Motivational Interviewing: Something to Consider When Fitting Hearing Aids to Patients with Tinnitus?

Zarenoe and colleagues (2016) evaluated motivational interviewing (MI) as a supplement to the traditional hearing fitting delivery model for patients with both hearing loss and tinnitus. MI is a counseling style designed to enhance one’s motivation towards making a behavior change (Miller and Rollnick, 2012).

In this study, 50 patients were originally enrolled into the study, with 25 randomized to receive MI and 25 randomized to “standard practice (SP).” None of these subjects had prior use of hearing aids.

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Study of tonotopic brain changes with functional MRI and FDG-PET in a patient with unilateral objective cochlear tinnitus

Publication date: Available online 20 September 2016
Source:Hearing Research
Author(s): A.-C. Guinchard, N. Ghazaleh, M. Saenz, E. Fornari, J.O. Prior, P. Maeder, S. Adib, R. Maire
We studied possible brain changes with functional MRI (fMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) in a patient with a rare, high-intensity "objective tinnitus" (high-level SOAEs) in the left ear of 10 years duration, with no associated hearing loss. This is the first case of objective cochlear tinnitus to be investigated with functional neuroimaging.The objective cochlear tinnitus was measured by Spontaneous Otoacoustic Emissions (SOAE) equipment (frequency 9689 Hz, intensity 57 dB SPL) and is clearly audible to anyone standing near the patient. Functional modifications in primary auditory areas and other brain regions were evaluated using 3T and 7T fMRI and FDG-PET.In the fMRI evaluations, a saturation of the auditory cortex at the tinnitus frequency was observed, but the global cortical tonotopic organization remained intact when compared to the results of fMRI of healthy subjects. The FDG-PET showed no evidence of an increase or decrease of activity in the auditory cortices or in the limbic system as compared to normal subjects.In this patient with high-intensity objective cochlear tinnitus, fMRI and FDG-PET showed no significant brain reorganization in auditory areas and/or in the limbic system, as reported in the literature in patients with chronic subjective tinnitus.



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Study of tonotopic brain changes with functional MRI and FDG-PET in a patient with unilateral objective cochlear tinnitus

Publication date: Available online 20 September 2016
Source:Hearing Research
Author(s): A.-C. Guinchard, N. Ghazaleh, M. Saenz, E. Fornari, J.O. Prior, P. Maeder, S. Adib, R. Maire
We studied possible brain changes with functional MRI (fMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) in a patient with a rare, high-intensity "objective tinnitus" (high-level SOAEs) in the left ear of 10 years duration, with no associated hearing loss. This is the first case of objective cochlear tinnitus to be investigated with functional neuroimaging.The objective cochlear tinnitus was measured by Spontaneous Otoacoustic Emissions (SOAE) equipment (frequency 9689 Hz, intensity 57 dB SPL) and is clearly audible to anyone standing near the patient. Functional modifications in primary auditory areas and other brain regions were evaluated using 3T and 7T fMRI and FDG-PET.In the fMRI evaluations, a saturation of the auditory cortex at the tinnitus frequency was observed, but the global cortical tonotopic organization remained intact when compared to the results of fMRI of healthy subjects. The FDG-PET showed no evidence of an increase or decrease of activity in the auditory cortices or in the limbic system as compared to normal subjects.In this patient with high-intensity objective cochlear tinnitus, fMRI and FDG-PET showed no significant brain reorganization in auditory areas and/or in the limbic system, as reported in the literature in patients with chronic subjective tinnitus.



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Study of tonotopic brain changes with functional MRI and FDG-PET in a patient with unilateral objective cochlear tinnitus

Publication date: Available online 20 September 2016
Source:Hearing Research
Author(s): A.-C. Guinchard, N. Ghazaleh, M. Saenz, E. Fornari, J.O. Prior, P. Maeder, S. Adib, R. Maire
We studied possible brain changes with functional MRI (fMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) in a patient with a rare, high-intensity "objective tinnitus" (high-level SOAEs) in the left ear of 10 years duration, with no associated hearing loss. This is the first case of objective cochlear tinnitus to be investigated with functional neuroimaging.The objective cochlear tinnitus was measured by Spontaneous Otoacoustic Emissions (SOAE) equipment (frequency 9689 Hz, intensity 57 dB SPL) and is clearly audible to anyone standing near the patient. Functional modifications in primary auditory areas and other brain regions were evaluated using 3T and 7T fMRI and FDG-PET.In the fMRI evaluations, a saturation of the auditory cortex at the tinnitus frequency was observed, but the global cortical tonotopic organization remained intact when compared to the results of fMRI of healthy subjects. The FDG-PET showed no evidence of an increase or decrease of activity in the auditory cortices or in the limbic system as compared to normal subjects.In this patient with high-intensity objective cochlear tinnitus, fMRI and FDG-PET showed no significant brain reorganization in auditory areas and/or in the limbic system, as reported in the literature in patients with chronic subjective tinnitus.



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Feasibility and reliability of using an exoskeleton to emulate muscle contractures during walking

Publication date: Available online 19 September 2016
Source:Gait & Posture
Author(s): M. Attias, A. Bonnefoy-Mazure, G. De Coulon, L. Cheze, S. Armand
Contracture is a permanent shortening of the muscle–tendon–ligament complex that limits joint mobility. Contracture is involved in many diseases (cerebral palsy, stroke, etc.) and can impair walking and other activities of daily living. The purpose of this study was to quantify the reliability of an exoskeleton designed to emulate lower limb muscle contractures unilaterally and bilaterally during walking.An exoskeleton was built according to the following design criteria: adjustable to different morphologies; respect of the principal lines of muscular actions; placement of reflective markers on anatomical landmarks; and the ability to replicate the contractures of eight muscles of the lower limb unilaterally and bilaterally (psoas, rectus femoris, hamstring, hip adductors, gastrocnemius, soleus, tibialis posterior, and peroneus). Sixteen combinations of contractures were emulated on the unilateral and bilateral muscles of nine healthy participants. Two sessions of gait analysis were performed at weekly intervals to assess the reliability of the emulated contractures. Discrete variables were extracted from the kinematics to analyse the reliability.The exoskeleton did not affect normal walking when contractures were not emulated. Kinematic reliability varied from poor to excellent depending on the targeted muscle. Reliability was good for the bilateral and unilateral gastrocnemius, soleus, and tibialis posterior as well as the bilateral hamstring and unilateral hip adductors. The exoskeleton can be used to replicate contracture on healthy participants. The exoskeleton will allow us to differentiate primary and compensatory effects of muscle contractures on gait kinematics.



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Feasibility and reliability of using an exoskeleton to emulate muscle contractures during walking

Publication date: Available online 19 September 2016
Source:Gait & Posture
Author(s): M. Attias, A. Bonnefoy-Mazure, G. De Coulon, L. Cheze, S. Armand
Contracture is a permanent shortening of the muscle–tendon–ligament complex that limits joint mobility. Contracture is involved in many diseases (cerebral palsy, stroke, etc.) and can impair walking and other activities of daily living. The purpose of this study was to quantify the reliability of an exoskeleton designed to emulate lower limb muscle contractures unilaterally and bilaterally during walking.An exoskeleton was built according to the following design criteria: adjustable to different morphologies; respect of the principal lines of muscular actions; placement of reflective markers on anatomical landmarks; and the ability to replicate the contractures of eight muscles of the lower limb unilaterally and bilaterally (psoas, rectus femoris, hamstring, hip adductors, gastrocnemius, soleus, tibialis posterior, and peroneus). Sixteen combinations of contractures were emulated on the unilateral and bilateral muscles of nine healthy participants. Two sessions of gait analysis were performed at weekly intervals to assess the reliability of the emulated contractures. Discrete variables were extracted from the kinematics to analyse the reliability.The exoskeleton did not affect normal walking when contractures were not emulated. Kinematic reliability varied from poor to excellent depending on the targeted muscle. Reliability was good for the bilateral and unilateral gastrocnemius, soleus, and tibialis posterior as well as the bilateral hamstring and unilateral hip adductors. The exoskeleton can be used to replicate contracture on healthy participants. The exoskeleton will allow us to differentiate primary and compensatory effects of muscle contractures on gait kinematics.



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Feasibility and reliability of using an exoskeleton to emulate muscle contractures during walking

Publication date: Available online 19 September 2016
Source:Gait & Posture
Author(s): M. Attias, A. Bonnefoy-Mazure, G. De Coulon, L. Cheze, S. Armand
Contracture is a permanent shortening of the muscle–tendon–ligament complex that limits joint mobility. Contracture is involved in many diseases (cerebral palsy, stroke, etc.) and can impair walking and other activities of daily living. The purpose of this study was to quantify the reliability of an exoskeleton designed to emulate lower limb muscle contractures unilaterally and bilaterally during walking.An exoskeleton was built according to the following design criteria: adjustable to different morphologies; respect of the principal lines of muscular actions; placement of reflective markers on anatomical landmarks; and the ability to replicate the contractures of eight muscles of the lower limb unilaterally and bilaterally (psoas, rectus femoris, hamstring, hip adductors, gastrocnemius, soleus, tibialis posterior, and peroneus). Sixteen combinations of contractures were emulated on the unilateral and bilateral muscles of nine healthy participants. Two sessions of gait analysis were performed at weekly intervals to assess the reliability of the emulated contractures. Discrete variables were extracted from the kinematics to analyse the reliability.The exoskeleton did not affect normal walking when contractures were not emulated. Kinematic reliability varied from poor to excellent depending on the targeted muscle. Reliability was good for the bilateral and unilateral gastrocnemius, soleus, and tibialis posterior as well as the bilateral hamstring and unilateral hip adductors. The exoskeleton can be used to replicate contracture on healthy participants. The exoskeleton will allow us to differentiate primary and compensatory effects of muscle contractures on gait kinematics.



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A novel homozygous HOXB1 mutation in a Turkish family with hereditary congenital facial paresis.

A novel homozygous HOXB1 mutation in a Turkish family with hereditary congenital facial paresis.

Brain Dev. 2016 Sep 15;

Authors: Sahin Y, Güngör O, Ayaz A, Güngör G, Sahin B, Yaykasli K, Ceylaner S

Abstract
Hereditary congenital facial paresis (HCFP) is characterized by isolated dysfunction of the facial nerve (CN VII) due to congenital cranial dysinnervation disorders. HCFP has genetic heterogeneity and HOXB1 is the first identified gene. We report the clinical, radiologic and molecular investigations of three patients admitted for HCFP in a large consanguineous Turkish family. High-throughput sequencing and Sanger sequencing of all patients revealed a novel homozygous mutation p.Arg230Trp (c.688C>T) within the HOXB1 gene. The report of the mutation brings the total number of HOXB1 mutations identified in HCFP to four. The results of this study emphasize that in individuals with congenital facial palsy accompanied by hearing loss and dysmorphic facial features, HOXB1 mutation causing HCFP should be kept in mind.

PMID: 27640920 [PubMed - as supplied by publisher]

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A Review of Singing Voice Subsystem Interactions—Toward an Extended Physiological Model of “Support”

Publication date: Available online 19 September 2016
Source:Journal of Voice
Author(s): Christian T. Herbst
During phonation, the respiratory, the phonatory, and the resonatory parts of the voice organ can interact, where physiological action in one subsystem elicits a direct effect in another. Here, three major subsystems of these synergies are reviewed, creating a model of voice subsystem interactions: (1) Vocal tract adjustments can influence the behavior of the voice source via nonlinear source-tract interactions; (2) The type and degree of vocal fold adduction controls the expiratory airflow rate; and (3) The tracheal pull caused by the respiratory system affects the vertical larynx position and thus the vocal tract resonances. The relevance of the presented model is discussed, suggesting, among others, that functional voice building work concerned with a particular voice subsystem may evoke side effects or benefits on other subsystems, even when having a clearly defined and isolated physiological target. Finally, four seemingly incongruous historic definitions of the concept of singing voice “support” are evaluated, showing how each of these pertain to different voice subsystems at various levels of detail. It is argued that presumed discrepancies between these definitions can be resolved by putting them into the wider context of the subsystem interaction model presented here, thus offering a framework for reviewing and potentially refining some current and historical pedagogical approaches.



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Effect of Performance Time of the Semi-Occluded Vocal Tract Exercises in Dysphonic Children

Publication date: Available online 19 September 2016
Source:Journal of Voice
Author(s): Lorena de Almeida Ramos, Ana Cristina Côrtes Gama
ObjectiveThis study aimed to verify the effects of execution time on auditory-perceptual and acoustic responses in children with dysphonia completing straw phonation exercises.Study designA randomized, prospective, comparative intra-subject study design was used.MethodsTwenty-seven children, ranging from 5 to 10 years of age, diagnosed with vocal cord nodules or cysts, were enrolled in the study. All subjects included in the Experimental Group were also included in the Control Group which involved complete voice rest. Sustained vowels (/a/e/ε/e/) counting from 1 to 10 were recorded before the exercises (m0) and then again after the first (m1), third (m3), fifth (m5), and seventh (m7) minutes of straw phonation exercises. The recordings were randomized and presented to five speech therapists, who evaluated vocal quality based on the Grade Roughness Breathiness Asthenia/Strain Instability scale. For acoustic analysis, fundamental frequency, jitter, shimmer, glottal to noise excitation ratio, and noise parameters were analyzed.ResultsReduced roughness, breathiness, and noise measurements as well as increased glottal to noise excitation ratio were observed in the Experimental Group after 3 minutes of exercise. Reduced grade of dysphonia and breathiness were noted after 5 minutes.ConclusionThe ideal duration of straw phonation in children with dysphonia is from 3 to 5 minutes.



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Data Collection of Infant Cries for Research and Analysis

Publication date: Available online 19 September 2016
Source:Journal of Voice
Author(s): Anshu Chittora, Hemant A. Patil
Analysis of infants cries may help in identifying the needs of infants such as hunger, pain, sickness, etc and thereby develop a tool or possible mobile application that can help the parents in monitoring the needs of their infant. Analysis of cries of infants who are suffering from neurologic disorders and severe diseases, which can later on result in motor and mental handicap, may prove helpful in early diagnosis of pathologies and protect infants from such disorders. The development of an infant cry corpus is necessary for the analysis of infant cries and for the development of infant cry tools. Infant cry database is not available commercially for research, which limits the scope of research in this area. Because the cry characteristics changes with many factors such as reason for crying, infant's health and weight, age, etc, care is required while designing a corpus for a particular research application of infant cry analysis and classification. In this paper, the ideal characteristics of the corpus are proposed along with factors influencing infant cry characteristics, and experiences during data collection are shared. This study may help other researchers to build an infant cry corpus for their specific problem of study. Justification of the proposed characteristics is also given along with suitable examples.



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Assessment of Grade of Dysphonia and Correlation With Quality of Life Protocol

Publication date: Available online 19 September 2016
Source:Journal of Voice
Author(s): Ana Lúcia Spina, Agrício Nubiato Crespo
ObjectiveThe main objective of this study is to check the correlation between vocal self-assessment and results of the Voice-Related Quality of Life (V-RQOL) protocol, and whether there is a correlation between perceptual vocal assessment made by voice therapists and the results from the V-RQOL protocol.Study DesignThe study included 245 subjects with vocal complaints. This was a prospective analytical clinical study.MethodsVocal perceptual assessment of each subject with dysphonia was made by three voice therapists, followed by self-assessment made by the subjects themselves, and the application of the V-RQOL protocol.ResultsThe results have shown poor level of agreement between vocal assessment made by the voice therapists and self-assessment made by the subjects. The statistical analysis indicated that the results of V-RQOL protocol showed significant correlation with the vocal assessment made by the voice therapists and the self-assessment by the subjects.ConclusionsThe agreement between the assessments was low and variable; age, gender, professional voice use, and clinical laryngoscopic diagnosis did not influence the agreement level. Protocol V-RQOL is sensitive to vocal assessment made by the voice therapists and self-assessment made by the patient.



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Electrocochleography for the Diagnosis of Meniere's Disease: The Wrong Stimulus.

No abstract available

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Response to Letter to the Editor: "Electrocochleography Versus MRI With Intratympanic Contrast in Meniere's Disease".

No abstract available

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The Effect of Piston Diameter in Stapedotomy for Otosclerosis: A Temporal Bone Model.

Hypothesis: The use of larger-diameter pistons in stapedotomy leads to better hearing outcomes compared with the use of smaller-diameter pistons. There is an interaction between stapes piston diameter and fenestration diameter. Background: Otosclerosis can be treated surgically by removing part of the stapes and bypassing the stapes footplate with a prosthesis. Available piston shaft diameters range between 0.3 and 0.8 mm. There has been a tendency toward the use of smaller-diameter pistons, because of a suspected decreased risk of cochlear trauma and subsequent sensorineural hearing loss (SNHL) with smaller pistons. However, mathematical models, temporal bone studies, and clinical studies suggest that the use of larger-diameter pistons is associated with better hearing outcomes. Methods: Three fresh-frozen, non-pathologic temporal bones were harvested from human cadaveric donors. Acoustic stimuli in the form of pure tones from 250 to 8000 Hz were generated at 110 dB sound pressure level. A total of 16 frequencies in a 1/3-octave series were used. Stapes and round window velocities in response to the acoustic stimuli were measured at multiple equally spaced points covering the stapes footplate and round window using a scanning laser Doppler interferometry system. Eight sets of measurements were performed in each temporal bone: 1) normal condition (mobile stapes), 2) stapes fixation and stapedotomy followed by insertion of 3) a 0.4-mm-diameter piston in a 0.5-mm-diameter fenestration, 4) a 0.4-mm-diameter piston in a 0.7-mm-diameter fenestration, 5) a 0.4-mm-diameter piston in a 0.9-mm-diameter fenestration, 6) a 0.6-mm-diameter piston in a 0.7-mm-diameter fenestration, 7) a 0.6-mm-diameter piston in a 0.9-mm-diameter fenestration, and 8) a 0.8-mm-diameter piston in a 0.9-mm-diameter fenestration. Results: At midrange frequencies, between 500 and 4000 Hz, round window velocities increased by 2 to 3 dB when using a 0.6-mm-diameter piston compared with a 0.4-mm-diameter piston. Using a 0.8-mm-diameter piston led to a further increase in round window velocities by 2 to 4 dB. Conclusion: Our results suggest a modest effect of piston diameter on hearing results following stapedotomy. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Two Common Second Causes of Dizziness in Patients With Meniere's Disease.

Objective: There are no epidemiological studies quantifying the prevalence of second causes of dizziness in Meniere's disease (MD). Therefore, we aimed to quantify which dizziness-inducing causes are prevalent alongside MD. Moreover, we analyzed which second cause of dizziness was more common in a specific age group and if age was a risk factor. Study Design: Retrospective cohort study. Setting: Tertiary referral center. Methods: Data were retrospectively obtained from all MD patients who visited our clinic between January 2000 and December 2013. Workup included vestibular tests, pure tone audiometry, blood pressure monitoring, and the hyperventilation provocation test, the Nijmegen Questionnaire (NQ) and the Hospital Anxiety and Depression Scale (HADS). The final causes of dizziness were based on consensus between an ENT-surgeon and a neurologist who were consulted simultaneously. Results: We found that 143 (30%) of 469 MD patients suffered from a second cause of dizziness. The two most common causes were psychological distress (PD) (70%) and benign paroxysmal positional vertigo (BPPV) (18%). The mean age for MD patients with PD was 58.7 +/- 13.3 years compared with the mean age of 63.9 +/- 14.3 years for MD patients without PD (mean difference = -5.2 years, 95% CI: -8.3 to -2.2, p = 0.001). MD patients younger than 60 of age had a 15% higher risk of suffering from psychological distress than those who were older than 60 (risk difference, 15%, 95% CI, 7.0-22%). Age could not be identified as a risk factor for BPPV in older MD patients. Conclusions: In 30% of the patients with MD a second cause of dizziness is present. PD most commonly coincides with MD, especially in younger patients. The second most common cause is BPPV. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Role of STAT1 and Oxidative Stress in Gentamicin-Induced Hair Cell Death in Organ of Corti.

Rationale: Oxidative stress plays a critical role in gentamicin-induced hair cell death. Previous work has implicated the cytoplasmic transcription factor signal transducer and activator of transcription 1 (STAT1) as a potential mediator of drug-induced ototoxicity, but role in aminoglycosides is largely unknown. This study investigated aminoglycosides-induced cell death, exploring contributions of reactive oxygen species and STAT1 pathway in injury and protection. Methods: Neonatal murine organ of Corti explants from 2 to 3 day postnatal pups (n = 96) were treated with gentamicin at (4 [mu]M, 50 [mu]M) for 4 to 72 hours, with/without protectants. Effects on STAT1 pathway and gentamicin-induced hair cell death were measured with 50 [mu]M Epigallocatechin gallate (EGCG, a STAT1 inhibitor) and all-trans retinoic acid (atRA, a STAT1 activator). Hair cell morphology was evaluated and hair cell loss was quantified with cytocochleograms. Mitochondrial membrane potential was assayed and superoxide generation and suppression was measured with dihydroethidium (DHE) staining. Results: Co-administration of 50 [mu]M EGCG conferred protection from 4 [mu]M gentamicin toxicity (p

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Meniere's Disease: Molecular Analysis of Aquaporins 2, 3 and Potassium Channel KCNE1 Genes in Brazilian Patients.

Objectives: Meniere's disease (MD) is a complex disease of unknown etiology characterized by a symptomatic tetrad of vertigo, hearing loss, tinnitus, and aural fullness. In addition to factors related to homeostasis of the inner ear, genetic factors have been implicated in its pathophysiology, including genes related to the transport of water and ionic composition maintenance of the endolymph, such as the aquaporin genes AQP2 and AQP3, and the potassium channel gene KCNE1. The aim of this study was to identify polymorphisms of these genes and determine their association with clinical characteristics of patients with MD. Design: A case-control genetic association study was carried out, including 30 patients with definite Meniere's disease and 30 healthy controls. The coding regions of the target genes were amplified from blood samples by polymerase chain reaction (PCR), followed by direct sequencing. The associations of polymorphisms with clinical characteristics were analyzed with logistic regression. Results: Five polymorphisms were identified: rs426496 in AQP2; rs591810 in AQP3; and rs1805127, rs1805128, and rs17173510 in KCNE1. After adjustment, rs426496 was significantly associated with tinnitus during the initial crisis and with altered electronystagmography, and rs1805127 was significantly associated with nephropathy. Conclusions: The genetic variant rs426496 in AQP2; rs591810 in AQP3 and rs1805127, rs1805128, and rs17173510, in KCNE1 were found in patients with Meniere's disease. The polymorphism rs426496, in AQP2, is associated with tinnitus at the onset of Meniere's disease and altered electronystagmography. In addition, rs1805127, in KCNE1, is associated with the presence of nephropathy. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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