Acoustic Properties of Collagenous Matrices of Xenogenic Origin for Tympanic Membrane Reconstruction.

Hypothesis: The acoustic properties of scaffolds made from decellularized extracellular cartilage matrices of porcine origin are comparable to those of the human tympanic membrane. Background: Currently, the reconstruction of tympanic membrane in the context of chronic tympanic membrane defects is mostly performed using autologous fascia or cartilage. Autologous tissue may be associated with lack of graft material in revision patients and requires more invasive and longer operative time. Therefore, other materials are investigated for reconstruction. An increasingly important role could be played by scaffolds from different materials, which are known to induce constructive tissue remodeling. Methods: To analyze the acoustic properties, the vibrations of the scaffolds, cartilage, perichondrium and tympanic membrane were measured by laser scanning doppler vibrometry under different static pressures. Results: The analysis of volume velocities serves as an indicator for sound transmission. The results of the average volume velocities at atmospheric pressure show a similar frequency response of the tympanic membrane and the scaffolds with a peak at about 800 Hz. After changing the artificial ear-canal pressure from atmospheric pressure to negative pressure (-100, -200, and -300 daPa) the vibration characteristics of the different membranes remain fairly constant, whereas the results of the perichondrium show a decrease after changing the pressure into the negative range in the frequencies 1 to 3 kHz. Conclusion: The present study showed that the vibration characteristics of the scaffolds under atmospheric and negative pressure can be interpreted as similar to those of thin cartilage (

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Long-term Results of Troublesome CWD Cavity Reconstruction by Mastoid and Epitympanic Bony Obliteration (CWR-BOT) in Adults.

Objective: To present the long-term surgical outcome of the bony mastoid and epitympanic obliteration technique with canal wall reconstruction (CWR-BOT) in adults with an unstable cavity after previous canal wall-down surgery for extensive cholesteatoma. Study Design: Retrospective study. Interventions: Therapeutic. Setting: Tertiary referral center. Patients: Fifty consecutive adult patients undergoing a CWR-BOT between 1998 and 2009. Main Outcome Measure(s): (A) Recurrence and residual rates of cholesteatoma, (B) postoperative hygienic status of the ear, including postoperative aspect of the tympanic membrane and external ear canal integrity (EAC), (C) functional outcome, and (D) long-term safety issues. Results: (A) The percentage of ears remaining safe without recurrent or residual disease after CWR-BOT was 96% after a mean follow-up time of 101.8 months. Recurrent cholesteatoma occurred in 2% (n = 1) and a residual cholesteatoma was detected in 2% (n = 1) of the patients. (B) A safe dry, and trouble-free graft and selfcleaning EAC was achieved in 94%. (C) The postoperative hearing results showed a gain of 1.7 dB on pure-tone average air-conduction. (D) Nonecho planar diffusion-weighted imaging (non-EP DW magnetic resonance imaging) documented the residual (n = 1) and recurrent cholesteatoma (n = 1). The 1- and 5-year imaging follow-up revealed no other recurrent or residual disease. Conclusion: The CWR-BOT is a safe and very effective option for treatment of problematic unstable canal wall-down mastoid cavities, resulting in dry trouble-free ears. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Microsurgical Anatomy of the Internal Acoustic Meatus as Seen Using the Retrosigmoid Approach.

Hypothesis: To show via a retrosigmoid approach the bony labyrinth anatomy and its relationship with the internal acoustic meatus so as to provide guidelines for a safer drilling to the fundus using this approach. Background: Few studies deal with the complex anatomy of petrous bone structures as observed by a retrosigmoid approach. Methods: Ten retrosigmoid approaches were performed bilaterally on five fresh cadaveric heads. Afterward high-resolution computed tomographic scans were obtained. Measurements of landmarks and distances between important topographic structures of the pyramid were obtained on its surface using a navigation system. Semicircular canals, vestibular aqueduct, and internal acoustic meatus were dissected to show their anatomy and relationships. Results: The anatomy of the inner ear structures was shown. Opening of the internal acoustic meatus was accomplished without injury to the labyrinth in 9 out of 10 sides. The distance between the drilled bone of the internal acoustic meatus and the vestibule was calculated on the postoperative computed tomographic scan. The mean value was 1.43 mm (SD, 0.30 mm; range, 1.0-1.8 mm). Conclusion: A better knowledge of the anatomy of the semicircular canals and of the vestibular aqueduct as observed by a retrosigmoid approach, together with their relationships to the fundus and other petrous bone landmarks, can be useful to get a general orientation in acoustic neuroma surgery. Using this information together with the neuronavigation, we were able to successfully open the internal acoustic meatus without entering labyrinthine structures in 90% of the study dissections. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Objectification and Differential Diagnosis of Vascular Pulsatile Tinnitus by Transcanal Sound Recording and Spectrotemporal Analysis: A Preliminary Study.

Objective: Although frequently classified as "objective tinnitus," in most cases vascular pulsatile tinnitus (VPT) is not equal to objective tinnitus because it is not easy to objectively document VPT. The present study was conducted to develop a novel transcanal sound recording and spectrotemporal analysis method for the objective and differential diagnosis of VPT. Study Design: A case series with a control group. Setting: Tertiary referral center. Patients: Six VPT subjects with radiological abnormalities and six normal controls. Interventions and Main Outcome Measure: The method was tested based on recordings obtained from the ipsilateral external auditory canal (EAC) using an insert microphone with the subject's head in four different positions. The recorded signals were first analyzed in the time domain, and short-time Fourier transform was performed to analyze the data in the time-frequency domain. Results: From the temporal analysis, the ear canal signals recorded from the VPT subjects exhibited large peak amplitudes and periodic structures, whereas the signals recorded from the control subjects had smaller peak amplitudes and weaker periodicity. From the STA represented by two-dimensional spectrograms and three-dimensional waterfall diagrams, all of the VPT subjects demonstrated pulse-synchronous acoustic characteristics that were representative of their respective presumptive vascular pathologies, whereas the control subjects did not display such characteristics. Conclusion: The present diagnostic approach may provide additional information regarding the origins of VPT cases as well as an efficient and objective diagnostic method. Furthermore, this approach may aid in the determination of appropriate imaging modalities, treatment planning, and evaluation of treatment outcomes. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Active Middle Ear Implantation: Long-term Medical and Technical Follow-up, Implant Survival, and Complications.

Objective: To evaluate the long-term medical and technical results, implant survival, and complications of the semi-implantable vibrant soundbridge (VSB), otologics middle ear transducer (MET), and the otologics fully implantable ossicular stimulator (FIMOS). Study Design: Retrospective cohort study. Patients: Patients with chronic external otitis and either moderate to severe sensorineural or conductive/mixed hearing loss. Setting: Tertiary referral center. Intervention: Implantation with the VSB, MET, or FIMOS. Main Outcome Measures: Medical complications, number of reimplantations, and explantations. Results: Ninety-four patients were implanted, 12 patients with a round window or stapes application. 28 patients were lost to follow-up. The average follow-up duration was 4.4 years (range, 1 month-15 years). 128 devices were evaluated: (92 VSB, 32 MET, 4 FIMOS). 36 devices (28%) have been explanted or replaced (18 VSB, 14 MET, 4 FIMOS). Device failure was 7% for VSB, 28% for MET, and 100% for FIMOS. In 16 patients (17%) revision surgery (n = 20) was performed. Twenty patients (21%) suffered any medical complication. Conclusion: Medical and technical complications and device failures have mostly occurred in the initial period of active middle ear implants (AMEI) implementation and during clinical trials or experimental procedures. All four FIMOS had technical difficulties. An important decrease in the occurrence of both medical and technical complications was observed. Application in more recent years did not show any complications and the recent device failure rates are acceptable. Magnetic resonance imaging (MRI) incompatibility should be taken into account when indicating AMEI. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Compressive acoustic sound speed profile estimation

Ocean acousticsound speed profile (SSP) estimation requires the inversion of acoustic fields using limited observations. Compressive sensing (CS) asserts that certain underdetermined problems can be solved in high resolution, provided their solutions are sparse. Here, CS is used to estimate SSPs in a range-independent shallow ocean by inverting a non-linear acoustic propagation model. It is shown that SSPs can be estimated using CS to resolve fine-scale structure.

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Modeling the voice source in terms of spectral slopesa)

A psychoacoustic model of the voicesourcespectrum is proposed. The model is characterized by four spectral slope parameters: the difference in amplitude between the first two harmonics (H1–H2), the second and fourth harmonics (H2–H4), the fourth harmonic and the harmonic nearest 2 kHz in frequency (H4–2 kHz), and the harmonic nearest 2 kHz and that nearest 5 kHz (2 kHz–5 kHz). As a step toward model validation, experiments were conducted to establish the acoustic and perceptual independence of these parameters. In experiment 1, the model was fit to a large number of voicesources. Results showed that parameters are predictable from one another, but that these relationships are due to overall spectral roll-off. Two additional experiments addressed the perceptual independence of the source parameters. Listener sensitivity to H1–H2, H2–H4, and H4–2 kHz did not change as a function of the slope of an adjacent component, suggesting that sensitivity to these components is robust. Listener sensitivity to changes in spectral slope from 2 kHz to 5 kHz depended on complex interactions between spectral slope, spectral noise levels, and H4–2 kHz. It is concluded that the four parameters represent non-redundant acoustic and perceptual aspects of voice quality.

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Compressive acoustic sound speed profile estimation

Ocean acousticsound speed profile (SSP) estimation requires the inversion of acoustic fields using limited observations. Compressive sensing (CS) asserts that certain underdetermined problems can be solved in high resolution, provided their solutions are sparse. Here, CS is used to estimate SSPs in a range-independent shallow ocean by inverting a non-linear acoustic propagation model. It is shown that SSPs can be estimated using CS to resolve fine-scale structure.

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Histopathology of the Human Inner Ear in the p.L114P COCH Mutation (DFNA9)

The histopathology of the inner ear in a patient with hearing loss caused by the p.L114P COCH mutation and its correlation with the clinical phenotype are presented. To date, 23 COCH mutations causative of DFNA9 autosomal dominant sensorineural hearing loss and vestibular disorder have been reported, and the histopathology of the human inner ear has been described in 4 of these. The p.L114P COCH mutation was first described in a Korean family. We have identified the same mutation in a family of non-Asian ancestry in the USA, and the temporal bone histopathology and clinical findings are presented herein. The histopathology found in the inner ear was similar to that shown in the 4 other COCH mutations and included degeneration of the spiral ligament with deposition of an eosinophilic acellular material, which was also found in the distal osseous spiral lamina, at the base of the spiral limbus, and in mesenchymal tissue at the base of the vestibular neuroepithelium. This is the first description of human otopathology of the COCH p.L114P mutation. In addition, it is the only case with otopathology characterization in an individual with any COCH mutation and residual hearing, thus allowing assessment of primary histopathological events in DFNA9, before progression to more profound hearing loss. A quantitative cytologic analysis of atrophy in this specimen and immunostaining using anti-neurofilament and anti-myelin protein zero antibodies confirmed that the principal histopathologic correlate of hearing loss was degeneration of the dendritic fibers of spiral ganglion cells in the osseous spiral lamina. The implications for cochlear implantation in this disorder are discussed.
Audiol Neurotol 2016;21:88-97

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Content analysis of the professional journal of the College of Speech Therapists II: coming of age and growing maturity, 1946-65.

Content analysis of the professional journal of the College of Speech Therapists II: coming of age and growing maturity, 1946-65.

Int J Lang Commun Disord. 2016 Mar 27;

Authors: Stansfield J, Armstrong L

Abstract
BACKGROUND: Following a content analysis of the first 10 years of the UK professional journal Speech, this study was conducted to survey the published work of the speech (and language) therapy profession in the 20 years following the unification of two separate professional bodies into the College of Speech Therapists.
AIM: To understand better the development of the speech (and language) therapy profession in the UK in order to support the development of an online history of the speech and language therapy profession in the UK.
METHODS & PROCEDURES: The 40 issues of the professional journal of the College of Speech Therapists published between 1946 and 1965 (Speech and later Speech Pathology and Therapy) were examined using content analysis and the content compared with that of the same journal as it appeared from 1935 to the end of the Second World War (1945).
OUTCOMES & RESULTS: Many aspects of the journal and its authored papers were retained from the earlier years, for example, the range of authors' professions, their location mainly in the UK, their number of contributions and the length of papers. Changes and developments included the balance of original to republished papers, the description and discussion of new professional issues, and an extended range of client groups/disorders.
CONCLUSIONS & IMPLICATIONS: The journal and its articles reflect the growing maturity of the newly unified profession of speech therapy and give an indication both of the expanding depth of knowledge available to speech therapists and of the rapidly increasing breadth of their work over this period.

PMID: 27018211 [PubMed - as supplied by publisher]

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Content analysis of the professional journal of the College of Speech Therapists II: coming of age and growing maturity, 1946-65.

Content analysis of the professional journal of the College of Speech Therapists II: coming of age and growing maturity, 1946-65.

Int J Lang Commun Disord. 2016 Mar 27;

Authors: Stansfield J, Armstrong L

Abstract
BACKGROUND: Following a content analysis of the first 10 years of the UK professional journal Speech, this study was conducted to survey the published work of the speech (and language) therapy profession in the 20 years following the unification of two separate professional bodies into the College of Speech Therapists.
AIM: To understand better the development of the speech (and language) therapy profession in the UK in order to support the development of an online history of the speech and language therapy profession in the UK.
METHODS & PROCEDURES: The 40 issues of the professional journal of the College of Speech Therapists published between 1946 and 1965 (Speech and later Speech Pathology and Therapy) were examined using content analysis and the content compared with that of the same journal as it appeared from 1935 to the end of the Second World War (1945).
OUTCOMES & RESULTS: Many aspects of the journal and its authored papers were retained from the earlier years, for example, the range of authors' professions, their location mainly in the UK, their number of contributions and the length of papers. Changes and developments included the balance of original to republished papers, the description and discussion of new professional issues, and an extended range of client groups/disorders.
CONCLUSIONS & IMPLICATIONS: The journal and its articles reflect the growing maturity of the newly unified profession of speech therapy and give an indication both of the expanding depth of knowledge available to speech therapists and of the rapidly increasing breadth of their work over this period.

PMID: 27018211 [PubMed - as supplied by publisher]

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The relationship between serum lipids and sudden sensorineural hearing loss: a systematic review and meta-analysis.

Related Articles

The relationship between serum lipids and sudden sensorineural hearing loss: a systematic review and meta-analysis.

PLoS One. 2015;10(4):e0121025

Authors: Chang IJ, Kang CJ, Yueh CY, Fang KH, Yeh RM, Tsai YT

Abstract
BACKGROUND: Sudden sensorineural hearing loss (SSNHL) is a relatively common condition that is usually of unknown etiology. A number of individual studies have investigated the association between various serum lipids and SSNHL; however, the findings have been inconsistent. In an attempt to obtain more definitive information on the relationship between serum lipids and SSNHL, we carried out a systematic review and meta-analysis.
METHODS: Medline, the Cochrane Library, and EMBASE were searched using the following key words: lipid, cholesterol, triglyceride, fat, serum, blood, sudden hearing loss, hearing loss, hearing disorders. Randomized controlled trials, prospective cohort studies, and retrospective case-control studies involving patients with SSNHL and healthy controls that examined the relationship (reported as odds ratios [OR]) between lipid profiles and SSNHL were included. Primary outcomes were total cholesterol and low-density lipoprotein cholesterol (LDL-C) concentrations. Secondary outcomes were triglyceride, high-density lipoprotein cholesterol, and lipoprotein(a) concentrations.
RESULTS: A total of 6 case-control studies were included in this systematic review/meta-analysis. The total number of participants ranged from 30 to 250 in the case group and from 43 to 271 in the control group. Meta-analysis revealed no significant difference in total cholesterol levels between the case and control groups (pooled OR = 1.79, 95% confidence interval [CI] = 0.98 to 3.26, P = 0.057). Likewise, meta-analysis revealed no significant difference in LDL-C concentrations between the case and control groups (pooled OR = 1.15, 95% CI = 0.64 to 2.07, P = 0.639). Since there were an insufficient number of studies reporting data for the secondary outcomes, meta-analysis was not possible.
CONCLUSIONS: Our results do not provide evidence for serum lipids being associated with SSNHL, nor do they definitively rule out such an association. Additional studies are needed to ascertain the relationship, or lack thereof, between serum lipids and SSNHL.

PMID: 25866869 [PubMed - indexed for MEDLINE]

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Development of traditional Chinese version of World Health Organization disability assessment schedule 2.0 36--item (WHODAS 2.0) in Taiwan: validity and reliability analyses.

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Development of traditional Chinese version of World Health Organization disability assessment schedule 2.0 36--item (WHODAS 2.0) in Taiwan: validity and reliability analyses.

Res Dev Disabil. 2014 Nov;35(11):2812-20

Authors: Chiu TY, Yen CF, Chou CH, Lin JD, Hwang AW, Liao HF, Chi WC

Abstract
BACKGROUND: World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) provided a standardized method for measuring the health and disability and the traditional Chinese version has not been developed.
AIMS: To describe the process of developing the traditional Chinese version of the WHODAS 2.0 36-item version and to evaluate the concurrent validity and test-retest reliability of this instrument.
METHODS: The study was conducted in two phases. Phase I was the process of translation of WHODAS 2.0 36-item version. Phase II was a cross-sectional study. The participants were 307 adults who were tested the validity and reliability of draft traditional Chinese version.
RESULTS: The reliability of Cronbach's α and ICC in the WHODAS 2.0 traditional Chinese version were 0.73-0.99 and 0.8-089, respectively. The content validity was good (r=0.7-0.76), and the concurrent validity was excellent in comparison with the WHOQOL-BREF (p<0.5). The construct validity, the model was explained total variance was 67.26% by the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) illustrated the traditional Chinese version was good to assess disability. There was a valid and reliable measurement scales for evaluating functioning and disability status.
CONCLUSION: For disability eligibility system of Taiwan government to measure the disability, the traditional Chinese version of the WHODAS 2.0 provided valuable evidence to design the assessment instrument.

PMID: 25094056 [PubMed - indexed for MEDLINE]

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Plantar flexor muscle weakness may cause stiff-knee gait

Publication date: Available online 28 March 2016
Source:Gait & Posture
Author(s): Adnan Apti, N. Ekin Akalan, Shavkat Kuchimov, Arzu Razak Özdinçler, Yener Temelli, Anand Nene
AimThe iterative simulation studies proclaim that plantar flexor (PF) muscle weakness is one of the contributors of stiff knee gait (SKG), although, whether isolated PF weakness generates SKG has not been validated in able-bodied people or individuals with neuromuscular disorders. The aim of the study was to investigate the effects of isolated PF muscle weakness on knee flexion velocity and SKG in healthy individuals.MethodTwenty able-bodied young adults (23±3 years) participated in this study. Passive stretch (PS) protocol was applied until the PF muscle strength dropped 33.1% according to the hand-held dynamometric measurement. Seven additional age-matched able-bodies were compared with participants’ to discriminate the influence of slow-walking. All participants underwent 3D gait analysis before and after the PS. Peak knee flexion angle, range of knee flexion between toe-off and peak knee flexion, total range of knee-flexion, and time of peak knee flexion in swing were selected to describe SKG pattern.ResultsAfter PS, the reduction of plantar flexor muscle strength (33.14%) caused knee flexion velocity drop at toe-off (p= 0.008) and developed SKG pattern by decreasing peak knee flexion (p=0.0001), range of knee flexion in early swing (p=0.006), and total knee flexion range (p=0.002). These parameters were significantly correlated with decreased PF velocity at toe-off (p=0.015, p=0.0001, p=0.005 respectively). The time of peak knee flexion was not significantly different between before and after stretch conditions (p=0.130).ConclusionsThese findings verified that plantar flexor weakness cause SKG pattern by completing three of SKG parameters. Any treatment protocol that weakens the plantar flexor muscle might impact the SKG pattern.



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Plantar flexor muscle weakness may cause stiff-knee gait

Publication date: Available online 28 March 2016
Source:Gait & Posture
Author(s): Adnan Apti, N. Ekin Akalan, Shavkat Kuchimov, Arzu Razak Özdinçler, Yener Temelli, Anand Nene
AimThe iterative simulation studies proclaim that plantar flexor (PF) muscle weakness is one of the contributors of stiff knee gait (SKG), although, whether isolated PF weakness generates SKG has not been validated in able-bodied people or individuals with neuromuscular disorders. The aim of the study was to investigate the effects of isolated PF muscle weakness on knee flexion velocity and SKG in healthy individuals.MethodTwenty able-bodied young adults (23±3 years) participated in this study. Passive stretch (PS) protocol was applied until the PF muscle strength dropped 33.1% according to the hand-held dynamometric measurement. Seven additional age-matched able-bodies were compared with participants’ to discriminate the influence of slow-walking. All participants underwent 3D gait analysis before and after the PS. Peak knee flexion angle, range of knee flexion between toe-off and peak knee flexion, total range of knee-flexion, and time of peak knee flexion in swing were selected to describe SKG pattern.ResultsAfter PS, the reduction of plantar flexor muscle strength (33.14%) caused knee flexion velocity drop at toe-off (p= 0.008) and developed SKG pattern by decreasing peak knee flexion (p=0.0001), range of knee flexion in early swing (p=0.006), and total knee flexion range (p=0.002). These parameters were significantly correlated with decreased PF velocity at toe-off (p=0.015, p=0.0001, p=0.005 respectively). The time of peak knee flexion was not significantly different between before and after stretch conditions (p=0.130).ConclusionsThese findings verified that plantar flexor weakness cause SKG pattern by completing three of SKG parameters. Any treatment protocol that weakens the plantar flexor muscle might impact the SKG pattern.



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Plantar flexor muscle weakness may cause stiff-knee gait

Publication date: Available online 28 March 2016
Source:Gait & Posture
Author(s): Adnan Apti, N. Ekin Akalan, Shavkat Kuchimov, Arzu Razak Özdinçler, Yener Temelli, Anand Nene
AimThe iterative simulation studies proclaim that plantar flexor (PF) muscle weakness is one of the contributors of stiff knee gait (SKG), although, whether isolated PF weakness generates SKG has not been validated in able-bodied people or individuals with neuromuscular disorders. The aim of the study was to investigate the effects of isolated PF muscle weakness on knee flexion velocity and SKG in healthy individuals.MethodTwenty able-bodied young adults (23±3 years) participated in this study. Passive stretch (PS) protocol was applied until the PF muscle strength dropped 33.1% according to the hand-held dynamometric measurement. Seven additional age-matched able-bodies were compared with participants’ to discriminate the influence of slow-walking. All participants underwent 3D gait analysis before and after the PS. Peak knee flexion angle, range of knee flexion between toe-off and peak knee flexion, total range of knee-flexion, and time of peak knee flexion in swing were selected to describe SKG pattern.ResultsAfter PS, the reduction of plantar flexor muscle strength (33.14%) caused knee flexion velocity drop at toe-off (p= 0.008) and developed SKG pattern by decreasing peak knee flexion (p=0.0001), range of knee flexion in early swing (p=0.006), and total knee flexion range (p=0.002). These parameters were significantly correlated with decreased PF velocity at toe-off (p=0.015, p=0.0001, p=0.005 respectively). The time of peak knee flexion was not significantly different between before and after stretch conditions (p=0.130).ConclusionsThese findings verified that plantar flexor weakness cause SKG pattern by completing three of SKG parameters. Any treatment protocol that weakens the plantar flexor muscle might impact the SKG pattern.



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