A Comprehensive Study on the Etiology of Patients Receiving Cochlear Implantation With Special Emphasis on Genetic Epidemiology

Objective: Cochlear implantation is the most important treatment currently available for profound sensorineural hearing loss. The aim of this study was to investigate the etiology of hearing loss in patients with cochlear implantation, and to compare outcomes. Methods: Japanese hearing loss patients who received cochlear implants (CIs) or electric acoustic stimulation (EAS) in Shinshu University hospital (n = 173, prelingual onset: 92, postlingual onset: 81) participated in this study. Invader assay followed by the targeted exon-sequencing of 63 deafness genes using Massively parallel DNA sequencing (MPS) was applied. For prelingual patients, additional imaging examination, cCMV screening, and pediatric examination were performed for precise diagnosis. Results: Genetic screening successfully identified the causative mutation in 60% of patients with prelingual onset hearing loss and in 36% of those with postlingual hearing loss. Differences in the kinds of genes identified were observed between the two groups. Although there were marked variations in the outcome of cochlear implantation, patients with specific deafness gene mutations showed relatively good results. Conclusion: The present study showed genetic etiology is a major cause of hearing loss in CI/EAS patients. Patients possessing mutations in a number of deafness genes known to be expressed within inner ear have achieved satisfactory auditory performance, suggesting that the identification of the genetic background facilitates the prediction of post-CI performance. MPS is a powerful tool for the identification of causative deafness genes in patients receiving cochlear implantation. Therefore, determination of the involved region inside/outside of the cochlea by identification of the responsible gene is essential.

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American Neurotology Society Preliminary Program

No abstract available

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Initial Results With Image-guided Cochlear Implant Programming in Children

Hypothesis: Image-guided cochlear implant (CI) programming can improve hearing outcomes for pediatric CI recipients. Background: CIs have been highly successful for children with severe-to-profound hearing loss, offering potential for mainstreamed education and auditory-oral communication. Despite this, a significant number of recipients still experience poor speech understanding, language delay, and, even among the best performers, restoration to normal auditory fidelity is rare. Although significant research efforts have been devoted to improving stimulation strategies, few developments have led to significant hearing improvement over the past two decades. Recently introduced techniques for image-guided CI programming (IGCIP) permit creating patient-customized CI programs by making it possible, for the first time, to estimate the position of implanted CI electrodes relative to the nerves they stimulate using CT images. This approach permits identification of electrodes with high levels of stimulation overlap and to deactivate them from a patient's map. Previous studies have shown that IGCIP can significantly improve hearing outcomes for adults with CIs. Methods: The IGCIP technique was tested for 21 ears of 18 pediatric CI recipients. Participants had long-term experience with their CI (5 mo to 13 yr) and ranged in age from 5 to 17 years old. Speech understanding was assessed after approximately 4 weeks of experience with the IGCIP map. Results: Using a two-tailed Wilcoxon signed-rank test, statistically significant improvement (p 

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Effects of Intralabyrinthine Hemorrhage on the Cochlear Elements: A Human Temporal Bone Study

Hypothesis: To compare histopathologic findings in the cochlea of human temporal bones with versus without intralabyrinthine hemorrhage. Background: Hemorrhagic labyrinthitis can cause sensorineural damage, sudden hearing loss, and vertigo. Yet, to our knowledge, no studies have quantitatively described histopathologic effects of intralabyrinthine hemorrhage on the elements of the cochlea. Methods: We analyzed 46 human temporal bone samples from 23 patients with unilateral intralabyrinthine hemorrhage (23 samples from ears with intralabyrinthine hemorrhage and 23 samples from contralateral ears without). We noted the location of hemorrhage in the inner ear, the degree of endolymphatic hydrops, the number of spiral ganglion cells and hair cells, mean loss of fibrocytes in spiral ligament, and areas of the stria vascularis and spiral ligament. Results: Intralabyrinthine hemorrhage caused significant loss of outer hair cells in the lower basal (p = 0.001), upper basal (p = 0.005), and lower middle (p = 0.012) cochlear turns. The degree of endolymphatic hydrops was significantly different between the hemorrhagic and contralateral sides (p = 0.011). But we found no significant difference between the 2 sides in the number of inner hair cells, spiral ganglion cells, and fibrocytes, or in the areas of the stria vascularis and spiral ligament between the two groups (p > 0.05). Conclusion: These findings suggest that such patients could be good candidates for hearing aid or cochlear implant if they have profound sensorineural hearing loss.

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Does Bilateral Experience Lead to Improved Spatial Unmasking of Speech in Children Who Use Bilateral Cochlear Implants?

Hypothesis: In children with bilateral cochlear implants (BiCIs), experience over a 1 to 3-year period can improve speech understanding and spatial unmasking of speech. Background: One reason for providing children with BiCIs is to improve spatial hearing abilities. Little is known about changes in performance with added bilateral experience, and the relation between sound localization and spatial unmasking of speech. Methods: Twenty children with BiCIs participated. Testing was conducted typically within a year of bilateral activation, and at 1, 2, or 3 follow-up annual intervals. All testing was done while children listened with both devices activated. Target speech was presented from front (co-located); interfering speech was from front, right (asymmetrical), or right and left (symmetrical). Speech reception thresholds (SRTs) were measured in each condition. Spatial release from masking (SRM) was quantified as the difference in SRTs between conditions with interferers at 0 degrees and 90 degrees. For 11 of the children, data are also compared with sound localization measures obtained on the same visit to the laboratory but published elsewhere. Results: Change in SRM with bilateral experience varied; some children showed improvement and others did not. Regression analyses identified relationships between SRTs and SRM. Comparison of the SRM with localization data suggests little evidence for correlations between the two spatial tasks. Conclusion: In children with BiCIs spatial hearing mechanisms involved in SRM and sound localization may be different. Reasons for reduced SRM include asymmetry between the ears, and individual differences in the ability to inhibit interfering information, switch and/or sustain attention.

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Results of Postoperative, CT-based, Electrode Deactivation on Hearing in Prelingually Deafened Adult Cochlear Implant Recipients

Objective: To test the use of a novel, image-guided cochlear implant (CI) programming (IGCIP) technique on prelingually deafened, adult CI recipients. Study Design: Prospective unblinded study. Setting: Tertiary referral center. Patients: Twenty-six prelingually deafened adult CI recipients with 29 CIs (3 bilateral). Intervention(s): Temporal-bone CT scans were used as input to a series of semiautomated computer algorithms which estimate the location of electrodes in reference to the modiolus. This information was used to selectively deactivate suboptimally located electrodes, i.e., those for which the distance from the electrode to the modiolus was further than a neighboring electrode to the same site. Patients used the new IGCIP program exclusively for 3–5 weeks. Main Outcome Measure(s): Minimum Speech Test Battery (MSTB), quality of life (QOL), and spectral modulation detection (SMD). Results: On average one-third of electrodes were deactivated. At the group level, no significant differences were noted for MSTB measures nor for QOL estimates. Average SMD significantly improved after IGCIP reprogramming, which is consistent with improved spatial selectivity. Using 95% confidence interval data for CNC, AzBio, and BKB-SIN at the individual level, 76 to 90% of subjects demonstrated equivocal or significant improvement. Ultimately 21 of 29 (72.41%) elected to keep the IGCIP map because of perceived benefit often substantiated by improvement on either MSTB, QOL, and/or SMD. Conclusions: Knowledge of the geometric relationship between CI electrodes and the modiolus appears to be useful in adjusting CI maps in prelingually deafened adults. Long-term improvements may be observed resulting from improved spatial selectivity and spectral resolution.

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Bilateral Sequential Cochlear Implantation in Patients With Enlarged Vestibular Aqueduct (EVA) Syndrome

Objectives: To analyze audiometric outcomes after bilateral cochlear implantation in patients with isolated enlarged vestibular aqueduct (EVA) syndrome and associated incomplete partition (IP) malformations. Secondary objective was to analyze rate of cerebrospinal fluid (CSF) gusher in patients with IP-EVA spectrum deformities and compare this with the existing literature. Study Design: Retrospective chart review. Methods: Thirty-two patients with EVA syndrome who received unilateral or bilateral cochlear implants between June 1999 and January 2014 were identified in the University Hospitals Case Medical Center cochlear implant database. Isolated EVA (IEVA) and Incomplete Partition Type II (IP-II) malformations were identified by reviewing high-resolution computed tomography (HRCT) imaging. Demographic information, age at implantation, surgical details, postimplantation audiometric data including speech reception thresholds (SRT), word, and sentence scores were reviewed and analyzed. Intra- and postoperative complications were analyzed as well and compared with the literature. Results: Seventeen patients (32 implanted ears) had pediatric cochlear implantation for EVA-associated hearing loss. Data from 16 controls (32 implanted ears) were used to compare audiometric and speech outcomes of EVA cohort. Mean age at implantation was 6.8 years for EVA cohort and 6.0 years for controls. There was no statistically significant difference in long-term postoperative SRT, monaurally aided word scores, and binaurally tested word scores between pediatric EVA group and controls. The EVA patients had a long-term mean sentence score of 85.92%. A subset of EVA patients implanted at mean age of 3.18 years (n = 15 ears) had similar audiometric outcomes to another control group with Connexin 26 mutations (n = 20 ears) implanted at a similar age. Further subset analysis revealed no significant differences in age at implantation, SRT, and word scores in patients with IEVA and IP-II malformation. There was no significant association between size of vestibular aqueduct and age at implantation. There was no CSF gusher or other intra- or postoperative complications reported in our series. Conclusion: Bilateral sequential cochlear implantation can be performed safely in patients with EVA. Audiometric outcomes are excellent and comparable to pediatric cochlear implant patients with no malformations. CSF gusher rates can be minimized by trans-round window approach. Further long-term studies are needed to identify differences within IP-EVA spectrum deformities, audiometric outcomes, and proportions of EVA patients who will need cochlear implantation for hearing rehabilitation.

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Deeper Cochlear Implant Electrode Insertion Angle Improves Detection of Musical Sound Quality Deterioration Related to Bass Frequency Removal

Background: Cochlear implant (CI) electrode arrays typically do not reach the most apical regions of the cochlea that intrinsically encode low frequencies. This may contribute to diminished implant-mediated musical sound quality perception. The objective of this study was to assess the effect of varying degrees of apical cochlear stimulation (measured by angular insertion depth) on musical sound quality discrimination. Hypothesis: Increased apical cochlear stimulation will improve low-frequency perception and musical sound quality discrimination. Methods: Standard (31.5 mm, n = 17) and medium (24 mm, n = 8) array Med-EL CI users, and normal hearing (NH) listeners (n = 16) participated. Imaging confirmed angular insertion depth. Participants completed a musical discrimination task in which they listened to a real-world musical stimulus (labeled reference) and provided sound quality ratings to versions of the reference, which included a hidden reference and test stimuli with increasing amounts of low-frequency removal. Scores for each CI users were calculated on the basis of how much their ratings differed from NH listeners for each stimulus version. Results: Medium array and standard users had significantly different insertion depths (389.4±64.5 and 583.9 ± 78.5 degrees, respectively; p 

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Single-sided Deafness Cochlear Implantation: Candidacy, Evaluation, and Outcomes in Children and Adults

Objectives: Although there are various available treatment options for unilateral severe-to-profound hearing loss, these options do not provide the benefits of binaural hearing since sound is directed from the poorer ear to the better ear. The purpose of this investigation was to review our center's experience with cochlear implantation in such patients in providing improved auditory benefits and useful binaural hearing. Study Design: Retrospective chart review. Methods: Twelve adult patients and four pediatric patients with unilateral severe-to-profound hearing loss received an implant in the poorer ear. Outcome measures performed preoperatively on each ear and binaurally included consonant–nucleus–consonant (CNC) monosyllabic words and sentences in noise. The mean pure-tune average in the better ear was within normal range. Results: Test scores revealed a significant improvement in CNC and sentence in noise test scores from the preoperative to most recent postoperative evaluation in the isolated implant ear. All adult subjects use the device full-time. Conclusions: The data reveal significant improvement in speech perception performance in quiet and in noise in patients with single-sided deafness after implantation. Performance might depend on factors including length of hearing loss, age at implantation, and device usage.

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Comparisons of Longitudinal Trajectories of Social Competence: Parent Ratings of Children With Cochlear Implants Versus Hearing Peers

Objective: To evaluate the longitudinal effects of cochlear implantation (CIs) on young, deaf children's social competence over 5 years of implant use and compare their social skills to those of same-aged, hearing peers. Study Design: Prospective, longitudinal between- and within-subjects design, with assessments completed 3 times over 5 years. Setting: This study was conducted at 6 cochlear implant centers and two preschools that enrolled both CI and hearing children. Patients: Parents of 132 children with CIs and 67 age-matched hearing controls completed the study measures. Children were between 5 and 9 years of age at the first time point. Interventions: Cochlear implantation and speech-language therapy. Main Outcome Measures: Three subscales were drawn from 2 standardized measures of behavioral and social functioning, the Behavioral Assessment Scale for Children (Adaptability, Social Skills) and the Social Skills Rating System (Social Skills). A latent social competence variable was created using multiple subscales, which was modeled over time. Results: Parent data indicated that children with CIs were delayed in comparison to their hearing peers on the social competence latent variable across all time points. Further, there was minimal evidence of “catch-up” growth over this 5-year period. Conclusion: Children with CIs continued to experience delays in social competence after several years of implant use. Despite documented gains in oral language, deficits in social competence remained. To date, no interventions for children with CIs have targeted these social and behavioral skills. Thus, interventions that address the functioning of the “whole child” following cochlear implantation are needed.

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Speech Understanding in Children With Normal Hearing: Sound Field Normative Data for BabyBio, BKB-SIN, and QuickSIN

Objective: The primary goal was to establish normative data for the Pediatric AzBio “BabyBio,” QuickSIN, and BKB-SIN measures in the sound field for children with normal hearing. Setting: Tertiary care hospital; cochlear implant (CI) program. Patients: Forty-one children with normal hearing were recruited across four age groups (5–6, 7–8, 9–10, and 11–12 yr). Interventions: Sentence recognition testing was assessed at four different signal-to-noise ratios (SNRs, +10, +5, 0, and −5 dB) for BabyBio sentences as well as for the BKB-SIN and QuickSIN tests. All measures were presented in the sound field at 60 dBA except QuickSIN, which was presented at 70 dBA. Main Outcome Measures: BabyBio sentence recognition, BKB-SIN SNR-50, and QuickSIN SNR-50 were analyzed to establish sound field norms. Results: BabyBio sentence recognition approached ceiling at all SNRs with mean scores ranging from 86% at −5 dB SNR to 99.3% at +10 dB SNR. Mean QuickSIN SNR-50 was 6.6 dB. Mean BKB-SIN SNR-50 was 1.6 dB with sound field data being consistent with insert earphone normative data in the BKB-SIN manual. Performance for all measures improved with age. Conclusion: Children with normal hearing achieve ceiling-level performance for BabyBio sentence recognition at SNRs used for clinical CI testing (≥0 dB SNR) and approach ceiling level even at −5 dB SNR. Consistent with previous reports, speech recognition in noise improved with age from 5 to 12 years in children with normal hearing. Thus, speech recognition in noise might also increase in the CI population across the same age range warranting age-specific norms for CI recipients. Last, the QuickSIN test could be substituted for the BKB-SIN test with appropriate age-normative data.

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Temporal-Bone Measurements of the Maximum Equivalent Pressure Output and Maximum Stable Gain of a Light-Driven Hearing System That Mechanically Stimulates the Umbo

Hypothesis: That maximum equivalent pressure output (MEPO) and maximum stable gain (MSG) measurements demonstrate high output and high gain margins in a light-driven hearing system (Earlens). Background: The nonsurgical Earlens consists of a light-activated balanced-armature transducer placed on the tympanic membrane (Lens) to drive the middle ear through direct umbo contact. The Lens is driven and powered by encoded pulses of light. In comparison to conventional hearing aids, the Earlens is designed to provide higher levels of output over a broader frequency range, with a significantly higher MSG. MEPO provides an important fitting guideline. Methods: Four fresh human cadaveric temporal bones were used to measure MEPO directly. To calculate MEPO and MSG, we measured the pressure close to the eardrum and the stapes velocity, for sound drive and light drive using the Earlens. Results: The baseline sound-driven measurements are consistent with previous reports. The average MEPO (n = 4) varies from 116 to 128 dB SPL in the 0.7 to 10 kHz range, with the peak occurring at 7.6 kHz. From 0.1 to 0.7 kHz, it varies from 83 to 121 dB SPL. For the average MSG, a broad minimum of about 10 dB occurs in the 1 to 4 kHz range, above which it rises as high as 42 dB at 7.6 kHz. From 0.2 to 1 kHz, the MSG decreases linearly from approximately 40 dB to 10 dB. Conclusion: With high output and high gain margins, the Earlens may offer broader-spectrum amplification for treatment of mild-to-severe hearing impairment.

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Sentence Recognition in Quiet and Noise by Pediatric Cochlear Implant Users: Relationships to Spoken Language

Objective: We investigated associations between sentence recognition and spoken language for children with cochlear implants (CI) enrolled in the Childhood Development after Cochlear Implantation (CDaCI) study. Study Design: In a prospective longitudinal study, sentence recognition percent-correct scores and language standard scores were correlated at 48-, 60-, and 72-months post-CI activation. Setting: Six tertiary CI centers in the United States. Patients: Children with CIs participating in the CDaCI study. Intervention (s): Cochlear implantation. Main Outcome Measure (s): Sentence recognition was assessed using the Hearing In Noise Test for Children (HINT-C) in quiet and at +10, +5, and 0 dB signal-to-noise ratio (S/N). Spoken language was assessed using the Clinical Assessment of Spoken Language (CASL) core composite and the antonyms, paragraph comprehension (syntax comprehension), syntax construction (expression), and pragmatic judgment tests. Results: Positive linear relationships were found between CASL scores and HINT-C sentence scores when the sentences were delivered in quiet and at +10 and +5 dB S/N, but not at 0 dB S/N. At 48 months post-CI, sentence scores at +10 and +5 dB S/N were most strongly associated with CASL antonyms. At 60 and 72 months, sentence recognition in noise was most strongly associated with paragraph comprehension and syntax construction. Conclusions: Children with CIs learn spoken language in a variety of acoustic environments. Despite the observed inconsistent performance in different listening situations and noise-challenged environments, many children with CIs are able to build lexicons and learn the rules of grammar that enable recognition of sentences.

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Is MRI Equal to CT in the Evaluation of Thin and Dehiscent Superior Semicircular Canals?

Objective: Can magnetic resonance imaging (MRI) diagnose abnormally thin and dehiscent superior semicircular canals (SSCs) that traditionally rely on evaluation by computed tomography (CT) imaging? Study Design: Retrospective clinical study. Setting: Tertiary referral center. Patients: Adults who underwent both MRI and CT of the temporal bones over the past 3 years. Interventions: CT and MR images of SSCs were separately reviewed, in a blinded fashion by three neuroradiologists at our institution. CT diagnosis of abnormally thin or dehiscent SSC was used as the “gold” standard. Main Outcome Measures: 1) Dehiscent SSC. 2) Abnormally thin SSC. 3) Normal SSC. Results: One hundred temporal bones with evaluable superior semicircular canals from 51 patients were eligible for review on CT and MR imaging. There were 26 patients of thin SSC and 17 patients of SSC dehiscence on CT imaging, of which 13 and 15 respectively were also found on MRI. There were nine false-positive dehiscent SSC patients and four thin SSC patients observed on MR imaging while not observed on CT. For thin SSCs, MRI sensitivity was 61.9% and specificity of 94.3% with a positive predictive value of 81.3% and a negative predictive value of 86.2%. For dehiscent SSCs, sensitivity was 88.2% and specificity of 89.2% with a positive predictive value of 62.5% and a negative predictive value of 97.4%. Conclusion: In this series, MRI in the axial and coronal plane had a high negative predicative value for thin SSC (86%) and dehiscent SSC (97%). However, MRI cannot conclusively diagnose thin or dehiscent SSCs.

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Project ASPIRE: Spoken Language Intervention Curriculum for Parents of Low-socioeconomic Status and Their Deaf and Hard-of-Hearing Children

Objective: To investigate the impact of a spoken language intervention curriculum aiming to improve the language environments caregivers of low socioeconomic status (SES) provide for their D/HH children with CI & HA to support children's spoken language development. Study Design: Quasiexperimental. Setting: Tertiary. Patients: Thirty-two caregiver–child dyads of low-SES (as defined by caregiver education ≤ MA/MS and the income proxies = Medicaid or WIC/LINK) and children aged 

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Age-related Refixating Saccades in the Three-Dimensional Video-Head-Impulse Test: Source and Dissociation From Unilateral Vestibular Failure

Objective: To examine “refixating saccades” in the three-dimensional video-head impulse test (vHIT) depending on the age and compare them to refixating saccades in pathological vHIT. Design: Retrospective database study. Setting: County hospital, specialized vertigo center. Patients: Eight hundred ninety-nine patients without a peripheral vestibular hypofunction were tested with the three-dimensional vHIT and compared with 135 patients with unilateral vestibular hypofunction (UVF). Main Outcome Measures: Occurrence and peak velocity of refixating saccades (covert and overt) during the video-head-impulse test (vHIT) in three age groups (0–30, 30–60, and 60–100 yr) and in UVF. Results: Overt saccade frequency of refixating saccades increased with increasing age, especially in the horizontal and posterior vHIT. Saccades were mostly directed opposite to the head movement. The aging effect was not explained by the VOR-gain decrease. Refixating saccades in normal vHIT were less frequent and slower than in UVF. Conclusion: We conclude that refixating saccades increase with higher age and could be differentiated from those in UVF by frequency and peak velocity. Saccades are not caused by a deficient VOR but might be caused by a deficient suppression of saccades to novel targets.

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Music Perception of Adolescents Using Electroacoustic Hearing

Background: Preserved residual hearing in adult recipients of short electrode cochlear implants (CIs) contributes to improve perception of speech in noise as well as music. Recently, children and adolescents with sufficient low-frequency hearing but profound loss at higher frequencies enrolled in a FDA trial intended to evaluate the benefit of a short electrode device on the maintenance of residual hearing. This article reports on the perception of several music listening tasks by adolescents using electroacoustic hearing. Methods: Five adolescents (13–18 yr) with 18–24 months of electroacoustic experience, 73 children (LEC) and adolescents (LEA) who use traditional implants, and 87 children with normal hearing (NH) tested on 3 measures of music perception: Complex Pitch Ranking (PR-C); Melodic Error Detection (MED); Melody Recognition X Information Cue (MRIC). The participants with ipsilateral residual hearing were tested preoperatively at intervals up to 24 months. Results: Pitch ranking scores for the electroacoustic group were significantly better than the LEC and LEA (p 

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Chronic Symptoms After Vestibular Neuritis and the High-Velocity Vestibulo-Ocular Reflex

Hypothesis: As the anterior and posterior semicircular canals are vital to the regulation of gaze stability, particularly during locomotion or vehicular travel, we tested whether the high-velocity vestibulo-ocular reflex (VOR) of the three ipsilesional semicircular canals elicited by the modified Head Impulse Test would correlate with subjective dizziness or vertigo scores after vestibular neuritis (VN). Background: Recovery after acute VN varies with around half reporting persistent symptoms long after the acute episode. However, an unanswered question is whether chronic symptoms are associated with impairment of the high-velocity VOR of the anterior or posterior canals. Methods: Twenty patients who had experienced an acute episode of VN at least 3 months earlier were included in this study. Participants were assessed with the video head impulse test (vHIT) of all six canals, bithermal caloric irrigation, the Dizziness Handicap Inventory (DHI), and the Vertigo Symptoms Scale short-form (VSS). Results: Of these 20 patients, 12 thought that they had recovered from the initial episode whereas 8 did not and reported elevated DHI and VSS scores. However, we found no correlation between DHI or VSS scores and the ipsilesional single or combined vHIT gain, vHIT gain asymmetry orcaloric paresis. The high-velocity VOR was not different between patients who thought they had recovered and patients who thought they had not. Conclusion: Our findings suggest that chronic symptoms of dizziness after VN are not associated with the high-velocity VOR of the single or combined ipsilesional horizontal, anterior, or posterior semicircular canals.

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American Otological Society Preliminary Program

No abstract available

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Transcanal Micro-Osteotome Only Technique for Excision of Exostoses

Objectives: To evaluate the outcomes and complications of transcanal excision of exostoses using micro-osteotomes, without a postauricular incision or the use of the drill. Study Design: A retrospective chart review of patients undergoing exostoses excision. Setting: Tertiary Care Medical Center. Subjects and Methods: All of the patients underwent surgical removal of the exostoses using only a 1 or 2 mm micro-osteotomes. Patients were followed postoperatively and associated complications were evaluated. Results: One-hundred thirty-eight ears in 106 patients were treated for obstructive exostosis. The average age of patients was 43 ± 16 years. Of these, 99 were man (93%) and 7 were woman (7%). A majority of the patients (84%, n = 89) had 90 to 100% obstruction of the ear canal. Complete ear canal healing was observed in 80% of patients by 3 weeks. All but one patient had healed by 6 weeks postoperatively. There were 9 (6.5%) slit tympanic membrane perforations that healed with intraoperative gelfoam or fascia myringoplasty. One patient had an anterior canal mobilization which required Xeroform packing for 3 weeks for stabilization. There were no postoperative vertigo, facial paresis, conductive/sensorineural hearing loss, soft tissue stenoses, and no skin grafting required. Conclusions: This is the first study to report a series of patients performing solely a transcanal approach using micro-osteotomes for removing exostoses. Results indicate that it is a safe procedure with low complication rate and expeditious healing. Patients with 100% obstruction can have this procedure performed with no significant increase in morbidity.

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Reading ability influences native and non-native voice recognition, even for unimpaired readers

Research suggests that phonological ability exerts a gradient influence on talker identification, including evidence that adults and children with reading disability show impaired talker recognition for native and non-native languages. The present study examined whether this relationship is also observed among unimpaired readers. Learning rate and generalization of learning in a talker identification task were examined in average and advanced readers who were tested in both native and non-native language conditions. The results indicate that even among unimpaired readers, phonological competence as captured by reading ability exerts a gradient influence on perceptual learning for talkers' voices.

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The aero-acoustic Galbrun equation in the time domain with perfectly matched layer boundary conditions

This paper presents a solution for aero-acoustic problems using the Galbrun equation in the time domain with a non-uniform steady mean flow in a two-dimensional coordinate system and the perfectly matched layer technique as the boundary conditions corresponding to an unbounded domain. This approach is based on an Eulerian–Lagrangian description corresponding to a wave equation written only in terms of the Lagrangian perturbation of the displacement. It is an alternative to the Linearized Euler Equations for solving aero-acoustic problems. The Galbrun equation is solved using a mixed pressure-displacement Finite Element Method. A complex Laplace transform scheme is used to study the time dependent variables. Several numerical examples are presented to validate and illustrate the efficiency of the proposed approach.

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Measurement of acoustic particle motion in shallow water and its application to geoacoustic inversion

Within an underwater acoustic waveguide, the interference among multipath arrivals causes a phase difference in orthogonal components of the particle velocity. When two components of the particle velocity are not in phase, the fluid particles follow an elliptical trajectory. This property of the acoustic field can be readily detected by a vector sensor. A non-dimensional vector quantity, the degree of circularity, is used to quantify how much the trajectory resembles a circle. In this paper, vector sensormeasurements collected during the 2013 Target and Reverberation Experiment are used to demonstrate the effect of multipath interference on the degree of circularity. Finally, geoacoustic properties representing the sandy sediment at the experimental site are inverted by minimization of a cost function, which quantifies the deviation between the measured and modeled degree of circularity.

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Reading ability influences native and non-native voice recognition, even for unimpaired readers

Research suggests that phonological ability exerts a gradient influence on talker identification, including evidence that adults and children with reading disability show impaired talker recognition for native and non-native languages. The present study examined whether this relationship is also observed among unimpaired readers. Learning rate and generalization of learning in a talker identification task were examined in average and advanced readers who were tested in both native and non-native language conditions. The results indicate that even among unimpaired readers, phonological competence as captured by reading ability exerts a gradient influence on perceptual learning for talkers' voices.

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Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial.

Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial.

Int J Audiol. 2016 Jan 14;:1-10

Authors: McCullagh MC, Banerjee T, Cohen MA, Yang JJ

Abstract
OBJECTIVE: The purpose of this study was to compare the effectiveness of three interventions designed to promote hearing protector device (HPD) use.
DESIGN: Randomized controlled trial.
STUDY SAMPLE: Farm operators (n = 491) were randomly assigned to one of five intervention groups: (1) interactive web-based information with mailed assortment of HPDs; (2) Interactive web-based information only; (3) static web-based information with mailed assortment of HPDs; (4) Static web-based information only; or (5) mailed assortment of HPDs only. Data were analysed using a mixed model approach.
RESULTS: HPD use increased among all participants, and increased more among participants receiving the mailed HPDs (with or without information) compared to participants receiving other interventions. Participants receiving the interactive web-based information had comparable increased use of HPDs to those receiving the static web-based information. Participants receiving the mailed HPDs had more positive situational influences scale scores than other participants. Program satisfaction was highest among mailed and web-based information groups.
CONCLUSIONS: A mailed assortment of hearing protectors was more effective than information. Interactive and static information delivered via web were similarly effective. Programs interested in increasing HPD use among farmers should consider making hearing protectors more available to farmers.

PMID: 26766172 [PubMed - as supplied by publisher]

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Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study.

Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study.

Int J Audiol. 2016 Jan 14;:1-8

Authors: Bouserhal RE, Macdonald EN, Falk TH, Voix J

Abstract
OBJECTIVE: Speech production in noise with varying talker-to-listener distance has been well studied for the open ear condition. However, occluding the ear canal can affect the auditory feedback and cause deviations from the models presented for the open-ear condition. Communication is a main concern for people wearing hearing protection devices (HPD). Although practical, radio communication is cumbersome, as it does not distinguish designated receivers. A smarter radio communication protocol must be developed to alleviate this problem. Thus, it is necessary to model speech production in noise while wearing HPDs. Such a model opens the door to radio communication systems that distinguish receivers and offer more efficient communication between persons wearing HPDs.
DESIGN: This paper presents the results of a pilot study aimed to investigate the effects of occluding the ear on changes in voice level and fundamental frequency in noise and with varying talker-to-listener distance.
STUDY SAMPLE: Twelve participants with a mean age of 28 participated in this study.
RESULTS: Compared to existing data, results show a trend similar to the open ear condition with the exception of the occluded quiet condition.
CONCLUSIONS: This implies that a model can be developed to better understand speech production for the occluded ear.

PMID: 26765993 [PubMed - as supplied by publisher]

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Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial.

Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial.

Int J Audiol. 2016 Jan 14;:1-10

Authors: McCullagh MC, Banerjee T, Cohen MA, Yang JJ

Abstract
OBJECTIVE: The purpose of this study was to compare the effectiveness of three interventions designed to promote hearing protector device (HPD) use.
DESIGN: Randomized controlled trial.
STUDY SAMPLE: Farm operators (n = 491) were randomly assigned to one of five intervention groups: (1) interactive web-based information with mailed assortment of HPDs; (2) Interactive web-based information only; (3) static web-based information with mailed assortment of HPDs; (4) Static web-based information only; or (5) mailed assortment of HPDs only. Data were analysed using a mixed model approach.
RESULTS: HPD use increased among all participants, and increased more among participants receiving the mailed HPDs (with or without information) compared to participants receiving other interventions. Participants receiving the interactive web-based information had comparable increased use of HPDs to those receiving the static web-based information. Participants receiving the mailed HPDs had more positive situational influences scale scores than other participants. Program satisfaction was highest among mailed and web-based information groups.
CONCLUSIONS: A mailed assortment of hearing protectors was more effective than information. Interactive and static information delivered via web were similarly effective. Programs interested in increasing HPD use among farmers should consider making hearing protectors more available to farmers.

PMID: 26766172 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1We8MGr
via IFTTT

Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study.

Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study.

Int J Audiol. 2016 Jan 14;:1-8

Authors: Bouserhal RE, Macdonald EN, Falk TH, Voix J

Abstract
OBJECTIVE: Speech production in noise with varying talker-to-listener distance has been well studied for the open ear condition. However, occluding the ear canal can affect the auditory feedback and cause deviations from the models presented for the open-ear condition. Communication is a main concern for people wearing hearing protection devices (HPD). Although practical, radio communication is cumbersome, as it does not distinguish designated receivers. A smarter radio communication protocol must be developed to alleviate this problem. Thus, it is necessary to model speech production in noise while wearing HPDs. Such a model opens the door to radio communication systems that distinguish receivers and offer more efficient communication between persons wearing HPDs.
DESIGN: This paper presents the results of a pilot study aimed to investigate the effects of occluding the ear on changes in voice level and fundamental frequency in noise and with varying talker-to-listener distance.
STUDY SAMPLE: Twelve participants with a mean age of 28 participated in this study.
RESULTS: Compared to existing data, results show a trend similar to the open ear condition with the exception of the occluded quiet condition.
CONCLUSIONS: This implies that a model can be developed to better understand speech production for the occluded ear.

PMID: 26765993 [PubMed - as supplied by publisher]

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Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial

10.3109/14992027.2015.1122239<br/>Marjorie C. McCullagh

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Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study

10.3109/14992027.2015.1122240<br/>Rachel E. Bouserhal

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Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial

10.3109/14992027.2015.1122239<br/>Marjorie C. McCullagh

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Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study

10.3109/14992027.2015.1122240<br/>Rachel E. Bouserhal

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Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial

10.3109/14992027.2015.1122239<br/>Marjorie C. McCullagh

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Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study

10.3109/14992027.2015.1122240<br/>Rachel E. Bouserhal

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Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial

10.3109/14992027.2015.1122239<br/>Marjorie C. McCullagh

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Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study

10.3109/14992027.2015.1122240<br/>Rachel E. Bouserhal

from #Audiology via xlomafota13 on Inoreader http://ift.tt/1PfGPbK
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Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial

10.3109/14992027.2015.1122239<br/>Marjorie C. McCullagh

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Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study

10.3109/14992027.2015.1122240<br/>Rachel E. Bouserhal

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Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial.

Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial.

Int J Audiol. 2016 Jan 14;:1-10

Authors: McCullagh MC, Banerjee T, Cohen MA, Yang JJ

Abstract
OBJECTIVE: The purpose of this study was to compare the effectiveness of three interventions designed to promote hearing protector device (HPD) use.
DESIGN: Randomized controlled trial.
STUDY SAMPLE: Farm operators (n = 491) were randomly assigned to one of five intervention groups: (1) interactive web-based information with mailed assortment of HPDs; (2) Interactive web-based information only; (3) static web-based information with mailed assortment of HPDs; (4) Static web-based information only; or (5) mailed assortment of HPDs only. Data were analysed using a mixed model approach.
RESULTS: HPD use increased among all participants, and increased more among participants receiving the mailed HPDs (with or without information) compared to participants receiving other interventions. Participants receiving the interactive web-based information had comparable increased use of HPDs to those receiving the static web-based information. Participants receiving the mailed HPDs had more positive situational influences scale scores than other participants. Program satisfaction was highest among mailed and web-based information groups.
CONCLUSIONS: A mailed assortment of hearing protectors was more effective than information. Interactive and static information delivered via web were similarly effective. Programs interested in increasing HPD use among farmers should consider making hearing protectors more available to farmers.

PMID: 26766172 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1We8MGr
via IFTTT

Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study.

Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study.

Int J Audiol. 2016 Jan 14;:1-8

Authors: Bouserhal RE, Macdonald EN, Falk TH, Voix J

Abstract
OBJECTIVE: Speech production in noise with varying talker-to-listener distance has been well studied for the open ear condition. However, occluding the ear canal can affect the auditory feedback and cause deviations from the models presented for the open-ear condition. Communication is a main concern for people wearing hearing protection devices (HPD). Although practical, radio communication is cumbersome, as it does not distinguish designated receivers. A smarter radio communication protocol must be developed to alleviate this problem. Thus, it is necessary to model speech production in noise while wearing HPDs. Such a model opens the door to radio communication systems that distinguish receivers and offer more efficient communication between persons wearing HPDs.
DESIGN: This paper presents the results of a pilot study aimed to investigate the effects of occluding the ear on changes in voice level and fundamental frequency in noise and with varying talker-to-listener distance.
STUDY SAMPLE: Twelve participants with a mean age of 28 participated in this study.
RESULTS: Compared to existing data, results show a trend similar to the open ear condition with the exception of the occluded quiet condition.
CONCLUSIONS: This implies that a model can be developed to better understand speech production for the occluded ear.

PMID: 26765993 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1JOezAD
via IFTTT

Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial.

Effects of interventions on use of hearing protectors among farm operators: A randomized controlled trial.

Int J Audiol. 2016 Jan 14;:1-10

Authors: McCullagh MC, Banerjee T, Cohen MA, Yang JJ

Abstract
OBJECTIVE: The purpose of this study was to compare the effectiveness of three interventions designed to promote hearing protector device (HPD) use.
DESIGN: Randomized controlled trial.
STUDY SAMPLE: Farm operators (n = 491) were randomly assigned to one of five intervention groups: (1) interactive web-based information with mailed assortment of HPDs; (2) Interactive web-based information only; (3) static web-based information with mailed assortment of HPDs; (4) Static web-based information only; or (5) mailed assortment of HPDs only. Data were analysed using a mixed model approach.
RESULTS: HPD use increased among all participants, and increased more among participants receiving the mailed HPDs (with or without information) compared to participants receiving other interventions. Participants receiving the interactive web-based information had comparable increased use of HPDs to those receiving the static web-based information. Participants receiving the mailed HPDs had more positive situational influences scale scores than other participants. Program satisfaction was highest among mailed and web-based information groups.
CONCLUSIONS: A mailed assortment of hearing protectors was more effective than information. Interactive and static information delivered via web were similarly effective. Programs interested in increasing HPD use among farmers should consider making hearing protectors more available to farmers.

PMID: 26766172 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1We8MGr
via IFTTT

Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study.

Variations in voice level and fundamental frequency with changing background noise level and talker-to-listener distance while wearing hearing protectors: A pilot study.

Int J Audiol. 2016 Jan 14;:1-8

Authors: Bouserhal RE, Macdonald EN, Falk TH, Voix J

Abstract
OBJECTIVE: Speech production in noise with varying talker-to-listener distance has been well studied for the open ear condition. However, occluding the ear canal can affect the auditory feedback and cause deviations from the models presented for the open-ear condition. Communication is a main concern for people wearing hearing protection devices (HPD). Although practical, radio communication is cumbersome, as it does not distinguish designated receivers. A smarter radio communication protocol must be developed to alleviate this problem. Thus, it is necessary to model speech production in noise while wearing HPDs. Such a model opens the door to radio communication systems that distinguish receivers and offer more efficient communication between persons wearing HPDs.
DESIGN: This paper presents the results of a pilot study aimed to investigate the effects of occluding the ear on changes in voice level and fundamental frequency in noise and with varying talker-to-listener distance.
STUDY SAMPLE: Twelve participants with a mean age of 28 participated in this study.
RESULTS: Compared to existing data, results show a trend similar to the open ear condition with the exception of the occluded quiet condition.
CONCLUSIONS: This implies that a model can be developed to better understand speech production for the occluded ear.

PMID: 26765993 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader http://ift.tt/1JOezAD
via IFTTT