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Hearing Disorders: HELP
Articles by Marlan Rex Hansen
Based on 34 articles published since 2009
(Why 34 articles?)
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Between 2009 and 2019, Marlan Hansen wrote the following 34 articles about Hearing Disorders.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Review Cochlear implantation and single-sided deafness. 2014

Tokita, Joshua / Dunn, Camille / Hansen, Marlan R. ·aDepartments of Otolaryngology-Head and Neck Surgery bNeurosurgery, University of Iowa, Iowa City, Iowa, USA. ·Curr Opin Otolaryngol Head Neck Surg · Pubmed #25050566.

ABSTRACT: PURPOSE OF REVIEW: Recently, more patients with single-sided deafness (SSD) have been undergoing cochlear implantation. We review recent studies and case reports to provide an overview of the efficacy of cochlear implants to rehabilitate patients with SSD with regards to sound localization, speech discrimination, and tinnitus suppression. RECENT FINDINGS: There are a growing number of studies evaluating the effect of cochlear implantation for rehabilitation of the deficits associated with SSD over the past several years as more centers offer this treatment modality to patients with SSD. Although individual studies have few patients and are underpowered, the vast majority report improvement in sound localization, speech understanding in quiet and noise, and tinnitus. In some cases, the outcomes with cochlear implant appear superior to those achieved with other devices, including contralateral routing of sound devices and osseointegrated implants. SUMMARY: Although cochlear implant is not a Food and Drug Administration-approved treatment for SSD, several recent studies show improvements in speech understanding, sound localization, and tinnitus. Because of the low number of cases, it is difficult to conclusively compare outcomes achieved with cochlear implants and those provided by other devices. However, on the basis of encouraging early results and the unique ability to restore binaural sound processing, a growing number of centers offer cochlear implants as treatment for SSD. Forthcoming studies will help define outcome expectations in different populations.

2 Clinical Trial Multicenter clinical trial of the Nucleus Hybrid S8 cochlear implant: Final outcomes. 2016

Gantz, Bruce J / Dunn, Camille / Oleson, Jacob / Hansen, Marlan / Parkinson, Aaron / Turner, Christopher. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa. · Department of Biostatistics, University of Iowa, Iowa City, Iowa. · Cochlear Americas, Centennial, Colorado. · Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A. · Department of Communication Disorders, University of Iowa, Iowa City, Iowa. ·Laryngoscope · Pubmed #26756395.

ABSTRACT: OBJECTIVES/HYPOTHESIS: The concept of expanding electrical speech processing to those with more residual acoustic hearing with a less-invasive shorter cochlear implant (CI) has been ongoing since 1999. A multicenter study of the Nucleus Hybrid S8 CI took place between 2002 and 2011. This report describes the final outcomes of this clinical trial. STUDY DESIGN: Multicenter, longitudinal, single-subject design. METHODS: Eighty-seven subjects received a Nucleus Hybrid S8 CI in their poorer ear. Speech perception in quiet (Consonant-Nucleus-Consonant [CNC] words) and in noise (Bamford-Kowal-Bench Sentences-In-Noise [BKB-SIN]) were collected pre- and postoperatively at 3, 6, and 12 months. Subjective questionnaire data using the Abbreviated Profile for Hearing Aid Benefit (APHAB) were also collected. RESULTS: Some level of hearing preservation was accomplished in 98% subjects, with 90% maintaining a functional low-frequency pure-tone average (LFPTA) at initial activation. By 12 months, five subjects had total hearing loss, and 80% of subjects maintained functional hearing. CNC words demonstrated that 82.5% and 87.5% of subjects had significant improvements in the hybrid and combined conditions, respectively. The majority had improvements with BKB-SIN. Results also indicated that as long as subjects maintained at least a severe LFPTA, there was significant improvement in speech understanding. Furthermore, all subjects reported positive improvements in hearing in three of the four subscales of the APHAB. CONCLUSIONS: The concept of hybrid speech processing has significant advantages for subjects with residual low-frequency hearing. In this study, the Nucleus Hybrid S8 provided improved word understanding in quiet and noise. Additionally, there appears to be stability of the residual hearing after initial activation of the device. LEVEL OF EVIDENCE: 2c.

3 Clinical Trial Outcomes of Adolescents With a Short Electrode Cochlear Implant With Preserved Residual Hearing. 2016

Gantz, Bruce J / Dunn, Camille / Walker, Elizabeth / Van Voorst, Tanya / Gogel, Stephanie / Hansen, Marlan. ·*Department of Otolaryngology-Head and Neck Surgery †Department of Communication Disorders, University of Iowa, Iowa City, Iowa, U.S.A. ·Otol Neurotol · Pubmed #26756143.

ABSTRACT: OBJECTIVE: The purpose of this study was to determine if adolescents with preserved residual low-frequency hearing can develop improved speech perception and maintain localization abilities by combining their acoustic hearing with electrical processing from a short electrode cochlear implant. STUDY DESIGN: Repeated-measure, single-subject experiment. SETTING: Research hospital. PATIENTS: Adolescents with sensorineural hearing loss with a pure-tone average (PTA) between 60 and 90 dB HL between 125 and 1500 Hz and profound loss at higher frequencies. INTERVENTION(S): rehabilitative. MAIN OUTCOME MEASURE(S): Five adolescents received a short electrode cochlear implant in their poorer ear. Audiometric, speech perception in quiet (CNC words), localization, speech production, and language outcomes were collected pre- and postoperatively at 4, 8, 12, and 24 months. RESULTS: Functional hearing preservation was accomplished in all subjects at initial activation and was maintained through 24 months. In the Combined and Hybrid conditions, all subjects showed significant improvements by 4 months postimplantation, with exception of Subject 2 in the Combined condition, who showed a significant improvement by 8 months postimplantation. Results also indicated that all subjects continue to have localization abilities postimplantation. CONCLUSIONS: All of the subjects have benefitted from the combined electric and acoustic processing for speech perception abilities. The results from this study suggest that it could be worthwhile to consider acoustic and electric hearing in the adolescent population that have some low-frequency residual hearing and are struggling with hearing aids.

4 Clinical Trial Risk factors for loss of ipsilateral residual hearing after hybrid cochlear implantation. 2014

Kopelovich, Jonathan C / Reiss, Lina A J / Oleson, Jacob J / Lundt, Emily S / Gantz, Bruce J / Hansen, Marlan R. ·*Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa; †Department of Otolaryngology Head and Neck Surgery, Oregon Health Science University, Portland, Oregon; and ‡Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, U.S.A. ·Otol Neurotol · Pubmed #24979394.

ABSTRACT: OBJECTIVE: Residual low-frequency acoustic hearing benefits cochlear implantees in difficult listening situations such as understanding speech in noise and music appreciation. Most subjects retain functional residual hearing in the operated ear. A small number of patients, however, will lose significant ipsilateral residual hearing after short-electrode cochlear implantation. The objectives of this retrospective series are to determine whether predisposition to hearing loss after implantation exists in a subset of patients and to assess the functional impact of this hearing loss on clinical measures of combined electric and acoustic hearing. STUDY DESIGN: Retrospective case series. SETTING: Multicenter clinical trial; tertiary care facility. PATIENTS: Hearing preservation cochlear implant recipients. MAIN OUTCOME MEASURE: Frequency-averaged ipsilateral hearing loss at 1 year after activation. RESULTS: Eighty-five patients from the Hybrid S8 FDA trial had serial postoperative audiometric measurements. Twenty-two of these patients, implanted at the home institution, provided additional medical data. Univariate analysis (Pearson's, Spearman's, Student's t test) showed that the severity of hearing loss at 1 year after activation was significantly correlated with age, male gender, and noise-induced hearing loss as the etiology of hearing impairment. A multivariate regression model corroborated these variables. No other medical factors were predictive. Clinical measures of speech perception (Consonant-Nucleus-Consonant and Hearing in Noise Test) worsened with hearing loss in ipsilateral but not bilateral listening conditions. CONCLUSION: Age, male gender, and a history of noise-induced hearing loss correlate with the severity of hearing loss at 1 year after activation. Even the most severely affected patients benefit from bilateral electric and acoustic inputs.

5 Clinical Trial Hybrid 10 clinical trial: preliminary results. 2009

Gantz, Bruce J / Hansen, Marlan R / Turner, Christopher W / Oleson, Jacob J / Reiss, Lina A / Parkinson, Aaron J. ·Department of Otolaryngology - Head and Neck Surgery, Iowa Cochlear Implant Clinical Research Center, University of Iowa, Iowa City, Iowa 52242-1078, USA. bruce-gantz@uiowa.edu ·Audiol Neurootol · Pubmed #19390173.

ABSTRACT: Acoustic plus electric (electric-acoustic) speech processing has been successful in highlighting the important role of articulation information in consonant recognition in those adults that have profound high-frequency hearing loss at frequencies greater than 1500 Hz and less than 60% discrimination scores. Eighty-seven subjects were enrolled in an adult Hybrid multicenter Food and Drug Administration clinical trial. Immediate hearing preservation was accomplished in 85/87 subjects. Over time (3 months to 5 years), some hearing preservation was maintained in 91% of the group. Combined electric-acoustic processing enabled most of this group of volunteers to gain improved speech understanding, compared to their preoperative hearing, with bilateral hearing aids. Most have preservation of low-frequency acoustic hearing within 15 dB of their preoperative pure tone levels. Those with greater losses (>30 dB) also benefited from the combination of electric-acoustic speech processing. Postoperatively, in the electric-acoustic processing condition, loss of low-frequency hearing did not correlate with improvements in speech perception scores in quiet. Sixteen subjects were identified as poor performers in that they did not achieve a significant improvement through electric-acoustic processing. A multiple regression analysis determined that 91% of the variance in the poorly performing group can be explained by the preoperative speech recognition score and duration of deafness. Signal-to-noise ratios for speech understanding in noise improved more than 9 dB in some individuals in the electric-acoustic processing condition. The relation between speech understanding in noise thresholds and residual low-frequency acoustic hearing is significant (r = 0.62; p < 0.05). The data suggest that, in general, the advantages gained for speech recognition in noise by preserving residual hearing exist, unless the hearing loss approaches profound levels. Preservation of residual low-frequency hearing should be considered when expanding candidate selection criteria for standard cochlear implants. Duration of profound high-frequency hearing loss appears to be an important variable when determining selection criteria for the Hybrid implant.

6 Article Bilateral Cochlear Implants Using Two Electrode Lengths in Infants With Profound Deafness. 2019

Dunn, Camille C / Walker, Elizabeth A / Gogel, Stephanie / Van Voorst, Tanya / Hansen, Marlan / Gantz, Bruce J. ·Department of Otolaryngology - Head and Neck Surgery. · Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa. ·Otol Neurotol · Pubmed #30741906.

ABSTRACT: OBJECTIVE: The goal of this investigation was to determine if a short electrode in one ear and standard electrode in the contralateral ear could be an option for infants with congenital profound deafness to theoretically preserve the structures of the inner ear. Similarities in performance between ears and compared with a control group of infants implanted with bilateral standard electrodes was evaluated. STUDY DESIGN: Repeated-measure, single-subject experiment. SETTING: University of Iowa-Department of Otolaryngology. PARTICIPANTS: Nine infants with congenital profound bilateral sensorineural hearing loss. INTERVENTION(S): Short and standard implants. MAIN OUTCOME MEASURE(S): Early speech perception test (ESP), children's vowel, phonetically balanced-kindergarten (PB-K) word test, and preschool language scales-3 (PLS-3). RESULTS: ESP scores showed performance reaching a ceiling effect for the individual short and standard ears and bilaterally. The children's vowel and PB-K word results indicated significant (both p < 0.001) differences between the two ears. Bilateral comparisons to age-matched children with standard bilateral electrodes showed no significant differences (p = 0.321) in performance. Global language performance for six children demonstrated standard scores around 1 standard deviation (SD) of the mean. Two children showed scores below the mean, but can be attributed to inconsistent device usage. Averaged total language scores between groups showed no difference in performance (p = 0.293). CONCLUSIONS: The combined use of a short electrode and standard electrode might provide an option for implantation with the goal of preserving the cochlear anatomy. However, further studies are needed to understand why some children have or do not have symmetric performance.

7 Article In Vivo Electrocochleography in Hybrid Cochlear Implant Users Implicates TMPRSS3 in Spiral Ganglion Function. 2018

Shearer, A Eliot / Tejani, Viral D / Brown, Carolyn J / Abbas, Paul J / Hansen, Marlan R / Gantz, Bruce J / Smith, Richard J H. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA. · Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA. richard-smith@uiowa.edu. · Interdepartmental PhD Program in Genetics, University of Iowa, Iowa City, Iowa, USA. richard-smith@uiowa.edu. · Department of Molecular Physiology & Biophysics, University of Iowa College of Medicine, Iowa City, Iowa, USA. richard-smith@uiowa.edu. ·Sci Rep · Pubmed #30242206.

ABSTRACT: Cochlear implantation, a surgical method to bypass cochlear hair cells and directly stimulate the spiral ganglion, is the standard treatment for severe-to-profound hearing loss. Changes in cochlear implant electrode array design and surgical approach now allow for preservation of acoustic hearing in the implanted ear. Electrocochleography (ECochG) was performed in eight hearing preservation subjects to assess hair cell and neural function and elucidate underlying genetic hearing loss. Three subjects had pathogenic variants in TMPRSS3 and five had pathogenic variants in genes known to affect the cochlear sensory partition. The mechanism by which variants in TMPRSS3 cause genetic hearing loss is unknown. We used a 500-Hz tone burst to record ECochG responses from an intracochlear electrode. Responses consist of a cochlear microphonic (hair cell) and an auditory nerve neurophonic. Cochlear microphonics did not differ between groups. Auditory nerve neurophonics were smaller, on average, in subjects with TMPRSS3 deafness. Results of this proof-of-concept study provide evidence that pathogenic variants in TMPRSS3 may impact function of the spiral ganglion. While ECochG as a clinical and research tool has been around for decades, this study illustrates a new application of ECochG in the study of genetic hearing and deafness in vivo.

8 Article Functions of CaBP1 and CaBP2 in the peripheral auditory system. 2018

Yang, Tian / Hu, Ning / Pangršič, Tina / Green, Steven / Hansen, Marlan / Lee, Amy. ·Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA 52242, USA; Department of Otolaryngology Head-Neck Surgery, University of Iowa, Iowa City, IA 52242, USA. · Department of Otolaryngology Head-Neck Surgery, University of Iowa, Iowa City, IA 52242, USA; Department of Biology, University of Iowa, Iowa City, IA 52242, USA. · Synaptic Physiology of Mammalian Vestibular Hair Cells Group, Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany. · Department of Otolaryngology Head-Neck Surgery, University of Iowa, Iowa City, IA 52242, USA; Department of Neurosurgery, University of Iowa, Iowa City, IA 52242, USA. · Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA 52242, USA; Department of Otolaryngology Head-Neck Surgery, University of Iowa, Iowa City, IA 52242, USA; Department of Neurology, University of Iowa, Iowa City, IA 52242, USA. Electronic address: amy-lee@uiowa.edu. ·Hear Res · Pubmed #29661613.

ABSTRACT: CaBPs are a family of Ca

9 Article Acoustic plus electric speech processing: Long-term results. 2018

Gantz, Bruce J / Dunn, Camille C / Oleson, Jacob / Hansen, Marlan R. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, U.S.A. · Department of Biostatistics, University of Iowa, Iowa City, Iowa, U.S.A. ·Laryngoscope · Pubmed #28543270.

ABSTRACT: OBJECTIVE: Few studies have investigated the stability of residual hearing and speech perception outcomes in individuals who were implanted with a shorter electrode device. STUDY DESIGN: Longitudinal, single-subject design. METHODS: Fifty subjects who received a Nucleus Hybrid (Cochlear, Sydney, Australia) short electrode cochlear implant (CI) and had a minimum of 2 years (and up to 15 years) of postoperative longitudinal experience were included in this study. Twenty-three subjects received a Nucleus Hybrid S8 (S8); 14 subjects received a Nucleus Hybrid L24 (L24); and 13 received a Nucleus Hybrid S12 (S12). Audiometric thresholds and consonant-nucleus-consonant (CNC) words were collected pre- and postoperatively for up to 15 years for the S8 subjects and for up to 7 years for the S12 and L24 subjects. AzBio Sentences in multi-talker babble was collected for up to 7 years on the S12 and L24 subjects. RESULTS: Longitudinally, 83% of the S8 subjects, 92% of the S12 subjects, and 86% of the L24 subjects maintained a functional hearing pure-tone average (PTA) (125-500 Hz). Predicted change using a piecewise linear mixed model in PTA over time showed a postoperative linear decrease in hearing for each group until 0.5 years, after which the PTA stabilizes and is maintained. The averaged individual data for CNC and AzBio sentences show a significant improvement in scores by 0.25 to 0.5 years postimplantation, after which scores start to reach their maximum. CONCLUSION: This long-term study demonstrates that acoustic-electric processing hearing and improvement in speech understanding in quiet and in noise can be accomplished and sustained for many years with a short electrode CI. LEVEL OF EVIDENCE: 2C. Laryngoscope, 128:473-481, 2018.

10 Article Delayed changes in auditory status in cochlear implant users with preserved acoustic hearing. 2017

Scheperle, Rachel A / Tejani, Viral D / Omtvedt, Julia K / Brown, Carolyn J / Abbas, Paul J / Hansen, Marlan R / Gantz, Bruce J / Oleson, Jacob J / Ozanne, Marie V. ·Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA; Department of Otolaryngology - Head and Neck Surgery, University of Iowa, Iowa City, IA 52242, USA. Electronic address: scheperler@montclair.edu. · Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA; Department of Otolaryngology - Head and Neck Surgery, University of Iowa, Iowa City, IA 52242, USA. Electronic address: viral-tejani@uiowa.edu. · Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA. Electronic address: julia-omtvedt@uiowa.edu. · Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA; Department of Otolaryngology - Head and Neck Surgery, University of Iowa, Iowa City, IA 52242, USA. Electronic address: carolyn-brown@uiowa.edu. · Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA; Department of Otolaryngology - Head and Neck Surgery, University of Iowa, Iowa City, IA 52242, USA. Electronic address: paul-abbas@uiowa.edu. · Department of Otolaryngology - Head and Neck Surgery, University of Iowa, Iowa City, IA 52242, USA. Electronic address: marlan-hansen@uiowa.edu. · Department of Otolaryngology - Head and Neck Surgery, University of Iowa, Iowa City, IA 52242, USA. Electronic address: bruce-gantz@uiowa.edu. · Department of Biostatistics, University of Iowa, Iowa City, IA 52242, USA. Electronic address: jacob-oleson@uiowa.edu. · Department of Biostatistics, University of Iowa, Iowa City, IA 52242, USA. Electronic address: marie-ozanne@uiowa.edu. ·Hear Res · Pubmed #28432874.

ABSTRACT: This retrospective review explores delayed-onset hearing loss in 85 individuals receiving cochlear implants designed to preserve acoustic hearing at the University of Iowa Hospitals and Clinics between 2001 and 2015. Repeated measures of unaided behavioral audiometric thresholds, electrode impedance, and electrically evoked compound action potential (ECAP) amplitude growth functions were used to characterize longitudinal changes in auditory status. Participants were grouped into two primary categories according to changes in unaided behavioral thresholds: (1) stable hearing or symmetrical hearing loss and (2) delayed loss of hearing in the implanted ear. Thirty-eight percent of this sample presented with delayed-onset hearing loss of various degrees and rates of change. Neither array type nor insertion approach (round window or cochleostomy) had a significant effect on prevalence. Electrode impedance increased abruptly for many individuals exhibiting precipitous hearing loss; the increase was often transient. The impedance increases were significantly larger than the impedance changes observed for individuals with stable or symmetrical hearing loss. Moreover, the impedance changes were associated with changes in behavioral thresholds for individuals with a precipitous drop in behavioral thresholds. These findings suggest a change in the electrode environment coincident with the change in auditory status. Changes in ECAP thresholds, growth function slopes, and suprathreshold amplitudes were not correlated with changes in behavioral thresholds, suggesting that neural responsiveness in the region excited by the implant is relatively stable. Further exploration into etiology of delayed-onset hearing loss post implantation is needed, with particular interest in mechanisms associated with changes in the intracochlear environment.

11 Article Treatment of Lateral Skull Base and Posterior Cranial Fossa Lesions Utilizing the Extended Middle Cranial Fossa Approach. 2017

Roche, Joseph P / Goates, Andrew J / Hasan, David M / Howard, Matthew A / Menezes, Arnold H / Hansen, Marlan R / Gantz, Bruce J. ·*Division of Otolaryngology, Department of Surgery, School of Medicine and Public Health, The University of Wisconsin, Madison, Wisconsin †Department of Otolaryngology-Head and Neck Surgery ‡The Department of Neurosurgery, The University of Iowa Carver College of Medicine, The University of Iowa, Iowa City, Iowa. ·Otol Neurotol · Pubmed #28234787.

ABSTRACT: OBJECTIVE: Define the indications and outcomes for subjects undergoing treatment utilizing the extended middle cranial fossa approach (EMCF). STUDY DESIGN: Retrospective records review. SETTING: University-based tertiary referral center. PATIENTS: Subjects undergoing treatment of posterior cranial fossa (PCF) lesions. INTERVENTION(S): EMCF exposure and treatment of the indicating PCF lesion. MAIN OUTCOME MEASURE(S): Demographic, audiometric, and cranial nerve functioning variables were assessed. RESULTS: Thirty-five subjects who underwent an EMCF exposure were identified over a 12-year period. The most common indication was meningioma (18; 51%) followed by schwannomas (six, 17%), and vascular lesions (five, 14%). Preoperative cranial nerve complaints were common (32, 94%) as were objective cranial nerve abnormalities on physical examination (21; 60%). Preoperative audiometric data from subjects with hearing demonstrated good functioning including pure-tone average (PTA) (21.7 ± 15.6 dB HL) and word understanding scores (95.1 ± 7.4%). Most (34, 97%) subjects had intact facial nerve function. The average length of stay was 11.6 days (median = 9). Cranial neuropathies were common postoperatively with 27 (79%) subjects demonstrating some objective cranial nerve dysfunction, the most common of which was trigeminal nerve hypesthesia (21, 61.7%). Subjects with identifiable pre- and postoperative audiometric data and preoperative hearing demonstrated small declines in the four-tone average (16.2 dB) and word recognition scores (22.4%). Two subjects (6%) had new profound hearing loss postoperatively. CONCLUSIONS: The EMCF approach can provide safe and effective exposure of the anterior PCF.

12 Article Genetic variants in the peripheral auditory system significantly affect adult cochlear implant performance. 2017

Shearer, A Eliot / Eppsteiner, Robert W / Frees, Kathy / Tejani, Viral / Sloan-Heggen, Christina M / Brown, Carolyn / Abbas, Paul / Dunn, Camille / Hansen, Marlan R / Gantz, Bruce J / Smith, Richard J H. ·Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA. · Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Department of Communication Sciences & Disorders, University of Iowa, Iowa City, IA, USA. · Department of Otolaryngology-Head & Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Interdepartmental PhD Program in Genetics, University of Iowa, Iowa City, IA, USA; Department of Molecular Physiology & Biophysics, University of Iowa College of Medicine, Iowa City, IA, USA. Electronic address: richard-smith@uiowa.edu. ·Hear Res · Pubmed #28213135.

ABSTRACT: BACKGROUND: Cochlear implantation is an effective habilitation modality for adults with significant hearing loss. However, post-implant performance is variable. A portion of this variance in outcome can be attributed to clinical factors. Recent physiological studies suggest that the health of the spiral ganglion also impacts post-operative cochlear implant outcomes. The goal of this study was to determine whether genetic factors affecting spiral ganglion neurons may be associated with cochlear implant performance. METHODS: Adults with post-lingual deafness who underwent cochlear implantation at the University of Iowa were studied. Pre-implantation evaluation included comprehensive genetic testing for genetic diagnosis. A novel score of genetic variants affecting genes with functional effects in the spiral ganglion was calculated. A Z-scored average of up to three post-operative speech perception tests (CNC, HINT, and AzBio) was used to assess outcome. RESULTS: Genetically determined spiral ganglion health affects cochlear implant outcomes, and when considered in conjunction with clinically determined etiology of deafness, accounts for 18.3% of the variance in postoperative speech recognition outcomes. Cochlear implant recipients with deleterious genetic variants that affect the cochlear sensory organ perform significantly better on tests of speech perception than recipients with deleterious genetic variants that affect the spiral ganglion. CONCLUSION: Etiological diagnosis of deafness including genetic testing is the single largest predictor of postoperative speech outcomes in adult cochlear implant recipients. A detailed understanding of the genetic underpinning of hearing loss will better inform pre-implant counseling. The method presented here should serve as a guide for further research into the molecular physiology of the peripheral auditory system and cochlear implants.

13 Article Survey on the Effectiveness of Dietary Supplements to Treat Tinnitus. 2016

Coelho, Claudia / Tyler, Richard / Ji, Haihong / Rojas-Roncancio, Eveling / Witt, Shelley / Tao, Pan / Jun, Hyung-Jin / Wang, Tang Chuan / Hansen, Marlan R / Gantz, Bruce J. ·University of Iowa, Iowa City. ·Am J Audiol · Pubmed #27681261.

ABSTRACT: PURPOSE: We surveyed the benefit of dietary supplements to treat tinnitus and reported adverse effects. METHOD: A website was created for people with tinnitus to complete a variety of questions. RESULTS: The 1,788 subjects who responded to questionnaires came from 53 different countries; 413 (23.1%) reported taking supplements. No effect on tinnitus was reported in 70.7%, improvement in 19.0%, and worsening in 10.3%. Adverse effects were reported in 6% (n = 36), including bleeding, diarrhea, headache, and others. Supplements were reported to be helpful for sleep: melatonin (effect size, d = 1.228) and lipoflavonoid (d = 0.5244); emotional reactions: melatonin (d = 0.6138) and lipoflavonoid (d = 0.457); hearing: Ginkgo biloba (d = 0.3758); and concentration Ginkgo biloba (d = 0.3611). The positive, subjective reports should be interpreted cautiously; many might have reported a positive effect because they were committed to treatment and expected a benefit. Users of supplements were more likely to have loudness hyperacusis and to have a louder tinnitus. CONCLUSIONS: The use of dietary supplements to treat tinnitus is common, particularly with Ginkgo biloba, lipoflavonoids, magnesium, melatonin, vitamin B12, and zinc. It is likely that some supplements will help with sleep for some patients. However, they are generally not effective, and many produced adverse effects. We concluded that dietary supplements should not be recommended to treat tinnitus but could have a positive outcome on tinnitus reactions in some people.

14 Article Manganese and Lipoflavonoid Plus(®) to Treat Tinnitus: A Randomized Controlled Trial. 2016

Rojas-Roncancio, Eveling / Tyler, Richard / Jun, Hyung-Jin / Wang, Tang-Chuan / Ji, Haihong / Coelho, Claudia / Witt, Shelley / Hansen, Marlan R / Gantz, Bruce J. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA. · Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA. ·J Am Acad Audiol · Pubmed #27564443.

ABSTRACT: BACKGROUND: Several tinnitus sufferers suggest that manganese has been helpful with their tinnitus. PURPOSE: We tested this in a controlled experiment where participants were committed to taking manganese and Lipoflavonoid Plus(®) to treat their tinnitus. RESEARCH DESIGN: Randomized controlled trial. STUDY SAMPLE: 40 participants were randomized to receive both manganese and Lipoflavonoid Plus(®) for 6 months, or Lipoflavonoid Plus(®) only (as the control). DATA COLLECTION AND ANALYSIS: Pre- and postmeasures were obtained with the Tinnitus Handicap Questionnaire, Tinnitus Primary Functions Questionnaire, and tinnitus loudness and annoyance ratings. An audiologist performed the audiogram, the tinnitus loudness match, and minimal masking level. RESULTS: Twelve participants were dropped out of the study because of the side effects or were lost to follow-up. In the manganese group, 1 participant (out of 12) showed a decrease in the questionnaires, and another showed a decrease in the loudness and annoyance ratings. No participants from the control group (total 16) showed a decrease in the questionnaires ratings. Two participants in the control group reported a loudness decrement and one reported an annoyance decrement. CONCLUSIONS: We were not able to conclude that either manganese or Lipoflavonoid Plus(®) is an effective treatment for tinnitus.

15 Article Vestibular Schwannomas: Do Linear and Volumetric Parameters on MRI Correlate With Hearing Loss? 2016

Bathla, Girish / Case, Brendan M / Berbaum, Kevin / Hansen, Marlan R / Policeni, Bruno. ·*Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City †Iowa Methodist Medical Center, Des Moines ‡Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa. ·Otol Neurotol · Pubmed #27466888.

ABSTRACT: PURPOSE: To determine if two-dimensional and volumetric imaging parameters in vestibular schwannomas (VS) correlate with hearing loss at presentation. STUDY DESIGN: Retrospective. METHODS: Forty-one cases of pathologically confirmed sporadic VS were analyzed. Maximal tumor dimensions in anteroposterior (AP), coronal (ML), and craniocaudal (CC) dimensions were obtained along with tumor-fundus distance and internal auditory canal (IAC) porus diameters. Volumetric analysis was done on 37 cases. Tumors volumes were calculated through both 3-D volumetric and ABC/2 [AP × ML × CC/2] methodology. With the 3-D method, total tumor volume (TTV), and cerebellopontine angle (CPA) tumor volume were separately calculated and IAC volumes obtained by subtracting CPA tumor volumes from TTV. Pure tone average (PTA) and speech discrimination scores (SDS) were correlated with tumor dimensions. RESULTS: Non-volumetric analysis was performed on 41 tumors. The AP and ML dimensions correlated with both PTA and SDS (p < 0.05). No significant correlations were seen between hearing loss and tumor-fundus distance or porus diameters. The tumor volume calculated through ABC/2 methodology correlated with PTA and SDS (p < 0.05). The 3-D TTV and CPA volumes only correlated with PTA. IAC tumor volumes did not correlate with hearing loss. CONCLUSION: Maximal AP and ML dimensions are the only non-volumetric variables, which significantly correlate with hearing loss. Tumor volume calculated through ABC/2 method significantly correlates with hearing impairment while the 3-D TTV and CPA tumor volumes only correlated significantly with PTA scores but not SDS scores.

16 Article Delayed loss of hearing after hearing preservation cochlear implantation: Human temporal bone pathology and implications for etiology. 2016

Quesnel, Alicia M / Nakajima, Hideko Heidi / Rosowski, John J / Hansen, Marlan R / Gantz, Bruce J / Nadol, Joseph B. ·Department of Otology and Laryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA. Electronic address: alicia_quesnel@meei.harvard.edu. · Department of Otology and Laryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA. Electronic address: heidi_nakajima@meei.harvard.edu. · Department of Otology and Laryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA. Electronic address: john_rosowski@meei.harvard.edu. · University of Iowa Hospitals and Clinics, Department of Otolaryngology, 200 Hawkins Drive, Iowa City, IA 52242-1078, USA. Electronic address: marlan-hansen@uiowa.edu. · University of Iowa Hospitals and Clinics, Department of Otolaryngology, 200 Hawkins Drive, Iowa City, IA 52242-1078, USA. Electronic address: bruce-gantz@uiowa.edu. · Department of Otology and Laryngology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA. Electronic address: joseph_nadol@meei.harvard.edu. ·Hear Res · Pubmed #26341474.

ABSTRACT: After initially successful preservation of residual hearing with cochlear implantation, some patients experience subsequent delayed hearing loss. The etiology of such delayed hearing loss is unknown. Human temporal bone pathology is critically important in investigating the etiology, and directing future efforts to maximize long term hearing preservation in cochlear implant patients. Here we present the temporal bone pathology from a patient implanted during life with an Iowa/Nucleus Hybrid S8 implant, with initially preserved residual hearing and subsequent hearing loss. Both temporal bones were removed for histologic processing and evaluated. Complete clinical and audiologic records were available. He had bilateral symmetric high frequency severe to profound hearing loss prior to implantation. Since he was implanted unilaterally, the unimplanted ear was presumed to be representative of the pre-implantation pathology related to his hearing loss. The implanted and contralateral unimplanted temporal bones both showed complete degeneration of inner hair cells and outer hair cells in the basal half of the cochleae, and only mild patchy loss of inner hair cells and outer hair cells in the apical half. The total spiral ganglion neuron counts were similar in both ears: 15,138 (56% of normal for age) in the unimplanted right ear and 13,722 (51% of normal for age) in the implanted left ear. In the basal turn of the implanted left cochlea, loose fibrous tissue and new bone formation filled the scala tympani, and part of the scala vestibuli. Delayed loss of initially preserved hearing after cochlear implantation was not explained by additional post-implantation degeneration of hair cells or spiral ganglion neurons in this patient. Decreased compliance at the round window and increased damping in the scala tympani due to intracochlear fibrosis and new bone formation might explain part of the post-implantation hearing loss. Reduction of the inflammatory and immune response to cochlear implantation may lead to better long term hearing preservation post-implantation.

17 Article Successful Hearing Preservation After Reimplantation of a Failed Hybrid Cochlear Implant. 2015

Dunn, Camille C / Etler, Christine / Hansen, Marlan / Gantz, Bruce J. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, U.S.A. ·Otol Neurotol · Pubmed #26440726.

ABSTRACT: Objective: The purpose of this case study was to demonstrate hearing preservation of a subject who was implanted with a 10-mm short electrode cochlear implant that was determined to be malfunctioning at 6 months postimplantation and was explanted and reimplanted with a 16-mm short electrode device.Study Design: Single-subject case study.Setting: Research hospital.Patient: A 60-year old female with a history of gradual progressive bilateral steeply sloping sensorineural hearing loss.Intervention: Rehabilitative.Main Outcome Measure(s): Audiometric data and speech perception in quiet and in noise were collected pre- and postoperatively at 3 and 6 months with the 10-mm short electrode device and pre-explantation and postoperatively at 3, 6, and 12 months with the 16-mm short electrode device.Results: Functional hearing preservation was accomplished following surgical implantation of both short electrode devices. Overall, the subject had a 22 dB HL total shift in pure-tone-average (0.125–1 kHz) after two cochlear implant surgeries. Speech perception growth was limited over the 6 months the subject was implanted with the 10-mm short electrode device. After 3 months of experience with the 16-mm short electrode device, the subject experienced significant improvements in both speech perception in quiet and in noise.Conclusions: The inner ear might be more robust than once thought, as was determined through preservation of residual hearing after implantation of two hearing preservation cochlear implants and one device explantation. Furthermore, it is important that hearing professionals remain cognizant of unusual speech perception patterns associated with the cochlear implant. Key Words: Hearing preservation—Residual hearing—Short electode. [Corrected]

18 Article Acoustic Hearing After Murine Cochlear Implantation: Effects of Trauma and Implant Type. 2015

Kopelovich, Jonathan C / Robinson, Barbara K / Soken, Hakan / Verhoeven, Kristien J / Kirk, Jonathon R / Goodman, Shawn S / Hansen, Marlan R. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, Colorado, USA. · Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA. · Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA Eskisehir Military Hospital, Eskisehir, Turkey. · Cochlear Technology Center Europe Belgium, Mechelen, Belgium. · Cochlear Ltd, Research and Technology Laboratories, Centennial, Colorado, USA. · Department of Communication Sciences and Disorders, University of Iowa, Iowa City, Iowa, USA. · Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA Department of Neurosurgery, University of Iowa, Iowa City, Iowa, USA marlan-hansen@uiowa.edu. ·Ann Otol Rhinol Laryngol · Pubmed #26091845.

ABSTRACT: OBJECTIVES: To model the contribution of implant material and insertion trauma on loss of acoustic hearing after cochlear implantation in an appropriate animal model. METHODS: Sixty-five C57Bl/6J mice underwent unilateral implantation with implant grade materials: 2 implant grade silicones and a third uncoated platinum wire. A sham surgery group was included as a control. Serial auditory brainstem response (ABR) thresholds and distortion product otoacoustic emissions (DPOAEs) were used to discern effects on hearing over 22 weeks. Histologic measurements of damage to the organ of Corti and spiral ganglion were correlated with degree of hearing loss and material type. RESULTS: Organ of Corti damage correlated with rate of hearing loss soon after implantation (0-2 weeks) but not subsequently (2-22 weeks). Organ of Corti damage did not depend on implant type and was present even in sham surgery subjects when hearing was severely damaged. Spiral ganglia appeared unaffected. There was no evidence of an inflammatory or toxic effect of the materials beyond the site of implant insertion. CONCLUSIONS: Hearing loss and cochlear damage appear to be related to insertion trauma, with minimal effect on delayed hearing loss caused by different materials. In the C57Bl/6J mouse model, the sensory epithelium appears to be the location of damage after cochlear implantation.

19 Article A Series of Case Studies of Tinnitus Suppression With Mixed Background Stimuli in a Cochlear Implant. 2015

Tyler, Richard S / Keiner, A J / Walker, Kurt / Deshpande, Aniruddha K / Witt, Shelley / Killian, Matthijs / Ji, Helena / Patrick, Jim / Dillier, Norbert / van Dijk, Pim / Lai, Wai Kong / Hansen, Marlan R / Gantz, Bruce. · ·Am J Audiol · Pubmed #26001407.

ABSTRACT: PURPOSE: Background sounds provided by a wearable sound playback device were mixed with the acoustical input picked up by a cochlear implant speech processor in an attempt to suppress tinnitus. METHOD: First, patients were allowed to listen to several sounds and to select up to 4 sounds that they thought might be effective. These stimuli were programmed to loop continuously in the wearable playback device. Second, subjects were instructed to use 1 background sound each day on the wearable device, and they sequenced the selected background sounds during a 28-day trial. Patients were instructed to go to a website at the end of each day and rate the loudness and annoyance of the tinnitus as well as the acceptability of the background sound. Patients completed the Tinnitus Primary Function Questionnaire (Tyler, Stocking, Secor, & Slattery, 2014) at the beginning of the trial. RESULTS: Results indicated that background sounds were very effective at suppressing tinnitus. There was considerable variability in sounds preferred by the subjects. CONCLUSION: The study shows that a background sound mixed with the microphone input can be effective for suppressing tinnitus during daily use of the sound processor in selected cochlear implant users.

20 Article Hearing Loss After Activation of Hearing Preservation Cochlear Implants Might Be Related to Afferent Cochlear Innervation Injury. 2015

Kopelovich, Jonathan C / Reiss, Lina A J / Etler, Christine P / Xu, Linjing / Bertroche, J Tyler / Gantz, Bruce J / Hansen, Marlan R. ·*Departments of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa; †Department of Otolaryngology-Head and Neck Surgery, Oregon Health Science University, Portland, Oregon; and ‡Departments of Communication Sciences and Disorders and §Neurosurgery, University of Iowa, Iowa City, Iowa, U.S.A. ·Otol Neurotol · Pubmed #25955750.

ABSTRACT: OBJECTIVE: Characterize hearing loss (HL) after hearing preservation cochlear implantation and determine the association between high charge electrical stimulation (ES) and late loss of acoustic hearing. METHODS: A retrospective cohort analysis of all hearing preservation implantees at our center (n = 42) assayed HL as a function of maximum charge. We analyzed serial audiometry from 85 patients enrolled in the multicenter Hybrid S8 trial to detail the hearing loss greater than 1 month after implantation. Cochleotypic explant cultures were used to assess susceptibility to high levels of ES. RESULTS: Early HL after implantation tends to be mild and averages 12.2 dB. After activation of the Hybrid S8 device, 17 (20%) of 85 patients experienced acceleration of HL. Compared with the majority of patients who did not lose significant hearing after activation, these patients experienced more severe HL at 1 year. Five patients implanted at our center experienced acceleration of HL after high charge exposure. In patients implanted at our center, high charge was associated with late HL (Pearson 0.366, p = 0.016). In rat cochleotypic explants, high voltage ES damaged afferent nerve fibers, reflected by blebbing and a 50% reduction in the number of fibers innervating the organ of Corti. In contrast, hair cells displayed only minor differences in cell number and morphology. CONCLUSIONS: Based on clinical and in vitro data, we theorize that the combination of acoustic amplification and ES in the setting of intact hair cells and neural architecture may contribute, in part, to cochlear toxicity, perhaps by damaging the afferent innervation.

21 Article Speech, Spatial and Qualities of Hearing Scale (SSQ) and Spatial Hearing Questionnaire (SHQ) Changes Over Time in Adults With Simultaneous Cochlear Implants. 2015

Zhang, Juan / Tyler, Richard / Ji, Haihong / Dunn, Camille / Wang, Ningyu / Hansen, Marlan / Gantz, Bruce. · ·Am J Audiol · Pubmed #25934950.

ABSTRACT: PURPOSE: The purpose of the present study is to evaluate the changes over time of the Spatial Hearing Questionnaire (SHQ; Tyler, Perreau, & Ji, 2009) and the Speech, Spatial and Qualities of Hearing Scale (SSQ; Gatehouse & Noble, 2004) in adults with simultaneous bilateral cochlear implants by collecting data for 2 years after implantation. METHOD: Nineteen postlingual subjects participated in this study. Average age at implant was 63 years. The subjects' data were included in this retrospective analysis only if they completed both questionnaires. We compared subjects' SSQ and SHQ scores to word recognition and sound localization performances. RESULTS: The study showed SHQ and SSQ scores continuously improved up to 1 year postimplantation, with the most improvement occurring within the first 6 months of implantation. After 1 year, the scores reached a plateau. This is consistent with laboratory tests from the same 19 subjects, and they showed high correlations (p < .05). The present study also showed a high degree of correlation between SHQ and SSQ scores. CONCLUSIONS: Both the SSQ and SHQ scores improved up to 12 months postimplantation, with the most improvement during the first 6 months of implantation. Both were consistent with laboratory tests. There was a high degree of correlation between SHQ and SSQ scores.

22 Article Hearing preservation among patients undergoing cochlear implantation. 2015

Van Abel, Kathryn M / Dunn, Camille C / Sladen, Douglas P / Oleson, Jacob J / Beatty, Charles W / Neff, Brian A / Hansen, Marlan / Gantz, Bruce J / Driscoll, Colin L W. ·*Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota; †Departments of Otolaryngology-Head and Neck Surgery, and ‡Biostatistics, University of Iowa, Iowa City, Iowa; and §Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, U.S.A. ·Otol Neurotol · Pubmed #25575373.

ABSTRACT: INTRODUCTION: Despite successful preservation of low-frequency hearing in patients undergoing cochlear implantation (CI) with shorter electrode lengths, there is still controversy regarding which electrodes maximize hearing preservation (HP). The thin straight electrode array (TSEA) has been suggested as a full cochlear coverage option for HP. However, very little is known regarding its HP potential. METHODS: A retrospective review was performed at two tertiary academic medical centers, reviewing the electronic records for 52 patients (mean, 58.2 yr; range, 11-85 yr) implanted with the Cochlear Nucleus CI422 Slim Straight (Centennial, CO, USA) electrode array, referred to herein as the thin straight electrode array or TSEA. All patients had a preoperative low-frequency pure-tone average (LFPTA) of 85 dB HL or less. Hearing thresholds were measured at initial activation (t1) and 6 months after activation (t2). HP was assessed by evaluating functional HP using a cutoff level of 85 dB HL PTA. RESULTS: At t1, 54% of the subjects had functional hearing; 33% of these subjects had an LFPTA between 71 and 85 dB HL, and 17% had an LFPTA between 56 and 70 dB HL. At t2, 47% of the patients had functional hearing, with 31% having an LFPTA between 71 and 85 dB HL. DISCUSSION: Preliminary research suggests that the TSEA has the potential to preserve functional hearing in 54% of patients at t1. However, 22% (n = 6) of the patients who had functional hearing at t1 (n = 28) lost their hearing between t1 and t2. Further studies are needed to evaluate factors that influence HP with the TSEA electrode and determine the speech perception benefits using electric and acoustic hearing over electric alone.

23 Article Outcomes after cochlear implantation for patients with single-sided deafness, including those with recalcitrant Ménière's disease. 2013

Hansen, Marlan R / Gantz, Bruce J / Dunn, Camille. ·Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, U.S.A. ·Otol Neurotol · Pubmed #24232066.

ABSTRACT: OBJECTIVE: Compare preoperative and postoperative performance in patients undergoing cochlear implantation (CI) for unilateral severe-to-profound sensorineural hearing loss (single-sided deafness, SSD). STUDY DESIGN: IRB-approved, prospective SETTING: Tertiary center PATIENTS: Twenty-nine patients have undergone CI for SSD. SSD was due to Ménière's disease (MD) in 10 subjects; these also suffered from recalcitrant vertigo spells and in these 10 patients along with 2 others the CI was placed simultaneous with a labyrinthectomy. INTERVENTION(S): CI with or without labyrinthectomy. MAIN OUTCOME MEASURE(S): CNC word and AzBio sentences in quiet were administered to the implanted ear. A multiple-loudspeaker sound localization test was administered in the bilateral listening condition. All data were collected preoperatively and 3, 6, and 12 months postoperatively with postoperative data available for 19 subjects. Additionally, a tinnitus handicap questionnaire is administered pre- and 12-months post-operatively. RESULTS: CNC word and AzBio sentence scores showed improvement in the implanted ear. Sound localization appeared to improve in an experience-dependent fashion in some patients. Most patients reported diminished tinnitus after cochlear implantation. All patients undergoing labyrinthectomy experienced resolution of vertigo attacks. CONCLUSION: CI restores auditory function to the deafened ear. Additionally, the binaural input appears to improve sound localization for most patients. In patients with severe hearing loss and recalcitrant vertigo attacks because of MD, simultaneous labyrinthectomy and CI effectively relieves vertigo attacks and improves auditory function.

24 Article Repair of posterior semicircular canal dehiscence from a high jugular bulb. 2013

Gubbels, Samuel P / Zhang, Qi / Lenkowski, Paul W / Hansen, Marlan R. ·Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave, Clinical Science Center-K4, Madison, WI 53792-3284, USA. ·Ann Otol Rhinol Laryngol · Pubmed #23697325.

ABSTRACT: OBJECTIVES: We describe the clinical evaluation and operative management of posterior semicircular canal dehiscence caused by a high jugular bulb. METHODS: We performed a retrospective case report. RESULTS: The patient had clinical and audiometric findings consistent with semicircular canal dehiscence and imaging findings that demonstrated erosion of the posterior semicircular canal by a high jugular bulb. Resurfacing of the eroded canal provided resolution of the vestibular symptoms without damage to the inner ear. CONCLUSIONS: Dehiscence of the posterior semicircular canal can cause clinical and audiometric findings similar to those of superior semicircular canal dehiscence syndrome. Resurfacing of the area of dehiscence can successfully relieve the vestibular symptoms. In the case of dehiscence of the posterior canal from a high jugular bulb, resurfacing may offer advantages over canal plugging for definitive management.

25 Article Mouse cochleostomy: a minimally invasive dorsal approach for modeling cochlear implantation. 2013

Soken, Hakan / Robinson, Barbara K / Goodman, Shawn S / Abbas, Paul J / Hansen, Marlan R / Kopelovich, Jonathan C. ·Department of Otolaryngology Head and Neck Surgery, University of Iowa, Iowa City, Iowa, U.S.A. ·Laryngoscope · Pubmed #23674233.

ABSTRACT: OBJECTIVES/HYPOTHESIS: The murine model has been used extensively to model and study human deafness. Technical difficulty in the surgical approach due to the small size of the tympanic bulla and a robust stapedial artery has limited its application for studies of cochlear implantation and electrical stimulation. We describe a minimally traumatic, stapedial artery-sparing approach to the round window that may be used to access the mouse cochlea for acute or chronic studies of implantation and stimulation. STUDY DESIGN: Animal model. METHODS: Fifteen C57BL6J mice were used to validate this approach. Auditory brainstem response threshold and distortion product otoacoustic emissions were obtained preoperatively and 2 weeks postoperatively to determine hearing preservation results. RESULTS: The approach provided excellent exposure for round-window implantation. Substantial hearing was preserved in all animals with a mean postimplantation auditory brainstem response threshold increase of 27.8 dB. Otoacoustic emissions were lost in subjects with the largest threshold shifts. CONCLUSIONS: Residual hearing after cochlear implantation is a determinant of success both with standard cochlear implant electrodes and with electrodes designed to optimize hearing preservation. Here, we have preserved usable hearing after implantation of C57BL6J mice, an endogenous model of human presbycusia. The murine model may become a powerful tool to assay the effects of cochlear intervention in different genetic backgrounds.

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