Relationship between clinical measures of hearing and clinical measures of vestibular function.

PURPOSE: Patients often have basic audiometry (BA) but not objective diagnostic tests of the vestibular system (VNG) when complaining of symptoms of a vestibular disorder. The relationship of BA results to VNG results is unknown. This study sought to determine if BA scores are related to impaired VNG scores. MATERIALS AND METHODS: We reviewed electronic medical records at a tertiary care center, for patients seen between 2015 and 2021 who had had both a BA and a VNG (n = 651). BA subtests were pure tone averages, word recognition, and tympanogram. VNG subtests were cervical vestibular evoked myogenic potentials, Dix-Hallpike maneuvers, and bi-thermal caloric tests. All tests were summarized as normal/abnormal. RESULTS: More subjects had abnormal BA than abnormal VNG scores. Age but not sex was significantly related to abnormal scores. High BP was a significant comorbidity in 15 % of the sample, more in patients with abnormal than normal VNG scores. Although the abnormal BA and abnormal VNG were significantly related, pure tone averages and tympanogram scores were not related to VNG subtests. Abnormal word recognition with both ears combined was significantly related to normal and abnormal bi-thermal caloric tests. CONCLUSIONS: If the clinician needs to know of any VNG impairment, in general, then performing a BA without a VNG might suffice. If the clinician needs information about the details of possible vestibular impairment, then a VNG should be performed.

Monopolar Cautery Use in Pediatric Cochlear Implant Users.

OBJECTIVES: To determine the incidence and impact of monopolar cautery use in a cohort of pediatric cochlear implant (CI) users. STUDY DESIGN: Case series from a retrospective chart review and a systematic review of the literature. SETTING: Tertiary academic referral center. METHODS: CI patient charts from 2012 to 2021 were reviewed from a single pediatric hospital system to determine if monopolar cautery was used during a subsequent surgical procedure. In addition, a systematic review of the literature was performed to identify additional, relevant patients. Postoperative CI function was the primary outcome measure. RESULTS: In total, 190 patients underwent a surgical procedure following cochlear implantation in a single pediatric hospital system. Fifteen patients (7.9%) and 17 distinct surgical procedures were identified in which monopolar cautery was used. Seven of these 17 cases (41.2%) involved the head and neck, and 10 were performed below the clavicles. No patients experienced a device failure or a decline in CI performance following surgery. A systematic review identified an additional 4 patients who underwent a surgery that used monopolar cautery following cochlear implantation, and no change in CI function was identified. CONCLUSIONS: The present study adds additional support to the notion that monopolar cautery does not necessarily injure CI functionality. While the most risk adverse strategy when planning a surgical procedure for a CI patient is to avoid monopolar cautery use altogether, the use of cautery should not immediately be associated with implant dysfunction.

Benefits from, Satisfaction with, and Self-Efficacy for Advanced Digital Hearing Aids in Users with Mild Sensorineural Hearing Loss.

Little evidence is available regarding outcomes of advanced digital technology (ADT) hearing aid wearers with mild sensorineural hearing loss (MSNHL). The purpose of this article is to report the characteristics of and outcomes for this population. A cross-sectional research design was employed with 56 participants from a private practice setting. The International Outcomes Inventory for Hearing Aids (IOI-HA), Satisfaction with Amplification in Daily Life (SADL), and the Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids (MARS-HA) were completed, scored, and compared with normative data. Results revealed that ADT aids were worn 10.5 hours/day, were mostly advanced to premium (55%), had an average cost per aid of $2,138 (SD = $840), and provided significant benefit (IOI-HA overall score: mean = 4.1; SD = 0.6) and satisfaction (SADL global score: mean = 5.4; SD = 0.8) to users who had good overall self-efficacy (MARS-HA composite score: mean = 81.7; SD = 12.8). Patients were most dissatisfied with and had the least self-efficacy for managing background noise and advanced handling of their devices. ADT hearing aid users with MSNHL achieved excellent outcomes, but ongoing follow-up and counseling from hearing health care providers may be important for successful management of background noise and mastery of advanced handling skills.