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Hearing Disorders: HELP
Articles by James E. Saunders
Based on 13 articles published since 2009
(Why 13 articles?)

Between 2009 and 2019, J. E. Saunders wrote the following 13 articles about Hearing Disorders.
+ Citations + Abstracts
1 Guideline Clinical practice guideline: sudden hearing loss. 2012

Stachler, Robert J / Chandrasekhar, Sujana S / Archer, Sanford M / Rosenfeld, Richard M / Schwartz, Seth R / Barrs, David M / Brown, Steven R / Fife, Terry D / Ford, Peg / Ganiats, Theodore G / Hollingsworth, Deena B / Lewandowski, Christopher A / Montano, Joseph J / Saunders, James E / Tucci, Debara L / Valente, Michael / Warren, Barbara E / Yaremchuk, Kathleen L / Robertson, Peter J / Anonymous4970719. ·Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan 48202, USA. rstachl1@hfhs.org ·Otolaryngol Head Neck Surg · Pubmed #22383545.

ABSTRACT: OBJECTIVE: Sudden hearing loss (SHL) is a frightening symptom that often prompts an urgent or emergent visit to a physician. This guideline provides evidence-based recommendations for the diagnosis, management, and follow-up of patients who present with SHL. The guideline primarily focuses on sudden sensorineural hearing loss (SSNHL) in adult patients (aged 18 and older). Prompt recognition and management of SSNHL may improve hearing recovery and patient quality of life (QOL). Sudden sensorineural hearing loss affects 5 to 20 per 100,000 population, with about 4000 new cases per year in the United States. This guideline is intended for all clinicians who diagnose or manage adult patients who present with SHL. PURPOSE: The purpose of this guideline is to provide clinicians with evidence-based recommendations in evaluating patients with SHL, with particular emphasis on managing SSNHL. The panel recognized that patients enter the health care system with SHL as a nonspecific, primary complaint. Therefore, the initial recommendations of the guideline deal with efficiently distinguishing SSNHL from other causes of SHL at the time of presentation. By focusing on opportunities for quality improvement, the guideline should improve diagnostic accuracy, facilitate prompt intervention, decrease variations in management, reduce unnecessary tests and imaging procedures, and improve hearing and rehabilitative outcomes for affected patients. RESULTS: The panel made strong recommendations that clinicians should (1) distinguish sensorineural hearing loss from conductive hearing loss in a patient presenting with SHL; (2) educate patients with idiopathic sudden sensorineural hearing loss (ISSNHL) about the natural history of the condition, the benefits and risks of medical interventions, and the limitations of existing evidence regarding efficacy; and (3) counsel patients with incomplete recovery of hearing about the possible benefits of amplification and hearing-assistive technology and other supportive measures. The panel made recommendations that clinicians should (1) assess patients with presumptive SSNHL for bilateral SHL, recurrent episodes of SHL, or focal neurologic findings; (2) diagnose presumptive ISSNHL if audiometry confirms a 30-dB hearing loss at 3 consecutive frequencies and an underlying condition cannot be identified by history and physical examination; (3) evaluate patients with ISSNHL for retrocochlear pathology by obtaining magnetic resonance imaging, auditory brainstem response, or audiometric follow-up; (4) offer intratympanic steroid perfusion when patients have incomplete recovery from ISSNHL after failure of initial management; and (5) obtain follow-up audiometric evaluation within 6 months of diagnosis for patients with ISSNHL. The panel offered as options that clinicians may offer (1) corticosteroids as initial therapy to patients with ISSNHL and (2) hyperbaric oxygen therapy within 3 months of diagnosis of ISSNHL. The panel made a recommendation against clinicians routinely prescribing antivirals, thrombolytics, vasodilators, vasoactive substances, or antioxidants to patients with ISSNHL. The panel made strong recommendations against clinicians (1) ordering computerized tomography of the head/brain in the initial evaluation of a patient with presumptive SSNHL and (2) obtaining routine laboratory tests in patients with ISSNHL.

2 Review Otolaryngology and the Global Burden of Disease. 2018

Saunders, James E / Rankin, Zane / Noonan, Kathryn Y. ·Geisel Medical School at Dartmouth, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. Electronic address: James.E.Saunders@hitchcock.org. · Institute for Health Metrics and Evaluation, 2301 Fifth Avenue, Suite 600, Seattle, WA 98121, USA. · House Ear Clinic, 2100 West 3rd Street, Los Angeles, CA 90057-1999, USA. ·Otolaryngol Clin North Am · Pubmed #29773124.

ABSTRACT: The Global Burden of Disease (GBD) project provides longitudinal analysis of the global burden of otolaryngologic diseases by measuring the all-cause mortality, years of life lost, the years of life lived with disability, and disability-adjusted life years. Hearing loss burden is assessed overall and as sequelae of other diseases, such as otitis media or meningitis. Using these measures, we can appreciate the high prevalence and disability related to hearing loss globally. Other otolaryngologic diseases that contribute to the GBD include otitis media, cleft lip and palate, head and neck cancer, facial trauma, and oral disorders.

3 Review Measuring Success: Cost-Effectiveness and Expanding Access to Cochlear Implantation. 2016

Saunders, James E / Francis, Howard W / Skarzynski, Piotr H. ·*Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire †Department of Otolaryngology, Johns Hopkins Medical Center, Baltimore, Maryland, U.S.A. ‡Institute of Physiology and Pathology of Hearing, Warsaw Medical University, Warsaw, Poland. ·Otol Neurotol · Pubmed #26756147.

ABSTRACT: Only a small fraction of patients with profound sensorineural hearing loss have access to cochlear implantation with the majority of these affected people living in developing countries. Cost effectiveness analysis (CEA) is an important tool to demonstrate the value of this technology to healthcare policy makers. This approach requires that hearing healthcare professionals incorporate methods of assessing long-term benefits of cochlear implantation that include psychosocial, quality of life, and disability outcomes. This review explores different aspects of CEA methodology relevant to cochlear implants and discusses ways that we can improve global access by addressing factors that influence cost-effectiveness.

4 Article Otoacoustic Emissions in Rural Nicaragua: Cost Analysis and Implications for Newborn Hearing Screening. 2017

Wong, Lye-Yeng / Espinoza, Francisca / Alvarez, Karen Mojica / Molter, Dave / Saunders, James E. ·1 Dartmouth Hitchcock Medical Center, West Lebanon, New Hampshire, USA. · 2 National Association of Casa Materna, Jinotega, Nicaragua. · 3 Hospital Metropolitano Vivian Pellas, Managua, Nicaragua. · 4 Washington University, St Louis, Missouri, USA. · 5 Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA. ·Otolaryngol Head Neck Surg · Pubmed #28457225.

ABSTRACT: Objective (1) Determine the incidence and risk factors for congenital hearing loss. (2) Perform cost analysis of screening programs. Study Design Proportionally distributed cross-sectional survey. Setting Jinotega, Nicaragua. Subjects and Methods Otoacoustic emissions (OAEs) were used to screen 640 infants <6 months of age from neonatal intensive care unit, institutional, and home birth settings. Data on 15 risk factors were analyzed. Cost of 4 implementation strategies was studied: universal screening, screening at the regional health center (RHC), targeted screening, and screening at the RHC plus targeted screening. Cost-effectiveness analysis over 10 years was based on disability-adjusted life year estimates, with the World Health Organization standard of cost-effectiveness ratio (CER) / gross domestic product (GDP) <3, with GDP set at $4884.15. Results Thirty-eight infants failed the initial OAE (5.94%). In terms of births, 325 (50.8%) were in the RHC, 69 (10.8%) in the neonatal intensive care unit, and 29 (4.5%) at home. Family history and birth defect were significant in univariate analysis; birth defect was significant in multivariate analysis. Cost-effectiveness analysis demonstrated that OAE screening is cost-effective without treatment (CER/GDP = 0.06-2.00) and with treatment (CER/GDP = 0.58-2.52). Conclusions Our rate of OAE failures was comparable to those of developed countries and lower than hearing loss rates noted among Nicaraguan schoolchildren, suggesting acquired or progressive etiology in the latter. Birth defects and familial hearing loss correlated with OAE failure. OAE screening of infants is feasible and cost-effective in rural Nicaragua, although highly influenced by estimated hearing loss severity in identified infants and the high travel costs incurred in a targeted screening strategy.

5 Article Moving Beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America. 2016

Emmett, Susan D / Tucci, Debara L / Bento, Ricardo F / Garcia, Juan M / Juman, Solaiman / Chiossone-Kerdel, Juan A / Liu, Ta J / de Muñoz, Patricia Castellanos / Ullauri, Alejandra / Letort, Jose J / Mansilla, Teresita / Urquijo, Diana P / Aparicio, Maria L / Gong, Wenfeng / Francis, Howard W / Saunders, James E. ·*Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine †Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A. ‡Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, U.S.A. §Department of Otolaryngology, University of Sao Paulo, Sao Paulo, Brazil ||Section of Otolaryngology, Santa Fe of Bogota Foundation, Bogota ¶Division of Otology and Neurotology, University of Health Sciences Foundation, FUCS, Bogota, Colombia #Division of Otolaryngology, Department of Surgery, University of the West Indies, St. Augustine, Trinidad **Cochlear Implant Department, Venezuelan Foundation of Otology, Caracas, Venezuela ††Department of Otolaryngology, National University of Asuncion, Asuncion ‡‡Catholic University of Asuncion, Asuncion, Paraguay §§CEDAF, Hearing Center, Guatemala City, Guatemala ||||Chicago Hearing Care, Chicago, Illinois, U.S.A. ¶¶Otolaryngology Center, Quito, Ecuador ***Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, U.S.A. ·Otol Neurotol · Pubmed #27518131.

ABSTRACT: HYPOTHESIS: Cochlear implantation (CI) and deaf education are cost effective management strategies of childhood profound sensorineural hearing loss in Latin America. BACKGROUND: CI has been widely established as cost effective in North America and Europe and is considered standard of care in those regions, yet cost effectiveness in other economic environments has not been explored. With 80% of the global hearing loss burden existing in low- and middle-income countries, developing cost effective management strategies in these settings is essential. This analysis represents the continuation of a global assessment of CI and deaf education cost effectiveness. METHODS: Brazil, Colombia, Ecuador, Guatemala, Paraguay, Trinidad and Tobago, and Venezuela participated in the study. A Disability Adjusted Life Years model was applied with 3% discounting and 10-year length of analysis. Experts from each country supplied cost estimates from known costs and published data. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the World Health Organization standard of cost effectiveness ratio/gross domestic product per capita (CER/GDP)<3. RESULTS: Deaf education was very cost effective in all countries (CER/GDP 0.07-0.93). CI was cost effective in all countries (CER/GDP 0.69-2.96), with borderline cost effectiveness in the Guatemalan sensitivity analysis (Max CER/GDP 3.21). CONCLUSION: Both cochlear implantation and deaf education are widely cost effective in Latin America. In the lower-middle income economy of Guatemala, implant cost may have a larger impact. GDP is less influential in the middle- and high-income economies included in this study.

6 Article GDP Matters: Cost Effectiveness of Cochlear Implantation and Deaf Education in Sub-Saharan Africa. 2015

Emmett, Susan D / Tucci, Debara L / Smith, Magteld / Macharia, Isaac M / Ndegwa, Serah N / Nakku, Doreen / Mukara, Kaitesi B / Ibekwe, Titus S / Mulwafu, Wakisa / Gong, Wenfeng / Francis, Howard W / Saunders, James E. ·*Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine; †Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.; ‡Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, U.S.A.; §Department of Otorhinolaryngology-Head and Neck Surgery, University of the Free State, Bloemfontein, South Africa; ∥Department of Surgery, University of Nairobi, Nairobi, Kenya; ¶Mbarara University of Science and Technology, Mbarara, Uganda; **University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda; ††Department of ENT, University of Abuja and the University of Abuja Teaching Hospital, Abuja, Nigeria; ‡‡Department of Surgery, University of Malawi College of Medicine, Blantyre, Malawi; and §§Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, U.S.A. ·Otol Neurotol · Pubmed #26244622.

ABSTRACT: HYPOTHESIS: Cochlear implantation and deaf education are cost effective in Sub-Saharan Africa. BACKGROUND: Cost effectiveness of pediatric cochlear implantation has been well established in developed countries but is unknown in low resource settings, where access to the technology has traditionally been limited. With incidence of severe-to-profound congenital sensorineural hearing loss 5 to 6 times higher in low/middle-income countries than the United States and Europe, developing cost-effective management strategies in these settings is critical. METHODS: Costs were obtained from experts in Nigeria, South Africa, Kenya, Rwanda, Uganda, and Malawi using known costs and published data, with estimation when necessary. A disability adjusted life years (DALY) model was applied using 3% discounting and 10-year length of analysis. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the WHO standard of cost-effectiveness ratio/gross domestic product per capita (CER/GDP) less than 3. RESULTS: Cochlear implantation was cost effective in South Africa and Nigeria, with CER/GDP of 1.03 and 2.05, respectively. Deaf education was cost effective in all countries investigated, with CER/GDP ranging from 0.55 to 1.56. The most influential factor in the sensitivity analysis was device cost, with the cost-effective threshold reached in all countries using discounted device costs that varied directly with GDP. CONCLUSION: Cochlear implantation and deaf education are equally cost effective in lower-middle and upper-middle income economies of Nigeria and South Africa. Device cost may have greater impact in the emerging economies of Kenya, Uganda, Rwanda, and Malawi.

7 Article Cost Effectiveness of Childhood Cochlear Implantation and Deaf Education in Nicaragua: A Disability Adjusted Life Year Model. 2015

Saunders, James E / Barrs, David M / Gong, Wenfeng / Wilson, Blake S / Mojica, Karen / Tucci, Debara L. ·*Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.; †Department of Otolaryngology, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A.; ‡Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, U.S.A.; §Duke University, Research Triangle Park, Durham, North Carolina, U.S.A.; ∥Department of Otolaryngology, Hospital Central Managua, Managua, Nicaragua; and ¶Duke University Medical Center, Durham, North Carolina, U.S.A. ·Otol Neurotol · Pubmed #26171672.

ABSTRACT: INTRODUCTION: Cochlear implantation (CI) is a common intervention for severe-to-profound hearing loss in high-income countries, but is not commonly available to children in low resource environments. Owing in part to the device costs, CI has been assumed to be less economical than deaf education for low resource countries. The purpose of this study is to compare the cost effectiveness of the two interventions for children with severe-to-profound sensorineural hearing loss (SNHL) in a model using disability adjusted life years (DALYs). METHODS: Cost estimates were derived from published data, expert opinion, and known costs of services in Nicaragua. Individual costs and lifetime DALY estimates with a 3% discounting rate were applied to both two interventions. Sensitivity analysis was implemented to evaluate the effect on the discounted cost of five key components: implant cost, audiology salary, speech therapy salary, number of children implanted per year, and device failure probability. RESULTS: The costs per DALY averted are $5,898 and $5,529 for CI and deaf education, respectively. Using standards set by the WHO, both interventions are cost effective. Sensitivity analysis shows that when all costs set to maximum estimates, CI is still cost effective. CONCLUSION: Using a conservative DALY analysis, both CI and deaf education are cost-effective treatment alternatives for severe-to-profound SNHL. CI intervention costs are not only influenced by the initial surgery and device costs but also by rehabilitation costs and the lifetime maintenance, device replacement, and battery costs. The major CI cost differences in this low resource setting were increased initial training and infrastructure costs, but lower medical personnel and surgery costs.

8 Article The global burden of disabling hearing impairment: a call to action. 2014

Olusanya, Bolajoko O / Neumann, Katrin J / Saunders, James E. ·Centre for Healthy Start Initiative, 286A Corporation Drive, Dolphin Estate, Ikoyi, Lagos, Nigeria . · Department of Phoniatrics and Pediatric Audiology, St Elisabeth Hospital, Bochum, Germany . · Dartmouth Hitchcock Medical Center, Lebanon, United States of America . ·Bull World Health Organ · Pubmed #24839326.

ABSTRACT: At any age, disabling hearing impairment has a profound impact on interpersonal communication, psychosocial well-being, quality of life and economic independence. According to the World Health Organization's estimates, the number of people with such impairment increased from 42 million in 1985 to about 360 million in 2011. This last figure includes 7.5 million children less than 5 years of age. In 1995, a "roadmap" for curtailing the burden posed by disabling hearing impairment was outlined in a resolution of the World Health Assembly. While the underlying principle of this roadmap remains valid and relevant, some updating is required to reflect the prevailing epidemiologic transition. We examine the traditional concept and grades of disabling hearing impairment - within the context of the International Classification of Functioning, Disability and Health - as well as the modifications to grading that have recently been proposed by a panel of international experts. The opportunity offered by the emerging global and high-level interest in promoting disability-inclusive post-2015 development goals and disability-free child survival is also discussed. Since the costs of rehabilitative services are so high as to be prohibitive in low- and middle-income countries, the critical role of primary prevention is emphasized. If the goals outlined in the World Health Assembly's 1995 resolution on the prevention of hearing impairment are to be reached by Member States, several effective country-level initiatives - including the development of public-private partnerships, strong leadership and measurable time-bound targets - will have to be implemented without further delay.

9 Article Hearing loss and heavy metal toxicity in a Nicaraguan mining community: audiological results and case reports. 2013

Saunders, J E / Jastrzembski, B G / Buckey, J C / Enriquez, D / MacKenzie, T A / Karagas, M R. ·Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. james.saunders@hitchcock.org ·Audiol Neurootol · Pubmed #23257660.

ABSTRACT: We measured fingernail metal levels, Békésy-type pure-tone thresholds and distortion product otoacoustic emission (DPOAE) levels in 59 subjects residing in the gold mining community of Bonanza, Nicaragua. Auditory testing revealed widespread hearing loss in the cohort. Nail metal concentrations (mercury, lead, aluminum, manganese and arsenic) far exceeded reference levels. No relationship was found between metal levels and auditory test results for the group as a whole. Statistically significant relationships were found between DPOAE response amplitudes and metal concentrations in a subgroup with less than 40 h per week of significant noise exposure; however, conclusions regarding these relationships should be tempered by the large number of analyses performed. Several young individuals with high metal levels reported neurological symptoms and had poor hearing. The data suggest that metal levels in artisanal mining communities present a significant public health problem and may affect hearing.

10 Article Balance in children with bilateral cochlear implants. 2011

Eustaquio, Marcia E / Berryhill, Wayne / Wolfe, Jace A / Saunders, James E. ·University of Colorado Denver Health Sciences Center, Aurora, Colorado 80045, USA. Marcia.Eustaquio@ucdenver.edu ·Otol Neurotol · Pubmed #21358560.

ABSTRACT: OBJECTIVE: To determine whether unilateral or bilateral cochlear implantation affects the functional balance of children when compared with children with severe-to-profound bilateral hearing loss without a cochlear implant. DESIGNS: An observational case control study. METHODS: Three cohorts of children aged 4 to 17 years were studied: those with unilateral cochlear implants, those with bilateral cochlear implants, and nonimplanted children with severe-to-profound bilateral hearing loss. Each participant's balance was assessed with the Bruininks-Oseretsky Test, Second Edition (BOT2). Raw test scores and age- and sex-matched scale scores were obtained and used to compare each of the 3 groups with one another as well as with standardized norms. RESULTS: Sixty-four children were tested. Twelve had a unilateral cochlear implant, 26 had bilateral cochlear implants, and 26 were nonimplanted. The mean scale scores for the unilateral cochlear implant group, the bilateral cochlear implant group, and the children with severe-to-profound hearing loss were 10.16, 11.31, and 11.15, respectively. The mean scale scores for the 3 groups did not differ significantly from each other. When compared with the standardized norms, all 3 groups had significantly lower scores on the BOT2 than the accepted mean score. CONCLUSION: Balance, as measured by the BOT2, is not significantly different in children with cochlear implants versus a hearing-impaired population. However, all 3 tested groups scored lower than the validated mean score for a healthy population of children.

11 Article Hyaluronic acid hydrogel sustains the delivery of dexamethasone across the round window membrane. 2011

Borden, Robert C / Saunders, James E / Berryhill, Wayne E / Krempl, Greg A / Thompson, David M / Queimado, Lurdes. ·Department of Otorhinolaryngology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. ·Audiol Neurootol · Pubmed #20431286.

ABSTRACT: BACKGROUND: The use of intratympanic (IT) steroids for the treatment of inner ear disorders is promising, but the clinical challenges of prolonged middle ear drug application have proven burdensome, and a sustainable delivery system is yet to be developed. METHOD: In this study, a guinea pig model was used to determine if dexamethasone in combination with a hyaluronic-acid (HA)-based hydrogel is an efficient, stable and sustainable dexamethasone delivery system to the inner ear. For each animal, right and left middle ear bullae were randomly selected to be filled with dexamethasone alone or dexamethasone-HA (Dex-HA) gel. Perilymph samples were collected at different time points and dexamethasone levels were determined using an ELISA. RESULTS: Dexamethasone was measurable in the perilymph samples up to 72 h after treatment. At 24 h after treatment, the perilymph dexamethasone concentrations were significantly higher (p = 0.01) in the ears treated with Dex-HA gel than in those treated with dexamethasone alone. While the perilymph dexamethasone concentration had decreased at 48 h after treatment with Dex-HA gel, the levels were still higher than those observed at 24 h in ears treated with dexamethasone alone. A high variability in dexamethasone concentration was observed between the samples, and the variability between matched ears receiving different treatments was remarkably lower than the variability within each treatment group, suggesting that individual parameters might play a major role in perilymph dexamethasone concentration. There was no statistically significant correlation between dexamethasone concentration and sex, weight or laterality. CONCLUSIONS: Our results show that the Dex-HA gel used in this study provides an effective and sustained dexamethasone release mechanism that might be utilized to treat conditions such as sudden sensorineural hearing loss. This could potentially reduce the morbidity and costs associated with IT treatment.

12 Article Aminoglycoside ototoxicity in Nicaraguan children: patient risk factors and mitochondrial DNA results. 2009

Saunders, James E / Greinwald, John H / Vaz, Sharon / Guo, Yinshi. ·Dartmouth Hitchcock Medical Center, Lebanon, NH 03756, USA. James.Saunders@Hitchcock.org ·Otolaryngol Head Neck Surg · Pubmed #19130971.

ABSTRACT: OBJECTIVE: Aminoglycoside ototoxicity remains a major problem in developing countries and accounts for 3 percent to 30 percent of hearing loss. This high prevalence rate may be related to genetic susceptibility from mitochondrial mutations in the 12S rRNA gene, comorbidity factors, or unregulated use of the medication. This study investigates the risk factors and prevalence of mtDNA mutations in serum from rural Nicaragua children with aminoglycoside-related hearing loss. STUDY DESIGN: Cross sectional study. SUBJECTS: Deaf children from rural Nicaragua. METHODS: Mitochondrial DNA isolated from serum collected from 31 deaf children with childhood or in utero exposure to gentamicin was amplified, sequenced, and analyzed for mutations in the 12S rRNA gene. RESULTS: No known pathologic mutations of the 12S rRNA gene were identified in this subpopulation of deaf children. In addition, patients with gentamicin exposure were often likely to have other comorbidity factors. CONCLUSION: These results suggest that genetic susceptibility is not a major factor in the high rate of gentamicin ototoxicity in this population sample. The high prevalence of gentamicin ototoxicty in this population is presumed to be due to unrestricted access to the drug.

13 Minor Routine testing for Borrelia serology in sudden sensorineural hearing loss. 2013

Saunders, James E. · ·Otolaryngol Head Neck Surg · Pubmed #23243138.

ABSTRACT: -- No abstract --