Given our aging society and the prevalence of age-related hearing loss that often develops during adulthood, hearing loss is a common public health issue affecting almost all older adults. Moderate-to-moderately severe hearing loss can usually be corrected with hearing aids; however, severe-to-profound hearing loss often requires a cochlear implant (CI). However, post-operative CI results vary, and the performance of the previous prediction models is limited, indicating that a new approach is needed. For postlingually deaf adults (n de120) who received CI with full insertion, we predicted CI outcomes using a Random-Forest Regression (RFR) model and investigated the effect of preoperative factors on CI outcomes. Postoperative word recognition scores (WRS) served as the dependent variable to predict. Predictors included duration of deafness (DoD), age at CI operation (ageCI), duration of hearing-aid use (DoHA), preoperative hearing threshold and sentence recognition score. Prediction accuracy was evaluated using mean absolute error (MAE) and Pearson’s correlation coefficient r between the true WRS and predicted WRS. The fitting using a linear model resulted in prediction of WRS with r = 0.7 and MAE = 15.6 ± 9. RFR outperformed the linear model (r = 0.96, MAE = 6.1 ± 4.7, p < 0.00001). Cross-hospital data validation showed reliable performance using RFR (r = 0.91, MAE = 9.6 ± 5.2). The contribution of DoD to prediction was the highest (MAE increase when omitted: 14.8), followed by ageCI (8.9) and DoHA (7.5). After CI, patients with DoD < 10 years presented better WRSs and smaller variations (p < 0.01) than those with longer DoD. Better WRS was also explained by younger age at CI and longer-term DoHA. Machine learning demonstrated a robust prediction performance for CI outcomes in postlingually deaf adults across different institutes, providing a reference value for counseling patients considering CI. Health care providers should be aware that the patients with severe-to-profound hearing loss who cannot have benefit from hearing aids need to proceed with CI as soon as possible and should continue using hearing aids until after CI operation.

Photobiomodulation (PBM) has been suggested to have a therapeutic effect on irreversible hearing loss induced by aminoglycosides, including gentamicin (GM). However, its intracellular mechanism(s) in GM-induced ototoxicity remain poorly understood. In the present study, we investigated the effect of PBM in GM-induced ototoxicity in auditory cells. We tried to characterize the downstream process by PBM, and the process that triggered the increased cell viability of auditory cells. As a result, the effects of PBM against GM-induced ototoxicity by increasing ATP levels and mitochondrial membrane potential was confirmed. These results suggest a theory to explain the therapeutic effects and support the use of PBM for aminoglycoside-induced hearing loss.

Objectives: The aim of this study was to quantitatively measure the tightness of the goggle strap during the video head impulse test (vHIT) and to identify slippage-induced artifacts according to tightness. We aimed to elucidate the mechanism of faulty gain caused by goggle slippage and explain the typical artifacts associated with it. Subjects and Methods: An endotracheal tube cuff manometer was coupled to the EyeSeeCam vHIT system (Interacoustics, Assens, Denmark) to monitor strap tightness. The instantaneous gain (40, 60, and 80 ms) and regression gain were compared in eight healthy subjects under the following strap tightness conditions: loose (25 cm H₂O), tight (35 cm H₂O), and very tight (45 cm H₂O). To elucidate the mechanism of faulty gain caused by goggle slippage, a fake fixed pupil with a vestibule ocular reflex (VOR) gain of 0 was attached to the subject's eyelid. The faulty gain recording pattern was analyzed as the tightness of the strap was decreased. Results: The most common slippage-induced artifacts were: 1) initial backward eye movement toward the head movement, 2) acceleration bumps, 3) high gain, and 4) deceleration bumps. At 40 ms, the gain was significantly lower in the 25 cm H₂O condition (0.68 ± 0.32 cm H₂O) compared with the 45 cm H₂O condition (0.90 ± 0.26 cm H₂O). At 80 ms, the gain was higher for the 25 cm H₂O condition (1.24 ± 0.27 cm H₂O) compared with the 45 cm H₂O condition (1.16 ± 0.30 cm H₂O). These findings were progressively more obvious as the tightness of the strap decreased in a dose-dependent manner. When the fake pupil was recorded, initial backward eye movement toward the head movement (negative VOR gain) and eye tracing mimicking a small VOR (positive VOR gain) were recorded, despite the fake pupil having absolutely no movement. These artifact recordings are presumed to be related to the faulty low (40 ms) and high (80 ms) gain calculation. Conclusions: Slippage-induced artifacts are presumed to be because of the slingshot-like movement of the goggles during head movement in three different phases (lagging, overshooting, and bouncing of the goggles). Monitoring the pressure of the strap tightness may be a solution for minimizing this slippage. A strap tightness of at least 45 cm H₂O is required for reliable vHIT recording and gain calculations.

Background: Sinonasal inverted papilloma (IP) is a neoplasm in the nasal cavity, characterized by its local aggressiveness and tendency to cause malignancy. Despite the frequent recurrence of IP, few studies have reported the effects of situational parameters including smoking on the recurrence rate of IP. This study was performed to evaluate clinical and environmental factors including smoking that can predict neoplasm recurrence after surgery in patients with IP. Methods: This study was conducted retrospectively on 132 patients who were diagnosed with IP between November 1985 and September 2007. The study focused on the risk factors of recurrence, such as smoking behaviors, diabetes mellitus (DM), hypertension (HTN), allergic rhinitis (AR), the sites of tumor origin and involvement, neoplasm staging, and the surgical method. The age of the patients ranged from 22 to 85 years, and among the 132 patients, 39 patients were smokers (29.5%), 17 (13.3%) with DM, 31 (24.4%) with HTN, and 11 (9.3%) with AR. Results: The recurrence rate showed great disparity between the groups of smokers and nonsmokers: 28.2% of smokers suffered recurrence compared with 10.7% recurrence from the nonsmoker group. The Krouse stage IV group experienced more frequent recurrence than the stage I, II, and III groups. Some patients in Krouse stage III (5/72, 6.9%) and IV (3/3, 100%) groups underwent malignant transformation of IP. Histories of DM, HTN, and AR did not exert a statistically meaningful influence on the recurrence and malignant transformation. Conclusion: The smoking behavior and tumor with extranasal/sinus extension appear to be associated with recurrence of IP after surgical resection.

Kim BJ, et al. Clin Exp Otorhinolaryngol. 2014 Jun;7(2):87-93. http://dx.doi.org/10.3342/ceo.2014.7.2.87