Yaqin Wu

Triple semicircular canal occlusion for the treatment of Meniere's disease

Conclusion. Triple semicircular canal occlusion (TSCO) controls vertigo, is easy to perform, and could be used as an alternative procedure for the treatment of Ménières disease in selected patients who complain mainly of intractable vertigo. Objective. To seek an effective alternative surgical procedure for treating Ménières disease in selected patients with intolerant rotational vertigo. Patients and methods. Three patients with Ménières disease who underwent unsuccessful endolymphatic sac decompression or mastoid shunt, then underwent TSCO. Vertigo control and vestibular and auditory function were measured. Results. The early vestibular symptoms caused by surgery resolved quickly and no hearing deterioration occurred after surgery. At the end of the follow-up period, based on the AAO-HNS criteria, two cases had complete control of vertigo (class A) and the other had substantial control of vertigo attacks (class B). Hearing was similar to the preoperative level at the end of the follow-up period.

Categories of Auditory Performance and Speech Intelligibility Ratings of Early-Implanted Children without Speech Training

Objective To assess whether speech therapy can lead to better results for early cochlear implantation (CI) children. Patients A cohort of thirty-four congenitally profoundly deaf children who underwent CI before the age of 18 months at the Sixth Hospital affiliated with Shanghai Jiaotong University from January 2005 to July 2008 were included. Nineteen children received speech therapy in rehabilitation centers (ST), whereas the remaining fifteen cases did not (NST), but were exposed to the real world, as are normal hearing children. Methods All children were assessed before surgery and at 6, 12, and 24 months after surgery with the Categories of Auditory Performance test (CAP) and the Speech Intelligibility Rating (SIR). Each assessment was given by the same therapist who was blind to the situation of the child at each observation interval. CAP and SIR scores of the groups were compared at each time point. Results Our study showed that the auditory performance and speech intelligibility of trained children were almost the same as to those of untrained children with early implantation. The CAP and SIR scores of both groups increased with increased time of implant use during the follow-up period, and at each time point, the median scores of the two groups were about equal. Conclusions These results indicate that great communication benefits are achieved by early implantation (<18 months) without routine speech therapy. The results exemplify the importance of enhanced social environments provided by everyday life experience for human brain development and reassure parents considering cochlear implants where speech training is unavailable.

Indications and Common Surgical Approaches for Cochlear Implantation in China

Cochlear implants have become widely used in the management of profound sensorineural hearing loss. With today’s technology and the demonstrated success of cochlear implantation, candidacy criteria have greatly widened. In this paper, we describe issues concerning the current indications and common surgical approaches to cochlear implantation in China.

Comparisons of Auditory Performance and Speech Intelligibility in Children With Cochlear Implants Placed Using Different Approaches

Objective To demonstrate whether there are differences in the outcomes of children with cochlear implants using the techniques between mastoidectomy with posterior tympanotomy (MPTA) and suprameatal approach (SMA). Patients A total of 44 congenitally deaf children who underwent cochlear implantation before the age of 5 years at the Sixth Hospital Affiliated to Shanghai Jiao tong University from January 2005 to March 2008 were included in this study. Children with severe mental retardation or with cochlear malformations were excluded. Each group had 22 patients; however, 4 patients in the SMA group and 5 in the MPTA group were not included in this study because the assessments for these patients were not available. Interventions All children were assessed before surgery and 6, 12, and 24 months after surgery with Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). Each assessment was given by the child’s speech therapist in the familiar environment of the child’s home or school. At each interval, the CAP and SIR scores of each group were compared. Results For the both groups, CAP and SIR scores increased with the time of implant usage during the follow-up period after implantation. However, there were no significant differences in scores of CAP and SIR at the 4 time points between the SMA group and the MPTA group. Conclusion Intelligible speech and auditory performance of children with cochlear implantation using the SMA were good. There were no differences between children implanted with the SMA technique versus the MPTA technique.

Cochlear implantation in a patient with severe cochlear hypoplasia

OBJECTIVE We report the case of a successful cochlear implantation in a patient with severe cochlear hypoplasia. CASE REPORT The outcome of cochlear implantation is generally less favourable for patients with cochlear hypoplasia than for those with a normal cochlear structure. In the reported patient, part of the electrode array was inserted into the internal auditory canal. Nevertheless, the benefits following cochlear implantation seemed to outweigh the risks for this patient. CONCLUSION Cochlear hypoplasia is not necessarily a contraindication for cochlear implantation.

Pitfalls in the management of monaural deafness

OBJECTIVE We report a patient who underwent cochlear implantation in an ear with long-term deafness, after an acoustic neuroma had been removed surgically from the other, hitherto good ear and the cochlear nerve had subsequently been resected to relieve severe tinnitus. METHOD Case report. RESULTS The patient could not tolerate the cochlear implant, because of a moderate headache due to the stimulation level necessary for environmental sound discrimination. CONCLUSION Cochlear implantation in patients with long-term deafness should be considered carefully, even if deafness is monaural.

Differences in platelet-related parameters among patients with audiographically distinct sudden sensorineural hearing loss: A retrospective study

Abstract We explored possible relationships between sudden sensorineural hearing loss (SSNHL) in patients differing in terms of audiographic data and the levels of vascular markers in routine blood data. We included 37 patients with low-frequency SSNHL (LF-SSNHL), 28 with high-frequency SSNHL (HF-SSNHL), 32 with all-frequency SSNHL (AF-SSNHL), 32 with total-deafness SSNHL (TD-SSNHL), and 31 age- and sex-matched healthy controls. Peripheral venous blood samples were collected, and routine blood parameters including platelet and lymphocyte count, mean platelet volume (MPV), and platelet-to-lymphocyte ratio (PLR) were measured. Each group was divided into recovery subgroup and unrecovery subgroup in accordance with hearing level after 1 month therapy, then compared the difference of platelet and lymphocyte count, MPV, and PLR between the 2 subgroups. No significant difference was observed between platelet count of all SSNHL patients and control group (all P > .05). MPV of AF-SSNHL and TD-SSNHL, PLR of all SSNHL patients were significantly higher than those of control group (all P < .05), while lymphocyte count of all audiographically distinct SSNHL patients was significantly lower than that of control group (all P < .05). However, the difference of platelet count, lymphocyte count, MPV, and PLR among audiographically distinct SSNHL patients was not significant (all P > .05). In HF-SSNHL patients, lymphocyte count of unrecovery subgroup was significantly lower, while MPV and PLR of the unrecovery subgroup were significantly higher than those of recovery subgroup (all P < .05). In AF-SSNHL patients, MPV of the unrecovery group was significantly higher than that of recovery subgroup (P < .05). Lymphocyte count, MPV, and PLR may be relative to SSSNHL, but they could not be used to distinct SSNHL audiographically. Lower lymphocyte, higher MPV, and PLR may be indicative for the prognosis of HF-SSNHL patients; higher MPV may be related to bad treatment outcome of AF-SSNHL patients.

Comparison of Hearing Results of Malleovestibulopexy and Total Ossicular Replacement Prosthesis for Chronic Otitis Media Patients With a Mobile Stapes Footplate

Objective: This study aimed to assess differences in hearing outcomes using the malleostapedotomy or malleovestibulopexy (MVP) and total ossicular replacement prosthesis (TORP) techniques in chronic otitis media patients with a mobile stapes footplate. Study Design: Case series with planned data collection. Setting: A university medical center. Subjects and Methods: In total, 27 patients with chronic otitis media at the Sixth Hospital affiliated with Shanghai Jiao Tong University, between January and October 2010, were included. All patients had destruction of incus and stapes superstructures and a mobile stapes footplate. In all patients, surgery was performed under general anesthesia by a retroauricular approach. After the lesions were removed completely, ossicular reconstruction was performed using 1 of the techniques. In all patients, pure-tone audiograms were assessed before and 12 months after surgery. Results: Thirteen patients underwent MVP surgery, whereas the other 14 cases received traditional TORP surgery. All patients showed improvements in functional hearing after surgery. Although the numbers of ears that had closure of the air–bone gap within 20 dB in the MVP group were not statistically significantly higher than those in the TORP group (Fisher’s exact test, P > .05), the average postoperative gain of the MVP group was significantly higher than that of the TORP group (t test, P < .05). Conclusion: Functional hearing in chronic otitis media patients with a mobile stapes footplate was better in those who underwent MVP surgery than in those who underwent TORP surgery.