectively reviewed. The presence of ISSNHL in the family medical history and degree of kinship of family members diagnosed with ISSNHL were determined. For univariate analysis, a chi-squared test and/or Fishers exact test was used for between-group comparisons of qualitative variables; a t-test was used for quantitative variables. Significant variables in the univariate analysis were introduced into stepwise logistic regression for multivariate analysis. P<0.05 indicated statistical significance. RESULTS Fifty-nine (47.2%) patients were male and 66 (52.8%) were female. Statistical analysis revealed no significant difference between sex and development of ISSNHL (p=0.04). Forty-two (33.6%) patients had a family medical history of ISSNHL, whereas 83 (66.4%) did not. A statistically significant association between the development of ISSNHL and a family history of ISSNHL was observed (p<0.05). CONCLUSION Our study supports an association between ISSNHL and genetic predisposition. Proving genetic susceptibility to ISSNHL will lead to improvements in the prediction, early diagnosis, and treatment of this disease.