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1.  Is cochlear implantation a good treatment method for profoundly deafened elderly? 
To assess the benefits of cochlear implantation in the elderly.
Patients and methods
A retrospective analysis of 31 postlingually deafened elderly (≥60 years of age) with unilateral cochlear implants was conducted. Audiological testing included preoperative and postoperative pure-tone audiometry and a monosyllabic word recognition test presented from recorded material in free field. Speech perception tests included Ling’s six sound test (sound detection, discrimination, and identification), syllable discrimination, and monosyllabic and multisyllabic word recognition (open set) without lip-reading. Everyday life benefits from cochlear implantation were also evaluated.
The mean age at the time of cochlear implantation was 72.4 years old. The mean postimplantation follow-up time was 2.34 years. All patients significantly improved their audiological and speech understanding performances. The preoperative mean pure-tone average threshold for 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz was 110.17 dB HL. Before cochlear implantation, all patients scored 0% on the monosyllabic word recognition test in free field at 70 dB SPL intensity level. The postoperative pure-tone average was 37.14 dB HL (the best mean threshold was 17.50 dB HL, the worst was 58.75 dB HL). After the surgery, mean monosyllabic word recognition reached 47.25%. Speech perception tests showed statistically significant improvement in speech recognition.
The results of this study showed that cochlear implantation is indeed a successful treatment for improving speech recognition and offers a great help in everyday life to deafened elderly patients. Therefore, they can be good candidates for cochlear implantation and their age alone should not be a relevant or excluding factor when choosing candidates for cochlear implantation.
PMCID: PMC3794868  PMID: 24124356
cochlear implantation; elderly; audiometry; speech perception; speech recognition; hearing loss; hearing aid
2.  Endoscopic transnasal management of inverted papilloma involving frontal sinuses 
Inverted papilloma is a benign locally aggressive tumor of paranasal sinuses which has been traditionally managed with external surgical approaches. Advances in tumor imaging, surgical instrumentation and intraoperative visualization have led to a gradual shift to endonasal attachment-oriented surgery. Involvement of both frontal sinuses by inverted papilloma is rare. There are scant reports in the literature regarding this topic. We present 2 cases of the tumor involving both frontal sinuses removed by median drainage (Draf III procedure) under endoscopic guidance without any additional external approach. The whole cavity of both frontal sinuses was easily inspected at the end of the procedure. No early or late complications were observed. No recurrence was seen in 1-year or 2-year follow-up. Management of frontal sinus inverted papilloma with the endoscopic median drainage approach is feasible and seems to be effective.
PMCID: PMC3557731  PMID: 23362431
frontal sinus; inverted papilloma; endoscopic modified Lothrop; Draf III
4.  Intraoperative Monitoring of Hearing During Cerebellopontine Angle Tumor Surgery Using Transtympanic Electrocochleography 
To investigate the use of transtympanic electrocochleography (TT-ECochG) analyzed on-line by a detector strategy software that made possible automatic extraction of TT-ECochG components intraoperatively in real-time domain.
Fifteen patients with cerebellopontine angle tumor among 50 patients were included in this study.
All subjects were operated on via middle fossa or retrosigmoid approach. Pure-tone average (PTA) was measured at 0.5, 1.0, and 2.0 kHz, and calculations were performed before and after surgery. Auditory function was monitored intraoperatively via TT-ECochG, and analyzed data were displayed on-line.
Main Outcome Measures
TT-ECochG changes in morphology were described. Postoperative PTA elevation level correlated with TT-ECochG morphology changes occurring intraoperatively.
Analyzed on-line, TT-ECochG data were displayed as first negative peak of compound action potential amplitude and latency in time domain every 3 to 5 seconds. A good correlation between postoperative PTA elevation and TT-ECochG morphology changes was showed (Spearman rank test, R = +0.93; t(N-2) = 9.00; p < 0.0001).
TT-EcochG seemed to effectively mirror even minimal changes in auditory function during intraoperative monitoring in real-time domain. Developed strategy of online analysis makes the intraoperative hearing status assessment faster and easier.
PMCID: PMC2094124  PMID: 17529854
Electrocochleography; Cerebellopontine angle tumor surgery; Intraoperative monitoring of hearing; Hearing preservation
5.  Clinical evaluation of cochlear implant sound coding taking into account conjectural masking functions, MP3000™ 
Cochlear Implants International  2011;12(4):194-204.
Efficacy of the SPEAK and ACE coding strategies was compared with that of a new strategy, MP3000™, by 37 European implant centers including 221 subjects. The SPEAK and ACE strategies are based on selection of 8–10 spectral components with the highest levels, while MP3000 is based on the selection of only 4–6 components, with the highest levels relative to an estimate of the spread of masking. The pulse rate per component was fixed. No significant difference was found for the speech scores and for coding preference between the SPEAK/ACE and MP3000 strategies. Battery life was 24% longer for the MP3000 strategy. With MP3000 the best results were found for a selection of six components. In addition, the best results were found for a masking function with a low-frequency slope of 50 dB/Bark and a high-frequency slope of 37 dB/Bark (50/37) as compared to the other combinations examined of 40/30 and 20/15 dB/Bark. The best results found for the steepest slopes do not seem to agree with current estimates of the spread of masking in electrical stimulation. Future research might reveal if performance with respect to SPEAK/ACE can be enhanced by increasing the number of channels in MP3000 beyond 4–6 and it should shed more light on the optimum steepness of the slopes of the masking functions applied in MP3000.
PMCID: PMC3175094  PMID: 22251806
Cochlear implant; Speech coding; Masking; Spread of excitation; Battery life

Results 1-5 (5)