The three-point fix tympanoplasty procedure is a stable and effective technique - with a high degree of graft take and satisfactory hearing results - for reconstruction of most tympanic membrane (TM) perforations. It is difficult to repair a TM perforation, including subtotal perforation, involving the anterior part of the annulus. Reperforation can occur when an underlay graft technique is used. An overlay graft technique may result in anterior blunting/lateralization. We introduce a three-point fix tympanoplasty procedure, which can provide additional support to yield a stable graft. The study enrolled a total of 234 patients who underwent a three-point fix tympanoplasty procedure from November 2005 to June 2011. Anatomic success was defined as an intact, repaired TM, while functional success was defined as a significant decrease in the air-bone gap at the end of follow-up compared with preoperative hearing (air-bone gap). The complication rate was also analyzed. The anatomic success rate was 93.2% (218/234 patients). The functional success rate after an average of 1 year was 73.5%. The postoperative average pure-tone air-bone gap (15.4 ± 11.4 dB) decreased successfully in comparison with the preoperative average air-bone gap (20.6 ± 12.1 dB). There were few postoperative complications (7.7%).
31 August 2023 in Clinical and Experimental Otorhinolaryngology
Objectives The aim of this study was to determine the most effective treatment approach by comparing the impacts of various otolith reduction techniques in patients with apogeotropic lateral semicircular canal benign paroxysmal positional vertigo (LC-BPPV).Methods We performed a multicenter randomized prospective study from January to December 2015, involving 72 consecutive patients with apogeotropic LC-BPPV. The patients were divided into three treatment groups: therapeutic head-shaking (group A), the Gufoni-Appiani maneuver (group B), and the cupulolith repositioning maneuver (CuRM; group C). Each group underwent evaluation and treatment up to the fourth week. Treatment success was defined as the disappearance of positional vertigo and nystagmus.Results This study included 72 patients (49 male and 23 female), with a mean (±standard deviation) age of 55.4±13.5 years. The mean duration of vertigo experienced prior to treatment was 3.9±4.4 days. The mean latency and duration of nystagmus were 2.7±3.0 seconds and 47.9±15.8 seconds, respectively. The overall treatment frequency was 2.0±0.9. The number of treatments differed significantly among the three groups (P0.05). However, CuRM was the only method with a 100% treatment success rate.Conclusion While no clear difference was observed among the three treatments for LC-BPPV, CuRM was found to be superior to the other approaches in the long term.
15 October 2022 in Journal of Healthcare Engineering
The initial software fitting prescribed by the fitting formula largely depends on the patient’s hearing loss, which may not be the optimal preference for a particular user. Certain criteria must also be readjusted by an audiologist to meet the user-specific requirements. Therefore, this study focuses on the novel application of a neural network (NN) technique to build a suitable fitting algorithm with prescribed hearing loss and the corresponding preferred gain to minimize the gap between optimized fittings. The algorithm intended to learn the hearing preferences of an individual user such that the initial fitting may be optimized. These findings demonstrate the efficiency of the algorithm, with and without additional features. Using the clinical fitting data, the average mean square error (MSE) for the simple NN algorithm was 5.4183%. By adding additional features to the data, the algorithm performed better, and the average MSE was as low as 5.2530%. However, the algorithm outperformed Company A fitting software, as the MSE was the highest at 5.4748%. As the company’s automatic fitting has a noticeable discrepancy with clinical fitting records, the impeccable results from this study can lead to a better path towards fitting satisfaction, thus benefiting the hearing-impaired community to a larger extent.
1 December 2020 in International Journal of Pediatric Otorhinolaryngology
The artificial intelligence (AI)-based genetic diagnostic program has been applied to genome sequencing to facilitate the diagnostic process. The objective of the current study was to evaluate the experience and level of satisfaction of participants using an AI-based diagnostic program for rare pediatric genetic diseases. The patients with neurodevelopmental disorders or hearing impairments, their guardians, and their physicians from 16 tertiary general hospitals were enrolled. The study period was from April 2020 to March 2021. A survey was designed to assess their experience and level of satisfaction. A total of 30 physicians and 243 patients and guardians (199 neurodevelopmental disorders and 44 hearing impairments) completed the survey. DNA samples of the subjects were collected through buccal swabs or blood collection: 211 subjects (86.8%) through buccal swab and 29 subjects (11.9%) through blood collection. Average turnaround time for result receipt was 57.54 ± 32.42 days. For the sampling method, 193 patients and guardians (81.1%) and 28 physicians (93.3%) preferred buccal swab. The level of satisfaction of the 2 groups participating in the AI-based diagnostic program was 8.31 ± 1.71 out of 10 in the patient and guardian group and 8.42 ± 1.23 in the physician group. Clinicians, patients, and guardians are satisfied with the AI-based diagnostic program in general. With an increase in AI-based precision medicine solutions, the evaluation of the user’s satisfaction with appropriate provision will help improve personal health care.
Motion sickness develops because of a mismatch or conflict between the information gathered from the visual input, somatosensory input, and the vestibular system. Altered gravity can cause motion sickness while traveling in space. In this study, we aimed to establish a rat model of hypergravity-stimulated motion sickness using hypergravity equipment and investigate changes in serotonin and histamine receptors. Overall, 21 rats were allocated to three experimental groups (4G-24 h, 4G-2 weeks, and 4G-4weeks) and one control group, with seven rats in each group. We performed western blotting and immunohistochemistry analysis to determine the protein levels and expression, respectively, of serotonin and histamine receptors in the vestibular nuclei (VN). Rats in the hypergravity group showed a significant reduction in vestibulo ocular reflex (VOR) gain compared to those in the control group. Decreased VOR gains were restored to the normal range on 3–4 days after stopping the hypergravity stimulation. Hypergravity stimulation significantly increased the expression levels of 5-HT1B and 5-HT2A receptors in the VN. Furthermore, histamine receptors (H1 and H2) were significantly increased in the VN after hypergravity stimulation. These findings indicate that altered gravity influences the vestibular system by inducing both functional behavioral changes and molecular alterations in receptor expression.