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Biomedical subjects

Sarah S Connell

Publications and source records attributed to Sarah S Connell.

4 recordsLinked to original sources

Cochlear implants.

Cochlear implants are cost-effective auditory prostheses that safely provide a high-quality sensation of hearing to adults who are severely or profoundly deaf. In the past 5 years, progress has been made in hardware and software design, candidate selection, surgical techniques, device programming, education and rehabilitation,and, most importantly, outcomes. Cochlear implantation in the elderly is well tolerated and provides marked improvement in auditory performance and psychosocial functioning.

Aged↗

The effect of organ of corti loss on ganglion cell survival in humans.

HYPOTHESIS: Severe spiral ganglion cell loss does not necessarily follow loss of hair cells or supporting cells in humans. BACKGROUND: Despite some publications to the contrary, statements that loss of hair cells and/or supporting cells of the organ of Corti results in a severe loss of spiral ganglion cells in humans still appear in the literature, especially in respect to cochlear implants. This assumption is apparently based on studies in animals or cell culture and not from studies of human temporal bones. METHODS: Morphological analysis of archival temporal bones with microscopic and statistical analysis of ganglion cell, hair cell, and supporting cell populations was performed in 33 ears with total hearing losses of varying causes and durations of deafness. None of the ears had remaining hair cells. Six ears had had cochlear implants. RESULTS: Ganglion cell counts ranging from 2,889 to 34,299 and the corresponding percentage of remaining ganglion cells based on age-normative data were not significantly related to the duration of hearing loss (r = -0.13 and 0.02, respectively, p > 0.05) or to remaining supporting cell populations (r's from 0.15 to 0.27, p > 0.05). More than half of ears (51.5%) had ganglion cell counts within two standard deviations of age-normative means. Mean ganglion cell counts and percentage of remaining ganglion cells of ears with surviving peripheral processes (dendrites) did not differ significantly from those of ears with no peripheral processes. CONCLUSION: The loss of hair and supporting cells in the organ of Corti in humans does not necessarily result in as significant a loss of spiral ganglion cells as has been reported animals. In fact, our results suggest that ganglion cell loss may be a primary concomitant loss due to the disease process.

Adult↗

Conservation of residual acoustic hearing after cochlear implantation.

OBJECTIVE: This study was designed to test the hypothesis that partial hearing conservation is attainable after cochlear implantation with a long perimodiolar electrode. Surgical strategies for hearing conservation during cochlear implantation are described. STUDY DESIGN: Prospective, single-subject, repeated-measures design. SETTING: Academic tertiary care center. PATIENTS: Twenty-eight severely to profoundly hearing-impaired adult cochlear implant recipients who had some measurable hearing preoperatively. INTERVENTION: Cochlear implantation using Nucleus Freedom Contour Advance electrode. MAIN OUTCOME MEASURES: Preimplant and postimplant pure-tone thresholds and speech recognition scores were obtained to determine the incidence and degree of conserved hearing at a mean interval of 9 (+/-3.9) months. RESULTS: Thirty-two percent of subjects experienced complete conservation of hearing (0- to 10-dB loss), and 57% experienced partial conservation of hearing (>11 dB) after implantation. However, open-set speech recognition was partially conserved in only one subject. Cochlear implant performance was not better in patients with conservation of residual hearing. CONCLUSION: Conservation of pure-tone hearing was possible in 89% of implanted patients; however, residual speech perception was not conserved with this long perimodiolar electrode. A ceiling effect tends to inflate the prevalence of hearing conservation in implantation studies of severely to profoundly hearing-impaired patients.

Adult↗

MRI evaluation of neurofibromatosis 2 patients: a standardized approach for accuracy in interpretation.

OBJECTIVE: To determine the level of agreement between local radiologists' and an experienced neuroradiologist's measurements of vestibular schwannomas. STUDY DESIGN: Prospective study with uniform magnetic resonance acquisition protocol parameters and reporting instructions across 30 magnetic resonance imaging facilities worldwide. SETTING: Multicenter natural history study of neurofibromatosis Type 2. SUBJECTS: One hundred fifteen magnetic resonance imaging examinations of 57 neurofibromatosis Type 2 patients older than 5 years of age. INTERVENTIONS: Thin-slice, postcontrast cranial magnetic resonance imaging. MAIN OUTCOME MEASURES: Spearman's rho interobserver association coefficient of vestibular schwannoma linear measurements. RESULTS: The local and experienced radiologist measurements and identification of tumors agreement was fair (kappa = 0.77). Discordant interpretations were adjudicated by another experienced neuroradiologist. CONCLUSION: The least interobserver variability was found in measurements of thin-slice postcontrast magnetic resonance imaging scans obtained at neurofibromatosis Type 2 centers in patients without previous operations and moderately sized tumors. If the schwannoma was difficult to assess, because of magnetic resonance imaging acquisition protocol, postoperative changes, or tumors smaller than 5 mm in greatest diameter, the neuroradiologist provided a more thorough assessment. The authors suggest uniform reporting criteria for vestibular schwannoma assessments to ensure clinically relevant information is communicated regarding vestibular schwannoma size.

Adolescent↗