Marzouqi Abdulaziz Salamah

To assess the S-value in pediatric cochlear implant (CI) patients using high-resolution CT images and examine its correlation with main cochlear parameters and angular insertion depth (AID). A retrospective review of preoperative CT images from pediatric CI recipients with normal cochlear anatomy was conducted at a referral hearing implant center. Cases involving congenital or acquired inner-ear abnormalities were excluded. Two independent reviewers with equivalent expertise used OTOPLAN to measure the main cochlear parameters, and the interrater reliability study revealed good agreement. S-values (the straight section of the cochlear basal turn) were measured and examined, and their correlation to electrode insertion angles and cochlear parameters (A- and B-values) was evaluated. The average cochlear duct length (CDL) of the included patients was 36.14 ± 0.26 mm, with an average S-value of 7.06 ± 0.40 mm, insertion angle of 598.20° ± 48.72°, and cochlear coverage of 77.49% ± 0.57. A statistically significant relationship was found between A- and the S-values (r = 0.65, p = 0.004). However, the B-value showed a moderate, non-significant correlation with the S-value (r = 0.43). Furthermore, a consistent negative, but not statistically significant, association was found between the S-value and the angular insertion depths of all electrode contacts (r = − 0.28 to − 0.30). The S-value is a dependable anatomical parameter that correlates positively with the A-value. The evaluated lateral-wall array showed consistent insertion depths among patients with similar CDL, even when S-values differed. Further studies are needed to investigate the impact of greater variability in S-values on clinical outcomes and electrode-array position among CI users.

Objective: To evaluate audiological outcomes, quality of life, and complications in patients implanted with Active middle ear implants (AMEI). The secondary objective is to investigate the required duration after implantation to reach satisfactory outcomes. Methods: This retrospective study included 31 patients implanted with Active middle ear implants (AMEI) with different methods of floating mass transducer attachment. Patients with incomplete medical records and those who did not respond to postoperative follow-up were excluded. Patients were assessed preoperatively, and at one, three, and six months postoperatively. The assessment included Pure Tone Average (PTA4), speech reception threshold (SRT), and speech discrimination score (SDS). The Speech Spatial and Qualities of Hearing scale (SSQ12) was also used to evaluate levels of satisfaction. Result: There are no significant differences found in PTA and SRT between the 3-, 6-, and 12-month visits. The speech reception threshold (SRT) showed a statistically significant improvement at 3, 6, and 12 months post-operative measures compared to pre-operative. Additionally, the SDS exhibited a significant increase only after 12 months, compared to the 3-month time point. However, satisfaction levels did not significantly differ between the 6-month and 12-month measurements following surgery. Conclusion: The Vibrant Soundbridge improves subjective satisfaction scores and audiological test scores in patients with different types of hearing loss. AMEI has a low risk of medical or surgical complications, the ease of using a hearing implant, and the social benefits of good hearing and communication.

Objective: To evaluate audiological outcomes, quality of life, and complications in patients implanted with Active middle ear implants (AMEI). The secondary objective is to investigate the required duration after implantation to reach satisfactory outcomes. Methods: This retrospective study included 31 patients implanted with Active middle ear implants (AMEI) with different methods of floating mass transducer attachment. Patients with incomplete medical records and those who did not respond to postoperative follow-up were excluded. Patients were assessed preoperatively, and at one, three, and six months postoperatively. The assessment included Pure Tone Average (PTA4), Speech Reception Threshold (SRT) and Speech Discrimination Score (SDS). The Speech Spatial and Qualities of Hearing scale (SSQ12) was also used to evaluate levels of satisfaction. Result: There are no significant differences found in PTA and SRT between the 3-, 6-, and 12-month visits. The speech reception threshold (SRT) showed a statistically significant improvement at 3, 6, and 12 months post-operative measures compared to pre-operative. Additionally, the SDS exhibited a significant increase only after 12 months, compared to the 3-month time point. However, satisfaction levels did not significantly differ between the 6-month and 12-month measurements following surgery. Conclusion: Vibrant Sound bridge improves subjective satisfaction scores and audiological test scores in patients with different types of hearing loss. AMEI has a low risk of medical or surgical complications, the ease of using a hearing implant, and the social benefits of good hearing and communication.

This study aimed to validate the role of 3D segmentation in measuring the volume of the vestibular aqueduct (VAD), and the inner ear, and to study the correlation between VAD volume and VAD linear measurements at the midpoint and operculum. The correlation with other cochlear metrics was also studied. We retrospectively recruited 21 children (42 ears) diagnosed with Mondini dysplasia (MD) plus enlarged vestibular aqueduct (EVA) from 2009 to 2021 and who underwent cochlear implantation (CI). Patients’ sociodemographic data were collected, and linear cochlear metrics were measured using Otoplan. Vestibular aqueduct width and vestibular aqueduct and inner ear volumes were measured by two independent neuro-otologists using 3D segmentation software (version 4.11.20210226) and high-resolution CT. We also conducted a regression analysis to determine the association between these variables and CT VAD and inner ear volumes. Among the 33 cochlear implanted ears, 13 ears had a gusher (39.4%). Regarding CT inner ear volume, we found that gender, age, A-value, and VAD at the operculum were statistically significant (p-Value = 0.003, p-Value < 0.04). Finally, gender (OR: 0.092; 95%CI: 0.009–0.982; p-Value = 0.048) and VAD at the midpoint (OR: 0.106; 95%CI: 0.015–0.735; p-Value = 0.023) were significant predictors of gusher risk. Patients’ gusher risk was significantly differentiated by gender and VAD width at the midpoint.

In this study, we aimed to investigate the effect of the coronavirus disease 2019 (COVID-19) pandemic-induced social restrictions, including face masks, on patients with hearing problems. This cross-sectional survey study was conducted in an ENT tertiary care center. After signing the consent form, we invited study subjects with hearing disabilities who were using unilateral or bilateral hearing aids to participate in filling out the study survey. The study questionnaire was completed by 80 subjects. The questionnaire included various questions about the respondent’s demographics, hearing aids, and communication with a face mask during COVID-19 restrictions. All statistical analyses were performed using SPSS version 19 (IBM Corp., Armonk, NY, USA). Overall, 40% of the study sample agreed that understanding people wearing face masks is harder because their speech is muffled, whereas 10% disagreed, and 50% were neutral. While 41.3% agreed that understanding is harder because they cannot see their mouth moving, 23.8% disagreed, and 35% were neutral. More than half of the study sample (55%) agreed that they are worried about how they will communicate with others if wearing face masks becomes more common. However, 50% of the participants thought that they can still hear people when they speak to them from a safe distance. Of note, 71.3% of subjects disagreed about tinnitus being worse since the lockdown. The widespread use of face masks had a significant impact on the daily communication and interactions of people with hearing impairments. More research is needed to find creative ways to help these patients improve their daily communication and social interactions.

A tracheal bronchus is an unusual bronchial division anomaly in which an accessory bronchus arises from the trachea or main bronchus and travels to the higher lobe territory. This report discusses a case of incidentally diagnosed tracheal bronchus after foreign body removal via bronchoscopy. A one-year-old boy presented to the hospital with cough and noisy breathing after choking on peanuts. On examination, he had mild tachypnea with non-prominent subcostal retractions and diminished airflow in the left lung. Rigid bronchoscopy revealed a foreign body in the trachea at the level of the left main bronchus, which was completely removed in one piece under vision using fiberoptic forceps. A tracheal bronchus is an unusual congenital abnormality, with most cases being asymptomatic. Appropriate reporting of such anomalies may help healthcare practitioners promptly diagnose, manage, and avoid complications in the tracheal bronchus.

Although hemangiomas are common in the head and neck area, they are uncommon in the temporal bone. External auditory canal (EAC) hemangiomas are a relatively uncommon otologic condition. In the English literature, only 29 cases of temporal bone hemangioma have been reported. We also present the case of a 32-year-old male patient who presented with an 8-month history of decreased hearing, tinnitus, and aural fullness on the right side. Otoscopic examination of the right ear revealed a smooth, oval, well-circumscribed, reddish, pulsatile, nontender mass, which was about 1 cm in diameter and occupied two-thirds of the EAC. It was soft in consistency, compressible, and appeared to be arising from the right posterior-superior portion of the bony canal wall; the tympanic membrane seemed to be uninvolved. The patient had mild conductive hearing loss of the right ear with an average air-bone gap of 20 dB; the left side was normal. High-resolution contrast-enhanced computed tomographic scanning of the temporal bone showed well-defined, rounded, homogenously enhancing lesions at the posterior-superior aspect of right EAC measuring 0.7 × 0.8 cm. Angiography was performed and there was evidence of vascular blush in the region of the right EAC. Three blood vessels were identified and embolized. The mass was completely removed by the endaural approach, and a retroauricular skin graft to restore cutaneous integrity was not required. Histopathology indicated a capillary hemangioma without cytological atypia or mitotic activity. There was no recurrence 1 year after the surgery.

Background: Vitamin D deficiency is a suggested cause and risk factor for various ear diseases. This review assessed the role of vitamin D in ear diseases such as otitis media (OM); this study aimed to assess potential relationships between serum vitamin D level and OM risk; and determined the usefulness of vitamin D supplementation for ear disease prevention and treatment. Material and methods: This systematic review searched the PubMed, EMBASE, Google Scholar, Web of Science, and the Cochrane Database for studies on vitamin D deficiency as a risk factor for ear diseases. A total of 55 articles were screened based on their titles. The abstracts were then reviewed to identify the 11 articles analyzed in the present study. Results: Statistical heterogeneity was observed among the 11 studies for subgroup analysis of plasma vitamin D level according to disease type (acute otitis media [AOM], P < 0.00001; chronic otitis media [COM], P = 0.00001) and age (≤ 5 years, P < 0.00001; > 5 years, P < 0.00001). Heterogeneity was also observed in the frequency of participants with sufficient plasma vitamin D levels according to disease type (AOM, P < 0.00001; COM, P = 0.00001) and age (≤ 5 years, P < 0.00001; > 5 years, P = 0.003; I² = 70%: substantial heterogeneity). Conclusion: Vitamin D deficiency is common in otolaryngology patients, for which supplementation showed promising results. Vitamin D deficiency was associated with the etiopathology of ear diseases in adults and children. We recommend empirical supplementation of vitamin D in otolaryngology patients and further studies investigating this supplementation.

To explore the clinical, pathological, and imaging characteristics of allergic fungal sinusitis (AFS) and to analyze the correlation of disease duration with imaging and histopathology findings. We reviewed all cases of AFS managed at the otorhinolaryngology department of King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia. Demographic and clinical features were collected, as well as imaging and histopathological findings, which were analyzed by time from onset. Forty-six patients were diagnosed AFS, representing 11.8% of total sinusitis cases; 25 (54.3%) were female, with mean (SD) age=33.57 (11.76). Patients presented with multiple symptoms of chronic rhinosinusitis (43, 93.5%), chronic headache (14, 30.4%), and hyposmia (2, 4.3%), and 36 (78.3%) were diagnosed late (≥5 years after onset). AFS involved all four sinuses in 32 (69.6%) patients and was bilateral in >53.5% of infected sinuses. Imaging showed increased intrasinus attenuation (88.2%-95.3%), complete opacification (74.4%-85.3%), sinus expansion (35.3%-51.2%), remodeling (20.6%-37.2%), wall thinning (41.2%-58.1%), and involvement of adjacent soft tissue (11.8%-25.6%), depending on the sinus type. Histology evidenced eosinophilic mucin (45.7%), eosinophils (91.3%), fungal hyphae (93.5%), and Charcot-Leyden crystals (6.5%). Patients who were diagnosed late had a higher percentage of imaging and pathological lesions, principally, the expansion and wall thinning of involved sinuses (p<0.050). AFS represents a significant proportion of chronic sinusitis cases treated in the otorhinolaryngology department and is often diagnosed late with extensive forms. Major efforts should be made to improve the early diagnosis and management of such disease, including raising awareness about this entity among general practitioners and family physicians to enhance clinical suspicion and detection rate.