Helena Wichova

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Scholarly Contributions

Books

• Slattery, W., Vambutas, A., & Wichova, H. (2023). Essential otology and neurotology. doi:10.52305/SNTB2258
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  Essential Otology and Neurotology is the newest addition to the Essential Otolaryngology: Head & Neck Surgery series which has been the benchmark guide to otolaryngology since 1973. It provides a concise and effective review of most relevant topics within the evolving field of neurotology. The textbook is structured to maximize data content and allow for quick clinical recall. Each chapter also includes a high yield review in the form of multiple-choice questions to retain critical information. This book serves as a handy study guide for all interested in learning more about the complex anatomy and physiology of the human ear. The editors carefully selected experts in each field to present the most up-to-date practice guidelines for each topic.

Chapters

• Wichova, H. (2023). Management of Skull Base Complications. In Essential Otology and Neurotology(pp 375-385).
• Wichova, H. (2023). Neurotological Surgical Approaches to Cerebellopontine Angle. In Essential Otology and Neurotology(pp 359-374).

Journals/Publications

• Arambula, A. M., Wichova, H., Lucas, J. C., Schelbar, N., Harn, N., Ledbetter, L., Chamoun, R. B., Camarata, P. J., Lin, J., & Staecker, H. (2023). Analysis of Imaging Results for Semisitting Compared with Supine Positioning in the Retrosigmoid Approach for Resection of Cerebellopontine Angle Vestibular Schwannomas. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 44(3), 266-272.
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  To compare the completeness of resection of vestibular schwannomas using three-dimensional segmented volumetric analysis of pre- and postoperative magnetic resonance imaging (MRI) of patients undergoing supine and semisitting positioning for the retrosigmoid approach.
• Wong, Y. T., Lopez, I. A., Wichova, H., Ishiyama, A., & Miller, M. E. (2023). Endolymphatic Hydrops in the Setting of Vestibular Schwannoma: A Temporal Bone Study. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 44(1), 81-85.
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  Vestibular schwannoma (VS) may be associated with endolymphatic hydrops (EH). EH may account for symptomatology in a subset of patients with VS.
• Wichova, H., Mills, D., Beatty, S., Peng, K., & Miller, M. (2022). Cochlear implantation performance outcomes in patients over 80 years old. Laryngoscope investigative otolaryngology, 7(3), 847-853.
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  To examine device datalogging characteristics and postoperative performance in the very elderly CI users.
• Wichova, H., Peng, K., Ledbetter, L., Slattery, W., Brackmann, D., & Lekovic, G. (2022). Safety of 3 Tesla Magnetic Resonance Imaging in Patients With Auditory Brainstem Implants. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 43(2), e263-e267.
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  To evaluate the safety of 3 Tesla (T) magnetic resonance imaging (MRI) in patients with auditory brainstem implants (ABI) with the magnet removed at implantation and report incidence of complications.
• Nallani, R., Wichova, H., McAroy, J. L., Chiu, A. G., & Villwock, J. A. (2021). Incidence of Odontogenic Disease in Patients With Pott's Puffy Tumor. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 79(2), 389-397.
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  Osteomyelitis with subperiosteal abscess of the frontal bone, or Pott's puffy tumor (PPT), is a rare but life-threatening condition. The relationship of concurrent dental disease to PPT has not been well described. This study sought to delineate the incidence of odontogenic disease in PPT, especially in cases where there is no history of facial trauma or prior frontal sinus surgery.
• Shew, M., Wichova, H., Bur, A., Koestler, D. C., St Peter, M., Warnecke, A., & Staecker, H. (2021). MicroRNA Profiling as a Methodology to Diagnose Ménière's Disease: Potential Application of Machine Learning. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 164(2), 399-406.
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  Diagnosis and treatment of Ménière's disease remains a significant challenge because of our inability to understand what is occurring on a molecular level. MicroRNA (miRNA) perilymph profiling is a safe methodology and may serve as a "liquid biopsy" equivalent. We used machine learning (ML) to evaluate miRNA expression profiles of various inner ear pathologies to predict diagnosis of Ménière's disease.
• Shew, M., Wichova, H., St Peter, M., Warnecke, A., & Staecker, H. (2021). Distinct MicroRNA Profiles in the Perilymph and Serum of Patients With Menière's Disease. Frontiers in neurology, 12, 646928.
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  Menière's disease microRNA (miRNA) profiles are unique and are reflected in the perilymph and serum of patients. Development of effective biomarkers for Menière's disease are needed. miRNAs are small RNA sequences that downregulate mRNA translation and play a significant role in a variety of disease states, ultimately making them a promising biomarker. miRNAs can be readily isolated from human inner ear perilymph and serum, and may exhibit disease-specific profiles. Perilymph sampling was performed in 10 patients undergoing surgery; 5 patients with Meniere's disease and 5 patients with otosclerosis serving as controls. miRNAs were isolated from the serum of 5 patients with bilateral Menière's disease and compared to 5 healthy age-matched controls. For evaluation of miRNAs an Agilent miRNA gene chip was used. Analysis of miRNA expression was carried out using Qlucore and Ingenuitey Pathway Analysis software. Promising miRNAs biomarkers were validated using qPCR. In the perilymph of patients with Menière's disease, we identified 16 differentially expressed miRNAs that are predicted to regulate over 220 different cochlear genes. Six miRNAs are postulated to regulate aquaporin expression and twelve miRNAs are postulated to regulate a variety of inflammatory and autoimmune pathways. When comparing perilymph with serum samples, miRNA-1299 and-1270 were differentially expressed in both the perilymph and serum of Ménière's patients compared to controls. Further analysis using qPCR confirmed miRNA-1299 is downregulated over 3-fold in Meniere's disease serum samples compared to controls. Patients with Ménière's disease exhibit distinct miRNA expression profiles within both the perilymph and serum. The altered perilymph miRNAs identified can be linked to postulated Ménière's disease pathways and may serve as biomarkers. miRNA-1299 was validated to be downregulated in both the serum and perilymph of Menière's patients.
• Shew, M., Wichova, H., Warnecke, A., Lenarz, T., & Staecker, H. (2021). Evaluating Neurotrophin Signaling Using MicroRNA Perilymph Profiling in Cochlear Implant Patients With and Without Residual Hearing. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 42(8), e1125-e1133.
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  MicroRNAs predicted to regulate neurotrophin signaling can be found in human perilymph.
• Wichova, H., Miller, M. E., & Derebery, M. J. (2021). Otologic Manifestations After COVID-19 Vaccination: The House Ear Clinic Experience. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 42(9), e1213-e1218.
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  With the increasing numbers of COVID-19 vaccinations available there are some reports of new onset of otologic symptoms. We present our experience in recently vaccinated patients over a 30-day time frame.
• Wichova, H., Shew, M., Nelson-Brantley, J., Warnecke, A., Prentiss, S., & Staecker, H. (2021). MicroRNA Profiling in the Perilymph of Cochlear Implant Patients: Identifying Markers that Correlate to Audiological Outcomes. Journal of the American Academy of Audiology, 32(10), 627-635.
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  MicroRNA (miRNA) expression profiles from human perilymph correlate to post cochlear implantation (CI) hearing outcomes.
• Boyd, C., Shew, M., Penn, J., Muelleman, T., Lin, J., Staecker, H., & Wichova, H. (2020). Postoperative Opioid Use and Pain Management Following Otologic and Neurotologic Surgery. The Annals of otology, rhinology, and laryngology, 129(2), 175-180.
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  The topic of prescription opioid overuse remains a growing concern in the United States. Our objective is to provide insight into pain perception and opioid use based on a patient cohort undergoing common otologic and neurotologic surgeries.
• Wichova, H., & Kraft, S. M. (2020). Calcified Subglottic Scar Band Secondary to Remote Neck Trauma Injury. Ear, nose, & throat journal, 99(2), NP23-NP24.
• Shew, M., New, J., Wichova, H., Koestler, D. C., & Staecker, H. (2019). Using Machine Learning to Predict Sensorineural Hearing Loss Based on Perilymph Micro RNA Expression Profile. Scientific reports, 9(1), 3393.
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  Hearing loss (HL) is the most common neurodegenerative disease worldwide. Despite its prevalence, clinical testing does not yield a cell or molecular based identification of the underlying etiology of hearing loss making development of pharmacological or molecular treatments challenging. A key to improving the diagnosis of inner ear disorders is the development of reliable biomarkers for different inner ear diseases. Analysis of microRNAs (miRNA) in tissue and body fluid samples has gained significant momentum as a diagnostic tool for a wide variety of diseases. In previous work, we have shown that miRNA profiling in inner ear perilymph is feasible and may demonstrate distinctive miRNA expression profiles unique to different diseases. A first step in developing miRNAs as biomarkers for inner ear disease is linking patterns of miRNA expression in perilymph to clinically available metrics. Using machine learning (ML), we demonstrate we can build disease specific algorithms that predict the presence of sensorineural hearing loss using only miRNA expression profiles. This methodology not only affords the opportunity to understand what is occurring on a molecular level, but may offer an approach to diagnosing patients with active inner ear disease.
• Shew, M., Wichova, H., Lin, J., Ledbetter, L. N., & Staecker, H. (2019). Magnetic resonance imaging with cochlear implants and auditory brainstem implants: Are we truly practicing MRI safety?. The Laryngoscope, 129(2), 482-489.
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  Our objective is to evaluate the safety in patients with cochlear implants (CIs) and auditory brainstem implants (ABI) undergoing 1.5 Tesla (T) magnetic resonance imaging (MRI). Secondly, we want to raise awareness on CI and MRI safety, and advocate for continued improvement and advancement to minimize morbidity for our CI patients.
• Wichova, H., Alvi, S., Boatright, C., Ledbetter, L., Staecker, H., & Lin, J. (2019). High-Resolution Computed Tomography of the Inner Ear: Effect of Otosclerosis on Cochlear Aqueduct Dimensions. The Annals of otology, rhinology, and laryngology, 128(8), 749-754.
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  The cochlear aqueduct is a bony duct connecting the scala tympani with the subarachnoid space. Given the pathophysiology of otosclerosis, including bone resorption and new bone deposition, we hypothesize that the cochlear aqueduct in otosclerotic ears is narrowed.
• Wichova, H., Shew, M., & Staecker, H. (2019). Utility of Perilymph microRNA Sampling for Identification of Active Gene Expression Pathways in Otosclerosis. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 40(6), 710-719.
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  Profiling of microRNA (miRNA) within perilymph samples collected at the time of stapedectomy can be used to identify active gene expression pathways in otosclerosis as compared with controls.
• Wichova, H., Subbarayan, R., Muelleman, T., & Kakarala, K. (2019). Rhabdomyolysis in a Morbidly Obese Patient After Oral Cavity Free Flap Reconstruction. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 71(Suppl 1), 752-754.
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  Post-operative rhabdomyolysis is a rare but life-threatening condition. Less than ten cases have been described in the otolaryngic literature and, to our knowledge, no reports exist in the setting of oral reconstructive free tissue transfer. Case report presentation. We discuss the clinical course that lead to the diagnosis of rhabdomyolysis with special consideration to simultaneous microvascular anastomosis. Serial lab values were closely followed to prevent kidney injury while preventing flap congestion. Excessive fluid resuscitation in free flap reconstruction has been associated with increased post-operative complications and flap failure. We present a cautionary case to highlight the need for early diagnosis of rhabdomyolysis, a condition that may become more prevalent in the head and neck population as obesity, the main risk factor, continues to increase worldwide.
• Alvi, S. A., Shew, M., Wichova, H., & Lin, J. (2018). Juxtafacial Lipoma within the Mastoid Bone. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 159(6), 1068-1069.
• Wichova, H., Alvi, S. A., Shew, M., Lin, J., Sale, K., Larsen, C., & Staecker, H. (2018). Tinnitus perception in patients after vagal nerve stimulator implantation for epilepsy. American journal of otolaryngology, 39(5), 599-602.
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  Vagal nerve stimulation in conjunction with sound therapy has been proposed as a treatment for subjective tinnitus. The purpose of this study is to retrospectively review the effect of VNS on perception of tinnitus in epilepsy patients. We explore the incidence of tinnitus and its perceived reduction in patients requiring implantation of VNS for medically refractory seizures.
• Wichova, H., Shew, M., Alvi, S., & Lin, J. (2018). A Case of Mesial Temporal Lobe Sclerosis Following Temporal Bone Encephalocele Repair for Medically Refractory Seizures. Cureus, 10(11), e3623.
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  The aim of this report is to present a case of mesial temporal lobe sclerosis (MTS) causing medically refractory seizures, which was initially disguised as temporal lobe encephalocele secondary to prior otologic surgery. Temporal lobe encephaloceles are characterized by a defect within the middle cranial fossa that results in the abnormal communication of the meninges into the pneumatized skull base. After the temporal lobe encephalocele repair, the patient continued to have seizures and was subsequently diagnosed with mesial temporal lobe sclerosis. Imaging revealed the serial progression of hippocampal atrophy and loss of internal architecture. Differentiation between mesial temporal sclerosis and encephalocele as the underlying epileptic etiology is critical. While repairing encephaloceles is necessary to address other potential sequelae, patients with mesial temporal lobe sclerosis will require additional interventions.
• Wichova, H., Chiu, A. G., & Villwock, J. A. (2017). Does the frontal sinus need to be obliterated following fracture with frontal sinus outflow tract injury?. The Laryngoscope, 127(9), 1967-1969.

Presentations

• Wichova, H. (2023, February). Otorrhea - the Draining Ear. ENT in the Desert. Tucson, AZ.
• Wichova, H. (2022, May). Otologic Manifestations after COVID-19 Vaccination: Long-term Symptomatic and Audiometric Follow-up. Combined Otolaryngology Spring Meeting - ANS.
• Wichova, H. (2022, September). Cochlear Implants in the Elderly. University of Arizona Audiology Outreach Dinner.
• Wichova, H. (2019, May). Neurotrophin Signaling in Various Degrees of Hearing Loss using MicroRNA Perilymph Profiling. Combined Otolaryngology Spring Meeting – ANS.
• Wichova, H. (2019, May).  Utility of Perilymph microRNA Sampling for Identification of Active Gene Expression Pathways in Otosclerosis. Combined Otolaryngology Spring Meeting – AOS.
• Wichova, H. (2019, September). Opioid Medication Used Following Otologic Surgery. American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting.

Poster Presentations

• Miller, M., Wichova, H., Ishiyama, A., & Wong, Y. (2022). Endolymphatic Hydrops in the Setting of Vestibular Schwannoma: A Temporal Bone Study. Combined Otolaryngology Spring Meeting – ANS.
• Shew, M., St. Peter, M., Wichova, H., & Staecker, H. (2021). A Prospective Evaluation of MicroRNAs as a Meniere’s Disease Biomarker. American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting.
• Warnecke, A., Schultze, J., Schamback, A., Buening, H., Rossi, A., Wichova, H., & Staecker, H. (2019). New vectorization approaches for inner ear gene therapy. MidWinter Association for Research in Otolaryngology.
• Wichova, H., Duffy, L., Lin, J., & Villwock, J. (2019). The Quality of Reporting Cochlear Implant Surgical Complications between 2013-2018: Analysis and Implications. . American Academy of Otolaryngology–Head and Neck Surgery Annual Meeting.
• Wichova, H., Shew, M., Nelson-Brantley, J., & Staecker, H. (2019). MicroRNA profiling in the human inner ear perilymph of cochlear implant patients. MidWinter Association for Research in Otolaryngology.