Aging, Cognitive Decline and Hearing Loss: Effects of Auditory Rehabilitation and Training with Hearing Aids and Cochlear Implants on Cognitive Function and Depression among Older Adults.

A growing interest in cognitive effects associated with speech and hearing processes is spreading throughout the scientific community essentially guided by evidence that central and peripheral hearing loss is associated with cognitive decline. For the present research, 125 participants older than 65 years of age (105 with hearing impairment and 20 with normal hearing) were enrolled, divided into 6 groups according to their degree of hearing loss and assessed to determine the effects of the treatment applied. Patients in our research program routinely undergo an extensive audiological and cognitive evaluation protocol providing results from the Digit Span test, Stroop color-word test, Montreal Cognitive Assessment and Geriatric Depression Scale, before and after rehabilitation. Data analysis was performed for a cross-sectional and longitudinal study of the outcomes for the different treatment groups. Each group demonstrated improvement after auditory rehabilitation or training on short- and long-term memory tasks, level of depression and cognitive status scores. Auditory rehabilitation by cochlear implants or hearing aids is effective also among older adults (median age of 74 years) with different degrees of hearing loss, and enables positive improvements in terms of social isolation, depression and cognitive performance.

Trastornos autoinmunitarios del oído interno / Autoimmune inner ear disorders

La incidencia de enfermedad autoinmunitaria del oído interno (EAOI) es difícil de determinar: probablemente,se trata de una entidad poco frecuente, responsable de menos del 1% del total de casos de trastornos auditivos o mareos. Sin embargo, el diagnóstico de EAOI puede pasarse por alto debido a la falta de pruebas diagnósticas específicas. La principal característica de esta afección clínicamente diagnosticada es la presencia de una pérdida de audición neurosensitiva (PANS) bilateral, rápidamente progresiva y, con frecuencia, fluctuante, que se produce durante un período de semanas a meses. La progresión de la pérdida auditiva es demasiado rápida como para ser diagnosticada como presbiacusia y demasiado lenta como para llevar al diagnóstico de PANS súbita. Los síntomas vestibulares, talescomo inestabilidad generalizada, ataxia, vértigo posicional y vértigo episódico, pueden estar presentes en casi el 50% de los pacientes. En ocasiones, sólo un oído se encuentra afectado inicialmente, pero la pérdida auditiva bilateral sucede en la mayoría de los pacientes, con umbrales audiométricos simétricoso asimétricos. Casi el 25% al 50% de los pacientes también presentan acúfenos y sensación de plenitud auditiva, los cuales pueden ser fluctuantes. Las enfermedades autoinmunitarias sistémicas coexisten enel 15% al 30% de los pacientes

ncidence of autoimmune inner ear disease (AIED) is difficult to determine: probably it is a rare disease, accounting for less than 1% of all cases of hearing impairment or dizziness. Nevertheless, the diag-nosis of AIED might be overlooked because of the lack of specific diagnostic tests. The hallmark of this clinically diagnosed condition is the presence of a rapidly progressive, often fluctuating, bilateral SNHL over a period of weeks to months. The progression of hearing loss is too rapid to be diagnostic for presbycusis and too slow to conclude a diagnosis of sudden SNHL. Vestibular symptoms, such as generalized imbalance, ataxia, positional vertigo and episodic vertigo may be present in almost 50% of patients. Occasionally only one ear is affected initially, but bilateral hearing loss occurs in most patients, with symmetric or asymmetric audiometric thresholds. Almost 25%-50% of patients have also tinnitus and aural fullness, which can fluctuate. Systemic autoimmune diseases coexist in 15%-30% of patients.

Endocochlear inflammation in cochlear implant users: case report and literature review.

OBJECTIVES: Cochlear implantation is a relatively safe procedure with a low complication rate. The overall rate of complications among cochlear implant patients ranges from 6% to 20%. Major complications are those that are life-threatening or require surgery, whereas minor complications are those that can be medically treated. Nonetheless, certain complications, even if highly rare, may require specific investigations and treatments. Among these rare complications are those with endocochlear involvement, such as cochleitis or labyrinthitis, with fibrosis or ossification that could lead to explantation. The aims of the present study were to report a particular case of post-operative cochleitis and to review the rate of complications after cochlear implantation, emphasising those conditions with proven endocochlear involvement. METHODS: We refer to the case of an eight-year-old Italian boy affected by the sudden onset of headache, ipsilateral otalgia and facial paresis, who presented to our clinic for inexplicable worsening of the performance of his implant and his residual hearing, six years after surgery. A complete investigation including (clinical history, routine, autoimmune and serological blood tests, electrophysiological measurements from the cochlear implant and neuroimaging) was performed and is herein described. Additionally, a comprehensive review of the literature was conducted using internet search engines; 274 papers were selected, 88 of which were best suited to our purposes. RESULTS: In our case, the progression of the symptoms and the performance decrement required explantation, followed by a complete recovery. Reviewing the literature revealed only three reports concerning cases of proven endocochlear phlogosis that required revision surgery. Wound swelling/infection and vertigo remain the two most common complications of cochlear implantation. Failure of the device is the third most frequent complication (10.06% of all complications and 1.53% of cochlear implantations). Other rare conditions (such as granulating labyrinthitis with cochlear fibrosis, ossification and erosion, silicone allergy and the formation of a biofilm around the internal device) are possible and unpredictable. Although rare (approximately 1%), such cases may require explantation. CONCLUSIONS: Despite efforts by both surgeons and manufacturers, device-related and surgical complications still occur. These and other rare conditions demand specific management, and their frequency may be underestimated. Further studies are needed to assess more realistic rates of complications and devise more efficient strategies for early diagnosis and treatment.