Iatrogenic Phenol Injury Causing Facial Paralysis With Tympanic Membrane and Ossicular Necrosis

Objective: To describe a serious iatrogenic injury and propose means of reducing the risk of its reoccurrence. Patients: A 21-year-old man who suffered facial paralysis, complete necrosis of the tympanic membrane, and ossicular discontinuity because of chemical burn from accidental application of copious amounts of topical anesthetic phenol into the ear. Interventions: Conservative management of facial paralysis and delayed reconstruction of the tympanic membrane and ossicular chain. Main Outcome Measures: Gradual recovery to grade 1/6 facial function, successful repair of the tympanic membrane, but persistent 30-dB conductive hearing loss after partial ossicular replacement prosthesis presumably because of scarring. Conclusion: Phenol is a highly toxic chemical, topically to both skin and eyes. Absorbed through the skin it can have lethal cardiotoxicity. It is also potent neurotoxin at concentrations much lower (4–7%) than used for tympanic membrane anesthesia (89%) and has long been used therapeutically to destroy nerves in patients of contractions or intractable pain. Otologists need to have a healthy respect for the dangers of using phenol. As only a minute quantity is needed for tympanic anesthesia, commercially available prepackaged applicators are preferred. Storage of stock bottles of 89% phenol solutions in clinical settings risks injury to both patients and practitioners.

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Barotrauma-induced Pneumolabyrinth and Pneumocephalus Associated With Semicircular Canal Dehiscence

No abstract available

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American Otological Society Preliminary Program

No abstract available

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Parallel-transmit-accelerated 2D Selective RF Excitation MR of the Temporal Bone: Enhanced Resolution of Labyrinthine and IAC Structures

Rationale and Objectives: The purpose of this study was to compare a standard T2 SPACE sequence (standard-SPACE) used in temporal bone imaging at 3 T with a new parallel-transmit-accelerated 2D-selective radio frequency excitation technique for SPACE which was either time-improved or resolution-improved. Materials and Methods: Thirty-two consecutive patients were examined in this IRB-approved study using a standard T2 SPACE sequence, and then a time-improved zoomed SPACE sequence (short z-SPACE) with identical resolution but accelerated image acquisition and a resolution-improved zoomed SPACE sequence (high-resolution z-SPACE) with identical acquisition time but higher resolution at a 3-T magnetic resonance imaging system. Signal-to-noise ratio (SNR) was measured within selected regions of interest. Image quality of anatomic temporal bone structures was determined by two independent readers using a four-point visual scale. Results: Significant image quality improvement (p 

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Lack of Evidence for Nonotosclerotic Stapes Fixation in Human Temporal Bone Histopathology

Hypothesis: Nonotosclerotic stapes fixation does not represent a significant cause of stapes ankylosis in patients undergoing stapedectomy; the vast majority have otosclerosis. Background: Nonotosclerotic stapes fixation has been proposed as the diagnosis in 30 to 40% of patients undergoing stapedectomy (after excluding rare congenital, systemic, and syndromic causes of stapes fixation and tympanosclerosis). This finding was based on the histopathologic evaluation of total stapedectomy surgical specimens. Since these specimens do not include the surrounding otic capsule, the histopathologic evidence of otosclerosis may be missed. Methods: Human temporal bone specimens from patients who underwent stapes mobilization, stapedotomy, or stapedectomy during life were evaluated for histologic evidence of otosclerosis. Patients with a history of temporal bone trauma, tympanosclerosis, and congenital, systemic, or syndromic causes of stapes fixation were excluded. Therefore, most temporal bone donors carried a clinical diagnosis of otosclerosis. Results: Two hundred ten specimens from three temporal bone collections were independently evaluated. Otosclerosis was found on histology in 99% (207/210). Therefore, the incidence of nonotosclerotic stapes fixation was 1% (3/210). In two of the three patients who did not have otosclerosis, the contralateral temporal bone had otosclerosis on histopathologic evaluation. These patients may have had otosclerosis in the footplate only (which was removed at the time of surgery and not available for review). Conclusion: Nonotosclerotic stapes fixation is not likely a distinct pathologic classification from otosclerosis. Most patients diagnosed with nonotosclerotic stapes fixation likely have otosclerosis, but do not have otosclerotic foci in the stapes itself.

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Clinical Outcome of a Wide-diameter Bone-anchored Hearing Implant and a Surgical Technique With Tissue Preservation

Objective: To investigate the clinical outcome of a surgical technique with tissue preservation for a wide bone-anchored hearing implant concerning postoperative complications, skin reactions, implant loss, and implant stability. Study Design: Consecutive, prospective case series. Setting: Tertiary referral center. Patients: Twenty-four adult patients with normal skin quality were enrolled. Intervention(s): Implantation of bone-anchored implant was performed using a one-stage linear-incision technique with tissue preservation surgery. Main Outcome Measures(s): Skin and soft tissue reactions according to Holgers grading system. Pain and numbness measured according to visual analogue scale. Implant stability quotient values were recorded using resonance frequency analysis. Follow-up at 10 days, 6 weeks, 6 months, and 1 year after surgery. Results: Primary implant stability was good and a significant increase in implant stability quotient occurred during the first 10 days and continued to be stable throughout the 1-year observation period. No implants were lost. Skin and soft tissue reactions were few, no reaction (Holger grade 0) was observed in 88% of the follow-up examinations and no grade 4 reactions occurred. Pain and numbness were minimal. Conclusion: The wide implant showed good stability initially and throughout the observation period. Skin and soft tissue reactions were rare and minor. No implants were lost.

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MPR-CT Imaging for Stapes Prosthesis: Accuracy and Clinical Significance

Objectives: The aims of this article are: 1) to re-evaluate the accuracy of multiple planar reconstruction computed tomography (MPR-CT) imaging on stapes-prosthesis parameters, and 2) to clarify possible relationships between prosthesis intravestibular depth and postoperative hearing outcomes. Patients: Seventy patients (46 women and 24 men; 32 right and 38 left sides) with the mean age of 40 years (range, 19–62 yr) with clinical otosclerosis. Intervention(s): All patients underwent stapedotomy and were implanted with the same type of titanium piston prosthesis by the same surgeon. Main Outcome Measure(s): Postoperative MPR-CTs were obtained at patients’ follow-up visits. The length and intravestibular depth of the stapes prosthesis (including absolute and relative depth) were calculated from the MPR-CT imaging. Relationships between the intravestibular depth of the prosthesis and hearing outcomes (pre- and postoperative audiograms) were analyzed using Spearman correlation analyses. Results: The length of the prosthesis was overestimated by 1.8% (0.1 mm) by the MPR-CT imaging. Axial and coronal measurements were significantly correlated (p 

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Molecular Impairment Mechanisms of Novel OPA1 Mutations Predicted by Molecular Modeling in Patients With Autosomal Dominant Optic Atrophy and Auditory Neuropathy Spectrum Disorder

Hypothesis: Different missense mutations of the optic atrophy 1 gene (OPA1) identified in optic atrophy patients with auditory neuropathy spectrum disorder (ANSD) induce functional impairment through different molecular mechanisms. Background: OPA1 is the gene responsible for autosomal dominant optic atrophy (ADOA), but some of its mutations are also associated with ANSD. OPA1 is a member of the GTPase family of proteins and plays a key role in the maintenance of mitochondrial activities that are dependent on dimer formation of the protein. There are many reports of OPA1 mutations, but the molecular mechanisms of their functional impairments are unclear. Methods: The sequences of coding regions in OPA1 were analyzed from blood samples of ADOA patients with ANSD. Molecular modeling of the protein's ability to form dimers and its GTP-binding ability were conducted to study the effects of structural changes in OPA1 caused by two identified mutations and their resultant effects on protein function. Results: Two heterozygous mutations, p.T414P (c.1240A>C) and p.T540P (c.1618A>C), located in the GTPase and middle domains of OPA1, respectively, were identified in two patients. Molecular modeling indicated decreased dimer formation caused by destabilization of the association structure of the p.T414P mutant, and decreased GTP-binding caused by destabilization of the binding site structure in the p.T540P mutant. Conclusion: These two different conformational changes might result in decreased GTPase activities that trigger ADOA associated with ANSD, and are likely to be associated with mild clinical features. Molecular modeling would provide useful information in clinical practice.

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Mandarin Tone Identification in Cochlear Implant Users Using Exaggerated Pitch Contours

Objective: To determine whether exaggerating the variations in fundamental frequency (F0) contours of Mandarin-based pitch fluctuations could improve tone identification by cochlear implant (CI) users. Methods: Twelve normal-hearing (NH) listeners and 11 CI users were tested for their ability to recognize F0 contours modeled after Mandarin tones, in 4- or 5-alternatives forced-choice paradigms. Two types of stimuli were used: computer-generated complex tones and voice recordings. Four contours were tested with voice recordings: flat, rise, fall, and dip. A fifth contour, peak, was added for complex tones. The F0 range of each contour was varied in an adaptive manner. A maximum-likelihood technique was used to fit a psychometric function to the performance data and extract threshold at 70% accuracy. Results: As F0 range increased, performance in tone identification improved but did not reach 100% for some CI users, suggesting that confusions between contours could always be made even with extremely exaggerated contours. Compared with NH participants, CI users required substantially larger F0 ranges to identify tones, on the order of 9.3 versus 0.4 semitones. CI users achieved better performance for complex tones than for voice recordings, whereas the reverse was true for NH participants. Confusion matrices showed that the “flat” tone was often a default option when the tone contour's F0 range presented was too narrow for participants to respond correctly. Conclusion: These results demonstrate markedly impaired ability for CI users to identify tonal contours, but suggest that the use of exaggerated pitch contours may be helpful for tonal language perception.

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Successful Hearing Preservation After Reimplantation of a Failed Hybrid Cochlear Implant: Erratum

No abstract available

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Intraoperative Real-time Cochlear Response Telemetry Predicts Hearing Preservation in Cochlear Implantation

Aim: To monitor cochlear function during cochlear implantation and determine correlations with postoperative acoustic hearing. Background: Cochlear response telemetry measures cochlear function directly from cochlear implant electrodes. We have adapted this system to provide real-time cochlear response telemetry (RT-CRT) monitoring of a patient's acoustic hearing as the cochlear implant electrode array is inserted. Methods: Eighteen subjects (1 child and 17 adults) with sloping high frequency hearing loss were implanted with Cochlear Ltd slim straight arrays (CI422/CI522). Tone bursts (500 Hz, 100–110 dB) were presented at 14 Hz continuously during the array insertion. RT-CRT amplitudes were correlated with surgical manoeuvres recorded on the video from the operating microscope and with postoperative pure tone audiograms. Results: Despite an excellent overall rate of complete or partial hearing preservation (79%), RT-CRT identified that in 47% of these implantations there was transient or permanent reduction in the amplitude of the cochlear microphonic (CM). Patients with a preserved CM at the end of insertion had on average 15 dB better low-frequency hearing preservation. The CM amplitude was most vulnerable during the last few millimeters of insertion or when inadvertent movement of the array occurred after full insertion. Physical contact/elevation of the basilar membrane is hypothesized as a likely mechanism of hearing loss rather than overt physical trauma. Conclusion: RT-CRT can be used to predict early postoperative hearing loss and to potentially refine surgical technique. In the future, feedback of RT-CRT may prove to be a valuable tool for maximizing preservation of residual hearing or providing feedback on electrode contact with the basilar membrane.

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American Neurotology Society Preliminary Program

No abstract available

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Insertion of Cochlear Implant Electrode Array Using the Underwater Technique for Preserving Residual Hearing

Objective: To describe a method of cochlear implantation in which the opening of the cochlea and the electrode array insertion are performed under water (underwater technique). Study Design: Retrospective patient review. Setting: Academic tertiary referral center. Patients: Fifteen implantations in children and adult patients with residual hearing at the frequencies 250, 500, and 1000 Hz on the unaided preoperative pure-tone audiometry were included in this study. Intervention(s): Cochlear implantation with a conventional full-length electrode, in which the opening of the cochlea and the electrode array insertion are performed after the tympanic cavity was filled with body-temperature Ringer solution. Main Outcome Measure(s): Changes on residual hearing 6 to 8 weeks after surgery and at subsequent follow-up appointments were analyzed. Preservation of residual hearing was defined as measurable postoperative threshold at the frequencies 250, 500, and 1000 Hz. Results: Overall postimplant hearing preservation 6 to 8 weeks after implantation was achieved in 13 of the patients (87%). Subsequent follow-up was performed on average 15.2 months after surgery (range, 7–32) in 14 out of 15 patients. At this late postoperative evaluation preservation of hearing was recorded in nine patients (64%), whereas in the remaining five patients (36%) no residual hearing was measured. Conclusion: The underwater technique offers a reliable nontraumatic method for electrode array insertions during cochlear implantation. The method respects the physiology of the cochlea und minimizes the pressure variations during cochlear opening and implantation.

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Assessment of Vestibulo-oculomotor Reflex in Ménière's Disease: Defining an Instrumental Profile

Objectives: To analyze and compare, in two groups of patients affected by definite Ménière's disease (MD) but treated differently, the Video Head Impulse Test findings especially by putting them in relationship with canal paresis, hearing loss, and duration of the disease. Study Design: Retrospective chart review. Patients: Seventy patients affected by unilateral definite MD (16 in Group 1 and 54 in Group 2) observed between March 2014 and May 2015 in a tertiary referral center were retrospectively studied and then divided into two groups: Group 1 was previously treated with intratympanic gentamicin, whereas Group 2 underwent only a conservative therapy. Instrumental tests included audiometry, caloric test, and Video Head Impulse Test. All the findings were statistically analyzed; significance was set at p = 0.005. Intervention: Diagnostic. Main Outcomes Measures: If MD is treated conservatively the high-frequency vestibulo-oculomotor reflex gain determined with Video Head Impulse Test is normal; it is pathological if MD is treated with gentamicin. Results: High-frequency vestibulo-oculomotor reflex gain showed a statistically significant reduction in Group 1; at the same time, it showed no correlation in both groups with hearing loss, duration of disease or canal paresis. Conclusion: High-frequency vestibulo-oculomotor reflex is naturally preserved even in late stage MD if the patient has been treated conservatively; the dissociation between Caloric Test and Video Head Impulse Test findings could be considered an instrumental hallmark of MD. Gentamicin significantly reduces high-frequency vestibulo-oculomotor reflex gain: this reduction can be taken into account when determining the effectiveness of an ablative treatment.

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“Physiological” Ear Clicking: Its Origin and Potential Usability as a Test Tool for the Eustachian Tube Function

Objective: To explore the origin of “physiological” ear clicks during deglutition or other pharyngeal movements, which, in contrast to disturbing frequent clicks under pathologic conditions, mostly remain unnoticed by the patient. Study Design: Clinical experimental study at a tertiary referral center. Methods: Ear clicks were recorded by a microphone sealing the external ear canal parallel to endoscopic or manometric evaluations of the Eustachian tube function. Results: Obviously, the acoustic signals (clicks) appear when the tube opens. The clicks might be explained by a disruption of fluid or mucus films covering the mucosa. As in our tests clicks could be recorded regularly, they might potentially be used as indicators in a new tube function test, which has to be elaborated.

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Diffusion Tensor Imaging Tractography of the Facial Nerve in Patients With Cerebellopontine Angle Tumors

Objective: To demonstrate the utility of diffusion tensor imaging (DTI) fiber tractography of the facial nerve in patients with cerebellopontine angle (CPA) tumors. Study Design: Prospective. Setting: Tertiary referral center. Patients: DTI technique was established in 113 patients without tumors and in 28 patients with CPA tumors. Subsequently, DTI results were compared with intraoperative findings in 21 patients with medium and large-sized tumors, treated surgically via a translabyrinthine approach. Intervention: Three Tesla magnetic resonance (MR) was used for DTI tractography. For patients without CPA tumors, the scanning protocol was 32 directions with a 3 × 3 × 3 mm voxel size. For CPA tumor patients, scanning protocol was 32 directions with a 2 × 2 × 2 mm voxel size. DTI data were used to track the facial nerve. Main Outcome Measures: Facial nerve identification rate. Results: Facial nerve identification rate in MR-DTI was 97% and 100% in patients without tumors and in patients with tumors of the CPA of the internal auditory canal that were not treated surgically, respectively. MR-DTI identification of the facial nerve was successful in 20 patients who were treated surgically (95%). Good agreement between surgical findings and MR-DTI results was found in 19 patients (90%). Conclusion: MR DTI tractography is an effective technique in positively identifying the position of the facial nerve in patients with CPA tumors.

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Endoscopically Guided Transtympanic Balloon Catheter Dilatation of the Eustachian Tube: A Cadaveric Pilot Study

Objective: To assess the feasibility, safety, and efficacy of transtympanic balloon catheter dilatation of the Eustachian tube (ET) in a cadaver model. Patients and Interventions: A cadaveric study of 10 cadaver heads, which underwent unilateral transtympanic dilatation of the ET with a 3 × 20 mm balloon catheter with full endoscopic guidance and visualization. Results: Procedural safety was demonstrated, with no damage to any essential structures found. Feasibility of the procedure was demonstrated in all cadavers with 100% success rate, despite a small number of encountered difficulties. Statistically significant efficacy was also demonstrated in both radiologic and manometric data. Conclusion: With full endoscopic visualization, the transtympanic approach to balloon catheter dilatation of the ET seems to be a feasible and safe procedure in the cadaver model.

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Intratympanic Iodine Contrast Injection Diffuses Across the Round Window Membrane Allowing for Perilymphatic CT Volume Acquisition Imaging

Hypothesis: Whether the round window membrane (RWM) is permeable to iodine-based contrast agents (IBCA) is unknown; therefore, our goal was to determine if IBCAs could diffuse through the RWM using CT volume acquisition imaging. Introduction: Imaging of hydrops in the living human ear has attracted recent interest. Intratympanic (IT) injection has shown gadolinium's ability to diffuse through the RWM, enhancing the perilymphatic space. Methods: Four unfixed human cadaver temporal bones underwent intratympanic IBCA injection using three sequentially studied methods. The first method was direct IT injection. The second method used direct RWM visualization via tympanomeatal flap for IBCA-soaked absorbable gelatin pledget placement. In the third method, the middle ear was filled with contrast after flap elevation. Volume acquisition CT images were obtained immediately postexposure, and at 1-, 6-, and 24-hour intervals. Postprocessing was accomplished using color ramping and subtraction imaging. Results: After the third method, positive RWM and perilymphatic enhancement were observed with endolymph sparing. Gray scale and color ramp multiplanar reconstructions displayed increased signal within the cochlea compared with precontrast imaging. The cochlea was measured for attenuation differences compared with pure water, revealing a preinjection average of −1,103 HU and a postinjection average of 338 HU. Subtraction imaging shows enhancement remaining within the cochlear space, Eustachian tube, middle ear epithelial lining, and mastoid. Conclusion: Iohexol iodine contrast is able to diffuse across the RWM. Volume acquisition CT imaging was able to detect perilymphatic enhancement at 0.5-mm slice thickness. The clinical application of IBCA IT injection seems promising but requires further safety studies.

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Repeated Postoperative Follow-up Diffusion-weighted Magnetic Resonance Imaging to Detect Residual or Recurrent Cholesteatoma

Objective: In our institution, follow-up diffusion-weighted imaging (DWI) after cholesteatoma surgery is performed at least twice. The aim of this study was to determine the yield of the second follow-up DWI (D-W MRI-2) in patients in whom the first postoperative DWI (D-W MRI-1) was negative for residual or recurrent cholesteatoma. Study Design: A retrospective analysis. Setting: Tertiary referral center. Patients: Patients were included if 1) they had at least two postoperative DWI examinations after a canal wall up procedure with apparently complete cholesteatoma resection; 2) D-W MRI-1 was performed between 6 and 24 months after surgery and D-W MRI-2 performed at least 6 months after D-W MRI-1; 3) both DWI examinations were of good quality and covering the whole mastoid-middle ear region; 4) D-W MRI-1 was unequivocally negative for cholesteatoma; and 5) there was no clinical suspicion on otoscopy of recurrent cholesteatoma nor a surgical intervention between these two postoperative DWI examinations. In total, 45 separate ears in 44 patients were included. Results: In 14 ears (31%) D-W MRI-2 was positive (n = 8) or equivocal (n = 6) for cholesteatoma. In six of eight patients with positive D-W MRI-2, follow-up surgery was performed. Cholesteatoma was found in five of them. None of the patients with equivocal findings on D-W MRI-2 was operated on. Patients with positive D-W MRI-2 were of young age. There were no observable differences for sex, side, time between surgery and D-W MRI-1, time between surgery and D-W MRI-2, or time between D-W MRI-1 and D-W MRI-2, or for the location of cholesteatoma at surgery. In the study period there was a trend to perform D-W MRI-1 and D-W MRI-2 earlier after initial surgery. In the same period, there was an evident decrease in average age of the patient population. Conclusion: Despite cholesteatoma surgery without macroscopic residue, clinical follow-up and routine first follow-up DWI without any signs of residual or recurrent disease, repeat follow-up DWI showed evidence of cholesteatoma in 31% of patients. On the basis of the findings in this study, repeated follow-up DWI is recommended.

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Fifty Years of the American Neurotology Society

Last year (2015) marked the 50th Anniversary of the American Neurotology Society (ANS). The past 50 years has observed significant progress in the fields of otology and neurotology. Progress did not come without controversies and conflicts. Nonetheless, the ANS flourished throughout this time. To isolate the workings of the ANS from the broader fields of otology and neurotology would be impossible—members of the ANS were and continue to be the leaders in the field, and the topics presented at the ANS meetings reflect its leading edge. Instead, this retrospective aims to highlight significant events in the field from the vantage point of the ANS, using the biannual ANS meeting programs are the primary source material.

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Linguistic Masking Release in School-Age Children and Adults

Purpose

This study assessed if 6- to 8-year-old children benefit from a language mismatch between target and masker speech for sentence recognition in a 2-talker masker.

Method

English sentence recognition was evaluated for English monolingual children (ages 6–8 years, n = 15) and adults (n = 15) in an English 2-talker and a Spanish 2-talker masker. A regression analysis with subject as a random variable was used to test the fixed effect of listener group and masker language and the interaction of these two effects.

Results

Thresholds were approximately 5 dB higher for children than for adults in both maskers. However, children and adults benefited to the same degree from a mismatch between the target and masker language with approximately 3 dB lower thresholds in the Spanish than the English masker.

Conclusions

Results suggest that children are able to take advantage of linguistic differences between English and Spanish speech maskers to the same degree as adults. Yet, overall worse performance for children may indicate general cognitive immaturity compared with adults, perhaps causing children to be less efficient when combining glimpses of degraded speech information into a meaningful sentence.

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Linguistic Masking Release in School-Age Children and Adults

Purpose

This study assessed if 6- to 8-year-old children benefit from a language mismatch between target and masker speech for sentence recognition in a 2-talker masker.

Method

English sentence recognition was evaluated for English monolingual children (ages 6–8 years, n = 15) and adults (n = 15) in an English 2-talker and a Spanish 2-talker masker. A regression analysis with subject as a random variable was used to test the fixed effect of listener group and masker language and the interaction of these two effects.

Results

Thresholds were approximately 5 dB higher for children than for adults in both maskers. However, children and adults benefited to the same degree from a mismatch between the target and masker language with approximately 3 dB lower thresholds in the Spanish than the English masker.

Conclusions

Results suggest that children are able to take advantage of linguistic differences between English and Spanish speech maskers to the same degree as adults. Yet, overall worse performance for children may indicate general cognitive immaturity compared with adults, perhaps causing children to be less efficient when combining glimpses of degraded speech information into a meaningful sentence.

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Linguistic Masking Release in School-Age Children and Adults

Purpose

This study assessed if 6- to 8-year-old children benefit from a language mismatch between target and masker speech for sentence recognition in a 2-talker masker.

Method

English sentence recognition was evaluated for English monolingual children (ages 6–8 years, n = 15) and adults (n = 15) in an English 2-talker and a Spanish 2-talker masker. A regression analysis with subject as a random variable was used to test the fixed effect of listener group and masker language and the interaction of these two effects.

Results

Thresholds were approximately 5 dB higher for children than for adults in both maskers. However, children and adults benefited to the same degree from a mismatch between the target and masker language with approximately 3 dB lower thresholds in the Spanish than the English masker.

Conclusions

Results suggest that children are able to take advantage of linguistic differences between English and Spanish speech maskers to the same degree as adults. Yet, overall worse performance for children may indicate general cognitive immaturity compared with adults, perhaps causing children to be less efficient when combining glimpses of degraded speech information into a meaningful sentence.

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The Influence of Linguistic Proficiency on Masked Text Recognition Performance in Adults With and Without Congenital Hearing Impairment.

Objective: The authors first examined the influence of moderate to severe congenital hearing impairment (CHI) on the correctness of samples of elicited spoken language. Then, the authors used this measure as an indicator of linguistic proficiency and examined its effect on performance in language reception, independent of bottom-up auditory processing. Design: In groups of adults with normal hearing (NH, n = 22), acquired hearing impairment (AHI, n = 22), and moderate to severe CHI (n = 21), the authors assessed linguistic proficiency by analyzing the morphosyntactic correctness of their spoken language production. Language reception skills were examined with a task for masked sentence recognition in the visual domain (text), at a readability level of 50%, using grammatically correct sentences and sentences with distorted morphosyntactic cues. The actual performance on the tasks was compared between groups. Results: Adults with CHI made more morphosyntactic errors in spoken language production than adults with NH, while no differences were observed between the AHI and NH group. This outcome pattern sustained when comparisons were restricted to subgroups of AHI and CHI adults, matched for current auditory speech reception abilities. The data yielded no differences between groups in performance in masked text recognition of grammatically correct sentences in a test condition in which subjects could fully take advantage of their linguistic knowledge. Also, no difference between groups was found in the sensitivity to morphosyntactic distortions when processing short masked sentences, presented visually. Conclusions: These data showed that problems with the correct use of specific morphosyntactic knowledge in spoken language production are a long-term effect of moderate to severe CHI, independent of current auditory processing abilities. However, moderate to severe CHI generally does not impede performance in masked language reception in the visual modality, as measured in this study with short, degraded sentences. Aspects of linguistic proficiency that are affected by CHI thus do not seem to play a role in masked sentence recognition in the visual modality. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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The Influence of Linguistic Proficiency on Masked Text Recognition Performance in Adults With and Without Congenital Hearing Impairment.

Objective: The authors first examined the influence of moderate to severe congenital hearing impairment (CHI) on the correctness of samples of elicited spoken language. Then, the authors used this measure as an indicator of linguistic proficiency and examined its effect on performance in language reception, independent of bottom-up auditory processing. Design: In groups of adults with normal hearing (NH, n = 22), acquired hearing impairment (AHI, n = 22), and moderate to severe CHI (n = 21), the authors assessed linguistic proficiency by analyzing the morphosyntactic correctness of their spoken language production. Language reception skills were examined with a task for masked sentence recognition in the visual domain (text), at a readability level of 50%, using grammatically correct sentences and sentences with distorted morphosyntactic cues. The actual performance on the tasks was compared between groups. Results: Adults with CHI made more morphosyntactic errors in spoken language production than adults with NH, while no differences were observed between the AHI and NH group. This outcome pattern sustained when comparisons were restricted to subgroups of AHI and CHI adults, matched for current auditory speech reception abilities. The data yielded no differences between groups in performance in masked text recognition of grammatically correct sentences in a test condition in which subjects could fully take advantage of their linguistic knowledge. Also, no difference between groups was found in the sensitivity to morphosyntactic distortions when processing short masked sentences, presented visually. Conclusions: These data showed that problems with the correct use of specific morphosyntactic knowledge in spoken language production are a long-term effect of moderate to severe CHI, independent of current auditory processing abilities. However, moderate to severe CHI generally does not impede performance in masked language reception in the visual modality, as measured in this study with short, degraded sentences. Aspects of linguistic proficiency that are affected by CHI thus do not seem to play a role in masked sentence recognition in the visual modality. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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The Influence of Linguistic Proficiency on Masked Text Recognition Performance in Adults With and Without Congenital Hearing Impairment.

Objective: The authors first examined the influence of moderate to severe congenital hearing impairment (CHI) on the correctness of samples of elicited spoken language. Then, the authors used this measure as an indicator of linguistic proficiency and examined its effect on performance in language reception, independent of bottom-up auditory processing. Design: In groups of adults with normal hearing (NH, n = 22), acquired hearing impairment (AHI, n = 22), and moderate to severe CHI (n = 21), the authors assessed linguistic proficiency by analyzing the morphosyntactic correctness of their spoken language production. Language reception skills were examined with a task for masked sentence recognition in the visual domain (text), at a readability level of 50%, using grammatically correct sentences and sentences with distorted morphosyntactic cues. The actual performance on the tasks was compared between groups. Results: Adults with CHI made more morphosyntactic errors in spoken language production than adults with NH, while no differences were observed between the AHI and NH group. This outcome pattern sustained when comparisons were restricted to subgroups of AHI and CHI adults, matched for current auditory speech reception abilities. The data yielded no differences between groups in performance in masked text recognition of grammatically correct sentences in a test condition in which subjects could fully take advantage of their linguistic knowledge. Also, no difference between groups was found in the sensitivity to morphosyntactic distortions when processing short masked sentences, presented visually. Conclusions: These data showed that problems with the correct use of specific morphosyntactic knowledge in spoken language production are a long-term effect of moderate to severe CHI, independent of current auditory processing abilities. However, moderate to severe CHI generally does not impede performance in masked language reception in the visual modality, as measured in this study with short, degraded sentences. Aspects of linguistic proficiency that are affected by CHI thus do not seem to play a role in masked sentence recognition in the visual modality. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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A theoretical model of barriers having inhomogeneous impedance surfaces

When barriers are placed in parallel on opposite sides of a source, their performance deteriorates markedly. However, barriers made from materials of inhomogeneous impedance eliminate this drawback by altering the behavior of sound as it undergoes multiple reflections between the barriers. In this paper, a theoretical approach is carried out to estimate the performance of the proposed barriers. By combining the ray-tracing method and sound diffraction theory, the existence of different ray paths between the proposed barriers is revealed. Compared to conventional rigid-walled barriers, barriers having inhomogeneous surfaces may have the potential to be widely used in environmental noise control.

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A theoretical model of barriers having inhomogeneous impedance surfaces

When barriers are placed in parallel on opposite sides of a source, their performance deteriorates markedly. However, barriers made from materials of inhomogeneous impedance eliminate this drawback by altering the behavior of sound as it undergoes multiple reflections between the barriers. In this paper, a theoretical approach is carried out to estimate the performance of the proposed barriers. By combining the ray-tracing method and sound diffraction theory, the existence of different ray paths between the proposed barriers is revealed. Compared to conventional rigid-walled barriers, barriers having inhomogeneous surfaces may have the potential to be widely used in environmental noise control.

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Can nutritional supplements impact genetic hearing loss in children?

Antioxidant regimen helps slow hearing loss in mouse model of most common form of childhood deafness.

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Can nutritional supplements impact genetic hearing loss in children?

Antioxidant regimen helps slow hearing loss in mouse model of most common form of childhood deafness.

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

Can nutritional supplements impact genetic hearing loss in children?

Antioxidant regimen helps slow hearing loss in mouse model of most common form of childhood deafness.

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