Τετάρτη 22 Ιουνίου 2016

University Of Colorado Menieres

As anyone who has ever experienced problems with hearing loss can attest, it can be one of the most frustrating and debilitating conditions a person can experience. As a result, more and more research has been conducted in recent years to find out not only the causes of hearing issues, but how to prevent and hopefully have a cure for those who deal with these conditions. Some of the most promising research has been conducted at the University of Colorado, where researchers believe they have found not only what causes Meniere’s disease, but also how to treat it in an effective manner for most patients.

What is Meniere’s Disease?
According to University of Colorado Menieres researchers, Meniere’s disease is a disorder resulting in numerous violent attacks of dizziness, ear ringing, and hearing loss that can last for several hours and eventually cause permanent deafness in the affected ear. With anywhere from 3-5 million people suffering from this disorder, researchers are moving quickly to find ways to treat it and eliminate it entirely.

What Causes This Disorder?
University of Colorado Menieres researchers, based on years of studying patients as well as analyzing large amounts of data, believe they may finally know what causes this extremely debilitating disorder. Based on their results, they believe the disorder is caused by a combination of two major factors, which are:
–Malformation of inner ear
–Risk factors such as smoking, migraine headaches, and sleep apnea
Based on their findings, university scientists feel that as fluid begins to build up inside the inner ear, a pressure-regulation problem is created. As a result, this lowers blood flow to the brain and ear, which in many ways resembles that which occurs in stroke victims. However, while the fluctuations are not enough to cause a stroke, they are strong enough to trigger attacks of vertigo, tinnitus, and hearing loss.

Treating Meniere’s Disease
While researchers have made great strides in learning what may cause Meniere’s disease, University of Colorado Menieres scientists agree there is still much work to be done when it comes to treatment options. Some researchers believe many medicines now used to treat strokes or migraine headaches may be used effectively against Meniere’s disease, but many clinical trials will need to be conducted to see if this is a viable option. In the meantime, patients who have this disorder may benefit by using treatment options usually applied to sleep apnea, in addition to audio therapies used to lessen the effects of tinnitus. While major treatment options may still be years away, there is no doubt this research represents a tremendous breakthrough.



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Sudden sensorineural hearing loss with positional vertigo: Initial findings of positional nystagmus and hearing outcomes

10.1080/14992027.2016.1194532<br/>Chang-Hee Kim

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Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children

10.1080/14992027.2016.1190871<br/>Sara Båsjö

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Results using the OPAL strategy in Mandarin speaking cochlear implant recipients

10.1080/14992027.2016.1190872<br/>Andrew E. Vandali

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Audiology patient fall statistics and risk factors compared to non-audiology patients

10.1080/14992027.2016.1193235<br/>Robin E. Criter

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Sudden sensorineural hearing loss with positional vertigo: Initial findings of positional nystagmus and hearing outcomes

10.1080/14992027.2016.1194532<br/>Chang-Hee Kim

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Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children

10.1080/14992027.2016.1190871<br/>Sara Båsjö

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Results using the OPAL strategy in Mandarin speaking cochlear implant recipients

10.1080/14992027.2016.1190872<br/>Andrew E. Vandali

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Audiology patient fall statistics and risk factors compared to non-audiology patients

10.1080/14992027.2016.1193235<br/>Robin E. Criter

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Sudden sensorineural hearing loss with positional vertigo: Initial findings of positional nystagmus and hearing outcomes

10.1080/14992027.2016.1194532<br/>Chang-Hee Kim

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Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children

10.1080/14992027.2016.1190871<br/>Sara Båsjö

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Results using the OPAL strategy in Mandarin speaking cochlear implant recipients

10.1080/14992027.2016.1190872<br/>Andrew E. Vandali

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Audiology patient fall statistics and risk factors compared to non-audiology patients

10.1080/14992027.2016.1193235<br/>Robin E. Criter

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Sudden sensorineural hearing loss with positional vertigo: Initial findings of positional nystagmus and hearing outcomes

10.1080/14992027.2016.1194532<br/>Chang-Hee Kim

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Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children

10.1080/14992027.2016.1190871<br/>Sara Båsjö

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Results using the OPAL strategy in Mandarin speaking cochlear implant recipients

10.1080/14992027.2016.1190872<br/>Andrew E. Vandali

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Audiology patient fall statistics and risk factors compared to non-audiology patients

10.1080/14992027.2016.1193235<br/>Robin E. Criter

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Sudden sensorineural hearing loss with positional vertigo: Initial findings of positional nystagmus and hearing outcomes

10.1080/14992027.2016.1194532<br/>Chang-Hee Kim

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Hearing thresholds, tinnitus, and headphone listening habits in nine-year-old children

10.1080/14992027.2016.1190871<br/>Sara Båsjö

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Results using the OPAL strategy in Mandarin speaking cochlear implant recipients

10.1080/14992027.2016.1190872<br/>Andrew E. Vandali

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Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Laryngoscope. 2016 Jun 21;

Authors: Härkönen K, Kivekäs I, Rautiainen M, Kotti V, Vasama JP

Abstract
OBJECTIVES/HYPOTHESIS: To explore long-term hearing results, quality of life (QoL), quality of hearing (QoH), work-related stress, tinnitus, and balance problems after idiopathic sudden sensorineural hearing loss (ISSNHL).
STUDY DESIGN: Cross-sectional study.
METHODS: We reviewed the audiograms of 680 patients with unilateral ISSNHL on average 8 years after the hearing impairment, and then divided the patients into two study groups based on whether their ISSNHL had recovered to normal (pure tone average [PTA] ≤ 30 dB) or not (PTA > 30 dB). The inclusion criteria were a hearing threshold decrease of 30 dB or more in at least three contiguous frequencies occurring within 72 hours in the affected ear and normal hearing in the contralateral ear. Audiograms of 217 patients fulfilled the criteria. We reviewed their medical records; measured present QoL, QoH, and work-related stress with specific questionnaires; and updated the hearing status.
RESULTS: Poor hearing outcome after ISSNHL was correlated with age, severity of hearing loss, and vertigo together with ISSNHL. Quality of life and QoH were statistically significantly better in patients with recovered hearing, and the patients had statistically significantly less tinnitus and balance problems. During the 8-year follow-up, the PTA of the affected ear deteriorated on average 7 dB, and healthy ear deteriorated 6 dB.
CONCLUSION: Idiopathic sudden sensorineural hearing loss that failed to recover had a negative impact on long-term QoL and QoH. The hearing deteriorated as a function of age similarly both in the affected and the healthy ear, and there were no differences between the groups. The cumulative recurrence rate for ISSNHL was 3.5%.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2016.

PMID: 27328455 [PubMed - as supplied by publisher]



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Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Laryngoscope. 2016 Jun 21;

Authors: Härkönen K, Kivekäs I, Rautiainen M, Kotti V, Vasama JP

Abstract
OBJECTIVES/HYPOTHESIS: To explore long-term hearing results, quality of life (QoL), quality of hearing (QoH), work-related stress, tinnitus, and balance problems after idiopathic sudden sensorineural hearing loss (ISSNHL).
STUDY DESIGN: Cross-sectional study.
METHODS: We reviewed the audiograms of 680 patients with unilateral ISSNHL on average 8 years after the hearing impairment, and then divided the patients into two study groups based on whether their ISSNHL had recovered to normal (pure tone average [PTA] ≤ 30 dB) or not (PTA > 30 dB). The inclusion criteria were a hearing threshold decrease of 30 dB or more in at least three contiguous frequencies occurring within 72 hours in the affected ear and normal hearing in the contralateral ear. Audiograms of 217 patients fulfilled the criteria. We reviewed their medical records; measured present QoL, QoH, and work-related stress with specific questionnaires; and updated the hearing status.
RESULTS: Poor hearing outcome after ISSNHL was correlated with age, severity of hearing loss, and vertigo together with ISSNHL. Quality of life and QoH were statistically significantly better in patients with recovered hearing, and the patients had statistically significantly less tinnitus and balance problems. During the 8-year follow-up, the PTA of the affected ear deteriorated on average 7 dB, and healthy ear deteriorated 6 dB.
CONCLUSION: Idiopathic sudden sensorineural hearing loss that failed to recover had a negative impact on long-term QoL and QoH. The hearing deteriorated as a function of age similarly both in the affected and the healthy ear, and there were no differences between the groups. The cumulative recurrence rate for ISSNHL was 3.5%.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2016.

PMID: 27328455 [PubMed - as supplied by publisher]



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Tibiofemoral contact forces during walking, running and sidestepping

Publication date: Available online 21 June 2016
Source:Gait & Posture
Author(s): David J. Saxby, Luca Modenese, Adam L. Bryant, Pauline Gerus, Bryce Killen, Karine Fortin, Tim V. Wrigley, Kim L. Bennell, Flavia M. Cicuttini, David G. Lloyd
We explored the tibiofemoral contact forces and the relative contributions of muscles and external loads to those contact forces during various gait tasks. Second, we assessed the relationships between external gait measures and contact forces. A calibrated electromyographydriven neuromusculoskeletal model estimated the tibiofemoral contact forces during walking (1.44±0.22ms−1), running (4.38±0.42ms−1) and sidestepping (3.58±0.50ms−1) in healthy adults (n=60, 27.3±5.4years, 1.75±0.11m, and 69.8±14.0kg). Contact forces increased from walking (∼1–2.8 BW) to running (∼3–8 BW), sidestepping had largest maximum total (8.47±1.57 BW) and lateral contact forces (4.3±1.05 BW), while running had largest maximum medial contact forces (5.1±0.95 BW). Relative muscle contributions increased across gait tasks (up to 80–90% of medial contact forces), and peaked during running for lateral contact forces (∼90%). Knee adduction moment (KAM) had weak relationships with tibiofemoral contact forces (all R2<0.36) and the relationships were gait taskspecific. Step-wise regression of multiple external gait measures strengthened relationships (0.20<Radj2<0.78), but were variable across gait tasks. Step-wise regression equations from a particular gait task (e.g. walking) produced large errors when applied to a different gait task (e.g. running or sidestepping). Muscles well stabilized the knee, increasing their role in stabilization from walking to running to sidestepping. KAM was a poor predictor of medial contact force and load distributions. Step-wise regression models results suggest the relationships between external gait measures and contact forces cannot be generalized across tasks. Neuromusculoskeletal modelling may be required to examine tibiofemoral contact forces and role of muscle in knee stabilization across gait tasks.



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Pain catastrophizing and trunk muscle activation during walking in patients with chronic low back pain

Publication date: Available online 21 June 2016
Source:Gait & Posture
Author(s): Pakzad Mohamad, Fung Joyce, Preuss Richard
It has been hypothesized that individuals with low back pain (LBP) will have higher trunk muscle activity during gait, in an attempt to limit spine motion, and that this “guarding strategy” may be influenced by the person’s psychological response to pain. This study investigated whether the amplitude of trunk muscle activation differs between persons with chronic LBP and healthy individuals during walking, and whether changes in muscle activation were related to pain catastrophizing. Thirty persons with chronic non-specific LBP, stratified into 2 groups of high (HLBP) and low (LLBP) pain catastrophizing, were contrasted with a control group of 15 healthy individuals during walking on a treadmill at a self-selected speed. Surface electromyographic (EMG) data were recorded from 10 trunk muscles. The effects of Group and gait Sub-phase on EMG activation amplitudes were assessed. The HLBP group exhibited higher activation of certain muscles throughout the gait cycle, and reduced variability of others at specific sub-phases of gait. A significant correlation was found between activation amplitude and pain catastrophizing in most muscles, when controlling for gait speed and pain intensity. These data indicate that altered trunk muscle activation is present in some patients with LBP during walking, but does not represent a universal increase in activation for all muscles. This altered neuromotor control is, however, more strongly associated with pain catastrophizing than with pain intensity, and appears to represent a non-functional, maladaptive behavior, as it alters the normal, phasic pattern of activation in certain trunk muscles.



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Tibiofemoral contact forces during walking, running and sidestepping

Publication date: Available online 21 June 2016
Source:Gait & Posture
Author(s): David J. Saxby, Luca Modenese, Adam L. Bryant, Pauline Gerus, Bryce Killen, Karine Fortin, Tim V. Wrigley, Kim L. Bennell, Flavia M. Cicuttini, David G. Lloyd
We explored the tibiofemoral contact forces and the relative contributions of muscles and external loads to those contact forces during various gait tasks. Second, we assessed the relationships between external gait measures and contact forces. A calibrated electromyographydriven neuromusculoskeletal model estimated the tibiofemoral contact forces during walking (1.44±0.22ms−1), running (4.38±0.42ms−1) and sidestepping (3.58±0.50ms−1) in healthy adults (n=60, 27.3±5.4years, 1.75±0.11m, and 69.8±14.0kg). Contact forces increased from walking (∼1–2.8 BW) to running (∼3–8 BW), sidestepping had largest maximum total (8.47±1.57 BW) and lateral contact forces (4.3±1.05 BW), while running had largest maximum medial contact forces (5.1±0.95 BW). Relative muscle contributions increased across gait tasks (up to 80–90% of medial contact forces), and peaked during running for lateral contact forces (∼90%). Knee adduction moment (KAM) had weak relationships with tibiofemoral contact forces (all R2<0.36) and the relationships were gait taskspecific. Step-wise regression of multiple external gait measures strengthened relationships (0.20<Radj2<0.78), but were variable across gait tasks. Step-wise regression equations from a particular gait task (e.g. walking) produced large errors when applied to a different gait task (e.g. running or sidestepping). Muscles well stabilized the knee, increasing their role in stabilization from walking to running to sidestepping. KAM was a poor predictor of medial contact force and load distributions. Step-wise regression models results suggest the relationships between external gait measures and contact forces cannot be generalized across tasks. Neuromusculoskeletal modelling may be required to examine tibiofemoral contact forces and role of muscle in knee stabilization across gait tasks.



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Pain catastrophizing and trunk muscle activation during walking in patients with chronic low back pain

Publication date: Available online 21 June 2016
Source:Gait & Posture
Author(s): Pakzad Mohamad, Fung Joyce, Preuss Richard
It has been hypothesized that individuals with low back pain (LBP) will have higher trunk muscle activity during gait, in an attempt to limit spine motion, and that this “guarding strategy” may be influenced by the person’s psychological response to pain. This study investigated whether the amplitude of trunk muscle activation differs between persons with chronic LBP and healthy individuals during walking, and whether changes in muscle activation were related to pain catastrophizing. Thirty persons with chronic non-specific LBP, stratified into 2 groups of high (HLBP) and low (LLBP) pain catastrophizing, were contrasted with a control group of 15 healthy individuals during walking on a treadmill at a self-selected speed. Surface electromyographic (EMG) data were recorded from 10 trunk muscles. The effects of Group and gait Sub-phase on EMG activation amplitudes were assessed. The HLBP group exhibited higher activation of certain muscles throughout the gait cycle, and reduced variability of others at specific sub-phases of gait. A significant correlation was found between activation amplitude and pain catastrophizing in most muscles, when controlling for gait speed and pain intensity. These data indicate that altered trunk muscle activation is present in some patients with LBP during walking, but does not represent a universal increase in activation for all muscles. This altered neuromotor control is, however, more strongly associated with pain catastrophizing than with pain intensity, and appears to represent a non-functional, maladaptive behavior, as it alters the normal, phasic pattern of activation in certain trunk muscles.



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Tibiofemoral contact forces during walking, running and sidestepping

Publication date: Available online 21 June 2016
Source:Gait & Posture
Author(s): David J. Saxby, Luca Modenese, Adam L. Bryant, Pauline Gerus, Bryce Killen, Karine Fortin, Tim V. Wrigley, Kim L. Bennell, Flavia M. Cicuttini, David G. Lloyd
We explored the tibiofemoral contact forces and the relative contributions of muscles and external loads to those contact forces during various gait tasks. Second, we assessed the relationships between external gait measures and contact forces. A calibrated electromyographydriven neuromusculoskeletal model estimated the tibiofemoral contact forces during walking (1.44±0.22ms−1), running (4.38±0.42ms−1) and sidestepping (3.58±0.50ms−1) in healthy adults (n=60, 27.3±5.4years, 1.75±0.11m, and 69.8±14.0kg). Contact forces increased from walking (∼1–2.8 BW) to running (∼3–8 BW), sidestepping had largest maximum total (8.47±1.57 BW) and lateral contact forces (4.3±1.05 BW), while running had largest maximum medial contact forces (5.1±0.95 BW). Relative muscle contributions increased across gait tasks (up to 80–90% of medial contact forces), and peaked during running for lateral contact forces (∼90%). Knee adduction moment (KAM) had weak relationships with tibiofemoral contact forces (all R2<0.36) and the relationships were gait taskspecific. Step-wise regression of multiple external gait measures strengthened relationships (0.20<Radj2<0.78), but were variable across gait tasks. Step-wise regression equations from a particular gait task (e.g. walking) produced large errors when applied to a different gait task (e.g. running or sidestepping). Muscles well stabilized the knee, increasing their role in stabilization from walking to running to sidestepping. KAM was a poor predictor of medial contact force and load distributions. Step-wise regression models results suggest the relationships between external gait measures and contact forces cannot be generalized across tasks. Neuromusculoskeletal modelling may be required to examine tibiofemoral contact forces and role of muscle in knee stabilization across gait tasks.



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Pain catastrophizing and trunk muscle activation during walking in patients with chronic low back pain

Publication date: Available online 21 June 2016
Source:Gait & Posture
Author(s): Pakzad Mohamad, Fung Joyce, Preuss Richard
It has been hypothesized that individuals with low back pain (LBP) will have higher trunk muscle activity during gait, in an attempt to limit spine motion, and that this “guarding strategy” may be influenced by the person’s psychological response to pain. This study investigated whether the amplitude of trunk muscle activation differs between persons with chronic LBP and healthy individuals during walking, and whether changes in muscle activation were related to pain catastrophizing. Thirty persons with chronic non-specific LBP, stratified into 2 groups of high (HLBP) and low (LLBP) pain catastrophizing, were contrasted with a control group of 15 healthy individuals during walking on a treadmill at a self-selected speed. Surface electromyographic (EMG) data were recorded from 10 trunk muscles. The effects of Group and gait Sub-phase on EMG activation amplitudes were assessed. The HLBP group exhibited higher activation of certain muscles throughout the gait cycle, and reduced variability of others at specific sub-phases of gait. A significant correlation was found between activation amplitude and pain catastrophizing in most muscles, when controlling for gait speed and pain intensity. These data indicate that altered trunk muscle activation is present in some patients with LBP during walking, but does not represent a universal increase in activation for all muscles. This altered neuromotor control is, however, more strongly associated with pain catastrophizing than with pain intensity, and appears to represent a non-functional, maladaptive behavior, as it alters the normal, phasic pattern of activation in certain trunk muscles.



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Outcomes of Transmastoid Surgery for Superior Semicircular Canal Dehiscence Syndrome.

Objective: To present the management strategy and outcomes for our series of superior semicircular canal dehiscence syndrome (SSCDS) patients. Study Design: Retrospective cross-sectional study. Setting: Tertiary referral center. Patients: Thirty-seven consecutive patients referred from June 2011 to January 2015. Diagnosis of SSCDS based on presence of classical symptoms, computerized tomography, and concordant reduction in cervical vestibular evoked myogenic potentials. Interventions: Transmastoid resurfacing or plugging. Main Outcome Measures: Pre- and postoperative pure tone audiometry. Nine item questionnaire grading pre- and postoperative symptom severity. Results of a short semi-structured telephone survey. Results: Twenty surgical patients: 13 women and 7 men. Mean age 52 years 6 months. Eighteen patients underwent transmastoid resurfacing and two underwent transmastoid plugging. Three of those who initially had resurfacing but had ongoing SSCD symptoms, subsequently had transmastoid plugging with complete resolution of third window symptoms. From the questionnaire there was improvement in mean scores for 8 of 9 of the SSCD symptoms, with statistically significant improvement in 6 of 9. Conclusions: Management strategies and surgical techniques continue to evolve for SSCDS. We currently offer transmastoid resurfacing having informed patients of a 25% possibility of incomplete symptom resolution, and explain that plugging can be performed as a "second stage," if necessary. However, as we accrue more experience and there is more evidence from the literature we are considering whether to offer transmastoid plugging as our primary surgical procedure. In our experience, patients with multiple vestibular pathologies or atypical vestibular symptoms are the ones for whom SSCD surgery has not been curative, although they do report improvement in their SSCD symptoms. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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