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   2016| January-June  | Volume 3 | Issue 1  
    Online since September 28, 2016

 
 
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ORIGINAL ARTICLES
Assessment of hearing loss in tympanic membrane perforation
Haider W Alsarhan, Mohammed R Dawood, Abd Alhussen Kareem Jwery, Ammar H Khammas, Abbas K Hamad
January-June 2016, 3(1):16-19
DOI:10.4103/2314-8667.191237  
Background Tympanic membrane perforation is a common problem and causes hearing disability, and many factors can affect the degree of hearing loss. Objective The aim of this study was to assess the degree of hearing loss in relation with the size and site of tympanic membrane perforation. Patients and methods This prospective study was conducted at Al-Yarmouk Teaching Hospital during the period from February 2015 to February 2016 on 75 patients (93 ears) with tympanic membrane perforations. The size and site of perforations were evaluated under the microscope and classified according to the size (small, moderate, and large), and the site (anteroinferior, anterosuperior, posteroinferior, and posterosuperior quadrants). Hearing loss was measured in each case with pure-tone audiometry and its relation with these parameters was analyzed. Results There was an increase in hearing loss with the increase in the size of perforation. Perforation locations had an impact on hearing loss; this was statistically significant, especially in the posteroinferior quadrant if compared with other quadrants, as P value was 0.037. Conclusion The size and site of tympanic membrane perforation had a significant effect on the magnitude of hearing loss.
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REVIEW ARTICLE
Evaluation of factors that influence cochlear implant performance
Vergena S Ahmed Elkayal, Mona I Mourad, Manal M Elbanna, Mohamed A Mohamed Talaat
January-June 2016, 3(1):1-8
DOI:10.4103/2314-8667.191235  
Background One of the primary goals of cochlear implantation is open-set auditory-only speech understanding in everyday listening environments. An understanding of the etiology and neurocognitive factors that contribute to a favorable outcome after cochlear implantation would potentially allow clinicians to predict the results for a cochlear implant patient. The ability to discriminate small acoustic differences is very important for the perception and processing of speech signals. The mismatch negativity (MMN) method is an objective tool that provides a measure of automatic stimuli discrimination. Objective of the study The aim of this study was to classify the communicative performance of children with cochlear implants and verify this outcome by means of electrophysiological biomarkers. Methods The study was carried out in three phases: phase I included completing an audiological data information sheet for all patients, with data taken from their records, which included demographic data, preoperative and postoperative audiological evaluation, operative detailed information, cochlear implant mapping data, and preoperative auditory verbal therapy details as regards regularity and benefit. Phase II involved classifying the patients’ communicative performance according to a phoniatric evaluation protocol into poor, fair, and good response, determining behavioral pure tone aided thresholds with their cochlear implants, and conducting electrophysiological studies ‘P1 and MMN’ for those with aided thresholds in the long-term average speech spectrum with their cochlear implant. Phase III entailed verification of factors that affect the outcome of all cochlear implant users. Results Age of cochlear implantation, cause of hearing loss, comorbidity, preoperative electrophysiological test results, and radiological findings are variables affecting cochlear implant performance and affecting the patient's communicative performance, whereas sex of the patient and number of stimulated electrodes are variables not affecting the cochlear implant performance. Conclusion Early cochlear implantation and good auditory verbal therapy have better outcomes as regards listening and communication skills. Cortical auditory evoked potential (P1) and MMN might provide a clinical tool to monitor aural rehabilitation outcome. These objective electrophysiological parameters may also be used as prognostic indicators for speech and language outcome.
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EVENTS
Les premières rencontres d'ORL et d'oto-neurochirurgie. Bejaia 17-18 septembre 2015, Auditorium Targa Ouzemour; Université Abd Errahmane Mira Bejaia, The 1st ENT and skull base surgery meeting of Bejaia 17-18 September Programme

January-June 2016, 3(1):20-23
DOI:10.4103/2314-8667.191135  
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ORIGINAL ARTICLES
Early detection of changes to hearing status attributed to treatment regimen with ototoxicity in the state of Qatar
Zainab Al Musleh, Maha Al Suliteen, Khalid Hadi, Maysoun El Abbadi, Waleed Omar, Awatif Ali, Amna Al Amin, Muna Alsufi, Nehal Alnajar, Nawal Ahmed
January-June 2016, 3(1):9-15
DOI:10.4103/2314-8667.191236  
Background Ototoxicity resulting from cisplatin chemotherapy constitutes a significant clinical problem and challenge. Therefore, an early and effective detection of hearing loss in pediatric oncology patients receiving ototoxic medication and early intervention are critical to help these patients in achieving these developmental milestones and improving their quality of life. Materials and methods This prospective, observational study was designed as an initial pilot study to collect and analyze data from January 2014 to January 2015 on a variety of parameters. All pediatric patients, aged less than 14 years, referred from the Pediatric Hematology/Oncology Clinic to the new Ototoxic Clinic were included in the study. Descriptive statistics were used to summarize the above data, and associations between two or more qualitative variables were assessed using the χ2-test or Fisher's exact test as appropriate. Results A total of 20 patients were included in the study. Diagnostic otoacoustic emission findings were found to be normal in 14 patients (80%); four patients (20%) had abnormal findings, and in two cases this test was not carried out. High-frequency audiometry test indicated that nine (52.9%) patients had normal findings, whereas five (29.4%) had abnormal results. High-frequency audiometry could not be carried out for six (30%) patients because of their ages. Hearing loss involving the speech frequencies affected only two patients (10%; 95% confidence interval 1.7–29.3); they were diagnosed to have β-thalassemia and retinoblastoma and are currently using xjade and cisplatin. Conclusion Early and effective identification of ototoxicity is vital in children receiving cancer treatments because of the impact acquired hearing loss has on social and educational outcomes in children. This study highlights the role of early detection of hearing loss in pediatric patient receiving ototoxic medication and of possible potential interventions to enhance their quality of life during and after treatment.
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