Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P249

Poster Presentations

Speech Understanding Results in Late
Reimplantation
Alessandra Zanoni (Presenter); Alexandros Giourgas; Anke
Lesinski-Schiedat; Thomas H. Lenarz, MD, PhD
Objectives: Cochlear implants are currently the best devices
for rehabilitation of patients with severe to profound, unilateral or bilateral sensorineural hearing loss. Some patients who
underwent cochlear implantation in the 1980s have come to
need to replace the equipment, either for technical reasons,
worsening speech performance, or the desire to technically
upgrade the system. The aim of this study was to compare
speech perception test results of patients with reimplantation
after more than 15 years of first cochlear implant surgery.
Methods: Retrospective analysis of medical records of pediatrics who underwent implantation between 1988 and 2000
and required reimplantation from 2015 onward, regardless of
the reason for replacing the equipment. Patients should have at
least 1 year of follow-up, with complete medical records.
Results: Of the 28 cases analyzed, 18 were prelingual and
10 postlingual. The performance of the speech comprehension
test was analyzed in 3 periods of time: pre-reimplantation and
1 month and 12 months after reimplantation. There was no
significant difference between the periods of time regarding
the variable numbers (P = .148). The variables monosyllables,
HSM in silence, and HSM in noise showed a significant
reduction between preoperative and 1 month (P = .007/P =
.001*/P = .013*); however, they increased significantly at
12 months at the same preoperative level (P = .027*/P <
.001*/P < .034*). When only the 5 cases of reimplantation by
upgrade were considered, no significant difference between
the moments for any of the variables was observed.
Conclusions: Late reimplantation is safe in relation to the
maintenance of preoperative performance in speech perception tests, but no improvement effect of technology upgrade
was observed.
Stapes Surgery: Comparison of
Hearing Results Among Stapedectomy,
Stapedotomy, and Stapes Mobilization in
Japanese Patients
Yu Yuasa, MD (Presenter)
Objectives: Otosclerosis is a rare disease and the degree of
the fixation in the stapes is sometimes not serious in Japanese
patients compared with Caucasians. The low occurrence of
inflammation and the small lesion to the footplate are suspected to be the reason. Stapes mobilization is sometimes
effective in such mild fixation cases. Although stapedectomy
using autologous tragal cartilage as a prosthesis for the ossicular reconstruction has been performed for severe otosclerosis
cases in our center, stapedotomy with a small fenestration
using an artificial prosthesis of polytetrafluoroethylene piston

was recently indicated. We compared postoperative hearing
results among these 3 procedures for otosclerosis.
Methods: Seventy-nine ears with otosclerosis that underwent stapes surgeries from 1994 to 2018 in Sendai Ear
Surgicenter were investigated. There were 17 ears in male
patients and 62 ears in female patients. The age ranged from
14 to 79 years, and the mean age was 54 years. A total of 34
ears underwent stapedectomy, 22 ears underwent stapedotomy, and 23 ears underwent stapes mobilization. The postoperative hearing was evaluated 1 year after each surgery.
Results: The average of the preoperative air-bone gap in
cases of stapedectomy, stapedotomy, and stapes mobilization
was 27.9, 28.0, and 23.8 dB, respectively. The average of
postoperative air-bone gap was 10.5, 5.3, and 11.6 dB, respectively. Cases of postoperative air-bone gap less than 20 dB
were 30 (88.2%), 20 (90.9%), and 18 (78.3%), respectively.
Conclusions: Stapedotomy should be the first choice for otosclerosis. When the luxation of the footplate during the manipulation to stapes is found, stapedectomy is indicated because
the refixation of the footplate after mobilization sometimes
occurs.
Steady-State Signal Attenuation in Patients
With Asymmetric Sensorineural Hearing Loss
Justin Alexander Hall, MD (Presenter); Stephanie
Tominaga, MD; Orrin Dayton; Reordan O. Dejesus;
Carolyn Ojano Dirain, PhD; Patrick J. Antonelli, MD
Objectives: Signal attenuation (SA) has been identified with
steady-state (SS) magnetic resonance imaging (MRI) of semicircular canals (SCs) in patients with otologic complaints. Our
study aimed to determine if SC-SS SA is associated with
asymmetric sensorineural hearing loss (ASNHL).
Methods: Retrospective chart review was conducted at a
tertiary care facility. Charts were reviewed for otologic complaints and audiometric data. MRIs were reviewed and scored
for SC-SS SA by a neuroradiologist blinded to clinical information. A total of 276 subjects were identified by searching
our billing database for cases that had MRI with an inner ear
protocol and a diagnosis of ASNHL between 2008 and 2018.
Patients with recognized causes for ASNHL, poor MRI quality, and insufficient records were excluded.
Results: In total, 152 subjects were included (mean [SD]
age, 56.7 [17.6], 55.3% were male). Forty patients (26%) had
SC-SS SA. In patients with SA, 37.5% was ipsilateral to the
worse-hearing ear, 27.5% contralateral, and 35% bilateral.
Ears showing SA ipsilateral to the worse-hearing ear was
associated with better median pure tone average (25.6 dB
hearing level [HL]) compared with those with contralateral or
bilateral changes (38.5 dB HL). Patients with SA were more
likely to have a history of diabetes (P = .0386). SS SA was not
linked to the onset/progression of the hearing loss, other
symptoms, or demographics.
Conclusions: SC-SS SA is present in a significant subset of
patients presenting with ASNHL. This finding does not correlate with clinical manifestations; thus, it likely does not

Otology/Neurotology

potentially because of social stigma associated with using a
hearing device in the teenage years.

P249

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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