Zdeněk Čada

Cochlear implant (CI) electrode placement inside the cochlea without any insertion complication is a key step in a CI surgery for a successful CI treatment (Friedland & Runge-Samuelson, 2009). The ...

Objective: Resection of the vestibular schwannoma causes acute peripheral vestibular loss. The process of central compensation starts immediately afterward. The rehabilitation goal is to support this process and restore the quality of life. Materials and methods: In this prospective single-center study, 67 consecutive patients underwent vestibular schwannoma resection (40 females, mean age 52 ± 12 years). The patients were divided into three groups: the prehabilitation with intratympanic gentamicin group, the virtual reality group (optokinetic stimulation via virtual reality goggles in the first ten days after the surgery), and the control group. All patients were examined with objective methods and completed questionnaires before the prehabilitation, before the surgery, at the hospital discharge, and after three months. Results: Intratympanic gentamicin prehabilitation leads ipsilaterally to a significant aVOR reduction in all semicircular canals (p < 0.050), the increase of the unilateral weakness in air calorics (p = 0.026), and loss of cVEMPs responses (p = 0.017). Prehabilitation and postoperative exposure to virtual reality scenes improved the patient’s perception of vertigo problems according to Dizziness Handicap Inventory (p = 0.039 and p = 0.076, respectively). These findings conform with the optokinetic testing results, which showed higher slow phase velocities at higher speeds (40 deg/s) in both targeted groups compared to the control group. Conclusion: Preoperative intratympanic gentamicin positively affects peripheral vestibular function, influencing balance perception after VS resection. In long-term follow-up, prehabilitation and postoperative exposure to virtual reality improve patients’ quality of life in the field of vertigo problems.

For this study, high-frequency audiometry was used to compare the hearing thresholds, with respect to age, among women exposed to noise in their working environment, as well as those not exposed to such noise. The cohort comprised 243 women (average age 36.2 years), of which 88 women were employed in a noisy (L_Aeq,8h 85–105 dB) workplace, while 155 women did not experience noise. Age categories were determined according to the World Health Organization (Geneva, Switzerland). Hearing thresholds were measured at frequencies of 0.125–16 kHz. Higher hearing thresholds were found in the youngest age groups (18–29 and 30–44 years) among those exposed to noise, as compared to those who were not. The difference in hearing thresholds between the exposed and unexposed groups increased with age, as well as with the frequencies. The highest difference in hearing thresholds for these age categories was measured at 11.25 kHz. The oldest age group (45–63 years) exposed to noise showed lower hearing thresholds than the unexposed group at all frequencies from 4 kHz to 16 kHz. High-frequency audiometry can be used for the early detection of increased hearing thresholds at high frequencies. High-frequency audiometry could be included in preventive programs, especially for younger people exposed to noise, in order to enable earlier detection of noise-induced hearing loss.

Hearing loss is the most frequent sensory disorder and is genetically extremely heterogeneous. By far the most frequent cause of nonsyndromic autosomal recessive hearing loss (AR-NSHL) are biallelic pathogenic mutations in the GJB2 gene causing DFNB1. The worldwide search for the second most common type of AR-NSHL took almost two decades. Recently reported alterations (mostly deletions) of the STRC gene, also named DFNB16, seem to be the second most frequent cause of AR-NSHL. Genetic testing of STRC is very challenging due to the highly homologous pseudogene. Anecdotal evidence from single patients shows that STRC mutations have their typical audiological findings and patients usually have moderate hearing loss. The aim of this study is to discover if audiological findings in patients with biallelic pathogenic mutations affecting STRC have the characteristic features and shape of audiological curves and if there are genotype/phenotype correlations in relation to various types of STRC mutations.

Revision operations after previous stapes surgery for persisting hearing loss