Biomedical subjects

Antonio Quaranta

Publications and source records attributed to Antonio Quaranta.

8 recordsLinked to original sources

PubMed2005

Air and bone conduction change after stapedotomy and partial stapedectomy for otosclerosis.

OBJECTIVE: The aim of this study was to analyze and compare the results obtained in otosclerosis patient undergoing stapedotomy and partial stapedectomy. STUDY DESIGN AND SETTINGS: Retrospective review of surgical series. The guidelines of the American Academy of Otolaryngology-Head and Neck Surgery for the evaluation of results of treatment of conductive hearing loss were used. RESULTS: Pure tone average (0.5 to 3 kHz) air-bone gap was 6.1 dB in the partial stapedectomy and 6 dB in the stapedotomy group. The air-bone gap (ABG) closure rate did not differ between the 2 groups, except at 4 kHz, where stapedotomy group showed greater closure (P 0.003). Mean postoperative ABG gain was significantly (P < 0.05) higher in the stapedotomy group at 2, 3, and 4 kHz. Mean postoperative air-conduction gain did not differ significantly. Mean postoperative bone conduction (BC) change (1, 2, and 4 kHz) was 3.68 dB in partial stapedectomy and -0.02 dB in stapedotomy group, the difference being significant (P 0.007). Differences in BC change between the 2 groups were significant at each frequency. CONCLUSIONS: Similar good results can be obtained in experienced hands using either partial stapedectomy or stapedotomy technique. ABG closure rates were analogous in the 2 techniques as well as the complication rate. Although stapedotomy obtain better results at high frequencies, partial stapedectomy is associated with increased BC threshold at all frequencies.

Audiometry, Pure-Tone↗

PubMed2005

Effects of efferent acoustic reflex activation on psychoacoustical tuning curves in humans.

CONCLUSIONS: The results show that, in humans, activation of the contralateral EAR makes the PTC narrower at 1 kHz but wider at 4 kHz. These data are consistent with those reported previously in animals and demonstrate that, during medial efferent stimulation in humans, frequency resolution is improved at low frequencies but impaired at high frequencies. OBJECTIVE: To evaluate, in humans, the effect of activation of the contralateral efferent acoustic reflex (EAR) on the psychoacoustical tuning curves (PTCs) recorded for 1- and 4-kHz probe tones. MATERIAL AND METHODS. Ten young (20-30 years) volunteers served as subjects. They had normal hearing (thresholds <20 dB HL in the frequency range 0.25-8 kHz) and a functioning EAR (contralateral suppression of transient-evoked otoacoustic emissions > or = 0.8 dB). Frequency resolution was evaluated using PTCs. PTCs were recorded at 1 and 4 kHz using a simultaneous masking method. Q10 and Q20 were calculated as the ratio between the test frequency and the bandwidth of the PTC at 10 and 20 dB above the tip of the curve, respectively. The EAR was activated with a 40-dB SL contralateral narrow-band noise centered on the characteristic frequency of the PTC (1 or 4 kHz). Q10 and Q20 were measured in the presence and absence of the contralateral noise. RESULTS: Activation of the EAR led to a significant increase (p < 0.001) in Q10 at 1 kHz and a significant decrease (p <0.001) at 4 kHz. Changes in the value of Q20 were not significant.

Acoustic Stimulation↗

PubMed2005

Cochlear implantation in otosclerosis.

OBJECTIVE: The purpose of this study was to evaluate and compare the results obtained in a group of implanted otosclerotic patients with a group of cochlear implant (CI) patients not affected by otosclerosis. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Nine patients affected by profound sensorineural hearing loss caused by otosclerosis and nine patients affected by profound sensorineural hearing loss not caused by otosclerosis were evaluated. INTERVENTION: Cochlear implantation. MAIN OUTCOME MEASURES: Preoperative imaging, intraoperative findings, postoperative facial nerve stimulation, and speech perception performance measures were performed and the data analyzed. RESULTS: Otosclerosis patients showed signs of cochlear ossification both on high-resolution computed tomography scans and intraoperatively. The incidence of facial nerve stimulation was higher in the otosclerosis group, three out of nine, and was generally related to the use of electrical stimulation from the Nucleus 22 cochlear implant. Psychophysical and speech perception measures did not show significant differences between the two groups, despite some otosclerosis patients showing increased electrical thresholds and comfort levels and slightly poorer speech perception performance scores. CONCLUSIONS: Patients with otosclerosis who have progressed to profound hearing loss derive significant benefit from cochlear implants; however, an increased risk of cochlear ossification and facial nerve stimulation has to be taken in account during preoperative counseling. The advance in imaging techniques, CI technology and the possibility to stimulate precise regions of the cochlea with lower intensities make it possible for the surgeons and audiologists to readily and successfully manage these complications as they arise.

Adolescent↗

PubMed2004

The effects of 'supra-physiological' vitamin B12 administration on temporary threshold shift.

The aim of this study was to evaluate, in 20 young volunteer subjects, the effects of supra-physiological vitamin B12 administration on noise-induced temporary threshold shift (TTS). All subjects had hearing thresholds within 15 dBHL and type A tympanograms. The subjects were randomly assigned to two different groups. Experimental group subjects received cyanocobalamin, 1 mg daily for 7 days, and 5 mg on the eighth day. Control group subjects received a placebo injection daily for 8 days. The vitamin B12 concentration, hearing thresholds and TTS2 (10 min of exposure, narrowband noise centred at 3 kHz, bandwidth of 775 Hz, 112 dBSPL) were measured before and 8 days after treatment. At the end of treatment, the serum vitamin B12 concentration was significantly increased in the experimental group. After 8 days of treatment, the control group showed the same hearing thresholds and TTS2 degrees. Statistical analysis showed that TTS2 decreased significantly at 3 and 4kHz when cobalamin was used to increase the serum concentration of vitamin B12 to > 2350 pg/ml. In addition, a protective effect at 3 kHz in the experimental group was evident when compared with the placebo group. These results suggest that elevated plasma cyanocobalamin levels may reduce the risk of hearing dysfunction resulting from noise exposure in healthy, young subjects.

Adult↗

PubMed2004

Cochlear implants: indications in groups of patients with borderline indications. A review.

Cochlear implants (CI) represent the current treatment for patients affected by profound sensorineural hearing loss (SNHL). Initially only deaf adult patients were considered to be candidates for a CI; however, the development of technology and matured experience have expanded the indications for cochlear implantation. Today, CIs are implanted in adults and children and broader indications are followed. There are, however, a number of patients who do not completely fulfill the current indications and who are potential candidates for CI. The duration of deafness and residual hearing represent prognostic indicators for CI performance; however, the candidacy of children with residual hearing and prelingually deafened adults are still under debate. Anatomical variants such as cochlear ossification, cochlear malformation and chronic otitis media represented and still represent for some surgeons a contraindication to CI. The otological experience of CI surgeons and the advent of auditory brainstem implants have changed the approach to these patients, who may still benefit from hearing rehabilitation. This paper briefly analyses and reviews the results obtained in these groups of patients, who were not, at least initially, considered to be candidates for cochlear implantation.

Cochlea↗

PubMed2003

Effect of ipsilateral and contralateral low-frequency narrow-band noise on temporary threshold shift in humans.

OBJECTIVE: To evaluate the effect of ipsilateral and contralateral low-frequency (250 Hz) narrow-band noise (NBN) on the temporary threshold shift (TTS) induced by a 2 kHz tone in young normally hearing subjects with a functioning auditory efferent system. MATERIAL AND METHODS: Sixteen young volunteers served as subjects. All the subjects were young (20-30 years), disease-free and had a medical history negative for otological disease, noise exposure and use of ototoxic drugs. They had normal hearing [thresholds of 125-8,000 Hz below 20 dB hearing level (HL)], transient-evoked otoacoustic emissions and contralateral suppression. The subjects were randomly assigned to one of three different groups. Subjects in Group A (n = 5) were exposed to a 90 dB HL 2 kHz pure tone for 10 min. Subjects in Group B (n = 6) were exposed to a 90 dB HL 2 kHz pure tone and an ipsilateral 45 dB HL 250 Hz NBN for 10 min. Subjects in Group C (n = 5) were exposed to a 90 dB HL 2 kHz pure tone and a contralateral 45 dB HL 250 Hz NBN for 10 min. The right ear served as the test ear. The TTS 2 min after the end of the exposure (TTS2) was measured in all subjects at 2, 3 and 4 kHz. RESULTS: TTS, in Group A was significantly higher at 3 kHz (p = 0.011) and at 4 kHz (p = 0.003) than TTS2 in Group B. At 4 kHz, TTS2 in Group C was significantly higher (p = 0.013) than TTS2 in Group B. Although TTS2 in Group C was lower than TTS2 in Group A, this difference was not significant. The presence of an ipsilateral low-frequency NBN significantly reduced TTS2 induced by a 90 dB HL 2 kHz tone. A contralateral low-frequency NBN reduced TTS2 in this group of subjects; however, the reduction was not significant. CONCLUSION: The results of this study show that an ipsilateral low-intensity, low-frequency (250 Hz) NBN can give protection from a TTS induced by a 2 kHz tone. Contralateral low-frequency NBN did not induce any protective effect.

Acoustic Stimulation↗

PubMed2002

Cochlear function in ears with immunomediated inner ear disorder.

The aim of the present study was to evaluate the performance of ears with inner ear disorder, responsive to immunosuppressive drugs, in advanced tests designed to assess primary cochlear functions (temporal integration, frequency selectivity, cochlear mechanics). The results of this study suggest that immunomediated inner ear disease results, in the acute clinical stage, in the development of endolymphatic hydrops, which increases the stiffness of the vibrating structures within the inner ear and causes dysfunctions of the outer hair cells. Our patients presented with upsloping or flat sensorineural hearing loss, absence of evoked otoacoustic emissions and distortion-product otoacoustic evoked emissions and abnormal temporal integration, frequency selectivity and cochlear mechanics. Following immunosuppressive treatment, hydrops recovered, hearing subsequently returned to normal, the audiometric curve became flat at low-to-middle frequencies and primary cochlear function tended to normalize. This study seems to support the usefulness of testing primary cochlear functions in order to monitor the clinical course of immunomediated inner ear disorders.

Acoustic Impedance Tests↗

PubMed2002

Cochlear implants in systemic autoimmune vasculitis syndromes.

The concept that autoimmunity may damage the inner ear was introduced by McCabe in 1979. Audiovestibular symptoms may occur in isolation or may be mediated by vasculitis in patients affected by systemic autoimmune disorders. Sensorineural hearing loss (SNHL) is typical in Cogan's syndrome but occurs less frequently in Beçhet's syndrome and in systemic necrotizing vasculitides. Patients affected by immune-mediated profound SNHL represent ideal candidates for cochlear implantation as these patients become deaf after years of hearing. The disease itself and the medication taken may, however, influence the prognosis of cochlear implantation in these patients. We retrospectively evaluated the pre- and intraoperative findings as well as the postoperative course and performance of a group of five patients affected by a systemic vasculitis syndrome who received a cochlear implant. Implantation was successful in all patients, no complications occurred and excellent postoperative speech perception was achieved. We conclude that cochlear implantation in patients affected by immune-mediated inner ear disorders is effective although the long-term results remain to be evaluated.

Adult↗