Audiology and hearing

Cochlear implantation in children under 12 months of age

Z. Aksenovová, J. Skřivan, M. Jurovčík, L. Říhová, L. Bauer, Z. Čada
doi: 10.48095/ccorl2025S1_1
Department of Ear, Nose and Throat, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Motol University Hospital, Prague, Czech Republic

Introduction: Newborn hearing screening allows early detection of hearing impairment. As a result, many children with severe and profound hearing loss can be implanted in early childhood. Aims: The aim of our study was to compare the auditory perception and speech development outcomes of children with early implantation with two cohorts of prelingually deaf children. The first group was implanted between the ages of 1 and 3 years, the second one between the ages of 3 and 6 years. Materials and Methods: Our study included 15 patients implanted before the age of 12 months. We evaluated their auditory performance and speech perception and expression using the Categories of auditory performance (CAP) and our own scale Motol speech scale (MSS) at intervals of 6 months, 1, 2, 3 and 5 years after surgery. We compared their results with a group of 96 children who were implanted between the ages of 1 and 3 years and a second group of 30 children implanted between the ages of 3 and 6 years. Results: Early development was similar in all groups. At 5 years after surgery the group of patients implanted under 12 months of age showed better results in all categories. Conclusion: Although implantation in early childhood presents many challenges (risk of anaesthesia, anatomical conditions, cooperation of the child during rehabilitation...), the results of these children in terms of auditory perception and speech development are very good and they are approaching their hearing peers.

Experiences with sodium-thiosulfate as otoprotectant in pediatric oncology – a review

A. am Zehnhoff-Dinnesen1, K. Knight2, I. Schmid3, K. Rajput4, N. Streefkerk5, A. Hoetink6, T. Langer7, D. Berndtson8, T. Juda Airlangga9, I. Dewi Mayangsari10, S. Adhina Putri9, H. Oguz11, M. Tayyar Kalcioglu12, R. Soeparwata13, H. Spoudeas14, A.-K. Rohlfs15, M. Drakovic16, D. Konrad-Martin17, M. van den Heuvel-Eibrink5, P. Brock18 
doi: 10.48095/ccorl2025S1_2

Introduction: Cisplatin is a highly effective agent in paediatric oncology. But the permanent cost is ototoxicity: tinnitus in 15.9%; hearing loss in 50% and up to 75% in younger children and vertigo in a few. To avoid severe hearing loss occurring on chemotherapy, conventionally, individual cisplatin dose reduction, replacement by carboplatin or other chemotherapy, reduction of other ototoxic medications and modification of cranial irradiation have been applied. Sodium thiosulfate (STS) now offers the opportunity to protect the inner ear, potentially updating current practice. Aims: To examine the knowledge on STS as otoprotectant and compare this with conventional strategies. Materials and Methods: A review of the literature and a summary of the combined experiences of the authors. Results: Intravenous STS as otoprotectant is approved by the US Food and Drug Administration, the European Medicines Agency, and the British Medicines and Health Regulatory Authority for paediatric patients receiving cisplatin for a non-metastasised localised solid tumour. Administering STS six hours after the cisplatin infusion reduces cisplatin-induced hearing loss (CIHL) without affecting cisplatin antitumour efficacy, with manageable side-effects. Close audiological monitoring should be mandatory. Prevention should start at the first dose of cisplatin as ototoxicity can occur from cycle one. Conclusion: Further discussion is required on: whether cisplatin storage in the inner ear causing further progressive hearing loss will be reduced after STS; the eligible tumour groups that need to be defined; other ototoxic substances and type of cranial irradiation to be considered; the risk benefit ratio for any particular child/adolescent and options for children with metastases.

Interrelationships between audiometric parameters across the lifespan

Z. Bureš1, O. Profant2, V. Vencovský1, J. Fuksa2, D. Čapková2, J. Syka3                                                                             
doi: 10.48095/ccorl2025S1_3
1 Department of Cognitive Systems and Neurosciences, Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University, Prague, Czech Republic
2 Department of Otorhinolaryngology, 3rd Faculty of Medicine, Charles University in Prague, University Hospital Královské Vinohrady, Prague, Czech Republic
3 Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Science, Prague, Czech Republic

Aging is associated with a complex decline in hearing functions, affecting both peripheral and central structures. To better understand this process, we measured a comprehensive set of auditory parameters in 291 healthy volunteers aged 20 to over 80 years. Our study focuses on exploring relationships between variables and how they vary with age and hearing status. We conducted three types of analyses: mutual correlations between variables, clustering of variables, and predicting speech comprehension ability based on fundamental auditory parameters. These analyses were performed in specific subgroups, such as individuals with excellent hearing thresholds or those within particular age groups. The findings reveal significant differences in variable relationships across subgroups and suggest that speech comprehension depends on different mechanisms based on age and hearing thresholds.

Auditory brain stem implant – first experiences in the Czech Republic

Z. Čada
doi: 10.48095/ccorl2025S1_4
Department of Otorhinolaryngology, University Hospital Motol, Charles University, 2nd Faculty of Medicine, Prague, Czech Republic

Introduction: A cochlear implantation is a standard procedure, that helps to restore hearing to patients with severe to profound hearing loss. In case of contraindication or impossibility to introduce a cochlear implant (CI), e. g. due to obliteration of the cochlea, aplasia or severe hypoplasia of the auditory nerve, tumors of cerebellopontine angle and post-operative changes, etc. There is an option to introduce an auditory implant into the brainstem (ABI – auditory brainstem implant). Accurate electrode placement during surgery is very important for ABI to fix it properly. There is also a much greater risk of the occurrence of various types of parasitic stimulation. This may reduce the benefit of the implant. In children, the setting of a brain stem implant is quite complicated due to their poorer cooperation, lack of experience with auditory sensations and limited possibilities of using subjective and objective examination methods. Methods: We present the introduction of ABI in the first children in the Czech Republic in October 2022 and in November 2024. We used eABR monitoring to control electrode placement during operations and to create a model and verify safe stimulation during sound process or activation. We evaluated the development of auditory perception using gain curves and according to the Nottingham scale. Results: Both patients with a brain stem implant responded to sounds with the first activation of the sound processor. In the course of setting up after the operation, they gradually detected also other sounds and identified some of the words. No serious complications were noted during the operation or in the postoperative course. Conclusions: In some indicated cases, an auditory stem implant can be a suitable alternative to solving a profound hearing loss. Early postoperative results in the first Czech children appear to be optimistic. The auditory perception and speech production is monitored.

Binaural hearing and sound localization assessment in patients with Cochlear implant

V. Caragli1, E. Zacheo2, S. Parretta1, E. Genovese1, D. Soloperto1       
doi: 10.48095/ccorl2025S1_5
1 University of Modena and Reggio Emilia, Modena, Italy
2 Rehabilitation Center La Nostra Famiglia, Padova, Italy

Introduction: Binaural hearing is important for sound source localization, particularly in noisy and social environments. Individuals with unilateral or bilateral hearing loss (HL) face significant challenges in this aspect, impacting their daily lives. Cochlear implants (CIs) can effectively restore sound localization for those with severe to profound HL. Current assessment tools include loudspeaker tests and questionnaires such as the Speech spatial and qualities of hearing scale (SSQ), Quality-adjusted life year (QALY), and Short form health survey (SF-36). Aims: This study aimed to systematically review literature to identify the most common tests evaluating binaural skills, sound localization abilities, and quality of life. Materials and Methods: A systematic literature review was conducted from 2013 to 2023 across PubMed, Embase, and Web of Science databases, according to PRISMA guidelines. Results: A total of 92 out of 253 studies met the inclusion criteria, encompassing 2,736 patients with monolateral CI, bilateral CI, or bimodal CI + HA, aged 2 to 88 years. In the majority of cases (84%) localization tests with loudspeakers were performed. Protocols widely varied, employing from 1 to 24 loudspeakers, positioned at different angles. The AB York was the most frequently protocol used (5%). Other testing methods included visual reinforcement and virtual reality; in one case SSQ test was administered. Studies suggested that impaired localization abilities can persist after CI although these skills may improve in time. Discussion: Up to now, no standard protocols are used to evaluate binaural hearing and sound localization abilities in patent with CI. Combining loudspeaker tests with tools like SSQ, QALY or SF-36 is crucial for a comprehensive evaluation of patients‘ conditions and their quality of life. Conclusion: This study emphasizes the importance binaural abilities assessment in patients with CI. Future research should aim for more sensitive measures and standard protocols integrating patient-reported outcomes with objective evaluations.

Results of hearing screening program for intellectually disabled people in Special Olympics events (Healthy Hearing program) in the Czech Republic

L. Černý 
doi: 10.48095/ccorl2025S1_6
Department of Phoniatrics, 1st Faculty of Medicine, Charles University, Prague, Czech Republic

Hearing screening is one of 8 health screening programmes organized by Special Olympics International for people with intellectual disability. These screenings are organised during Special Olympics sports events annually over the world, also in the Czech Republic. Hearing problems and ear problems are more common in people with intellectual disability than in the general population. These problems are very often unknown, because usually not reported by people with intellectual disability nor by their families or teachers. The hearing screening consists of the ear canal inspection, otoacoustic emissions measurement (DPOAE) in the first step. The second step (tympanometry and pure tone audiometry including bone conduction) follows immediately for “refer” results from the first step. The individual report and recommendation for follow-up based on screening results is given at the end. We will discuss our data (N = 250) collected at the Special Olympics events in Brno in 2014 and in Jihlava 2024. We will also compare it with data gathered in other Healthy Hearing programs in Europe.

Our experience with TRT (Tinnitus retraining treatment) in treatment of subjective tinnitus

I. Csekesova1, A. Nagy Potasch2
doi: 10.48095/ccorl2025S1_7
1 Center for Vestibular Disorders, ENT, Komárno Agel Hospital, Komárno, Slovakia
2 Center for Vestibular Disorders, Komárno Agel Hospital, Komárno, Slovakia

Introduction: Tinnitus is the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes tinnitus disorder – when associated with emotional distress, cognitive dysfunction, and/or autonomic arousal leading to behavioral changes and functional disability. It is frequently associated with Menières disease, hearing loss, otosclerosis or vestibular schwanoma. More than 200 drugs list tinnitus as a potential side effect. Recent studies showed that anxiety associated with COVID-19 has been shown to enhance tinnitus. Aims: The aim of this study is to evaluate the general effect, sufficiency and patient’s compliance to TRT. Materials and Methods: In this 1-year-long study of 112 patients we would like to present our experience with TRT adhering to the categorization, diagnostic and therapeutical protocol. We have been collecting reported data on regular check-ups while using specific questionary forms structured by Pawel J. Jastreboff and Tinnitus handicap inventory. Results: We observe various effects depending on category, age, psychological state, social handicap, other ear related problems or previous experiences with different treatments. Conclusion: Tinnitus is a quite common problem which affects 10–17% of the general population, even more prevalent in the elderly over 65 years of age. For about 50% of this population is prolonged tinnitus significantly annoying causing them to seek medical help. We conclude that TRT is an effective method leading to habituation of perception and reaction to the annoying tinnitus. In combination with adequate counselling and psychological treatment can lead to a significant improvement of the patient’s quality of life.

Surgical treatment of otosclerosis

Z. Fík, J. Bouček, V. Koucký, P. Kalitová, M. Tesařová, K. Pospíšilová, J. Kluh 
doi: 10.48095/ccorl2025S1_8 Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic

Introduction: Otosclerosis is one of the most common causes of acquired hearing loss caused by fixation of the stapes footplate due to the abnormal bone metabolism of the otic capsule. The etiology of the disease is most likely multifactorial, with a hereditary predisposition being assumed. The principle of surgical treatment is to restore the mobility of the ossicular chain by creating a communication, a fenestra, into the vestibule at the site of the fixed disc and replacing the stapes with a prosthesis. Material and Methods: A retrospective analysis evaluated 266 cases of stapedial surgery performed in 2019–2023, including at the Department of Otorhinolaryngology and Head and Neck Surgery of the 1st Faculty of Medicine, Charles University and the Faculty Hospital in Motol, Prague. 177 procedures were performed in women, 89 in men. The average age of patients at the time of surgery was 45 years. Preoperative and postoperative audiometric outputs were evaluated in all patients and their influence by demographic parameters and technical parameters of the operation was then statistically processed. Results: Overall, the patients had a significant correction of conductive hearing loss. The success rate of the procedure according to the postoperative air-bone gap ≤ 10 dB was 64.66%, one case of postoperative deafness was recorded. Moreover gender, age, surgical approach and stapedotomy method had a significant influence on audiometric results. Vertigo occurred in 16 cases, significantly more often in after stapedectomy. Conclusion: Surgical treatment of otosclerosis is a safe solution leading to hearing improvement in most patients.

Asymmetric and unilateral hearing impairment in children: etiology, audiologic factors, and typical audiograms

L. Hahn, M. Fleischer, F. Wohlfarth, C. Männel, J. Althaus, D. Mürbe, A. Hirschfelder
doi: 10.48095/ccorl2025S1_9
Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany

Introduction: Asymmetric and unilateral pediatric hearing loss (AHL, UHL) originate from large interaural differences in hearing loss (HL) severity. To date, clinical characteristics of affected children have not been sufficiently examined. Aims: We provide etiologic and audiologic factors of children with AHL and UHL from the German Registry of Hearing Loss in Children. Materials and Methods: Children with AHL (N = 783) had averaged hearing thresholds of at least 20 dBHL on both ears (PTA-4) and at least 30 dB interaural difference at two or more frequencies (0.5–4 kHz). Children with UHL (N = 2,412) had averaged hearing thresholds of at least 35 dBHL on one ear (PTA-4 or ABR), second ear is normal hearing (< 20 dBHL). Etiologic and audiologic factors were compared using absolute standardized mean difference (ASMD). Audiograms (N = 2,455 ears; PTA-4) were mapped to standard audiograms, using shape-similarity and minimum variance. Results: Hereditary HL was more common in AHL-children than in the group with UHL (24% AHL vs. 16% UHL; ASMD 0.19). In both groups, about 25% of children had a family history and about 50% of children had comorbidities alongside their HL. Risk factors affected more children with AHL than UHL (36% AHL vs. 24% UHL; ASMD 0.27). In the subgroup of children with comorbidities, combined HL occurred more frequently in AHL children (16% AHL vs. 8% UHL; ASMD 0.24). Conductive HL was most common in UHL children (8% AHL vs. 34% UHL; ASMD 0.66). The most common audiogram configuration in both groups was pantonal or high-frequency hearing loss. In 60% of children with AHL, audiogram configurations were different between both ears. Conclusion: Preliminary results suggest a need for a subgroup-specific approach, for example regarding the proportion of conductive and combined HL in children with comorbidities. As interaural differences in audiogram configurations were common, they should be considered when assessing binaural hearing.

A rationale for hearing screening programs in elderly

R. Hernández-Villoria1, G. Guerra2, P. Malavé2 
doi: 10.48095/ccorl2025S1_10
1 Departamento de Foniatría, Medicina Audiovestibular y Deglutología, Centro Clínico de Audición y Lenguaje Cealca, Caracas, Venezuela
2 Departamento de Foniatría, Audiológía y Otoneurología, Hospital Luis Razzetti, Barcelona, Venezuela

Introduction: Despite its high prevalence among individuals aged 60 and older, hearing impairment remains underdiagnosed and therefore, undertreated. Lack of routine hearing screening in older adults may be an important gap that significantly impacts quality of life, cognitive function, and social engagement. Early identification through screening can facilitate timely interventions, such as hearing aids or auditory rehabilitation, which have been shown to improve communication, emotional well-being, and overall health outcomes. Aims: Estimate the prevalence of undiagnosed hearing loss and evaluate the detection rates achieved through screening programs; compare the literature-reported accuracy, feasibility, and acceptability of different hearing screening tools and identify best practices for implementing hearing screening programs in diverse settings, such as primary care clinics, senior centers, and community health programs, in elderly populations. Materials and Methods: It developed a scoping review protocol following the PRISMA-ScR guidelines. Peer-reviewed articles, grey literature and conference abstracts. A comprehensive search of electronic databases was conducted. Two independent reviewers will screen and select studies, with disagreements resolved through discussion or consultation with a third reviewer. The data obtained were summarized in the form of narrative synthesis and visual mapping. Results: The prevalence of undiagnosed hearing loss in elderly populations is high, particularly among older age groups and underserved populations. Studies estimate that 20–40% of elderly individuals have undiagnosed hearing loss. Detection rates vary depending on the screening tool and setting. Best practices vary according to primary care clinics, senior centers or community health centers. Conclusion: Screening programs are effective in increasing detection rates and improving outcomes, but their success depends on the tools used, the setting, and the availability of follow-up care. The literature highlights that no single screening tool is perfect for all settings related to elderly populations. This justifies the efforts to design and develop screening programs for the elderly.

Cochlear implantation outcomes in patients with far-advanced otosclerosis

V. Koucký, E. Košlabová, Z. Fík, P. Kalitová, L. Bauer, J. Bouček 
doi: 10.48095/ccorl2025S1_11
Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic

Introduction: Otosclerosis can affect the cochlea and lead to a progressive sensorineural hearing loss. Cochlear implantation (CI) is a possible solution for hearing rehabilitation in these patients. However, CI in otosclerotic cases might show difficulties such as challenging scala tympani insertion because of the ossification or facial nerve stimulation due to transotic conduction from the electrode bundle. The aim of this retrospective study was to evaluate perioperative difficulties and hearing outcomes in patients with far-advanced otosclerosis (FAO) undergoing cochlear implantation. Methods: A retrospective analysis of 29 ears in 24 patients who underwent cochlear implantation for hearing loss due to advanced otosclerosis at the Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University and Motol University Hospital, Prague between years 2015–2023. Perioperative difficulties with electrode insertion, electrode position, postoperative complications and hearing outcomes were assessed. Results: Improved hearing with a better mean value for the pure tone average and speech intelligibility was registered in more than 90% of patients. Severity of ossification of cochlea analyzed on preoperative CT scans and MRI was associated with electrode insertion difficulties; however, a full insertion was accomplished in more than 95% of cases. In 5 cases scala vestibuli insertion was necessary. Cochlear ossification and extent of surgical approach did not predict a poor hearing outcome. In spite of the extensive surgical approaches to cochlea, a permanent severe vestibular lesion due to the surgery was found only in 1 patient. Conclusion: Despite more complicated surgery in patients with FAO, which can result into partial cochlea resection and scala vestibuli insertion, the complication rate is low and effect of CI on hearing restoration is favourable in most of the cases.

Sudden bilateral sensorineural hearing loss as a manifestation of Susac syndrome

N. Barankiewicz-Tyc1, B. Maciejewska2, K. Kania1, A. Kalinowska3  
doi: 10.48095/ccorl2025S1_12
1 Poznan University of Medical Sciences, Neurological Clinic, Poznan, Poland
2 Department and Clinic of Phoniatrics and Audiology, Poznan University of Medical Sciences, Poznan, Poland
3 Neurological Clinic, Poznan University of Medical Sciences, Poznan, Poland

Introduction: Susac syndrome (SS) is a rare autoimmune condition. It is also known as retinocochleocerebral vasculopathy or SICRET syndrome (small infarctions of cochlear, retinal and encephalic tissue). It is characterized by microangiopathic multifocal changes that affect the retina, brain, and cochlea. Hearing loss may be one of the first initial presentation of the clinical triad which is often ignored till the other organs get involved. In spite of the ear being one of the main organs involved in the SS, few audiologists are aware of this condition. Aim: To present rare condition with focus on otological and audiological aspect of Susac syndrome. Materials and Methods: A 31-year-old female patient was referred to audiologist for hearing loss consultation. She was admitted in neurological ward for moderate to severe recurrent unilateral headache since 5 years. Her medical history revealed an episodic sudden hearing deterioration with tinnitus 4 years ago. Neurological, audiological and oculomotor examination as well as psychological examination were performed. Subjective and objective audiological tests were performed and bilateral moderate/severe sensorineural hearing loss was found. MRI examination showed multiple hyperintense lesions (FLAIR, T2), mainly in the frontal lobes of both hemispheres and additionally lesions in the corpus callosum which are considered to be almost pathognomonic. Conclusion: Hearing loss can be associated with SS. SS can present with hearing loss as the first presenting symptoms. This rare condition should be known to audiologists.

Disease patterns in individuals with intellectual disabilities with and without hearing loss

A. Naghipour1, V. Jankovic2, M. Scharpenberg2, S. Zielonkowski1, C. Gietmann1, P. Mathmann1, L. Prein1, K. Schwarze3, A. Neumann3, W. Brannath2, K. Neumann1       
doi: 10.48095/ccorl2025S1_13
1 Department of Phoniatrics and Pediatric Audiology, University Hospital Muenster, University of Muenster, Muenster, Germany
2 Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
3 Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany

Background: A higher disease prevalence is described in individuals with intellectual disabilities (ID) and hearing loss (HL). HL disproportionately occurs in ID and often remains undetected. We assessed the medical history of individuals with ID with and without HL to evaluate: 1. Which diseases are most common in ID and HL; 2. How disease prevalence differs between those with and without HL; and 3. Whether severity of ID or HL influences disease quantity, medication intake, or surgeries. Methods: This population-based, prospective cohort study included 1,053 participants with ID and applied a multi-method approach combining assessment of medical history via questionnaire/ interview and on-site hearing screening. The cohort spanned ages 1–90 years. Diseases were coded according to the International classification of diseases 11th revision (ICD-11). Statistical analysis included descriptive statistics and used binary logistic regressions to assess associations between common diseases and age, sex, HL, and ID grade. Results: In our data, individuals with ID and HL show higher percentages of a majority of diseases, increased multimorbidity, and greater medication intake than individuals with ID without HL. Conclusion: Heightened awareness and multidisciplinary management are essential to ensure equitable care and prevent secondary complications.

How to implement a universal program of hearing screenings, diagnostics, and interventions for people with intellectual disabilities in their living environment?

K. Neumann1, P. Mathmann1, V. Jankovic2, A. Naghipour1, S. Zielonkowski1, S. Wasmuth1, L. Prein1, A. Wiegand1, A. S. Schwalen1, C. Gietmann1, W. Brannath2, M. Scharpenberg2, A. Neumann3, K. Schäfer4, K. Schwarze3, S. Schlierenkamp5, Ch. Speckemeier5   
doi: 10.48095/ccorl2025S1_14

Introduction: People with intellectual disabilities (ID) are 5–10-times more likely to have hearing impairments than the general population. These often remain undetected and untreated. Aims: A large cohort study investigated the effectiveness, feasibility, and costs of an outreach program of repeated hearing screenings, diagnostics, interventions, and monitoring of people with ID in their living environment compared to an invitation-only program in a clinical setting and to standard care. Materials and Methods: 1,052 people with ID of all ages underwent hearing screenings and reference measurements in their living environment (schools, nurseries, homes, workplaces). If they failed the screening, audiometric diagnostics were carried out and, in case of hearing loss, therapy or further external diagnostics were initiated or existing therapy was monitored. A control cohort of 141 participants was invited to a clinic for the same procedure. The program was repeated 1 year later to review the treatment outcome. Furthermore, prevalence of hearing loss, comorbidities and the hearing-related quality of life (QoL) of the participants were determined, and costs were analyzed and modelled. Results: In the cohort visited, hearing loss was diagnosed in 42% of cases, 68.3% of which were previously unknown. Screening and diagnostics lead to clear results in 95% of cases. Screening specificity was 96.3%, sensitivity 98.0%. Hospital invitations in the invited cohort were not accepted. Certain comorbidities (e. g. hypertension) frequently coincided with hearing loss. The severity of the hearing loss correlated significantly with hearing-related QoL. Recommended therapies were only carried out to a small extent (24% of newly prescribed hearing aids). Conclusion: The outreach program is feasible, valid, and essential for improving social participation and QoL of people with ID. However, as the implementation of interventions represent a significant barrier, a hearing rehabilitation program involving those affected and their caregivers that includes hearing and communication training, is crucial.

Long-term hearing outcomes and surgical strategy in revision stapes surgery for otosclerosis

K. Obtulovičová, M. Sičák
doi: 10.48095/ccorl2025S1_15

Department of ENT and Head and Neck Surgery, Central Military Hospital SNP Ružomberok – Faculty Hospital, Ružomberok, Slovakia

Introduction: Revision stapes surgery is delicate and relatively rare procedure. It is carried out on 5–10% after primary stapes surgeries. It includes a heterogeneous group of patients for indication, perioperative finding, and the surgical strategy. Aims: The aim of the study was to evaluate the cause of poor hearing after primary stapedotomy and to evaluate the results and safety of revision stapes surgery. Materials and Methods: Retrospective analysis of 58 patients after 63 revision stapes surgeries over a period of 13 years (2012–2024) was done. The majority of the group were females, with a female-to-male ratio of 46 : 12. We review the peri-operative findings, type of piston and surgical strategy. Long-term hearing outcomes were evaluated in 47 cases. Preand post-operative air and bone conductive thresholds, pure tone average (PTA), air-bone gap (AGB) at 500–2,000 Hz were measured with minimum of 1-year follow-up. Results: The most common perioperative finding in our series was the resorption of the long process of the incus in 22 cases, complete dislocation of the piston in 8 cases, loose loop of the piston in 8 cases and obliterated stapedotomy in 7 cases, followed by less frequent findings. We have correlated findings with the time of the primary surgery and type of the piston used. Surgical strategy was discussed. A mean postoperative air-bone gap closure within 10 dB occurred in 28 cases (59%), within 20 dB in 44 cases (93%) We achieved an average improvement in PTA of 19 dB. In one case, we noted a postoperative deterioration of the bone threshold (2%). Conclusion: The results of revision stapes surgery depend on the careful evaluation of the perioperative finding and surgical strategy. The outcome is not individually predictable but generally favorable. In experienced hands it is relatively safe procedure with a low risk of deafness.

Behavioural audiometric methods – specifics of hearing examination in the youngest children

P. Šestáková1, R. Havlík2  
doi: 10.48095/ccorl2025S1_16
1 Pedaudiology, Audio Fon Centr, s.r.o., Brno, Czech Republic
2 Audio Fon Centr, s.r.o., Brno, Czech Republic

BAM (behavioral audiometrics methods) are accepted as the gold standard for examination and assessment of the state of auditory perception in the youngest children by the professional community. Examinations of behavioural reactions to auditory stimuli in the youngest children are fundamental to decision-making within therapeutic and rehabilitation procedures that follow. We have been performing BAM (incl. VRA – visual reinforcement audiometry) examinations for more than 10 years at our clinic. Only thanks to practical experience and knowledge gained by using this method, we are able to examined those kids for whom it would only be possible to rely on objective audiometric methods. The combination of the results of objective audiometry and behavioural audiometric methods (e. g. VRA) emergers as an effective way in the diagnosis and therapy in the youngest patients with hearing impairment. The aim of this presentation is to demonstrate how and when behavioral audiometric methods permeate and enter into the care of varied diagnostic groups of children with hearing impairment, while highlighting the possibilities to standardize the procedure itself.

Treatment of sensorineural hearing loss in case of lesions of the central parts of the auditory system due to blast injury

T. Shydlovska1, L. Petruk2 
doi: 10.48095/ccorl2025S1_17
1 Voice and Hearing Department, State Institution “O. S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
2 ENT, Military Medical Clinical Center of the Southern Region of the Ministry of Defense of Ukraine, Odessa, Ukraine

Introduction: In modern full-scale warfare, the intensive use of powerful explosive weapons has resulted in a significant number of military personnel and civilians sustaining damage to the auditory system, often in combination with other injuries, including brain trauma. Aims: To increase the effectiveness of treatment for sensorineural hearing loss (SNHL) associated with lesions of the central auditory system due to blast injuries. Materials and Methods: 54 patients with SNHL due to blast injuries, involving lesions to the central parts of the auditory system, were examined and treated. Diagnostic methods included audiometry, auditory evoked potentials, and electroencephalography. Results: In addition to hearing loss, patients commonly reported tinnitus, impaired speech intelligibility, headaches, and dizziness. Based on the examination results, a treatment plan was prescribed. The complex treatment included corticosteroids, nootropics, vascular drugs, and sedatives. Instrumental examinations, including objective tests, showed positive results in 94.4% of cases. The patients‘ hearing thresholds authentically improved, instrumental test results moved toward normalization, the intensity of tinnitus decreased, headache frequency reduced, and speech intelligibility improved. Conclusion: A comprehensive treatment approach for patients with SNHL due to damage to the central parts of the auditory system caused by blast injuries – incorporating steroids, nootropics, vascular drugs, and sedatives when indicated – enhances treatment effectiveness and achieve a positive result in most cases

Tympanic paraganglioma – overview of 38 patients

V. Souček, M. Kaňa, J. Bouček, J. Plzák  
doi: 10.48095/ccorl2025S1_18
Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University, and Motol University Hospital, Prague, Czech Republic

Introduction: Overview and evaluation of hearing outcomes, postoperative findings and complications of patients who were diagnosed and treated with the tympanic paraganglioma (T-PGL). Material and Methods: In the period 2003–2023, a total of 38 patients with T-PGL were diagnosed in the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, Prague. The diagnosis T-PGL was established after evaluation of clinical and radiological findings. 33 patients underwent surgical resection of the tumor (20 after preoperative embolization), 4 patients for associated internal and neurological diseases were only followed up and 1 patient was indicated for primary radiotherapy due to tumor progression with long-term follow-up and contraindication to surgical treatment. Preand postoperative clinical findings, tone audiometry in 12 patients, resection success rate, and postoperative complications associated with surgical therapy were retrospectively evaluated. T-PGL was classified according to the modified Fish classification. Results: There were 35 women and 3 men in the age range from 25 to 77 years (mean age 55.4 years). Before treatment, 33 (86.8%) of them reported hearing impairment, 22 (57.9%) had pulsatile tinnitus, which persisted after surgery in 7 (37.8%) of them. Pain in the affected ear was presented in 7 (18.4%) patients, 4 (57.1%) of which resolved postoperatively. Vertigo was observed in 1 patient, which disappeared after surgery. In the 12 patients with available audiometric documentation, 10 had an air-bone gap (ABG) less than 15 dB. The mean preoperative ABG was 22.6 dB, and postoperatively it was 7.1 dB. One patient was deaf preoperatively and underwent cochlear implantation subsequently in the second stage. One patient became deaf postoperatively. Conclusion: Tympanic paragangliomas are the most common benign tumors of the tympanic bone, affecting mostly women in later life and are not endocrinologically active. Therapy is surgical with a high probability of tinnitus resolution and hearing improvement.

Hearing-related quality of life of people with intellectual disabilities and hearing loss

S. Zielonkowski1, P. Mathmann1, A. Naghipour1, S. Wasmuth1, L. Prein1, R. Parfitt1, W. Brannath2, M. Scharpenberg2, V. Jankovic2, A. Neumann3, K. Schwarze3, K. Schäfer4, Ch. Speckemeier5, C. Gietmann1, K. Neumann1                       
doi: 10.48095/ccorl2025S1_19

1 Department of Phoniatrics and Pediatric Audiology, University Hospital Muenster, University of Muenster, Muenster, Germany

2 Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany

3 Institute for Health Care Management and Research, University of Duisburg-Essen, Essen, Germany

4 Institute for Special Needs Education (Deaf and Hard of Hearing), University of Duisburg-Essen, Germany

5 Essener Forschungsinstitut fuer Medizinmanagement – EsFoMed GmbH, Essen, Germany

Background: People with intellectual disabilities are more likely to have hearing loss than the general population, but in most cases it remains unrecognised and untreated. The aims of this study were to determine whether the hearing status of people with intellectual disability can be correctly evaluated by themselves and/or their caregivers and whether hearing loss compromises the hearing-related quality of life of people with intellectual disability. Design: In the prospective cohort study, HörGeist, 1,053 individuals with intellectual disability received hearing screening and, where necessary, diagnostic assessment and intervention within their living environment. A self-developed multi-part questionnaire including items regarding hearingrelated quality of life was answered by caregivers of the participants and was cross-checked with the results of the hearing tests. A multivariable regression was performed to verify an association between the hearing-related quality of life score and the degree of hearing loss. Results: Hearing loss was diagnosed in 463 (44.0%) participants, thereof only 120 (25.9%) cases were known beforehand. In 404 participants (59.0%) and 580 caregivers (61.5%) hearing status was rated correctly; it was overestimated in 34.6% and 33.4%, respectively (sensitivity: 0.223/0.271, respectively). The mean hearing-related quality of life score was 3.0 of 4 possible points. The multivariable regression revealed a small but significant association between the degree of hearing loss and hearing-related quality of life (b = –0.069; P < 0.001; adjusted R2 = 0.081). Conclusion: Regular audiometric tests and intervention seem useful for improving the hearing-related quality of life in people with intellectual disability.