Auditory Brainstem Implantation in Chinese Patients With Neurofibromatosis Type II: The Hong Kong Experience

Objective: To describe our experience and outcomes of auditory brainstem implantation (ABI) in Chinese patients with Neurofibromatosis Type II (NF2). Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: Patients with NF2 who received ABIs. Results: Between 1997 and 2014, eight patients with NF2 received 9 ABIs after translabyrinthine removal of their vestibular schwannomas. One patient did not have auditory response using the ABI after activation. Environmental sounds could be differentiated by six (75%) patients after 6 months of ABI use (mean score 46% [range 28–60%]), and by five (63%) patients after 1 year (mean score 57% [range 36–76%]) and 2 years of ABI use (mean score 48% [range 24–76%]). Closed-set word identification was possible in four (50%) patients after 6 months (mean score 39% [range 12–72%]), 1 year (mean score 68% [range 48–92%]), and 2 years of ABI use (mean score 62% [range 28–100%]). No patient demonstrated open-set sentence recognition in quiet in the ABI-only condition. However, the use of ABI together with lip-reading conferred an improvement over lip-reading alone in open-set sentence recognition scores in two (25%) patients after 6 months of ABI use (mean improvement 46%), and five (63%) patients after 1 year (mean improvement 25%) and 2 years of ABI use (mean improvement 28%). At 2 years postoperatively, three (38%) patients remained ABI users. Conclusion: This is the only published study to date examining ABI outcomes in Cantonese-speaking Chinese NF2 patients and the data seems to show poorer outcomes compared with English-speaking and other nontonal language-speaking NF2 patients. Environmental sound awareness and lip-reading enhancement are the main benefits observed in our patients. More work is needed to improve auditory implant speech-processing strategies for tonal languages and these advancements may yield better speech perception outcomes in the future.

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In Memoriam: John K. Niparko, MD, 1954 to 2016

No abstract available

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Mary Gantz, 1949–2016, A Friend to So Many…

No abstract available

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An Unusual Complication of Stapes Surgery

No abstract available

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Book Review

No abstract available

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Cochlear Patency After Transmastoid Labyrinthectomy for Ménière's Syndrome

Objective: Labyrinthectomy is considered the “gold standard” in the treatment of intractable vertigo attacks because of Ménière's Disease (MD) but sacrifices all residual hearing. Interest in auditory rehabilitation has lead to cochlear implantation in some patients. Concern remains that the cochlear lumen may fill with tissue or bone after surgery. This study sought to determine the incidence of obliteration of the cochlea after transmastoid labyrinthectomy. Study Design: Retrospective observational study. Setting: Tertiary referral center. Patients: Eighteen patients with intractable vertigo from MD who underwent surgery. Interventions: Transmastoid labyrinthectomy between 2008 and 2013. Cochleas were imaged with unenhanced, heavily T2-weighted magnetic resonance imaging (MRI). Main Outcome Measure: Presence of symmetrical cochlear fluid signals on MRI. Results: There was no loss of fluid signal in the cochleas of operated ear compared with the contralateral, unoperated ear in any subject an average of 3 years (standard deviation [SD]: 1.2) after surgery. Five of 18 patients had the vestibule blocked with bone wax at the time of surgery. Blocking the vestibule with bone wax did not change the cochlear fluid signal. Conclusion: The risk of cochlear obstruction after labyrinthectomy for MD is very low. The significance of this finding is that patients with MD who undergo labyrinthectomy will likely remain candidates for cochlear implantation in the labyrinthectomized ear long after surgery if this becomes needed. Immediate cochlear implantation or placement of a cochlear lumen keeper during labyrinthectomy for MD is probably not necessary.

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Botulinum Toxin Treatment of Objective Tinnitus Because of Essential Palatal Tremor: A Systematic Review

Introduction: In contrast to subjective tinnitus, objective tinnitus can be heard by the examiner as well as by the patient. It can be triggered by, among many other etiologies, idiopathic muscular tremor in the soft palate, the essential palatal tremor (EPT). Many treatment modalities have been investigated, of which only Botulinum toxin (BT) injections have shown promising results. Goal: The aim of this study was to evaluate the effect of BT treatment on objective tinnitus due to EPT by a systematic review of the literature. Methods: In accordance with PRISMA guideline a systematic literature search in three databases was performed. Results: Twenty-two studies fulfilled the inclusion criteria, mainly case reports and case series. A total of 51 BT treated patients diagnosed with EPT were identified in the literature. The studies were evaluated with focus on diagnostics, injection technique and BT dose, follow-up, effect on objective tinnitus, complications, and adverse effects. Conclusions: The included studies suffer from an extremely low evidence level with several sources of bias. When optimally injected, BT seems to be an effective treatment of objective tinnitus due to EPT, with few adverse effects and complications. We suggest BT injections as first choice in case of EPT and present a guideline regarding diagnostics, treatment, and follow-up.

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FleQ, a Transcriptional Activator, Is Required for Biofilm Formation In Vitro But Does Not Alter Virulence in a Cholesteatomas Model

Hypothesis: Bacterial biofilm formation within cholesteatomas is responsible for increased persistence and tissue destruction and Pseudomonas aeruginosa deficient in biofilm formation (PAO1 ΔfleQ) are less virulent than the parent bacteria. Background: Infected aural cholesteatomas have been demonstrated to be more destructive than uninfected cholesteatomas and infections are more persistent. The chronicity and persistence of infections within cholesteatomas may be because of the presence of biofilm formation. Methods: Twenty-seven mutant strains of PAO1 were screened for surface adherence. These strains were also screened for static biofilm formation. The biofilms were quantified by staining with crystal violet. Aural cholesteatomas were then induced in Mongolian gerbils by ligation of the ear canal. At the time of ligation, the ear canals were inoculated with wild-type PAO1 and a biofilm deficient PAO1 ΔfleQ strain of P. aeruginosa. A 7 weeks course of ciprofloxacin (20 mg/kg/day) was started on postoperative day 7. Eight weeks after induction of cholesteatomas, the cholesteatoma size, levels of bone destruction, and levels of bone remodeling were evaluated using microCT imaging. Results: PAO1 ΔfleQ was identified as a poorly adherent and deficient biofilm forming mutant strain of P. aeruginosa. Infected cholesteatomas had more growth, bone destruction and bone remodeling than uninfected cholesteatomas. However, there was no difference observed between cholesteatomas infected with PAO1 (biofilm competent strain) and PAO1 ΔfleQ (biofilm deficient strain). Conclusion: We demonstrate that the biofilm phenotype is not an important virulence factor in cholesteatomas infected with P. aeruginosa.

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A Systematic Review on Complications of Tissue Preservation Surgical Techniques in Percutaneous Bone Conduction Hearing Devices

Objective: To investigate skin-related postoperative complications from tissue preservation approaches in percutaneous bone conduction device (BCD) implantations. Data Sources: PubMed, Embase, and Cochrane Library. Study Selection: We identified studies on BCDs including the opted surgical technique and derived complications. Retrieved articles were screened using predefined inclusion criteria. Critical appraisal included directness of evidence and risk of bias. Studies that successfully passed critical appraisal were included. Data Extraction: Outcome measures included patient demographics, surgery time, follow-up time, and complications reported by Holgers classification. Data Synthesis: We selected 18 articles for data extraction; encompassing 381 BCDs implanted using non-skin thinning approaches. Four studies reported an implantation technique using the punch method (81 implants), 13 studies applied the linear incision technique without soft tissue reduction (288 implants) and one study used the Weber technique (12 implants). Holgers 3 was described in 2.5% following the punch technique, in 5.9% following the linear incision technique, and in no implants following the Weber technique. One patient was mentioned having Holgers 4, skin overgrowth was reported in 6 patients, and 10 studies compared their non-skin thinning technique with a skin-thinning technique. Overall, the soft tissue preservation technique had a similar or superior complication rate, shorter surgical time, and better and faster healing, compared with the soft tissue reduction technique. Conclusion: Tissue preservation surgical techniques for percutaneous BCDs have limited postoperative skin complication rates. Moreover, these techniques are suggested to have at least similar complications rates compared with skin-thinning techniques.

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Imaging Characteristics of Cerebellopontine Angle Chloroma

No abstract available

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Type I Tympanoplasty Meta-Analysis: A Single Variable Analysis

Objective: To determine which independent variables influence the efficacy of type I tympanoplasty in adult and pediatric populations. Data Sources: A search of the PubMed database and Cochrane Database of Systematic Reviews using the key words “tympanoplasty OR myringoplasty” from January 1966 to July 2014 was performed. Study Selection: Studies reporting outcomes of myringoplasty or Type I tympanoplasty in primary non-cholesteatomatous chronic tympanic membrane (TM) perforation were included. Data Extraction: Of 4,698 abstracts reviewed, 214 studies involving 26,097 patients met our inclusion criteria and contributed to meta-analysis. Data Synthesis: The primary outcome of success was defined as closure rate at 12 months. The independent variables analyzed were age, follow-up period, approach, graft material, perforation cause, size, location, ear dryness, and surgical technique. Only those studies providing data on a given parameter of interest could be included when comparing each variable. Conclusion: The weighted average success rate of tympanic closure was 86.6%. Based on this meta-analysis, pediatric surgery has a 5.8% higher failure rate than adults and there is no correlation between follow-up period and success. Other variables associated with improved closure rates include perforation with a size less than 50% of total area (improved by 6.1%) and the use of cartilage as a graft (improved by 2.8% compared with fascia), while ears that were operated on while still discharging, those in different locations of the pars tensa, or using different surgical approaches or techniques did not have significantly different outcomes.

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Using Balance Function to Screen for Vestibular Impairment in Children With Sensorineural Hearing Loss and Cochlear Implants

Objectives: 1) To determine if bilateral vestibular dysfunction can be predicted by performance on standardized balance tasks in children with sensorineural hearing loss (SNHL) and cochlear implants (CI). 2) To provide clinical recommendations for screening for vestibular impairment in children with SNHL. Study Design: Retrospective cohort study. Setting: Tertiary care pediatric implant center. Patients: Pediatric patients (4.8–18.6 years) with profound SNHL using CIs. Interventions: Vestibular end-organ (horizontal canal and otoliths), and balance assessment. Main Outcome Measures: Comparison of balance skills, measured by the Bruininks Oseretsky Test of Motor Proficiency II (BOT-2), was performed between two groups of children with SNHL and CI: 1) total bilateral vestibular loss (TBVL) (n = 45), and 2) normal bilateral vestibular function (n = 20). Sensitivity, specificity, and suitability of each task as a screening tool for the detection of TBVL were assessed. Results: Balance as measured by the BOT-2 balance subtest was significantly poorer in children with TBVL then those with normal vestibular function (p 

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TeleAudiology in the Veterans Health Administration

Objective: To assess effectiveness of TeleAudiology for hearing aid services. Study Design: Retrospective case-control. Setting: Ambulatory Veterans Health Administration and Community-Based Outpatient Clinics (CBOCs). Patients: 42,697 veterans who received hearing aids from January through September, 2014. Intervention(s): TeleAudiology (TA) and conventional in-person (IP) audiology care. Main Outcome Measure(s): International Outcome Inventory for Hearing Aids (IOI-HA) outcomes data. The IOI-HA is a 7-item survey used to assess hearing aid effectiveness. Scored from 7 to 35 points, higher scores are more favorable. Results: Among veterans nationwide who received hearing aids and completed the IOI-HA survey, 1,009 received TA and 41,688 received IP care. TA and IP groups have comparable mean IOI-HA values (TA = 29.6, SD = 3.9; IP = 28.7, SD = 4.2). Although comparison showed a statistically significant difference (p  0.05, t test). Conclusion: TA and IP encounters to provide hearing aid services to veterans are comparable, as both are highly effective based on IOI-HA results. The noninferiority of TA suggests its adoption to non-veterans may improve access while preserving high satisfaction. Financial impact of migration to TA will require future econometric analysis.

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Petroclival Chondrosarcoma: A Multicenter Review of 55 Cases and New Staging System

Objective: To analyze clinical outcomes after treatment of petroclival chondrosarcoma and to propose a novel staging system. Study Design: Retrospective case review, 1995 to 2015. Setting: Multicenter study. Patients: Consecutive patients with histopathologically proven petroclival chondrosarcoma. Intervention(s): Microsurgery, endoscopic endonasal surgery, radiation therapy, observation. Main Outcome Measures: Disease- and treatment-associated morbidity, recurrence, mortality. Results: Fifty-five patients (mean age 42 years; 56% women) presenting with primary or recurrent petroclival chondrosarcoma were analyzed. The mean duration of follow-up was 74 months. Among 47 primary cases, the most common presenting symptoms were headache (55%) and diplopia (49%) and the mean tumor size at diagnosis was 3.3 cm. Subtotal resection was performed in 33 (73%) patients and gross total resection in 12 (27%). Adjuvant postoperative radiation was administered in 30 (64%) cases. Preoperative cranial neuropathy improved in 13 (29%), worsened in 11 (24%), and remained stable in 21 (47%) patients; notably, 11 preoperative sixth nerve palsies resolved after treatment. Nine recurrences occurred at a mean of 42 months. The 1-, 3-, 5- and 10-year recurrence-free survival rate for all 45 patients who underwent primary microsurgery with or without adjuvant radiation therapy was 97%, 89%, 70%, and 56%, respectively. Higher tumor stage, larger categorical size (

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Long-term Follow-up Study of the Sandwich Cartilage Shoe Technique in Cases of Insecure Stapes Footplate

Objective: Analysis of the audiometric results after repair of a defective footplate with the sandwich cartilage shoe technique in a follow-up study. Study Design: Retrospective analysis of audiometric data. Setting: Hospital. Patients: The cohort consisted of 12 patients, who underwent ossicular reconstruction after sandwich cartilage shoe technique in a case of insecure stapes footplate. The mean age was 42.7 years with an equal sex distribution. In every patient, cholesteatoma was the reason for surgery with 75% being revision cases. Intervention: Sandwich cartilage shoe technique in case of insecure stapes footplate at the department of otorhinolaryngology, head and neck surgery at the University of Cologne over an 8-year period (2007–2015). Main Outcome Measure: The use of the “sandwich cartilage shoe technique” in case of a broken or unstable footplate allows a safe occlusion of the open vestibule. Results: The statistical analysis revealed a significant improvement of the pure-tone average (p = 0.011) and air-bone gap (ABG) (p = 0.016) after total ossicular replacement prosthesis (TORP) implantation. The hearing was stable at 9 months of follow up. Conclusion: The sandwich cartilage shoe technique offers a safe and effective option as a two-stage procedure in treating patients with fractures of the stapes footplate in case of chronic otitis media. In view of the possible risk of deafness going along with a destruction of an inner ear window, our results can be considered substantial as all our patients will at least be able to regain “social hearing” as they all either achieved a hearing threshold is less than 30 dB or can be sufficiently supplied with a conventional hearing aid.

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Prevalence of Cochlear-Facial Dehiscence in a Study of 1,020 Temporal Bone Specimens

Objective: To determine the prevalence of cochlear-facial dehiscence (CFD) and to examine the influence of otic capsule area, age, sex, and race on CFD. Study Design: Descriptive study of archived temporal bone specimens. Materials and Methods: Targeted sections from 1,020 temporal bone specimens were scanned and examined for CFD. Cochlear-facial partition width (CFPW) and otic capsule area (OCA), a marker of bone thickness, were measured using image analysis software. Demographic data were analyzed using multiple linear regression analysis. Results: The mean CFPW was 0.23 mm (range, 0–0.92 mm; SD, 0.15 mm). Six patients were completely dehiscent (0.59%). Fallopian canal width, age, sex, race, and OCA were found to be significant predictors of CFPW. Age was found to be negatively correlated with CFPW (β = −0.001) (p 

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Stapedotomy With Adipose Tissue Seal: Hearing Outcomes, Incidence of Sensorineural Hearing Loss, and Comparison to Alternative Techniques

Objective: To evaluate hearing outcomes and incidence of sensorineural hearing loss (SNHL) after stapedotomy with adipose tissue seal, and to compare adipose tissue sealing with alternative techniques. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: Primary stapedotomy was performed in 179 patients using a KTP laser, microdrill, piston prosthesis, and adipose tissue seal of the oval window fenestra between 1991 and 2015. An additional 123 patients underwent stapes surgery with alternative techniques. Interventions: Stapes surgery for otosclerosis. Audiograms were performed preoperatively and 3 months postoperatively. Main Outcome Measures: Hearing outcomes were measured as percentage of cases with closure of the air-bone gap (ABG) to within 10 and 15 dB. SNHL was identified as cases with decrement in bone conduction thresholds greater than 10 or 5 dB. The median postoperative ABG and change in bone conduction thresholds were compared between the primary stapedotomy group (KTP laser with adipose tissue seal) and various subgroups with alternative techniques. Results: We found excellent hearing outcomes after primary stapedotomy with adipose tissue seal. The ABG closed to within 10 dB in 81.01% of cases and within 15 dB in 93.30% of cases. We observed a low rate of SNHL without any cases of profound hearing loss. 1.67% of cases had a decrement in bone conduction greater than 10 dB while 6.14% of cases had a decrement greater than 5 dB. Stapedotomy with adipose tissue seal compared favorably with alternative techniques with respect to hearing outcomes and SNHL. Conclusions: Adipose tissue is an effective and cost-efficient tissue seal during stapedotomy with excellent hearing outcomes and low incidence of SNHL.

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Tinnitus Treatment Trends

Objective: The American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) recently published guidelines on the treatment of tinnitus. This paper examines the possible impact of those guidelines on otologic practice. Design: A survey was sent to the members of the American Neurotology Society before and after the publication of Clinical practice guideline: tinnitus. The goals of this study were to see if the guidelines changed attitudes of otologists, confirm what treatments and explanations are being used in the field before and after the guidelines were published. Main Outcomes: Five hundred fifty-eight surveys were sent out and there were 216 responses. Otologists generally seemed to practice in accordance with the recommendations of the guidelines even before these were published. Drugs and sound therapies were not commonly used for primary tinnitus either before or after publication of the guidelines. One treatment that otologists seemed to have confidence in that was omitted from the guidelines was surgical treatment of hearing loss. Conclusion: Opinions regarding the treatment of tinnitus vary considerably. The AAO-HNS clinical practice guideline: tinnitus has not significantly altered the practices of otologists, but the guidelines provide meaningful, important information for other clinicians who deal infrequently with tinnitus.

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Focal Endolymphatic Hydrops as Seen in the Pars Inferior of the Human Inner Ear

Hypothesis: Endolymphatic hydrops of the human inner ear may be localized focally in the pars inferior of the human inner ear. Background: Endolymphatic hydrops may be found in the human inner ear in patients who in life had suffered from Ménière's syndrome or a variety of other disorders. The degree of endolymphatic hydrops may differ based on location in the inner ear. Methods: A computer-assisted search of all cases in the collection of the Massachusetts Eye and Ear Infirmary in which endolymphatic hydrops was found in the inner ear yielded 13 specimens in which there was good evidence for focal endolymphatic hydrops in the pars inferior. Temporal bones were prepared for light microscopy. Semi-serial sections were reviewed to generate localization data for endolymphatic hydrops and also to search for evidence of a previous inflammatory process, including fibrosis or new bone formation. Results: Endolymphatic hydrops was present in the saccule in 10 of 13 specimens. In the cochlear duct, there were segments of the cochlea in which there was no cochlear hydrops juxtaposed to other regions in which there was severe endolymphatic hydrops. Transition between hydropic and non-hydropic status in the cochlear duct was often abrupt. Evidence for a previous inflammation process was found in 6 of 13 specimens including fibrosis because of temporal bone fracture, or traumatic stapedectomy and in those cases in which the cause of hearing loss was idiopathic, fibrosis, and osteoid between the labyrinthine surface of the footplate and the hydropic saccular wall, and/or osteoid in the scala vestibuli, or in the proximate Rosenthal's canal. Evidence of a previous inflammatory process was uniformly seen in the perilymphatic compartment. Conclusions: Endolymphatic hydrops of the pars inferior in the human may have a focal distribution. This study suggests that the pathogenesis of endolymphatic hydrops is unlikely to be because of distal obstruction of longitudinal flow and was more consistent with the hypothesis that homeostasis of the endolymphatic and perilymphatic volumes occurs all along the cochlear duct. Other factors including variable distensibility of Reissner's membrane or disturbance of local solute homeostatic mechanisms may be responsible for wide variations in the degree of hydrops. A focal inflammatory process during life may be one cause of focal endolymphatic hydrops as seen histopathologically.

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Autophony in a Patient With Giant Cell Tumor of the Temporal Bone

No abstract available

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Sudden Ringing In Ear

What Is Tinnitus?

If you have experienced sudden ringing in the ear, then you may have a condition called tinnitus. This is a condition that affects around 20 percent of adults. It is often a sign of an underlying problem, such as a circulatory problem or ear injury. It may also be a sign of hearing loss.

In addition to sudden ringing in ear, a person may notice a clicking, roaring or hissing sound. One may hear the noise in one or both ears. In some cases, the noise is so loud that a person is unable to concentrate.

What Causes Sudden Ringing In Ear?

There are a number of things that can possibly cause tinnitus. It can be caused by an infection or blockage in the ear. It may also be caused by exposure to loud noises. In fact, it is estimated that 90 percent of people with tinnitus have noise-induced hearing loss.

High blood pressure and heart disease can also cause tinnitus. This condition can also occur due to aging. As a person gets older, the cochlea starts to deteriorate. The cochlea has an organ called the corti. Tinnitus can occur when the hair cells inside of the corti become damaged. In rare cases, tinnitus is a sign of a tumor. Additionally, certain medications can cause tinnitus.

Types Of Tinnitus

There are two types of tinnitus, subjective and objective. Subjective tinnitus is the type of tinnitus that only you can hear. Objective tinnitus is the type that can be heard during an examination.

Treatments For Tinnitus

There is no cure for tinnitus, but there are some things that can be done to manage it. If your tinnitus is caused by the buildup of earwax, then removing the earwax can help alleviate the sudden ringing in ear. Earwax can be removed by flushing the ear out with warm water. It can also be removed with a device called a curette.

There are also some medications that can be used to reduce the tinnitus symptoms. Valium, which is an anti-anxiety medication, can be used to treat tinnitus. Alprazolam, which is another medication that is prescribed to treat anxiety, can also reduce tinnitus symptoms.

White noise machines can also be beneficial for people who suffer from tinnitus. These machines create environmental sounds, such as ocean waves and falling rain. Additionally, if a person suffers from noise-induced tinnitus, then hearing aids can also be helpful.

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Brief Assessment of Parental Perception (BAPP): Development and validation of a new measure for assessing paediatric outcomes after bilateral cochlear implantation

10.1080/14992027.2016.1204669<br/>V. Samuel

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Brief Assessment of Parental Perception (BAPP): Development and validation of a new measure for assessing paediatric outcomes after bilateral cochlear implantation

10.1080/14992027.2016.1204669<br/>V. Samuel

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Brief Assessment of Parental Perception (BAPP): Development and validation of a new measure for assessing paediatric outcomes after bilateral cochlear implantation

10.1080/14992027.2016.1204669<br/>V. Samuel

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Brief Assessment of Parental Perception (BAPP): Development and validation of a new measure for assessing paediatric outcomes after bilateral cochlear implantation

10.1080/14992027.2016.1204669<br/>V. Samuel

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Brief Assessment of Parental Perception (BAPP): Development and validation of a new measure for assessing paediatric outcomes after bilateral cochlear implantation

10.1080/14992027.2016.1204669<br/>V. Samuel

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Neonatal seizure automatism and human inborn pattern of quadrupedal locomotion.

Publication date: Available online 18 July 2016
Source:Gait & Posture
Author(s): E. Pavlidis, G. Cantalupo, L. Cattani, C.A. Tassinari, F. Pisani
Seizures in newborns do not always show a clear electro-clinical correlation. The real epileptic nature of some stereotyped rhythmic movements, included in the ‘subtle seizures’ and considered as brainstem release phenomena, is still debated. We report a brain injured newborn, who displayed several episodes of repetitive limb movements. The ictal EEG discharge, during one of these episodes, was associated with a motor pattern modification, which was endowed with quadrupedal locomotion kinematic features. This might represent an indirect evidence of cervical and lumbar Central Pattern Generators interconnection with in-phase coordination between diagonal limbs since the first hours of life in humans.



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Radiographic and clinical factors associated with one-leg standing and gait in patients with mild-to-moderate secondary hip osteoarthritis

Publication date: Available online 18 July 2016
Source:Gait & Posture
Author(s): Hiroshige Tateuchi, Yumiko Koyama, Haruhiko Akiyama, Koji Goto, Kazutaka So, Yutaka Kuroda, Noriaki Ichihashi
A decline in physical function associated with secondary hip osteoarthritis (OA) may be caused by both radiographic and clinical factors; however, the underlying mechanism remains unclear. The purpose of this study was to determine how joint degeneration, hip morphology, pain, hip range of motion (ROM), and hip muscle strength relate to one-leg standing (OLS) and gait in patients with mild-to-moderate secondary hip osteoarthritis. Fifty-five female patients (ages 22–65 years) with mild-to-moderate hip OA secondary to hip dysplasia were consecutively enrolled. Balance during OLS and three-dimensional hip angle changes while maintaining the OLS and at foot-off of the raised leg were measured. Gait speed and peak three-dimensional hip joint angles during gait were also measured. The associations between dependent variables (balance, gait speed, and hip kinematic changes) and independent variables (age, body mass index, pain, joint degeneration, hip morphologic abnormality, passive hip ROM, and hip muscle strength) were determined. While lower hip muscle strength was associated with hip kinematic changes such as flexion and internal rotation while maintaining OLS, decreased acetabular head index (AHI) and increased pain were associated with hip extension and abduction at foot-off in OLS. Decreased passive hip ROM was associated with decreased peak hip angles (extension, adduction, and external and internal rotation) during gait, although increased pain and decreased hip extension muscle strength were associated with slower gait speed. In this study of patients with secondary hip OA, AHI, pain, and hip impairments were associated with OLS and gait independently from age and radiographic degeneration.



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Mechanical and Neuromuscular Changes with Lateral Trunk Lean Gait Modifications

Publication date: Available online 18 July 2016
Source:Gait & Posture
Author(s): Shawn M. Robbins, Anthony Teoli, Richard A. Preuss
Lateral trunk lean (LTL) is a proposed intervention for knee osteoarthritis but increased muscular demands have not been considered. The objective was to compare lower extremity and trunk muscle activation and joint mechanics between normal and increased LTL gait in healthy adults. Participants (n=20, mean age 22 years) were examined under two gait conditions: normal and increased LTL. A motion capture system and force plates sampled at 100 and 2000Hz respectively were used to determine joint angles and external moments including LTL angle and external knee adduction moment (KAM). Surface electromyography, sampled at 2000Hz, measured activation of six trunk/hip muscles bilaterally. Peak LTL angle, peak KAM, gait speed, and mean values from electromyography waveforms were compared between normal and LTL conditions using paired t-tests or 2-way analysis of variance. There was a significant (p<0.05) increase in peak LTL angle, decrease in first but not second peak KAM, and decrease in gait speed during LTL gait. There were significant (p<0.01) increases in external oblique and iliocostalis muscle activation during LTL gait. There was no change in activation for internal oblique, rectus abdominis, longissimus, and gluteus medius. LTL gait decreased early/mid-stance KAM demonstrating its ability to decrease medial compartment knee loading. Increases in external oblique and iliocostalis activation were present but small to moderate in size and unlikely to lead to short term injury. Longitudinal studies should evaluate the effectiveness of increased LTL for knee osteoarthritis and if the increase in muscular demands leads to negative long term side effects.



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Neonatal seizure automatism and human inborn pattern of quadrupedal locomotion.

Publication date: Available online 18 July 2016
Source:Gait & Posture
Author(s): E. Pavlidis, G. Cantalupo, L. Cattani, C.A. Tassinari, F. Pisani
Seizures in newborns do not always show a clear electro-clinical correlation. The real epileptic nature of some stereotyped rhythmic movements, included in the ‘subtle seizures’ and considered as brainstem release phenomena, is still debated. We report a brain injured newborn, who displayed several episodes of repetitive limb movements. The ictal EEG discharge, during one of these episodes, was associated with a motor pattern modification, which was endowed with quadrupedal locomotion kinematic features. This might represent an indirect evidence of cervical and lumbar Central Pattern Generators interconnection with in-phase coordination between diagonal limbs since the first hours of life in humans.



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Radiographic and clinical factors associated with one-leg standing and gait in patients with mild-to-moderate secondary hip osteoarthritis

Publication date: Available online 18 July 2016
Source:Gait & Posture
Author(s): Hiroshige Tateuchi, Yumiko Koyama, Haruhiko Akiyama, Koji Goto, Kazutaka So, Yutaka Kuroda, Noriaki Ichihashi
A decline in physical function associated with secondary hip osteoarthritis (OA) may be caused by both radiographic and clinical factors; however, the underlying mechanism remains unclear. The purpose of this study was to determine how joint degeneration, hip morphology, pain, hip range of motion (ROM), and hip muscle strength relate to one-leg standing (OLS) and gait in patients with mild-to-moderate secondary hip osteoarthritis. Fifty-five female patients (ages 22–65 years) with mild-to-moderate hip OA secondary to hip dysplasia were consecutively enrolled. Balance during OLS and three-dimensional hip angle changes while maintaining the OLS and at foot-off of the raised leg were measured. Gait speed and peak three-dimensional hip joint angles during gait were also measured. The associations between dependent variables (balance, gait speed, and hip kinematic changes) and independent variables (age, body mass index, pain, joint degeneration, hip morphologic abnormality, passive hip ROM, and hip muscle strength) were determined. While lower hip muscle strength was associated with hip kinematic changes such as flexion and internal rotation while maintaining OLS, decreased acetabular head index (AHI) and increased pain were associated with hip extension and abduction at foot-off in OLS. Decreased passive hip ROM was associated with decreased peak hip angles (extension, adduction, and external and internal rotation) during gait, although increased pain and decreased hip extension muscle strength were associated with slower gait speed. In this study of patients with secondary hip OA, AHI, pain, and hip impairments were associated with OLS and gait independently from age and radiographic degeneration.



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Mechanical and Neuromuscular Changes with Lateral Trunk Lean Gait Modifications

Publication date: Available online 18 July 2016
Source:Gait & Posture
Author(s): Shawn M. Robbins, Anthony Teoli, Richard A. Preuss
Lateral trunk lean (LTL) is a proposed intervention for knee osteoarthritis but increased muscular demands have not been considered. The objective was to compare lower extremity and trunk muscle activation and joint mechanics between normal and increased LTL gait in healthy adults. Participants (n=20, mean age 22 years) were examined under two gait conditions: normal and increased LTL. A motion capture system and force plates sampled at 100 and 2000Hz respectively were used to determine joint angles and external moments including LTL angle and external knee adduction moment (KAM). Surface electromyography, sampled at 2000Hz, measured activation of six trunk/hip muscles bilaterally. Peak LTL angle, peak KAM, gait speed, and mean values from electromyography waveforms were compared between normal and LTL conditions using paired t-tests or 2-way analysis of variance. There was a significant (p<0.05) increase in peak LTL angle, decrease in first but not second peak KAM, and decrease in gait speed during LTL gait. There were significant (p<0.01) increases in external oblique and iliocostalis muscle activation during LTL gait. There was no change in activation for internal oblique, rectus abdominis, longissimus, and gluteus medius. LTL gait decreased early/mid-stance KAM demonstrating its ability to decrease medial compartment knee loading. Increases in external oblique and iliocostalis activation were present but small to moderate in size and unlikely to lead to short term injury. Longitudinal studies should evaluate the effectiveness of increased LTL for knee osteoarthritis and if the increase in muscular demands leads to negative long term side effects.



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Neonatal seizure automatism and human inborn pattern of quadrupedal locomotion.

Publication date: Available online 18 July 2016
Source:Gait & Posture
Author(s): E. Pavlidis, G. Cantalupo, L. Cattani, C.A. Tassinari, F. Pisani
Seizures in newborns do not always show a clear electro-clinical correlation. The real epileptic nature of some stereotyped rhythmic movements, included in the ‘subtle seizures’ and considered as brainstem release phenomena, is still debated. We report a brain injured newborn, who displayed several episodes of repetitive limb movements. The ictal EEG discharge, during one of these episodes, was associated with a motor pattern modification, which was endowed with quadrupedal locomotion kinematic features. This might represent an indirect evidence of cervical and lumbar Central Pattern Generators interconnection with in-phase coordination between diagonal limbs since the first hours of life in humans.



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Radiographic and clinical factors associated with one-leg standing and gait in patients with mild-to-moderate secondary hip osteoarthritis

Publication date: Available online 18 July 2016
Source:Gait & Posture
Author(s): Hiroshige Tateuchi, Yumiko Koyama, Haruhiko Akiyama, Koji Goto, Kazutaka So, Yutaka Kuroda, Noriaki Ichihashi
A decline in physical function associated with secondary hip osteoarthritis (OA) may be caused by both radiographic and clinical factors; however, the underlying mechanism remains unclear. The purpose of this study was to determine how joint degeneration, hip morphology, pain, hip range of motion (ROM), and hip muscle strength relate to one-leg standing (OLS) and gait in patients with mild-to-moderate secondary hip osteoarthritis. Fifty-five female patients (ages 22–65 years) with mild-to-moderate hip OA secondary to hip dysplasia were consecutively enrolled. Balance during OLS and three-dimensional hip angle changes while maintaining the OLS and at foot-off of the raised leg were measured. Gait speed and peak three-dimensional hip joint angles during gait were also measured. The associations between dependent variables (balance, gait speed, and hip kinematic changes) and independent variables (age, body mass index, pain, joint degeneration, hip morphologic abnormality, passive hip ROM, and hip muscle strength) were determined. While lower hip muscle strength was associated with hip kinematic changes such as flexion and internal rotation while maintaining OLS, decreased acetabular head index (AHI) and increased pain were associated with hip extension and abduction at foot-off in OLS. Decreased passive hip ROM was associated with decreased peak hip angles (extension, adduction, and external and internal rotation) during gait, although increased pain and decreased hip extension muscle strength were associated with slower gait speed. In this study of patients with secondary hip OA, AHI, pain, and hip impairments were associated with OLS and gait independently from age and radiographic degeneration.



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Mechanical and Neuromuscular Changes with Lateral Trunk Lean Gait Modifications

Publication date: Available online 18 July 2016
Source:Gait & Posture
Author(s): Shawn M. Robbins, Anthony Teoli, Richard A. Preuss
Lateral trunk lean (LTL) is a proposed intervention for knee osteoarthritis but increased muscular demands have not been considered. The objective was to compare lower extremity and trunk muscle activation and joint mechanics between normal and increased LTL gait in healthy adults. Participants (n=20, mean age 22 years) were examined under two gait conditions: normal and increased LTL. A motion capture system and force plates sampled at 100 and 2000Hz respectively were used to determine joint angles and external moments including LTL angle and external knee adduction moment (KAM). Surface electromyography, sampled at 2000Hz, measured activation of six trunk/hip muscles bilaterally. Peak LTL angle, peak KAM, gait speed, and mean values from electromyography waveforms were compared between normal and LTL conditions using paired t-tests or 2-way analysis of variance. There was a significant (p<0.05) increase in peak LTL angle, decrease in first but not second peak KAM, and decrease in gait speed during LTL gait. There were significant (p<0.01) increases in external oblique and iliocostalis muscle activation during LTL gait. There was no change in activation for internal oblique, rectus abdominis, longissimus, and gluteus medius. LTL gait decreased early/mid-stance KAM demonstrating its ability to decrease medial compartment knee loading. Increases in external oblique and iliocostalis activation were present but small to moderate in size and unlikely to lead to short term injury. Longitudinal studies should evaluate the effectiveness of increased LTL for knee osteoarthritis and if the increase in muscular demands leads to negative long term side effects.



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Volumes of Cochlear Nucleus Regions in Rodents

Publication date: Available online 18 July 2016
Source:Hearing Research
Author(s): Donald A. Godfrey, Augustine C. Lee, Walter D. Hamilton, Louis C. Benjamin, Shilpa Vishwanath, Hermann Simo, Lynn M. Godfrey, Abdurrahman I.A.A. Mustapha, Rickye S. Heffner
The cochlear nucleus receives all the coded information about sound from the cochlea and is the source of auditory information for the rest of the central auditory system. As such, it is a critical auditory nucleus. The sizes of the cochlear nucleus as a whole and its three major subdivisions – anteroventral cochlear nucleus (AVCN), posteroventral cochlear nucleus (PVCN), and dorsal cochlear nucleus (DCN) - have been measured in a large number of mammals, but measurements of its subregions at a more detailed level for a variety of species have not previously been made. Size measurements are reported here for the summed granular regions, DCN layers, AVCN, PVCN, and interstitial nucleus in 15 different rodent species, as well as a lagomorph, carnivore, and small primate. This further refinement of measurements is important because the granular regions and superficial layers of the DCN appear to have some different functions than the other cochlear nucleus regions. Except for DCN layers in the mountain beaver, all regions were clearly identifiable in all the animals studied. Relative regional size differences among most of the rodents, and even the 3 non-rodents, were not large and did not show a consistent relation to their wide range of lifestyles and hearing parameters. However, the mountain beaver, and to a lesser extent the pocket gopher, two rodents that live in tunnel systems, had relative sizes of summed granular regions and DCN molecular layer distinctly larger than those of the other mammals. Among all the mammals studied, there was a high correlation between the size per body weight of summed granular regions and that of the DCN molecular layer, consistent with other evidence for a close relationship between granule cells and superficial DCN neurons.



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Volumes of Cochlear Nucleus Regions in Rodents

Publication date: Available online 18 July 2016
Source:Hearing Research
Author(s): Donald A. Godfrey, Augustine C. Lee, Walter D. Hamilton, Louis C. Benjamin, Shilpa Vishwanath, Hermann Simo, Lynn M. Godfrey, Abdurrahman I.A.A. Mustapha, Rickye S. Heffner
The cochlear nucleus receives all the coded information about sound from the cochlea and is the source of auditory information for the rest of the central auditory system. As such, it is a critical auditory nucleus. The sizes of the cochlear nucleus as a whole and its three major subdivisions – anteroventral cochlear nucleus (AVCN), posteroventral cochlear nucleus (PVCN), and dorsal cochlear nucleus (DCN) - have been measured in a large number of mammals, but measurements of its subregions at a more detailed level for a variety of species have not previously been made. Size measurements are reported here for the summed granular regions, DCN layers, AVCN, PVCN, and interstitial nucleus in 15 different rodent species, as well as a lagomorph, carnivore, and small primate. This further refinement of measurements is important because the granular regions and superficial layers of the DCN appear to have some different functions than the other cochlear nucleus regions. Except for DCN layers in the mountain beaver, all regions were clearly identifiable in all the animals studied. Relative regional size differences among most of the rodents, and even the 3 non-rodents, were not large and did not show a consistent relation to their wide range of lifestyles and hearing parameters. However, the mountain beaver, and to a lesser extent the pocket gopher, two rodents that live in tunnel systems, had relative sizes of summed granular regions and DCN molecular layer distinctly larger than those of the other mammals. Among all the mammals studied, there was a high correlation between the size per body weight of summed granular regions and that of the DCN molecular layer, consistent with other evidence for a close relationship between granule cells and superficial DCN neurons.



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Volumes of Cochlear Nucleus Regions in Rodents

Publication date: Available online 18 July 2016
Source:Hearing Research
Author(s): Donald A. Godfrey, Augustine C. Lee, Walter D. Hamilton, Louis C. Benjamin, Shilpa Vishwanath, Hermann Simo, Lynn M. Godfrey, Abdurrahman I.A.A. Mustapha, Rickye S. Heffner
The cochlear nucleus receives all the coded information about sound from the cochlea and is the source of auditory information for the rest of the central auditory system. As such, it is a critical auditory nucleus. The sizes of the cochlear nucleus as a whole and its three major subdivisions – anteroventral cochlear nucleus (AVCN), posteroventral cochlear nucleus (PVCN), and dorsal cochlear nucleus (DCN) - have been measured in a large number of mammals, but measurements of its subregions at a more detailed level for a variety of species have not previously been made. Size measurements are reported here for the summed granular regions, DCN layers, AVCN, PVCN, and interstitial nucleus in 15 different rodent species, as well as a lagomorph, carnivore, and small primate. This further refinement of measurements is important because the granular regions and superficial layers of the DCN appear to have some different functions than the other cochlear nucleus regions. Except for DCN layers in the mountain beaver, all regions were clearly identifiable in all the animals studied. Relative regional size differences among most of the rodents, and even the 3 non-rodents, were not large and did not show a consistent relation to their wide range of lifestyles and hearing parameters. However, the mountain beaver, and to a lesser extent the pocket gopher, two rodents that live in tunnel systems, had relative sizes of summed granular regions and DCN molecular layer distinctly larger than those of the other mammals. Among all the mammals studied, there was a high correlation between the size per body weight of summed granular regions and that of the DCN molecular layer, consistent with other evidence for a close relationship between granule cells and superficial DCN neurons.



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Volumes of Cochlear Nucleus Regions in Rodents

Publication date: Available online 18 July 2016
Source:Hearing Research
Author(s): Donald A. Godfrey, Augustine C. Lee, Walter D. Hamilton, Louis C. Benjamin, Shilpa Vishwanath, Hermann Simo, Lynn M. Godfrey, Abdurrahman I.A.A. Mustapha, Rickye S. Heffner
The cochlear nucleus receives all the coded information about sound from the cochlea and is the source of auditory information for the rest of the central auditory system. As such, it is a critical auditory nucleus. The sizes of the cochlear nucleus as a whole and its three major subdivisions – anteroventral cochlear nucleus (AVCN), posteroventral cochlear nucleus (PVCN), and dorsal cochlear nucleus (DCN) - have been measured in a large number of mammals, but measurements of its subregions at a more detailed level for a variety of species have not previously been made. Size measurements are reported here for the summed granular regions, DCN layers, AVCN, PVCN, and interstitial nucleus in 15 different rodent species, as well as a lagomorph, carnivore, and small primate. This further refinement of measurements is important because the granular regions and superficial layers of the DCN appear to have some different functions than the other cochlear nucleus regions. Except for DCN layers in the mountain beaver, all regions were clearly identifiable in all the animals studied. Relative regional size differences among most of the rodents, and even the 3 non-rodents, were not large and did not show a consistent relation to their wide range of lifestyles and hearing parameters. However, the mountain beaver, and to a lesser extent the pocket gopher, two rodents that live in tunnel systems, had relative sizes of summed granular regions and DCN molecular layer distinctly larger than those of the other mammals. Among all the mammals studied, there was a high correlation between the size per body weight of summed granular regions and that of the DCN molecular layer, consistent with other evidence for a close relationship between granule cells and superficial DCN neurons.



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Volumes of Cochlear Nucleus Regions in Rodents

Publication date: Available online 18 July 2016
Source:Hearing Research
Author(s): Donald A. Godfrey, Augustine C. Lee, Walter D. Hamilton, Louis C. Benjamin, Shilpa Vishwanath, Hermann Simo, Lynn M. Godfrey, Abdurrahman I.A.A. Mustapha, Rickye S. Heffner
The cochlear nucleus receives all the coded information about sound from the cochlea and is the source of auditory information for the rest of the central auditory system. As such, it is a critical auditory nucleus. The sizes of the cochlear nucleus as a whole and its three major subdivisions – anteroventral cochlear nucleus (AVCN), posteroventral cochlear nucleus (PVCN), and dorsal cochlear nucleus (DCN) - have been measured in a large number of mammals, but measurements of its subregions at a more detailed level for a variety of species have not previously been made. Size measurements are reported here for the summed granular regions, DCN layers, AVCN, PVCN, and interstitial nucleus in 15 different rodent species, as well as a lagomorph, carnivore, and small primate. This further refinement of measurements is important because the granular regions and superficial layers of the DCN appear to have some different functions than the other cochlear nucleus regions. Except for DCN layers in the mountain beaver, all regions were clearly identifiable in all the animals studied. Relative regional size differences among most of the rodents, and even the 3 non-rodents, were not large and did not show a consistent relation to their wide range of lifestyles and hearing parameters. However, the mountain beaver, and to a lesser extent the pocket gopher, two rodents that live in tunnel systems, had relative sizes of summed granular regions and DCN molecular layer distinctly larger than those of the other mammals. Among all the mammals studied, there was a high correlation between the size per body weight of summed granular regions and that of the DCN molecular layer, consistent with other evidence for a close relationship between granule cells and superficial DCN neurons.



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