HLAA 2016 Convention Highlights the Academies and PCAST Reports

​The Hearing Loss As​sociation of America (HLAA) kicked off its 2016 National Convention in Washington, DC with a plenary session on recent groundbreaking reports issued by the National Academies of Sciences, Engineering, and Medicine (the Academies) and the President's Council of Advisors on Science and Technology Policy (PCAST).

More than 1,200 people attended the convention, which was also a joint event with The International Federation of Hard of Hearing People (IFHOH). Leading the plenary session was the Academies' Committee Chairperson Dr. Dan G. Blazer, who gave a comprehensive account of their findings and recommendations on hearing health care affordability and accessibility.

"Our goal was to say, 'People who are purchasing services, including purchases for hearing aid, need to know what they're paying for,' and that's the bottom line," said Dr. Blazer on the recommendation to unbundle audiologist and hearing aid charges.

"What we love about this report is that the person with hearing loss is front and center, and it really makes hearing loss a primary health concern – and that's what we've been talking about for a long time," HLAA Executive Director Barbara Kelley told The Hearing Journal. "Now we have a report that is evidence-based to back us up and we are really happy about that."

Dr. Susan Graham discussed the implications of the PCAST report, including the recommendation to modify FDA guidelines to allow over-the-counter "basic" hearing aid sale.

"Within the FDA, they have a lot of differing opinions about these issues – just as the audiology community has a lot of different opinions," Dr. Graham said. "But having the public speak up is always helpful."

Much of the PCAST report recommendations were sounded off in the Academies report.

"I think it's rather amazing that two very independent groups came to very similar conclusions," Dr. Blazer said. "These reports have the potential to have the legs to move if there is willingness to work together."

"There are oppositions from audiologists who are afraid of change in the business model and afraid they will lose their patients," Dr Graham told The Hearing Journal. "But they will have to change."

The two reports also stressed the importance of boosting access to hearing aid technology and personal sound amplification products.

"Our convention goers are people who want to learn about technology. They want to use amplification. They are motivated. They want to stay in the hearing world and they will do anything to help themselves hear well," explained Director Kelley. "We want to educate everybody and we hope to be able to take the lead in seeing that these recommendations be implemented."

Tags: convention, National Academies of Sciences, Engineering, and Medicine, PCAST

Published: 6/27/2016 2:07:00 PM

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HLAA 2016 Convention Highlights the Academies and PCAST Reports

​The Hearing Loss As​sociation of America (HLAA) kicked off its 2016 National Convention in Washington, DC with a plenary session on recent groundbreaking reports issued by the National Academies of Sciences, Engineering, and Medicine (the Academies) and the President's Council of Advisors on Science and Technology Policy (PCAST).

More than 1,200 people attended the convention, which was also a joint event with The International Federation of Hard of Hearing People (IFHOH). Leading the plenary session was the Academies' Committee Chairperson Dr. Dan G. Blazer, who gave a comprehensive account of their findings and recommendations on hearing health care affordability and accessibility.

"Our goal was to say, 'People who are purchasing services, including purchases for hearing aid, need to know what they're paying for,' and that's the bottom line," said Dr. Blazer on the recommendation to unbundle audiologist and hearing aid charges.

"What we love about this report is that the person with hearing loss is front and center, and it really makes hearing loss a primary health concern – and that's what we've been talking about for a long time," HLAA Executive Director Barbara Kelley told The Hearing Journal. "Now we have a report that is evidence-based to back us up and we are really happy about that."

Dr. Susan Graham discussed the implications of the PCAST report, including the recommendation to modify FDA guidelines to allow over-the-counter "basic" hearing aid sale.

"Within the FDA, they have a lot of differing opinions about these issues – just as the audiology community has a lot of different opinions," Dr. Graham said. "But having the public speak up is always helpful."

Much of the PCAST report recommendations were sounded off in the Academies report.

"I think it's rather amazing that two very independent groups came to very similar conclusions," Dr. Blazer said. "These reports have the potential to have the legs to move if there is willingness to work together."

"There are oppositions from audiologists who are afraid of change in the business model and afraid they will lose their patients," Dr Graham told The Hearing Journal. "But they will have to change."

The two reports also stressed the importance of boosting access to hearing aid technology and personal sound amplification products.

"Our convention goers are people who want to learn about technology. They want to use amplification. They are motivated. They want to stay in the hearing world and they will do anything to help themselves hear well," explained Director Kelley. "We want to educate everybody and we hope to be able to take the lead in seeing that these recommendations be implemented."

Tags: convention, National Academies of Sciences, Engineering, and Medicine, PCAST

Published: 6/27/2016 2:07:00 PM

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HLAA 2016 Convention Highlights the Academies and PCAST Reports

​The Hearing Loss As​sociation of America (HLAA) kicked off its 2016 National Convention in Washington, DC with a plenary session on recent groundbreaking reports issued by the National Academies of Sciences, Engineering, and Medicine (the Academies) and the President's Council of Advisors on Science and Technology Policy (PCAST).

More than 1,200 people attended the convention, which was also a joint event with The International Federation of Hard of Hearing People (IFHOH). Leading the plenary session was the Academies' Committee Chairperson Dr. Dan G. Blazer, who gave a comprehensive account of their findings and recommendations on hearing health care affordability and accessibility.

"Our goal was to say, 'People who are purchasing services, including purchases for hearing aid, need to know what they're paying for,' and that's the bottom line," said Dr. Blazer on the recommendation to unbundle audiologist and hearing aid charges.

"What we love about this report is that the person with hearing loss is front and center, and it really makes hearing loss a primary health concern – and that's what we've been talking about for a long time," HLAA Executive Director Barbara Kelley told The Hearing Journal. "Now we have a report that is evidence-based to back us up and we are really happy about that."

Dr. Susan Graham discussed the implications of the PCAST report, including the recommendation to modify FDA guidelines to allow over-the-counter "basic" hearing aid sale.

"Within the FDA, they have a lot of differing opinions about these issues – just as the audiology community has a lot of different opinions," Dr. Graham said. "But having the public speak up is always helpful."

Much of the PCAST report recommendations were sounded off in the Academies report.

"I think it's rather amazing that two very independent groups came to very similar conclusions," Dr. Blazer said. "These reports have the potential to have the legs to move if there is willingness to work together."

"There are oppositions from audiologists who are afraid of change in the business model and afraid they will lose their patients," Dr Graham told The Hearing Journal. "But they will have to change."

The two reports also stressed the importance of boosting access to hearing aid technology and personal sound amplification products.

"Our convention goers are people who want to learn about technology. They want to use amplification. They are motivated. They want to stay in the hearing world and they will do anything to help themselves hear well," explained Director Kelley. "We want to educate everybody and we hope to be able to take the lead in seeing that these recommendations be implemented."

Tags: convention, National Academies of Sciences, Engineering, and Medicine, PCAST

Published: 6/27/2016 2:07:00 PM

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The World’s Most Powerful Pair of Glasses—Part 2 of 3

We asked if you had been to seen the movie Finding Dory last week. Our specific interest was the marvelous capability of Bailey the beluga to use sound to locate objects. This bio sonar capability in toothed whales and dolphins has evolved to be so sophisticated that dolphins can detect a steel plate 1 square inch in size 100 meters away. After extolling the virtues of the use of bio sonar in these animals we left the readers with a puzzle.

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IU study finds testicular cancer survivors may have hearing loss after cisplatin therapy

Many testicular cancer survivors experience hearing loss after cisplatin-based chemotherapy, according to researchers at Indiana University.The researchers, led by Lois B. Travis, M.D., Sc.D.

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IU study finds testicular cancer survivors may have hearing loss after cisplatin therapy

Many testicular cancer survivors experience hearing loss after cisplatin-based chemotherapy, according to researchers at Indiana University.The researchers, led by Lois B. Travis, M.D., Sc.D.

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IU study finds testicular cancer survivors may have hearing loss after cisplatin therapy

Many testicular cancer survivors experience hearing loss after cisplatin-based chemotherapy, according to researchers at Indiana University.The researchers, led by Lois B. Travis, M.D., Sc.D.

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Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.

Related Articles

Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.

Int J Audiol. 2016 Jun 27;:1-5

Authors: Park MJ, Lee JR, Yang CJ, Yoo MH, Jin IS, Choi CH, Park HJ

Abstract
OBJECTIVE: Transcutaneous devices have a disadvantage, the dampening effect by soft tissue between the bone and devices. We investigated hearing outcomes with percutaneous and transcutaneous devices using test-bands in an induced unilateral conductive hearing loss.
DESIGN: Comparison of hearing outcomes of two devices in the same individuals.
STUDY SAMPLE: The right ear was plugged in 30 subjects and a test-band with devices (Cochlear™ Baha® BP110 Power and Sophono® Alpha-2 MPO™) was applied on the right mastoid tip with the left ear masked. Sound-field thresholds, speech recognition thresholds (SRTs), and word recognition scores (WRSs) were compared.
RESULTS: Aided thresholds of Sophono were significantly better than those of Baha at most frequencies. Sophono WRSs (86 ± 12%) at 40 dB SPL and SRTs (14 ± 5 dB HL) were significantly better than those (73 ± 24% and 23 ± 8 dB HL) of Baha. However, Sophono WRSs (98 ± 3%) at 60 dB SPL did not differ from Baha WRSs (95 ± 12%).
CONCLUSION: Amplifications of the current transcutaneous device were not inferior to those of percutaneous devices with a test-band in subjects with normal bone-conduction thresholds. Since the percutaneous devices can increase the gain when fixed to the skull by eliminating the dampening effect, both devices are expected to provide sufficient hearing amplification.

PMID: 27347717 [PubMed - as supplied by publisher]

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Paediatric tinnitus: The unmet clinical need.

Related Articles

Paediatric tinnitus: The unmet clinical need.

Int J Audiol. 2016 Jun 27;:1-2

Authors: Humphriss R, Hall A, Baguley D

PMID: 27347601 [PubMed - as supplied by publisher]

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Spectrum of DNA variants for non-syndromic deafness in a large cohort from multiple continents.

Related Articles

Spectrum of DNA variants for non-syndromic deafness in a large cohort from multiple continents.

Hum Genet. 2016 Jun 25;

Authors: Yan D, Tekin D, Bademci G, Foster J, Cengiz FB, Kannan-Sundhari A, Guo S, Mittal R, Zou B, Grati M, Kabahuma RI, Kameswaran M, Lasisi TJ, Adedeji WA, Lasisi AO, Menendez I, Herrera M, Carranza C, Maroofian R, Crosby AH, Bensaid M, Masmoudi S, Behnam M, Mojarrad M, Feng Y, Duman D, Mawla AM, Nord AS, Blanton SH, Liu XZ, Tekin M

Abstract
Hearing loss is the most common sensory deficit in humans with causative variants in over 140 genes. With few exceptions, however, the population-specific distribution for many of the identified variants/genes is unclear. Until recently, the extensive genetic and clinical heterogeneity of deafness precluded comprehensive genetic analysis. Here, using a custom capture panel (MiamiOtoGenes), we undertook a targeted sequencing of 180 genes in a multi-ethnic cohort of 342 GJB2 mutation-negative deaf probands from South Africa, Nigeria, Tunisia, Turkey, Iran, India, Guatemala, and the United States (South Florida). We detected causative DNA variants in 25 % of multiplex and 7 % of simplex families. The detection rate varied between 0 and 57 % based on ethnicity, with Guatemala and Iran at the lower and higher end of the spectrum, respectively. We detected causative variants within 27 genes without predominant recurring pathogenic variants. The most commonly implicated genes include MYO15A, SLC26A4, USH2A, MYO7A, MYO6, and TRIOBP. Overall, our study highlights the importance of family history and generation of databases for multiple ethnically discrete populations to improve our ability to detect and accurately interpret genetic variants for pathogenicity.

PMID: 27344577 [PubMed - as supplied by publisher]

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Identification of Adeno-associated viral vectors (AAV) that target neonatal and adult mammalian inner ear cell subtypes.

Related Articles

Identification of Adeno-associated viral vectors (AAV) that target neonatal and adult mammalian inner ear cell subtypes.

Hum Gene Ther. 2016 Jun 24;

Authors: Shu Y, Tao Y, Wang Z, Tang Y, Li H, Dai P, Gao G, Chen ZY

Abstract
The mammalian inner ear consists of diverse cell types with important functions. Gene mutations in these diverse cell types have been found to underlie different forms of genetic hearing loss. Targeting these mutations for gene therapy development represents a future therapeutic strategy to treat hearing loss. Adeno-associated viral vectors have become the vector of choice for gene delivery in animal models in vivo. To identify AAV vectors that target inner ear cell subtypes, we systemically screened 12 AAV vectors with different serotypes including AAV1, 2, 5, 6, 6.2, 7, 8, 9, rh.8, rh.10, rh.39 and rh.43 that carry a reporter gene GFP in neonatal and adult mice by microinjection in vivo. We found that most AAVs infect both neonatal and adult inner ear, with different specificities and expression levels. The inner ear cochlear sensory epithelial region, which includes auditory hair cells and supporting cells, is most frequently targeted for gene delivery. Expression of the transgene is sustained, and neonatal inner ear delivery does not adversely affect hearing. Adult inner ear injection of AAV has a similar infection pattern as the younger inner ear, with the exception that outer hair cell death caused by the injection procedure can lead to hearing loss. In the adult, more so than in the neonatal mice, cell types infected and efficiency of infection are correlated with the site of injection. Most infected cells survive in neonatal and adult inner ears. The study adds to the list of AAV vectors that transduce the mammalian inner ear efficiently, providing the tools that are important to study inner ear gene function and for the development of gene therapy to treat hearing loss.

PMID: 27342665 [PubMed - as supplied by publisher]

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Uncovering the acoustic vowel space of a previously undescribed language: The vowels of Nambo

This study presents the first acoustic description of the vowel space of a Papuan language—Nambo, spoken in southern Papua New Guinea—based on duration and first and second formant measurements from 19 adult male and female speakers across three age groups (young, middle-aged, senior). Phonemically, Nambo has six full vowels /i, e, æ, ɑ, o, u/ and a reduced vowel tentatively labeled /ə/. Unlike the full vowels, the quality of /ə/ showed great variation: seniors' and young females' realizations tended to be more open and retracted than those by young males, while middle-aged speakers' productions fell between these two variants.

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Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.

Related Articles

Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.

Int J Audiol. 2016 Jun 27;:1-5

Authors: Park MJ, Lee JR, Yang CJ, Yoo MH, Jin IS, Choi CH, Park HJ

Abstract
OBJECTIVE: Transcutaneous devices have a disadvantage, the dampening effect by soft tissue between the bone and devices. We investigated hearing outcomes with percutaneous and transcutaneous devices using test-bands in an induced unilateral conductive hearing loss.
DESIGN: Comparison of hearing outcomes of two devices in the same individuals.
STUDY SAMPLE: The right ear was plugged in 30 subjects and a test-band with devices (Cochlear™ Baha® BP110 Power and Sophono® Alpha-2 MPO™) was applied on the right mastoid tip with the left ear masked. Sound-field thresholds, speech recognition thresholds (SRTs), and word recognition scores (WRSs) were compared.
RESULTS: Aided thresholds of Sophono were significantly better than those of Baha at most frequencies. Sophono WRSs (86 ± 12%) at 40 dB SPL and SRTs (14 ± 5 dB HL) were significantly better than those (73 ± 24% and 23 ± 8 dB HL) of Baha. However, Sophono WRSs (98 ± 3%) at 60 dB SPL did not differ from Baha WRSs (95 ± 12%).
CONCLUSION: Amplifications of the current transcutaneous device were not inferior to those of percutaneous devices with a test-band in subjects with normal bone-conduction thresholds. Since the percutaneous devices can increase the gain when fixed to the skull by eliminating the dampening effect, both devices are expected to provide sufficient hearing amplification.

PMID: 27347717 [PubMed - as supplied by publisher]

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Paediatric tinnitus: The unmet clinical need.

Related Articles

Paediatric tinnitus: The unmet clinical need.

Int J Audiol. 2016 Jun 27;:1-2

Authors: Humphriss R, Hall A, Baguley D

PMID: 27347601 [PubMed - as supplied by publisher]

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Establishing a "Vestibular Migraine Diagnosis Questionnaire" and Testing Its Validity.

Related Articles

Establishing a "Vestibular Migraine Diagnosis Questionnaire" and Testing Its Validity.

Neurologist. 2016 Jul;21(4):51-54

Authors: Celebisoy N, Karapolat H, Gokcay F, Bilgen C, Ozgen G, Kirazli T, Kose T

Abstract
OBJECTIVE: To establish a questionnaire and check its validity and reliability for the diagnosis of vestibular migraine in patients reporting recurrent vestibular symptoms.
BACKGROUND: Vestibular migraine is the most common cause for recurrent spontaneous vertigo. However, it is still underdiagnosed needing validated and reliable screening instruments such as ID Migraine, that can be used in primary care settings, dizziness, and migraine clinics.
MATERIALS AND METHOD: Sixty consecutive patients referred to our dizziness clinic with recurring vestibular symptoms were given a questionnaire that they filled in, consisting of 8 short and simple questions. The questionnaire-based diagnosis was compared with the diagnosis based on face-to-face interview and clinical examination. Test stability was evaluated by asking the patients to fill in the questionnaire a week later during a second visit. κ analysis was used to assess item-specific test-retest reliability and also the conformity between the questionnaire-based diagnosis and the clinical diagnosis.
RESULTS: The conformity between the clinical diagnosis and the diagnosis based on the questionnaire was 83.3% and the κ coefficient was 0.666 (good). Sensitivity of the questionnaire was 82.8% (24/29) and the specificity was 83.9% (26/31). The κ values in test-retest repetition were good to excellent (0.71 to 0.87) when each question was considered.
CONCLUSIONS: The validity of the "Vestibular Migraine Diagnosis Questionnaire" was good and its reliability was good to excellent indicating that it can be used as a screening tool in identifying patients with vestibular migraine in our country.

PMID: 27348138 [PubMed - as supplied by publisher]

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Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.

Related Articles

Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.

Int J Audiol. 2016 Jun 27;:1-5

Authors: Park MJ, Lee JR, Yang CJ, Yoo MH, Jin IS, Choi CH, Park HJ

Abstract
OBJECTIVE: Transcutaneous devices have a disadvantage, the dampening effect by soft tissue between the bone and devices. We investigated hearing outcomes with percutaneous and transcutaneous devices using test-bands in an induced unilateral conductive hearing loss.
DESIGN: Comparison of hearing outcomes of two devices in the same individuals.
STUDY SAMPLE: The right ear was plugged in 30 subjects and a test-band with devices (Cochlear™ Baha® BP110 Power and Sophono® Alpha-2 MPO™) was applied on the right mastoid tip with the left ear masked. Sound-field thresholds, speech recognition thresholds (SRTs), and word recognition scores (WRSs) were compared.
RESULTS: Aided thresholds of Sophono were significantly better than those of Baha at most frequencies. Sophono WRSs (86 ± 12%) at 40 dB SPL and SRTs (14 ± 5 dB HL) were significantly better than those (73 ± 24% and 23 ± 8 dB HL) of Baha. However, Sophono WRSs (98 ± 3%) at 60 dB SPL did not differ from Baha WRSs (95 ± 12%).
CONCLUSION: Amplifications of the current transcutaneous device were not inferior to those of percutaneous devices with a test-band in subjects with normal bone-conduction thresholds. Since the percutaneous devices can increase the gain when fixed to the skull by eliminating the dampening effect, both devices are expected to provide sufficient hearing amplification.

PMID: 27347717 [PubMed - as supplied by publisher]

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Paediatric tinnitus: The unmet clinical need.

Related Articles

Paediatric tinnitus: The unmet clinical need.

Int J Audiol. 2016 Jun 27;:1-2

Authors: Humphriss R, Hall A, Baguley D

PMID: 27347601 [PubMed - as supplied by publisher]

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Multicenter Clinical Trial of Vibroplasty Couplers to Treat Mixed/Conductive Hearing Loss: First Results

Objective: To evaluate the safety and effectiveness of round window (RW), oval window (OW), CliP and Bell couplers for use with an active middle ear implant. Methods: This is a multicenter, long-term, prospective trial with consecutive enrollment, involving 6 university hospitals in Germany. Bone conduction, air conduction, implant-aided warble-tone thresholds and Freiburger monosyllable word recognition scores were compared with unaided preimplantation results in 28 moderate-to-profound hearing-impaired patients after 12 months of follow-up. All patients had previously undergone failed reconstruction surgeries (up to 5 or more). In a subset of patients, additional speech tests at 12 months postoperatively were used to compare the aided with the unaided condition after implantation with the processor switched off. An established quality-of-life questionnaire for hearing aids was used to determine patient satisfaction. Results: Postoperative bone conduction remained stable. Mean functional gain for all couplers was 37 dB HL (RW = 42 dB, OW = 35 dB, Bell = 38 dB, CliP = 27 dB). The mean postoperative Freiburger monosyllable score was 71% at 65 dB SPL. The postimplantation mean SRT₅₀ (speech reception in quiet for 50% understanding of words in sentences) improved on average by 23 dB over unaided testing and signal-to-noise ratios also improved in all patients. The International Outcome Inventory for Hearing Aids (IOI-HA)quality-of-life questionnaire was scored very positively by all patients. Conclusion: A significant improvement was seen with all couplers, and patients were satisfied with the device at 12 months postoperatively. These results demonstrate that an active implant is an advantage in achieving good hearing benefit in patients with prior failed reconstruction surgery.
Audiol Neurotol 2016;21:212-222

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Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.

Related Articles

Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss.

Int J Audiol. 2016 Jun 27;:1-5

Authors: Park MJ, Lee JR, Yang CJ, Yoo MH, Jin IS, Choi CH, Park HJ

Abstract
OBJECTIVE: Transcutaneous devices have a disadvantage, the dampening effect by soft tissue between the bone and devices. We investigated hearing outcomes with percutaneous and transcutaneous devices using test-bands in an induced unilateral conductive hearing loss.
DESIGN: Comparison of hearing outcomes of two devices in the same individuals.
STUDY SAMPLE: The right ear was plugged in 30 subjects and a test-band with devices (Cochlear™ Baha® BP110 Power and Sophono® Alpha-2 MPO™) was applied on the right mastoid tip with the left ear masked. Sound-field thresholds, speech recognition thresholds (SRTs), and word recognition scores (WRSs) were compared.
RESULTS: Aided thresholds of Sophono were significantly better than those of Baha at most frequencies. Sophono WRSs (86 ± 12%) at 40 dB SPL and SRTs (14 ± 5 dB HL) were significantly better than those (73 ± 24% and 23 ± 8 dB HL) of Baha. However, Sophono WRSs (98 ± 3%) at 60 dB SPL did not differ from Baha WRSs (95 ± 12%).
CONCLUSION: Amplifications of the current transcutaneous device were not inferior to those of percutaneous devices with a test-band in subjects with normal bone-conduction thresholds. Since the percutaneous devices can increase the gain when fixed to the skull by eliminating the dampening effect, both devices are expected to provide sufficient hearing amplification.

PMID: 27347717 [PubMed - as supplied by publisher]

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Paediatric tinnitus: The unmet clinical need.

Related Articles

Paediatric tinnitus: The unmet clinical need.

Int J Audiol. 2016 Jun 27;:1-2

Authors: Humphriss R, Hall A, Baguley D

PMID: 27347601 [PubMed - as supplied by publisher]

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Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss

10.1080/14992027.2016.1193234<br/>Marn Joon Park

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Paediatric tinnitus: The unmet clinical need

10.1080/14992027.2016.1190467<br/>Rachel Humphriss

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Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss

10.1080/14992027.2016.1193234<br/>Marn Joon Park

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Paediatric tinnitus: The unmet clinical need

10.1080/14992027.2016.1190467<br/>Rachel Humphriss

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Amplification of transcutaneous and percutaneous bone-conduction devices with a test-band in an induced model of conductive hearing loss

10.1080/14992027.2016.1193234<br/>Marn Joon Park

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Paediatric tinnitus: The unmet clinical need

10.1080/14992027.2016.1190467<br/>Rachel Humphriss

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An Easy and Reliable Method to Locate the Dehiscence During Middle Fossa Superior Canal Dehiscence Surgery: It is a (C)inch.

Objective: The middle fossa floor lacks reliable surface landmarks. In cases of superior semicircular canal dehiscence (SSCD), multiple skull base defects may be present, further confounding the location of the labyrinth. Misidentification of the SSCD during surgery may lead to treatment failure or sensorineural hearing loss. Anecdotally, the authors have observed the distance from the lateral edge of the craniotomy to the SSCD to be consistently 1 inch. Herein, we present radiologic evidence of this practical and clinically useful relationship. Patients: All patients at two tertiary care academic referral centers with high-resolution temporal bone computed tomography (CT) evidence of SSCD were retrospectively reviewed. Intervention(s): Review of high-resolution temporal bone CT. Main Outcome Measures: The horizontal distance from the outer cortex of the squama temporalis immediately superior to the bony external auditory canal (approximating lateral edge of craniotomy) to the SSCD was measured in the coronal plane by two independent reviewers. Results: A total of 151 adult ears with SSCD were analyzed. A Shapiro-Wilk goodness-of-fit test confirmed that measurements were normally distributed. Pearson inter-rater correlation was 0.95, confirming very strong agreement. The mean distance between the outer cortex of the squama temporalis and SSCD was 25.9 mm, or 1.02 inches. Sixty-eight percent of the SSCD population would fall between 0.92 and 1.12 inches and 95% would lie between 0.83 and 1.21 inches. Conclusions: The horizontal distance from the outer cortex of the squama temporalis to the SSCD consistently approximates 1 inch. This easily remembered distance can aid surgeons in locating or confirming the SSCD during middle fossa surgery. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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National Utilization and Forecasting of Ototopical Antibiotics: Medicaid Data Versus "Dr. Google".

Objectives: To forecast national Medicaid prescription volumes for common ototopical antibiotics, and correlate prescription volumes with internet user search interest using Google Trends (GT). Study Design: National United States Medicaid prescription and GT user search database analysis. Methods: Quarterly national Medicaid summary drug utilization data and weekly GT search engine data for ciprofloxacin-dexamethasone (CD), ofloxacin (OF), and Cortisporin (CS) ototopicals were obtained from January 2008 to July 2014. Time series analysis was used to assess prescription seasonality, Holt-Winter's method for forecasting quarterly prescription volumes, and Pearson correlations to compare GT and Medicaid data. Results: Medicaid prescription volumes demonstrated sinusoidal seasonality for OF (r2 = 0.91), CS (r2 = 0.71), and CD (r2 = 0.62) with annual peaks in July, August, and September. In 2017, OF was forecasted to be the most widely prescribed ototopical, followed by CD. CS was the least prescribed, and volumes were forecasted to decrease 9.0% by 2017 from 2014. GT user search interest demonstrated analogous sinusoidal seasonality and significant correlations with Medicaid data prescriptions for CD (r = 0.38, p = 0.046), OF (r = 0.74, p

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Electrode Location and Angular Insertion Depth Are Predictors of Audiologic Outcomes in Cochlear Implantation.

Objectives: 1) Investigate the impact of electrode type and surgical approach on scalar electrode location; and 2) examine the relation between electrode location and postoperative audiologic performance. Setting: Tertiary academic hospital. Patients: Two hundred twenty post-lingually deafened adults undergoing cochlear implant (CI). Main Outcome Measures: Primary outcome measures of interest were scalar electrode location and postoperative audiologic performance. Results: In 68% of implants, electrodes were observed to be located solely in the scala tympani (ST). Multivariate analysis demonstrated perimodiolar (PM) and mid-scala (MS) electrodes were 22.4 (95% CI: 6.3-80.0, p

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Revision Surgery for Superior Canal Dehiscence Syndrome.

Objective: To identify factors associated with surgical failure for superior canal dehiscence syndrome (SCDS) and define rates of complications and cure after revision SCDS repair. Study Design: Retrospective patient series. Setting: Tertiary care referral center. Patients: Adults who underwent revision surgery for SCDS. Interventions: None. Main Outcome Measures: Initial surgical approach, intraoperative findings at the time of revision, persistence of symptoms, and complications for revision surgery. Results: Two hundred twenty-two surgical SCDS patients were identified, including 21 subjects who underwent 23 revision surgeries. Fourteen (61%) underwent previous middle fossa and nine (39%) underwent previous transmastoid approaches. Intraoperative findings showed that in 17 (74%) the previous material used to plug or resurface the canal was present but not entirely covering the dehiscence. In one (4%) the material was not present. In one (4%) the material was in proper position, whereas in four (17%) the material was in proper position with very thin bone adjacent. After revision surgery, symptoms were completely resolved in eight (35%), partially resolved in seven (30%), and not resolved in seven (30%). Findings of thin bone adjacent to the previous plug was associated with failure of symptom resolution (p = 0.03). Hearing outcomes were compared to a previously studied cohort of primary surgery patients, and outcomes were similar. Three subjects (13%) had a significant decrease in their word recognition score after revision surgery (p=0.52), and seven (30%) had a significant increase in their pure-tone average (p=0.78). Conclusion: Revision surgery for SCDS can be curative in carefully selected patients, but there may be a higher failure rate than primary surgery, with similar hearing outcomes. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Risk Assessment and Prevention of Corneal Complications After Lateral Skull Base Surgery.

Objective: To analyze the rate of corneal complications after lateral skull base surgery, and the relative risk of each potential contributing factor. Study Design: Retrospective cohort study. Setting: Tertiary care center. Patients: Adult patients who had undergone lateral skull base surgery involving an otolaryngologist at our institution from 2007 to 2015. Intervention: None. Main Outcome Measure: Relative risk (RR) for each potential contributing factor to corneal complications. Results: Four hundred sixty nine patients met inclusion criteria. Of those, 35 developed mild exposure keratopathy, 13 developed moderate exposure keratopathy, and 5 developed severe exposure keratopathy. Age, sex, previous eye surgery, tumor side, and pathology were not significant predictors of keratopathy. Tumor size greater than 30 mm (RR 4.75), postoperative trigeminal palsy (RR 3.42), postoperative abducens palsy (RR 9.08), House-Brackman score 5-6 (RR 4.77), lagophthalmos (RR 11.85), ectropion (RR 4.29), and previous eye disease (RR 1.83) were all significantly associated with the development of corneal complications. On multivariate analysis, lagophthalmos, abducens palsy, and tumor size were independent predictors of keratopathy. Conclusions: There are several important risk factors for exposure keratopathy after lateral skull base surgery, and knowledge of these risk factors can help identify high-risk patients in whom early, aggressive preventative therapy is warranted. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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