Abnormal values in the interpeak I-III associated with normal distortion product OEA suggest neurotoxicity in the brainstem pathways. The statistical significance reached only in the left ear may be due to small number of cases studied.
POSTERSsurgical treatment was decided which comprised nerve decompression, or anastomosis between the end of intratympanic segment and the distal segment of facial nerve by interposing sural or auricularis magnus nerve graft. Results:The interposition of the graft in facial nerve was carried out in the mastoid, in 11 cases in the 72 hours after trauma, in 5 cases 3 months later and in 1 case twelve months later. Nerve decompression was performed in 4 cases. The nerve graft and the nervous ends were prepared beforehand by cutting a few millimeters of the epineural sheet. Then the graft was positioned in the bone canal, the ends were put together and the anastomosis was made with autologous fibrin adhesive. In this study, we will prove the intravenous route of stem cell transplantation to the inner ear and the efficacy of the umbilical cord blood-derived mesenchymal stem cell transplantation in hearing restoration of deaf animal model. Conclusion Method:About 100,000 umbilical cord blood-derived mesenchymal stem cells which were tagged as PKH26 were infused to deaf guinea pigs intravenously. After 1 week and 3 weeks, auditory brainstem response test was checked and we obtained a guinea pig cochlea. A cryosection of each cochlea every 120 µm was obtained and we calculated stem cells for 3 sections of each animal.Results: No hearing gain was shown after stem cell transplantation, but PKH26 tagging mesenchymal stem cell was found in Modiolus, Rosenthal's canals and organ of Corti. Cells were not found in scala tympani, scala media, and scala vestibuli. Average number of cells in the inner ear was about 88 cells (59-123 cells/section). Most cells were found in spiral ganglion and migrated into the organ of Corti. Conclusion:In this study, we demonstrated that cord bloodderived mesenchymal stem cells could be delivered into the inner ear with intravenous infusion. Based on these results, intravenous injection of stem cells may be used in the treatment of sensorineural hearing loss, regeneration of the auditory hair cells, and neurons. Otology/Neurotology New Surgical approach for Lateralized tympanic Membranes Yuya Narui (presenter)Objective: Lateralization of the tympanic membrane (TM) is a condition in which the visible surface of the TM is located lateral to the bony annular ring and loses contact with the ossicular chain of the middle ear. This condition typically occurs as a complication of otological surgery. Surgical correction of the lateralized TM and restoration of hearing may pose some problems because the grafts tend to relateralize after the revision. Though we have performed that surgical correction in our hospital, we have not had good success. Therefore we have changed our way of technique. Method:We now use a custom-made ceramic columella which is 2 times longer than the one we had previously used. It now directly reaches the lateralized TM from the stapes, instead of changing the position of the lateralized TM.Results: The merit of this approach is that relateralizing never occurs because we do not c...
ORAL PRESENTATIONSamong those with pathological cVEMP (N = 4 in the pathological VEMP group too small to allow statistical analysis). 14 (58%) patients had recurrent PCBPPV (rPCBPPV). Twelve (86%) of the subjects with rPCBPPV had normal and 2 (14%) had pathological cVEMP. The proportions of subjects having abnormal cVEMP did not differ significantly between the recurrence and non-recurrence groups (Fisher exact test). Conclusion:Most patients suffering from PCBPPV had normal cVEMP. Reduced symptomatology as quantified by the DHI score was found when the cVEMP was pathological. This finding suggests that functional integrity of the inferior vestibular nerve is required for the complete clinical picture of PCBPPV to take place. Otology/NeurotologyThe Socioeconomic impact of Revision Otologic Surgery Sahar Nadimi, MD (presenter); John P. Leonetti, MD Objective: To estimate the socioeconomic impact of revision canal wall down (CWD) mastoidectomy.Method: Retrospective chart analysis from our tertiary care medical center that evaluated all adult patients who underwent CWD mastoidectomy by the senior surgeon between 2006 to 2011. Institutional charges and collections for all patients were extrapolated to estimate the overall healthcare cost of revision surgery at state (Illinois) and national levels. Results:One hundred eighty-nine CWD mastoidectomies were reviewed, of which 89 were primary and 100 were revision procedures. The total charge for this group of revision cases was $2,783,700, and the net reimbursement (collections) was $843,245. Using Illinois Hospital Consortium data, the estimated cost of reimbursement for revision CWD mastoidectomy for 387 cases in FY 2011 was nearly $3.3 million. An additional $2160 per patient in lost wages was predicted to have been related to time away from work. The 9214 patients who underwent revision CWD mastoidectomy in the U.S. represented a national healthcare cost of roughly $80 million. Conclusion:Known causes for failed CWD mastoidectomy include inadequate meatoplasty, high facial ridge, and residual or recurrent cholesteatoma. A better understanding of these factors can reduce the need for revision surgery, thereby resulting in a positive impact on the socioeconomic strain related to this procedure at local, state, and national levels. Method: This case-control study was performed in 2 groups of normal hearing patients: study group (SG): 68 patients with tinnitus; and control group (CG): 46 patients without tinnitus. Patients were submitted to otoacoustic emissions tests, to THI evaluation, and to anxiety and depression search by Beck Scale. Otology/NeurotologyResults: Seventy-five ears (67.0%) in SG showed abnormal TOAE versus 18 ears (19.6%) in CG (P < .0001). Sixty-eight ears (65.2%) had abnormal DPOAE in SG versus 46 ears (50%) in the CG (P < .029). There was no correlation between THI and the results of TOAE (P = .799) and DPOAE (P > .7) tests. SG had 44.1% (N = 30) individuals with anxiety versus 17.4% (N = 8) in CG (P < .003). There was a statistical difference betw...
Otolaryngology-Head and Neck Surgery 147(2S) ORAL PRESENTATIONS Conclusion: A relationship between pre-and postimplantation monaural auditory performance in SCI recipients was not identified. The first implanted ear is more likely to exhibit better monaural auditory performance, even if this ear had worse preimplantation hearing. This finding highlights the plasticity of central auditory pathways in cochlear implant recipients.
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