Engineering out the Noise

Publication date: Available online 7 January 2017
Source:Hearing Research
Author(s): Kurt Yankaskas, Raymond Fischer, Jesse Spence, Jeff Komrower
The US Navy, through an Office of Naval Research (ONR) lead effort on Noise Induced Hearing Loss (NIHL), is investigating methods and techniques to mitigate hearing loss for the crews and warfighters. Hearing protection is a viable and increasingly popular method of reducing hearing exposure for many ship crewmembers; however, it has limitations on comfort and low frequency effectiveness. Furthermore, Personal Hearing Protection (PHP) is often used improperly. Proper vessel planning, programmatic changes and advances in noise control engineering can also have significant impacts by inherently reducing noise exposure through ship design and use of noise control treatments. These impacts go beyond hearing loss mitigation since they can improve quality of life onboard vessels and provide enhanced warfighter performance. Such approaches also can be made to work in the lower frequency range where hearing protection is not as effective. This paper describes non-hearing protection methods being implemented to mitigate and control noise within the US Navy and US Marine Corps. These approaches reflect the latest changes to Mil-Std 1474E, Appendix F.



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Translational issues in cochlear synaptopathy

Publication date: Available online 7 January 2017
Source:Hearing Research
Author(s): Ann E. Hickox, Erik Larsen, Michael G. Heinz, Leslie Shinobu, Jonathon P. Whitton
Understanding the biology of the previously underappreciated sensitivity of cochlear synapses to noise insult, and its clinical consequences, is becoming a mission for a growing number of auditory researchers. In addition, several research groups have become interested in developing therapeutic approaches that can reverse synaptopathy and restore hearing function. One of the major challenges to realizing the potential of synaptopathy rodent models is that current clinical audiometric approaches cannot yet reveal the presence of this subtle cochlear pathology in humans. This has catalyzed efforts, both from basic and clinical perspectives, to investigate novel means for diagnosing synaptopathy and to determine the main functional consequences for auditory perception and hearing abilities. Such means, and a strong concordance between findings in pre-clinical animal models and clinical studies in humans, are important for developing and realizing therapeutics. This paper frames the key outstanding translational questions that need to be addressed to realize this ambitious goal.



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Engineering out the Noise

Publication date: Available online 7 January 2017
Source:Hearing Research
Author(s): Kurt Yankaskas, Raymond Fischer, Jesse Spence, Jeff Komrower
The US Navy, through an Office of Naval Research (ONR) lead effort on Noise Induced Hearing Loss (NIHL), is investigating methods and techniques to mitigate hearing loss for the crews and warfighters. Hearing protection is a viable and increasingly popular method of reducing hearing exposure for many ship crewmembers; however, it has limitations on comfort and low frequency effectiveness. Furthermore, Personal Hearing Protection (PHP) is often used improperly. Proper vessel planning, programmatic changes and advances in noise control engineering can also have significant impacts by inherently reducing noise exposure through ship design and use of noise control treatments. These impacts go beyond hearing loss mitigation since they can improve quality of life onboard vessels and provide enhanced warfighter performance. Such approaches also can be made to work in the lower frequency range where hearing protection is not as effective. This paper describes non-hearing protection methods being implemented to mitigate and control noise within the US Navy and US Marine Corps. These approaches reflect the latest changes to Mil-Std 1474E, Appendix F.



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Translational issues in cochlear synaptopathy

Publication date: Available online 7 January 2017
Source:Hearing Research
Author(s): Ann E. Hickox, Erik Larsen, Michael G. Heinz, Leslie Shinobu, Jonathon P. Whitton
Understanding the biology of the previously underappreciated sensitivity of cochlear synapses to noise insult, and its clinical consequences, is becoming a mission for a growing number of auditory researchers. In addition, several research groups have become interested in developing therapeutic approaches that can reverse synaptopathy and restore hearing function. One of the major challenges to realizing the potential of synaptopathy rodent models is that current clinical audiometric approaches cannot yet reveal the presence of this subtle cochlear pathology in humans. This has catalyzed efforts, both from basic and clinical perspectives, to investigate novel means for diagnosing synaptopathy and to determine the main functional consequences for auditory perception and hearing abilities. Such means, and a strong concordance between findings in pre-clinical animal models and clinical studies in humans, are important for developing and realizing therapeutics. This paper frames the key outstanding translational questions that need to be addressed to realize this ambitious goal.



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Engineering out the Noise

Publication date: Available online 7 January 2017
Source:Hearing Research
Author(s): Kurt Yankaskas, Raymond Fischer, Jesse Spence, Jeff Komrower
The US Navy, through an Office of Naval Research (ONR) lead effort on Noise Induced Hearing Loss (NIHL), is investigating methods and techniques to mitigate hearing loss for the crews and warfighters. Hearing protection is a viable and increasingly popular method of reducing hearing exposure for many ship crewmembers; however, it has limitations on comfort and low frequency effectiveness. Furthermore, Personal Hearing Protection (PHP) is often used improperly. Proper vessel planning, programmatic changes and advances in noise control engineering can also have significant impacts by inherently reducing noise exposure through ship design and use of noise control treatments. These impacts go beyond hearing loss mitigation since they can improve quality of life onboard vessels and provide enhanced warfighter performance. Such approaches also can be made to work in the lower frequency range where hearing protection is not as effective. This paper describes non-hearing protection methods being implemented to mitigate and control noise within the US Navy and US Marine Corps. These approaches reflect the latest changes to Mil-Std 1474E, Appendix F.



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Translational issues in cochlear synaptopathy

Publication date: Available online 7 January 2017
Source:Hearing Research
Author(s): Ann E. Hickox, Erik Larsen, Michael G. Heinz, Leslie Shinobu, Jonathon P. Whitton
Understanding the biology of the previously underappreciated sensitivity of cochlear synapses to noise insult, and its clinical consequences, is becoming a mission for a growing number of auditory researchers. In addition, several research groups have become interested in developing therapeutic approaches that can reverse synaptopathy and restore hearing function. One of the major challenges to realizing the potential of synaptopathy rodent models is that current clinical audiometric approaches cannot yet reveal the presence of this subtle cochlear pathology in humans. This has catalyzed efforts, both from basic and clinical perspectives, to investigate novel means for diagnosing synaptopathy and to determine the main functional consequences for auditory perception and hearing abilities. Such means, and a strong concordance between findings in pre-clinical animal models and clinical studies in humans, are important for developing and realizing therapeutics. This paper frames the key outstanding translational questions that need to be addressed to realize this ambitious goal.



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Validity and Reliability of a French Version of Reflux Symptom Index

Publication date: Available online 6 January 2017
Source:Journal of Voice
Author(s): Jérôme R. Lechien, Kathy Huet, Camille Finck, Mohamad Khalife, Anne-Françoise Fourneau, Véronique Delvaux, Myriam Piccaluga, Bernard Harmegnies, Sven Saussez
ObjectiveTo develop a French version of the Reflux Symptom Index (Fr-RSI) and to assess its internal consistency, reliability, and clinical validity.Study DesignControlled, prospective trial.Materials and MethodsForty-four patients with a reflux finding score > 7 and an Fr-RSI > 13 were enrolled and treated with 20 mg of pantoprazole twice daily and diet changes for 3 months. Ninety asymptomatic subjects were also included in the study. To assess reliability, Fr-RSI was completed twice within a 7-day period. Validity was assessed by comparing Fr-RSI scores with scores from the Voice Handicap Index (VHI) in 24 of 44 patients, at baseline and at 3 months posttherapy.ResultsThe mean values of Fr-RSI at baseline and after 7 days were 20.17 ± 5.76 and 19.75 ± 7.08, respectively, for patients with laryngopharyngeal reflux (LPR) and 4.02 ± 3.49 and 3.71 ± 3.82, respectively, for controls. The test-retest reliability was high in patients with LPR (rBP = 0.78) and in healthy subjects (rBP = 0.80). Cronbach's alpha was 0.85, indicating high internal consistency. The mean Fr-RSI score significantly improved from a baseline of 20.17 ± 5.76 to 5.58 ± 3.65 after 3 months of treatment (P = 0.001), and the initial mean VHI total score significantly improved from 20.29 ± 19.62 to 12.87 ± 12.04 after treatment (P = 0.029), indicating validity of the results. However, of the subcategories of the VHI, only the mean physical score improved from a baseline of 11.19 ± 9.22 to 7.35 ± 5.96 after treatment (P = 0.016).ConclusionThe Fr-RSI developed in this study demonstrated both reliability and validity. It can be easily administered to assist in diagnosing and monitoring of LPR in French-speaking patients.



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Voice Disorders in Older Adults Living in Nursing Homes: Prevalence and Associated Factors

Publication date: Available online 6 January 2017
Source:Journal of Voice
Author(s): Leandro Pernambuco, Albert Espelt, Amanda C.B. Góis, Kenio Costa de Lima
ObjectivesTo estimate the prevalence and the associated factors with voice disorders (VDs) in older adults living in nursing homes.Study designCross-sectional.MethodsA sample of 117 Brazilian individuals of both sexes and preserved cognitive function, aged >59 years, living in 10 nursing homes, was studied. VDs were screened using the validated tool “Rastreamento de Alterações Vocais em Idosos” (RAVI—Screening for Voice Disorders in Older Adults). Associated factors included variables related to socioeconomic and demographic profile; nursing home; general health; ear, nose, and throat conditions; lifestyle; functionality; and psychosocial status. Bivariate analysis was performed by Pearson's chi-square or Fisher's exact test. Multivariate analysis was performed by multiple binomial regression. The significance level was 5%.ResultsThe prevalence of VDs was 39.3% (95% confidence interval [CI] = 30.4–48.1). There was no significant difference in prevalence according to age and sex. Multivariate analysis revealed that the prevalence of VDs were independently associated with anxiety symptoms (prevalence ratio [PR] = 1.97, 95% CI = 1.17–3.29), smoking (PR = 1.56, CI = 1.02–2.38), general daily inactivity (PR = 1.62, CI = 1.10–2.38), temporomandibular disorder (PR = 1.68, CI = 1.11–2.54), choking (PR = 1.53, CI = 1.06–2.20), and self-reported hearing loss (PR = 1.52, CI = 1.04–2.21).ConclusionVDs are common among older adults with preserved cognitive function living in nursing homes. The associated factors with VDs in this population can be prevented, diagnosed, controlled, or treated. Screening procedures and early intervention should be considered.



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Cochlear Nerve Deficiency and Brain Abnormalities in Pediatric Patients.

Cochlear Nerve Deficiency and Brain Abnormalities in Pediatric Patients.

Otol Neurotol. 2017 Jan 04;:

Authors: Morlet T, Pazuniak M, O'Reilly RC, Kandula V, Choudhary AK

Abstract
HYPOTHESIS: To investigate the intracranial abnormalities present in children with cochlear nerve deficiency (CND), including abnormalities of other cranial nerves, and to describe their auditory abilities.
BACKGROUND: The prevalence of CND has increased with the development of high resolution magnetic resonance imaging (MRI). There are varying degrees of CND from true aplasia to hypoplasia. The etiology of CND remains unclear and it may be associated with intracranial abnormalities in some instances. CND needs to be identified as early as possible to ensure prompt and adequate management of hearing loss since hearing aids and cochlear implants may not be an option.
METHODS: A retrospective chart review of 56 ears of pediatric patients with CND was conducted between August 2006 and November 2014 at a tertiary care pediatric hospital.
RESULTS: 27.6% of children had cochlear abnormalities and 48.9.8% had concomitant vestibular anomalies. Five patients had absent or abnormal facial nerves and two patients had aplastic bilateral olfactory nerves. In the 27 ears with an absent nerve that were functionally tested, eight (29.6%) had partial hearing which indicates the presence of an extremely small nerve whose size is below the limits of spatial resolution of the MRI.
CONCLUSION: MRI is becoming the initial imaging choice for children with sensorineural hearing loss to identify CND and other brain anomalies. Concomitant vestibular and cochlear abnormalities were observed in respectively half and one-third of the pediatric patients with CND. The incidence of vestibular malformation suggests that balance testing should be recommended for most if not all CND patients.

PMID: 28060175 [PubMed - as supplied by publisher]

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Hydroxyapatite cement cranioplasty following translabyrinthine approach: Long-term study of 369 cases.

Hydroxyapatite cement cranioplasty following translabyrinthine approach: Long-term study of 369 cases.

Laryngoscope. 2017 Jan 06;:

Authors: Volsky PG, Hillman TA, Stromberg KJ, Buchinsky FJ, Chen DA, Jackson NM, Arriaga MA

Abstract
OBJECTIVE: To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long-term safety and efficacy in repairing translabyrinthine skull-base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections.
STUDY DESIGN: Retrospective case-control study (primary study arm); prospective cross-sectional study of patients not examined within the last 5 years (secondary arm).
SETTING: tertiary-care neurotology private practice and academic practice (two centers).
METHODS: Hydroxyapatite cement implanted following translabyrinthine approach, with or without fat graft, was included. Combined approaches were excluded. Implant-associated adverse events were defined as 1) CSF leaks requiring reoperation or spinal drainage, and (2) infections requiring reoperation. Patients not examined within 5 years were interviewed by telephone to update their condition. Incidence of adverse events was compared to published data for translabyrinthine cranioplasty using fat graft alone. Implant survival analysis was performed.
RESULTS: The study cohort included 369 HAC implants in the same number of patients. There were seven CSF leaks and seven infections. Combined (n = 14) incidence of adverse events was 3.8% (2.09%, 6.28%). Compared to fat graft alone, the adverse events associated with HAC were fewer (P < 0.001). Up to 15 years (5,475 days), HAC cement maintained 95% adverse event-free survival. There were no cases of meningitis.
CONCLUSION: Cranioplasty using HAC with autologous fat following translabyrinthine skull-base surgery is safer and more effective than fat graft alone, up to 15 years after surgery.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.

PMID: 28059442 [PubMed - as supplied by publisher]

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Cochlear Nerve Deficiency and Brain Abnormalities in Pediatric Patients.

Cochlear Nerve Deficiency and Brain Abnormalities in Pediatric Patients.

Otol Neurotol. 2017 Jan 04;:

Authors: Morlet T, Pazuniak M, O'Reilly RC, Kandula V, Choudhary AK

Abstract
HYPOTHESIS: To investigate the intracranial abnormalities present in children with cochlear nerve deficiency (CND), including abnormalities of other cranial nerves, and to describe their auditory abilities.
BACKGROUND: The prevalence of CND has increased with the development of high resolution magnetic resonance imaging (MRI). There are varying degrees of CND from true aplasia to hypoplasia. The etiology of CND remains unclear and it may be associated with intracranial abnormalities in some instances. CND needs to be identified as early as possible to ensure prompt and adequate management of hearing loss since hearing aids and cochlear implants may not be an option.
METHODS: A retrospective chart review of 56 ears of pediatric patients with CND was conducted between August 2006 and November 2014 at a tertiary care pediatric hospital.
RESULTS: 27.6% of children had cochlear abnormalities and 48.9.8% had concomitant vestibular anomalies. Five patients had absent or abnormal facial nerves and two patients had aplastic bilateral olfactory nerves. In the 27 ears with an absent nerve that were functionally tested, eight (29.6%) had partial hearing which indicates the presence of an extremely small nerve whose size is below the limits of spatial resolution of the MRI.
CONCLUSION: MRI is becoming the initial imaging choice for children with sensorineural hearing loss to identify CND and other brain anomalies. Concomitant vestibular and cochlear abnormalities were observed in respectively half and one-third of the pediatric patients with CND. The incidence of vestibular malformation suggests that balance testing should be recommended for most if not all CND patients.

PMID: 28060175 [PubMed - as supplied by publisher]

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Hydroxyapatite cement cranioplasty following translabyrinthine approach: Long-term study of 369 cases.

Hydroxyapatite cement cranioplasty following translabyrinthine approach: Long-term study of 369 cases.

Laryngoscope. 2017 Jan 06;:

Authors: Volsky PG, Hillman TA, Stromberg KJ, Buchinsky FJ, Chen DA, Jackson NM, Arriaga MA

Abstract
OBJECTIVE: To report the authors' experience with hydroxyapatite cement (HAC) cranioplasty and analyze the material's long-term safety and efficacy in repairing translabyrinthine skull-base defects by examining adverse events, specifically cerebrospinal fluid (CSF) leaks and surgical site infections.
STUDY DESIGN: Retrospective case-control study (primary study arm); prospective cross-sectional study of patients not examined within the last 5 years (secondary arm).
SETTING: tertiary-care neurotology private practice and academic practice (two centers).
METHODS: Hydroxyapatite cement implanted following translabyrinthine approach, with or without fat graft, was included. Combined approaches were excluded. Implant-associated adverse events were defined as 1) CSF leaks requiring reoperation or spinal drainage, and (2) infections requiring reoperation. Patients not examined within 5 years were interviewed by telephone to update their condition. Incidence of adverse events was compared to published data for translabyrinthine cranioplasty using fat graft alone. Implant survival analysis was performed.
RESULTS: The study cohort included 369 HAC implants in the same number of patients. There were seven CSF leaks and seven infections. Combined (n = 14) incidence of adverse events was 3.8% (2.09%, 6.28%). Compared to fat graft alone, the adverse events associated with HAC were fewer (P < 0.001). Up to 15 years (5,475 days), HAC cement maintained 95% adverse event-free survival. There were no cases of meningitis.
CONCLUSION: Cranioplasty using HAC with autologous fat following translabyrinthine skull-base surgery is safer and more effective than fat graft alone, up to 15 years after surgery.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2017.

PMID: 28059442 [PubMed - as supplied by publisher]

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Interpersonal interactions for haptic guidance during maximum forward reaching

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): S.M. Steinl, L. Johannsen
Caregiver–patient interactions rely on interpersonal coordination (IPC) involving the haptic and visual modalities. We investigated in healthy individuals spontaneous IPC during joint maximum forward reaching. A ‘contact-provider’ (CP; n=2) kept light interpersonal touch (IPT) laterally with the wrist of the extended arm of a forward reaching, blind-folded ‘contact-receiver’ (CR; n=22). Due to the stance configuration, CP was intrinsically more stable. CR received haptic feedback during forward reaching in two ways: (1) presence of a light object (OBT) at the fingertips, (2) provision of IPT. CP delivered IPT with or without vision or tracked manually with vision but without IPT. CR’s variabilities of Centre-of-Pressure velocity (CoP) and wrist velocity, interpersonal cross-correlations and time lags served as outcome variables. OBT presence increased CR’s reaching amplitude and reduced postural variability in the reach end-state. CR’s variability was lowest when CP applied IPT without vision. OBT decreased the strength of IPC. Correlation time lags indicated that CP retained a predominantly reactive mode with CR taking the lead. When CP had no vision, presumably preventing an effect of visual dominance, OBT presence made a qualitative difference: with OBT absent, CP was leading CR. This observation might indicate a switch in CR’s coordinative strategy by attending mainly to CP’s haptic ‘anchor’. Our paradigm implies that in clinical settings the sensorimotor states of both interacting partners need to be considered. We speculate that haptic guidance by a caregiver is more effective when IPT resembles the only link between both partners.



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Interpersonal interactions for haptic guidance during maximum forward reaching

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): S.M. Steinl, L. Johannsen
Caregiver–patient interactions rely on interpersonal coordination (IPC) involving the haptic and visual modalities. We investigated in healthy individuals spontaneous IPC during joint maximum forward reaching. A ‘contact-provider’ (CP; n=2) kept light interpersonal touch (IPT) laterally with the wrist of the extended arm of a forward reaching, blind-folded ‘contact-receiver’ (CR; n=22). Due to the stance configuration, CP was intrinsically more stable. CR received haptic feedback during forward reaching in two ways: (1) presence of a light object (OBT) at the fingertips, (2) provision of IPT. CP delivered IPT with or without vision or tracked manually with vision but without IPT. CR’s variabilities of Centre-of-Pressure velocity (CoP) and wrist velocity, interpersonal cross-correlations and time lags served as outcome variables. OBT presence increased CR’s reaching amplitude and reduced postural variability in the reach end-state. CR’s variability was lowest when CP applied IPT without vision. OBT decreased the strength of IPC. Correlation time lags indicated that CP retained a predominantly reactive mode with CR taking the lead. When CP had no vision, presumably preventing an effect of visual dominance, OBT presence made a qualitative difference: with OBT absent, CP was leading CR. This observation might indicate a switch in CR’s coordinative strategy by attending mainly to CP’s haptic ‘anchor’. Our paradigm implies that in clinical settings the sensorimotor states of both interacting partners need to be considered. We speculate that haptic guidance by a caregiver is more effective when IPT resembles the only link between both partners.



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Interpersonal interactions for haptic guidance during maximum forward reaching

Publication date: March 2017
Source:Gait & Posture, Volume 53
Author(s): S.M. Steinl, L. Johannsen
Caregiver–patient interactions rely on interpersonal coordination (IPC) involving the haptic and visual modalities. We investigated in healthy individuals spontaneous IPC during joint maximum forward reaching. A ‘contact-provider’ (CP; n=2) kept light interpersonal touch (IPT) laterally with the wrist of the extended arm of a forward reaching, blind-folded ‘contact-receiver’ (CR; n=22). Due to the stance configuration, CP was intrinsically more stable. CR received haptic feedback during forward reaching in two ways: (1) presence of a light object (OBT) at the fingertips, (2) provision of IPT. CP delivered IPT with or without vision or tracked manually with vision but without IPT. CR’s variabilities of Centre-of-Pressure velocity (CoP) and wrist velocity, interpersonal cross-correlations and time lags served as outcome variables. OBT presence increased CR’s reaching amplitude and reduced postural variability in the reach end-state. CR’s variability was lowest when CP applied IPT without vision. OBT decreased the strength of IPC. Correlation time lags indicated that CP retained a predominantly reactive mode with CR taking the lead. When CP had no vision, presumably preventing an effect of visual dominance, OBT presence made a qualitative difference: with OBT absent, CP was leading CR. This observation might indicate a switch in CR’s coordinative strategy by attending mainly to CP’s haptic ‘anchor’. Our paradigm implies that in clinical settings the sensorimotor states of both interacting partners need to be considered. We speculate that haptic guidance by a caregiver is more effective when IPT resembles the only link between both partners.



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