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The Journal of International Advanced... Sep 2021Vestibular schwannomas (VS) frequently lead to ipsilateral sensorineural hearing loss (HL) as part of its natural history or as a result of treatment. Cochlear...
BACKGROUND AND OBJECTIVES
Vestibular schwannomas (VS) frequently lead to ipsilateral sensorineural hearing loss (HL) as part of its natural history or as a result of treatment. Cochlear implantation represents a well-documented treatment of profound HL that cannot be treated adequately with a conventional hearing aid, thus being offered to selected VS patients. A functional cochlea and cochlear nerve are prerequisites for sound perception with a cochlear implant (CI). The potential impact of radiotherapy on these structures is thus an important issue for subsequent CI hearing outcomes. The objective of this article is to present a case and to review the existing literature on the outcomes of cochlear implantation in irradiated VS patients systematically.
METHODS
A systematic literature review using preferred reporting items for systematic reviews and meta-analyses was conducted. Medline was searched systematically. Papers reporting ipsilateral CI outcomes after radiotherapy of VS were included. Additionally, results of CI after stereotactic radiotherapy in a 54-year-old male with neurofibromatosis type 2 are presented.
RESULTS
A total of 14 papers (33 patients) fulfilled inclusion criteria. Moderate preoperative HL was found in 11 patients. Six had moderate to severe HL, whereas 16 had severe HL or total deafness. Postoperative hearing outcomes varied from poor in 27% of patients to excellent in 19%, with remaining cases lying in between (mean follow-up of 19 months). Most patients achieved improvement in hearing and quality of life.
CONCLUSION
Despite variation in the degree of hearing outcome, CI after radiotherapy of VS appears to be effective in the majority of cases, as more than 70% of patients have good or excellent outcomes within 1-2 years post-implantation. Subjective benefits are considerable, even in cases with relatively poor objective outcome.
Topics: Cochlear Implantation; Cochlear Implants; Hearing Loss, Sensorineural; Humans; Male; Middle Aged; Neuroma, Acoustic; Quality of Life; Speech Perception; Treatment Outcome
PubMed: 34617898
DOI: 10.5152/iao.2021.21008 -
The British Journal of Nutrition Mar 2023Iodine, through the thyroid hormones, is required for the development of the auditory cortex and cochlea (the sensory organ for hearing). Deafness is a well-documented... (Review)
Review
Iodine, through the thyroid hormones, is required for the development of the auditory cortex and cochlea (the sensory organ for hearing). Deafness is a well-documented feature of endemic cretinism resulting from severe iodine deficiency. However, the range of effects of suboptimal iodine intake during auditory development on the hearing ability of children is less clear. We therefore aimed to systematically review the evidence for the association between iodine exposure (i.e. intake/status/supplementation) during development (i.e. pregnancy and/or childhood) and hearing outcomes in children. We searched PubMed and Embase and identified 330 studies, of which thirteen were included in this review. Only three of the thirteen studies were of low risk of bias or of good quality, this therefore limited our ability to draw firm conclusions. Nine of the studies (69 %) were in children (one RCT, two non-RCT interventions and six cross-sectional studies) and four (31 %) were in pregnant women (one RCT, one cohort study and two case reports). The RCT of iodine supplementation in mildly iodine-deficient pregnant women found no effect on offspring hearing thresholds. However, hearing was a secondary outcome of the trial and not all women were from an iodine-deficient area. Iodine supplementation of severely iodine-deficient children (in both non-RCT interventions) resulted in improved hearing thresholds. Five of six cross-sectional studies (83 %) found that higher iodine status in children was associated with better hearing. The current evidence base for the association between iodine status and hearing outcomes is limited and further good-quality research on this topic is needed.
Topics: Child; Humans; Female; Pregnancy; Iodine; Child Development; Cohort Studies; Cross-Sectional Studies; Dietary Supplements; Hearing
PubMed: 35535480
DOI: 10.1017/S0007114522001441 -
Ear and Hearing 2021To conduct a systematic review to address two research questions: (Q1) Does hearing loss have an effect on fatigue? (Q2) Does hearing device fitting have an effect on... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To conduct a systematic review to address two research questions: (Q1) Does hearing loss have an effect on fatigue? (Q2) Does hearing device fitting have an effect on fatigue? It was hypothesized that hearing loss would increase fatigue (H1), and hearing device fitting would reduce fatigue (H2).
DESIGN
Systematic searches were undertaken of five bibliographic databases: Embase, MedLine, Web of Science, Psychinfo, and the Cochrane Library. English language peer-reviewed research articles were included from inception until present. Inclusion and exclusion criteria were formulated using the Population, Intervention, Comparison, Outcomes and Study design strategy.
RESULTS
Initial searches for both research questions produced 1,227 unique articles, after removal of duplicates. After screening, the full text of 61 studies was checked, resulting in 12 articles with content relevant to the research questions. The reference lists of these studies were examined, and a final updated search was conducted on October 16, 2019. This resulted in a final total of 20 studies being selected for the review. For each study, the information relating to the Population, Intervention, Comparison, Outcomes and Study design criteria and the statistical outcomes relating to both questions (Q1 and Q2) were extracted. Evidence relating to Q1 was provided by 15 studies, reporting 24 findings. Evidence relating to Q2 was provided by six studies, reporting eight findings. One study provided evidence for both. Using the Grading of Recommendations Assessment, Development and Evaluation guidelines, the quality of evidence on both research questions was deemed to be "very low." It was impossible to perform a meta-analysis of the results due to a lack of homogeneity.
CONCLUSIONS
As the studies were too heterogeneous to support a meta-analysis, it was not possible to provide statistically significant evidence to support the hypotheses that hearing loss results in increased fatigue (H1) or that hearing device fitting results in decreased fatigue (H2). Despite this, the comparative volume of positive results and the lack of any negative findings are promising for future research (particularly in respect of Q1). There was a very small number of studies deemed eligible for the review, and there was large variability between studies in terms of population, and quantification of hearing loss and fatigue. The review highlights the need for consistency when measuring fatigue, particularly when using self-report questionnaires, where the majority of the current evidence was generated.
Topics: Adult; Deafness; Fatigue; Hearing; Hearing Loss; Humans; Self Report
PubMed: 32639255
DOI: 10.1097/AUD.0000000000000909 -
The Journal of International Advanced... Jan 2021This study's aim was to establish outcomes following cochlear implantation (CI) in patients with mitochondrial disorders associated with deafness. Systematic review and...
This study's aim was to establish outcomes following cochlear implantation (CI) in patients with mitochondrial disorders associated with deafness. Systematic review and narrative synthesis. Databases searched: Medline, EMBASE, Web of Science, COCHRANE, and ClinicalTrials.gov. No limits on language or year of publication. Review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Searches identified 437 abstracts and 37 full text articles, of which 11 studies met the inclusion criteria reporting outcomes in a total of 17 patients. All implants achieved good hearing outcomes, and follow-up ranged between 1 week and 12 months. The methodological quality of the included studies was sufficient, scoring grades 3 to 4 using the Oxford Centre for Evidence Based Medicine grading system. All studies were retrospective and consisted of case reviews and case reports. All cases of CI showed positive outcomes in speech perception and detection. There is some qualitative evidence to suggest improvement in quality of life and satisfaction postoperatively. There was very limited information available on secondary outcomes such as surgical complications, quality of life, and method of cochlear implant insertion. The small sample size of our patient cohort and quality of studies suggests a need for large-scale studies with more robust methodology to assess the effectiveness of CI. There is a need for studies that assess other factors to be considered when counseling patients about cochlear implants, such as adverse events, surgical complications, and long-term benefits.
Topics: Adult; Aged; Aged, 80 and over; Child; Cochlear Implantation; Cochlear Implants; Female; Hearing Loss; Humans; Male; Middle Aged; Quality of Life; Retrospective Studies
PubMed: 33605225
DOI: 10.5152/iao.2020.9226 -
Scientific Reports Nov 2022Although learning disorders (LD) and developmental language disorder (DLD) can be linked to overlapping psychological and behavioral deficits, such as phonological,... (Meta-Analysis)
Meta-Analysis
Although learning disorders (LD) and developmental language disorder (DLD) can be linked to overlapping psychological and behavioral deficits, such as phonological, morphological, orthographic, semantic, and syntactic deficits, as well as academic (e.g., reading) difficulties, they are currently separate diagnoses in the DSM-5 with explicit phenotypic differences. At a neural level, it is yet to be determined to what extent they have overlapping or distinct signatures. The identification of such neural markers/endophenotypes could be important for the development of physiological diagnostic tools, as well as an understanding of disorders across different dimensions, as recommended by the Research Domain Criteria Initiative (RDoC). The current systematic review and meta-analysis examined whether the two disorders can be differentiated based on the auditory brainstem response (ABR). Even though both diagnoses require hearing problems to be ruled out, a number of articles have demonstrated associations of these disorders with the auditory brainstem response. We demonstrated that both LD and DLD are associated with longer latencies in ABR Waves III, V, and A, as well as reduced amplitude in Waves V and A. However, multilevel subgroup analyses revealed that LD and DLD do not significantly differ for any of these ABR waves. Results suggest that less efficient early auditory processing is a shared mechanism underlying both LD and DLD.
Topics: Humans; Evoked Potentials, Auditory, Brain Stem; Learning Disabilities; Auditory Perception; Deafness; Language Development Disorders
PubMed: 36418364
DOI: 10.1038/s41598-022-20438-7 -
Ear and Hearing 2022The objective of this study was to understand the functional impact of vestibular dysfunction on balance control in children with hearing loss. The vestibular system is...
OBJECTIVES
The objective of this study was to understand the functional impact of vestibular dysfunction on balance control in children with hearing loss. The vestibular system is an important contributor to maintaining balance. In adults, vestibular dysfunction is known to lead to unsteadiness and falls. Considerably less is known about the effects of vestibular dysfunction in children with hearing loss.
DESIGN
We conducted a systematic review in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included articles on children with hearing loss who underwent vestibular and balance testing. The Downs and Black checklist was used to assess the risk of bias.
RESULTS
A total of 20 articles were included in this systematic review, of which, 17 reported an association between vestibular dysfunction and balance abnormalities in children with hearing loss. Bias (as measured by the Downs and Black Checklist) was a concern, as most studies were nonblinded cohort studies or case series selected through convenience sampling.
CONCLUSIONS
Research to date has predominantly found that children with concomitant hearing loss and vestibular impairment tend to perform more poorly on balance measures than either children with hearing loss and normal vestibular function or children with both normal-hearing and normal vestibular function. A standardized approach to assessing both vestibular function and balance would better characterize the impact of vestibular dysfunction in children with hearing loss at the population level.
Topics: Child; Deafness; Hearing Loss; Hearing Loss, Sensorineural; Humans; Postural Balance; Vestibular Diseases; Vestibule, Labyrinth
PubMed: 34611117
DOI: 10.1097/AUD.0000000000001131 -
European Archives of... Mar 2024This study is a systematic review of the literature which seeks to evaluate auditory and quality of life (QOL) outcomes of cochlear implantation in patients with Usher... (Review)
Review
PURPOSE
This study is a systematic review of the literature which seeks to evaluate auditory and quality of life (QOL) outcomes of cochlear implantation in patients with Usher syndrome.
METHODS
Systematic review of studies indexed in Medline via PubMed, Ovid EMBASE, Web of Science, CENTRAL and clinicaltrials.gov was performed up to March 9th 2022, conducted in accordance with the PRISMA statement. Patient demographics, comorbidity, details of cochlear implantation, auditory, and QOL outcomes were extracted and summarized.
RESULTS
33 studies reported over 217 cochlear implants in 187 patients with Usher syndrome, comprising subtypes 1 (56 patients), 2 (9 patients), 3 (23 patients), and not specified (99 patients). Auditory outcomes included improved sound detection, speech perception, and speech intelligibility. QOL outcomes were reported for 75 patients, with benefit reported in the majority.
CONCLUSIONS
Many patients with Usher syndrome develop improved auditory outcomes after cochlear implantation with early implantation being an important factor.
Topics: Humans; Cochlear Implantation; Usher Syndromes; Quality of Life; Treatment Outcome; Cochlear Implants; Speech Perception
PubMed: 37930386
DOI: 10.1007/s00405-023-08304-2 -
Annals of Palliative Medicine Dec 2021Abnormal inner ear anatomy increases the risk of cochlear implantation because only a certain number of neurons can input signals to the auditory cortex. Therefore, the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Abnormal inner ear anatomy increases the risk of cochlear implantation because only a certain number of neurons can input signals to the auditory cortex. Therefore, the effectiveness and safety of cochlear implantation for patients with large vestibular aqueduct deformity (LVAD) are controversial and we explored whether cochlear implantation can improve the hearing of patients with this defect.
METHODS
Randomized controlled trials of cochlear implantation for the treatment of LVAD were retrieved from the CNKI, Baidu Academic, VIP Medical, Wanfang Data, PubMed, EBSCO, Medline, and Cochrane databases from the date of establishment of the database to July 20, 2021. Chinese and English search keywords included Large vestibular canal malformation, Deafness, large vestibular aqueduct, and Cochlear implants. We used RevMan 5.3 to evaluate the quality of the literature.
RESULTS
A total of 5 documents that met the inclusion criteria were tested for overall heterogeneity. For the heterogeneity test of categories of auditory performance, Chi-squared (Chi2) =4.00, degrees of freedom (df) =1, I2=75%>50%, and P=0.05. Overall analysis using a random-effects model showed no statistically considerable difference between the deformity group and the control group [Z=0.78, mean difference (MD) =-0.65, 95% confidence interval (CI): -2.29 to 0.98, P=0.43]. There was no substantial difference in postoperative hearing ability between LVAD patients and those with normal inner ear structure. Continuous variables were used to describe the speech intelligibility rate (SIR) in a total of 48 cases, including 24 cases in the deformity group and 24 cases in the control group. For the heterogeneity test of the whole population, Chi2 =1.75, df =1, I2=43%<50%, and P=0.19. Overall analysis using a fixed-effects model showed that the difference between the deformity group and the control group was statistically considerable (Z=3.09, MD =-1.03, 95% CI: -1.69 to -0.38, P=0.002).
DISCUSSION
The meta-analysis results confirmed that with postoperative rehabilitation for LVAD patients with cochlear implants the clinical efficacy is similar to that of deaf patients with normal inner ear structure, providing an important basis for hearing restoration.
Topics: Cochlear Implantation; Cochlear Implants; Ear, Inner; Hearing Loss, Sensorineural; Humans; Vestibular Aqueduct
PubMed: 35016448
DOI: 10.21037/apm-21-3327 -
Brazilian Journal of Otorhinolaryngology 2023To determine the cut-off point of the cochlear radiation dose as a risk factor for hearing loss in patients with vestibular schwannoma treated with radiosurgery. (Review)
Review
OBJECTIVES
To determine the cut-off point of the cochlear radiation dose as a risk factor for hearing loss in patients with vestibular schwannoma treated with radiosurgery.
METHODS
A systematic review of the literature was performed without language or publication year restrictions in the MEDLINE/PubMed, EMBASE, Web of Science, LILACS/VHL and Cochrane Library databases. Studies that met the following criteria were included: 1) population: adults of both sexes who underwent radiosurgery for vestibular schwannoma treatment; 2) exposure: cochlear radiation; 3) outcome: hearing loss; 4) type of study: cohort. Two independent reviewers conducted the entire review process. The registration number in PROSPERO was CRD42020206128.
RESULTS
From the 333 articles identified in the searches, seven were included after applying the eligibility criteria. There was no standardization as to how to measure exposure or outcome in the included studies, and most studies did not present sufficient data to enable meta-analysis.
CONCLUSION
It was not possible to determine a cut-off point for high cochlear dose that could be considered a risk factor for hearing loss.
Topics: Adult; Female; Humans; Male; Deafness; Hearing Loss; Neuroma, Acoustic; Radiation Dosage; Radiosurgery; Retrospective Studies; Treatment Outcome
PubMed: 37579571
DOI: 10.1016/j.bjorl.2023.101300 -
International Journal of Environmental... Sep 2022Leprosy is a public health problem in South American, African and Oceanian countries. National programs need to be evaluated, and the survival analysis model can aid in... (Review)
Review
Leprosy is a public health problem in South American, African and Oceanian countries. National programs need to be evaluated, and the survival analysis model can aid in the construction of new indicators. The aim of this study was to assess the period of time until the outcomes of interest for patients with or exposed to leprosy by means of survival analysis surveys. This review researched articles using the databases of PubMed, Science Direct, Scopus, Scielo and BVS published in English and Portuguese. Twenty-eight articles from Brazil, India, Bangladesh, the Philippines and Indonesia were included. The Kaplan-Meier method, which derives the log-rank test, and Cox's proportional hazards regression, which obtains the hazard ratio, were applied. The mean follow-up until the following outcomes were: (I) leprosy (2.3 years) in the population who were exposed to it, (II) relapse (5.9 years), (III) clinical manifestations before, during and after treatment-nerve function impairment (5.2 years), leprosy reactions (4.9 years) and physical disability (8.3 years) in the population of patients with leprosy. Therefore, the use of survival analysis will enable the evaluation of national leprosy programs and assist in the decision-making process to face public health problems.
Topics: Chronic Disease; Deafness; Disabled Persons; Humans; Leprosy; Peripheral Nervous System Diseases; Proportional Hazards Models; Recurrence; Survival Analysis
PubMed: 36231457
DOI: 10.3390/ijerph191912155