Πέμπτη 16 Μαρτίου 2017

Asymptomatic radiographic hip osteoarthritis is associated with gait differences, especially in women: A population-based study

Publication date: Available online 16 March 2017
Source:Gait & Posture
Author(s): Vincentius J.A. Verlinden, Marjolein de Kruijf, Sita M.A. Bierma-Zeinstra, Albert Hofman, André G. Uitterlinden, M. Arfan Ikram, Joyce B.J. van Meurs, Jos N. van der Geest
BackgroundHip and knee osteoarthritis (OA) are debilitating diseases that impair gait at severe stages. Although associations between OA and gait are established for normal walking, little is known on its relation with turning and tandem (heel-to-toe) walking. Furthermore, it is unknown how asymptomatic OA associates with gait, and whether associations differ by sex. We investigated how symptomatic and asymptomatic hip and knee OA associate with gait in community-dwelling individuals.MethodsIn 2706 participants of a population-based cohort study, gait was assessed by electronic walkway and summarised into seven gait domains. Hip and knee radiographs were graded for radiographic OA (ROA) using the Kellgren and Lawrence (KResultsIn total, 177 participants (6.5%) had hip ROA and 441 (16.3%) knee ROA. We found no associations of knee ROA with gait. Hip ROA associated with Rhythm, Tandem, and Turning. Furthermore, unilateral hip ROA associated with larger gait asymmetry and gait differences in osteoarthritic and non-osteoarthritic leg, when compared to people without hip ROA. Associations between hip ROA and gait were generally stronger for women than men. Associations for hip ROA remained after restricting to asymptomatic ROA.ConclusionHip ROA, but not knee ROA, associates with gait differences in normal walking, turning, and tandem walking in community-dwelling individuals. These associations differ between the sexes, and are already present for asymptomatic ROA.



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Asymptomatic radiographic hip osteoarthritis is associated with gait differences, especially in women: A population-based study

Publication date: Available online 16 March 2017
Source:Gait & Posture
Author(s): Vincentius J.A. Verlinden, Marjolein de Kruijf, Sita M.A. Bierma-Zeinstra, Albert Hofman, André G. Uitterlinden, M. Arfan Ikram, Joyce B.J. van Meurs, Jos N. van der Geest
BackgroundHip and knee osteoarthritis (OA) are debilitating diseases that impair gait at severe stages. Although associations between OA and gait are established for normal walking, little is known on its relation with turning and tandem (heel-to-toe) walking. Furthermore, it is unknown how asymptomatic OA associates with gait, and whether associations differ by sex. We investigated how symptomatic and asymptomatic hip and knee OA associate with gait in community-dwelling individuals.MethodsIn 2706 participants of a population-based cohort study, gait was assessed by electronic walkway and summarised into seven gait domains. Hip and knee radiographs were graded for radiographic OA (ROA) using the Kellgren and Lawrence (KResultsIn total, 177 participants (6.5%) had hip ROA and 441 (16.3%) knee ROA. We found no associations of knee ROA with gait. Hip ROA associated with Rhythm, Tandem, and Turning. Furthermore, unilateral hip ROA associated with larger gait asymmetry and gait differences in osteoarthritic and non-osteoarthritic leg, when compared to people without hip ROA. Associations between hip ROA and gait were generally stronger for women than men. Associations for hip ROA remained after restricting to asymptomatic ROA.ConclusionHip ROA, but not knee ROA, associates with gait differences in normal walking, turning, and tandem walking in community-dwelling individuals. These associations differ between the sexes, and are already present for asymptomatic ROA.



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Asymptomatic radiographic hip osteoarthritis is associated with gait differences, especially in women: A population-based study

Publication date: Available online 16 March 2017
Source:Gait & Posture
Author(s): Vincentius J.A. Verlinden, Marjolein de Kruijf, Sita M.A. Bierma-Zeinstra, Albert Hofman, André G. Uitterlinden, M. Arfan Ikram, Joyce B.J. van Meurs, Jos N. van der Geest
BackgroundHip and knee osteoarthritis (OA) are debilitating diseases that impair gait at severe stages. Although associations between OA and gait are established for normal walking, little is known on its relation with turning and tandem (heel-to-toe) walking. Furthermore, it is unknown how asymptomatic OA associates with gait, and whether associations differ by sex. We investigated how symptomatic and asymptomatic hip and knee OA associate with gait in community-dwelling individuals.MethodsIn 2706 participants of a population-based cohort study, gait was assessed by electronic walkway and summarised into seven gait domains. Hip and knee radiographs were graded for radiographic OA (ROA) using the Kellgren and Lawrence (KResultsIn total, 177 participants (6.5%) had hip ROA and 441 (16.3%) knee ROA. We found no associations of knee ROA with gait. Hip ROA associated with Rhythm, Tandem, and Turning. Furthermore, unilateral hip ROA associated with larger gait asymmetry and gait differences in osteoarthritic and non-osteoarthritic leg, when compared to people without hip ROA. Associations between hip ROA and gait were generally stronger for women than men. Associations for hip ROA remained after restricting to asymptomatic ROA.ConclusionHip ROA, but not knee ROA, associates with gait differences in normal walking, turning, and tandem walking in community-dwelling individuals. These associations differ between the sexes, and are already present for asymptomatic ROA.



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Itunes Tinnitus

What Is Tinnitus?
Tinnitus, or ringing in the ears, is a condition in which you hear phantom sounds that other people do not hear. The sounds are a result of age-related hearing loss, an injury to your ear or circulatory system disorders. This perception of sound in the ears is a common frustration and affects up to one in every five adults in the United States. Treatments such as iTunes tinnitus melodies aim to mask the ringing in your ears so that the tinnitus does not annoy you or cause negative impacts on your life.

How Our Itunes Tinnitus Sounds Work
Each person experiences a different frequency of tinnitus sounds. If you want to use masking audio to get rid of the tinnitus, you will need to detect the frequency of the sounds you perceive. You can do this on the Audio Notch website or with a participating audiologist. Once you know the frequency of your tinnitus, you will then visit the Audio Notch website and create a masking audio file. The online software is easy to use and simple to navigate through. Your customized notched sound therapy will be produced online. You can then stream or download your personalized audio file and play it on your desktop or laptop computer for up to 1.5 hours per day as a form of tinnitus therapy. You can also download your file to any device with MP3 capability.

What to Expect from Our Itunes Tinnitus Sounds
Over time, the volume of your tinnitus sounds will decrease. Once you no longer notice tinnitus, you may decrease the frequency of the therapeutic audio files. If you discover that your frequency of tinnitus changes, you can simply make yourself a new notched audio file and restart your therapy with the new sounds. Most people notice that the volume of their tinnitus decreases within a few weeks. Over the course of a few months, your tinnitus may go away or bother you only intermittently.

How to Access Itunes Tinnitus Sounds and Use Them
Accessing the iTunes Tinnitus therapy system is simple. Just go to your account page and open iTunes. Then choose the file that you want to listen to. If you are importing the file onto an iTunes-compatible device, be sure to sync your device so that it receives the new data. Play your white noise file on a repeat pattern according to your treatment plan.



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Speech perception in Mandarin-speaking children with cochlear implants: A systematic review

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Speech perception in Mandarin-speaking children with cochlear implants: A systematic review

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Speech perception in Mandarin-speaking children with cochlear implants: A systematic review

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Does Combat Hearing Preservation Equipment Affect Balance?

Related Articles

Does Combat Hearing Preservation Equipment Affect Balance?

Mil Med. 2017 Mar;182(S1):230-233

Authors: Ambrosio A, Hoffer AN, Hoffer M

Abstract
OBJECTIVES: (1) To investigate whether the occlusion effect and hearing attenuation produced by 3M Combat Arms Ear Plugs (CAEP) affects balance when compared to no hearing protection and (2) to investigate whether the occlusion effect and noise-canceling capabilities of the Nacre QuietPro system affects balance when compared to no hearing protection.
METHODS: This prospective study collected pilot data for investigation of mechanisms of balance. 20 subjects with normal hearing and no vestibular dysfunction were tested with blackened goggles in three conditions-no hearing protection, CAEP, and with the Nacre QuietPro.
RESULTS: A static posturogrpahy forceplate was used to measure center of gravity angular acceleration for a period of 20 seconds. The order of the conditions tested was randomized for each individual. Mean angular acceleration and standard deviation (degrees/second) of the three conditions were: (1) no hearing protection (control), 0.65 + 0.19, (2) CAEP, 0.69 + 0.23, and (3) QuietPro, 0.70 + 0.20 (one-way analysis of variance [ANOVA], df = 2, F = 0.38, p = 0.706).
CONCLUSIONS: The components of an intact balance system include a variety of neural inputs, to include vesitbuloocular, vestibulospinal, and labyrinthine afferents. Both the CAEP and Nacre QuietPro are hearing preservation devices utilized during Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan. Our pilot data show no decrement in balance with utilization of these combat hearing preservation devices.

PMID: 28291479 [PubMed - in process]



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Does Combat Hearing Preservation Equipment Affect Balance?

Related Articles

Does Combat Hearing Preservation Equipment Affect Balance?

Mil Med. 2017 Mar;182(S1):230-233

Authors: Ambrosio A, Hoffer AN, Hoffer M

Abstract
OBJECTIVES: (1) To investigate whether the occlusion effect and hearing attenuation produced by 3M Combat Arms Ear Plugs (CAEP) affects balance when compared to no hearing protection and (2) to investigate whether the occlusion effect and noise-canceling capabilities of the Nacre QuietPro system affects balance when compared to no hearing protection.
METHODS: This prospective study collected pilot data for investigation of mechanisms of balance. 20 subjects with normal hearing and no vestibular dysfunction were tested with blackened goggles in three conditions-no hearing protection, CAEP, and with the Nacre QuietPro.
RESULTS: A static posturogrpahy forceplate was used to measure center of gravity angular acceleration for a period of 20 seconds. The order of the conditions tested was randomized for each individual. Mean angular acceleration and standard deviation (degrees/second) of the three conditions were: (1) no hearing protection (control), 0.65 + 0.19, (2) CAEP, 0.69 + 0.23, and (3) QuietPro, 0.70 + 0.20 (one-way analysis of variance [ANOVA], df = 2, F = 0.38, p = 0.706).
CONCLUSIONS: The components of an intact balance system include a variety of neural inputs, to include vesitbuloocular, vestibulospinal, and labyrinthine afferents. Both the CAEP and Nacre QuietPro are hearing preservation devices utilized during Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan. Our pilot data show no decrement in balance with utilization of these combat hearing preservation devices.

PMID: 28291479 [PubMed - in process]



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Speech perception in Mandarin-speaking children with cochlear implants: A systematic review.

Speech perception in Mandarin-speaking children with cochlear implants: A systematic review.

Int J Audiol. 2017 Mar 15;:1-10

Authors: Chen Y, Wong LL

Abstract
OBJECTIVE: This paper reviewed the literature on the trajectories and the factors significantly affecting post-implantation speech perception development in Mandarin-speaking children with cochlear implants (CIs).
DESIGN: A systematic literature search of textbooks and peer-reviewed published journal articles in online bibliographic databases was conducted.
STUDY SAMPLE: PubMed, Scopus and Wiley online library were searched for eligible studies based on predefined inclusion and exclusion criteria.
RESULTS: A total of 14 journal articles were selected for this review. A number of consistent results were found. That is, children with CIs, as a group, exhibited steep improvement in early speech perception, from exhibiting few prelingual auditory behaviours before implantation to identifying sentences in noise after one year of CI use. After one to three years of CI use, children are expected to identify tones above chance and recognition of words in noise. In addition, early age at implantation, longer duration of CI use and higher maternal education level contributed to greater improvements in speech perception.
CONCLUSIONS: Findings from this review will contribute to the establishment of appropriate short-term developmental goals for Mandarin-speaking children with CIs in mainland China and clinicians could use them to determine whether children have made appropriate progress with CIs.

PMID: 28296526 [PubMed - as supplied by publisher]



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Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing.

Related Articles

Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing.

Int J Audiol. 2017 Mar 14;:1-9

Authors: Rønne FM, Laugesen S, Jensen NS

Abstract
OBJECTIVE: To investigate the magnitude of the change in speech-reception threshold (SRT) provided by altering four different test-setup parameters. Furthermore, to determine whether these changes in SRT are of a sufficient magnitude, such that they can be used to design a test-setup in future experiments that target a predefined signal-to-noise ratio (SNR) region. This could be particularly important if the test contrast investigated is confounded with test SNR.
DESIGN: The investigated test-setup parameters were: Spatial separation between target (0°) and maskers (±15°, ±30°, ±45°, or ±75°), number of maskers (two, four or six), scoring method (scoring percent-correct words or sentences) and masker gender (same or opposite to target). Twenty SRTs were measured per test subject.
STUDY SAMPLE: Twenty hearing-impaired test subjects participated over two visits.
RESULTS: Alteration of masker gender, spatial separation between target and masker (±15°, ±30°, ± 45°), and scoring method was shown to offer SRT changes of a sufficient magnitude. The different test setups resulted in average SRTs ranging from -4.0 to 3.3 dB.
CONCLUSION: Deliberately selecting test setup parameters can change the overall difficulty of the test by up to 7.3 dB SRT. Thus, a future experiment can, to this extent, be designed to target a specific SNR region.

PMID: 28290709 [PubMed - as supplied by publisher]



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Constitutional LZTR1 Mutation Presenting with a Unilateral Vestibular Schwannoma in a Teenager.

Constitutional LZTR1 Mutation Presenting with a Unilateral Vestibular Schwannoma in a Teenager.

Clin Genet. 2017 Mar 14;:

Authors: Gripp KW, Baker L, Kandula V, Piatt J, Walter A, Chen Z, Messiaen L

Abstract
Schwannomatosis is a rare neurofibromatosis clinically diagnosed by age-dependent criteria, with bilateral vestibular schwannoma and/or a constitutional NF2 mutation representing exclusion criteria. Following SMARCB1 germline mutations, constitutional mutations in LZTR1 were discovered. We report on the molecular investigation in a patient presenting at 14 years with a unilateral vestibular schwannoma, ultimately causing blindness and unilateral hearing loss, in the absence of other schwannomas or a positive family history. In DNA derived from frozen tumor tissue, a comprehensive NF2, SMARCB1 and LZTR1 analysis showed an NF2 truncating mutation c.1006_1021delins16; an LZTR1 mutation c.791+1G>A; and a partial 22q deletion including NF2, SMARCB1 and LZTR1. Sequence analysis on peripheral blood derived DNA showed the LZTR1 mutation to be constitutional, but the NF2 mutation and partial 22q deletion were not found, indicating them to be somatic events. RNA-based targeted analysis confirmed missplicing of LZTR1 intron 8, predicted to result in a premature stop codon. This LZTR1 mutation was paternally inherited. While isolated vestibular schwannoma or NF2 may be considered in a young individual with a unilateral vestibular schwannoma, this report suggests that LZTR1-related schwannomatosis be added to this differential diagnosis.

PMID: 28295212 [PubMed - as supplied by publisher]



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Isolated Hearing Impairment Caused by SPATA5 Mutations in a Family with Variable Phenotypic Expression.

Related Articles

Isolated Hearing Impairment Caused by SPATA5 Mutations in a Family with Variable Phenotypic Expression.

Adv Exp Med Biol. 2017 Mar 15;:

Authors: Szczałuba K, Szymańska K, Kosińska J, Pollak A, Murcia V, Kędra A, Stawiński P, Rydzanicz M, Demkow U, Płoski R

Abstract
Biallelic mutations in the SPATA5 gene, encoding ATPase family protein, are an important cause of newly recognized epileptic encephalopathy classified as epilepsy, hearing loss, and mental retardation syndrome (EHLMRS, OMIM: 616577). Herein we describe a family in which two SPATA5 mutations with established pathogenicity (p.Thr330del and c.1714+1G>A) were found in the proband and her younger sister. The proband had a similar clinical picture to the previous descriptions of EHLMRS. In the sister, the only manifestation was an isolated sensorineural hearing loss. Our findings extend the phenotypic spectrum of SPATA5-associated diseases and indicate that SPATA5 defects may account for a fraction of isolated sensorineural hearing impairment cases.

PMID: 28293831 [PubMed - as supplied by publisher]



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A novel biallelic splice site mutation of TECTA causes moderate to severe hearing impairment in an Algerian family.

http:--linkinghub.elsevier.com-ihub-imag Related Articles

A novel biallelic splice site mutation of TECTA causes moderate to severe hearing impairment in an Algerian family.

Int J Pediatr Otorhinolaryngol. 2016 Aug;87:28-33

Authors: Behlouli A, Bonnet C, Abdi S, Hasbellaoui M, Boudjenah F, Hardelin JP, Louha M, Makrelouf M, Ammar-Khodja F, Zenati A, Petit C

Abstract
Congenital deafness is certainly one of the most common monogenic diseases in humans, but it is also one of the most genetically heterogeneous, which makes molecular diagnosis challenging in most cases. Whole-exome sequencing in two out of three Algerian siblings affected by recessively-inherited, moderate to severe sensorineural deafness allowed us to identify a novel splice donor site mutation (c.5272+1G > A) in the gene encoding α-tectorin, a major component of the cochlear tectorial membrane. The mutation was present at the homozygous state in the three affected siblings, and at the heterozygous state in their unaffected, consanguineous parents. To our knowledge, this is the first reported TECTA mutation leading to the DFNB21 form of hearing impairment among Maghrebian individuals suffering from congenital hearing impairment, which further illustrates the diversity of the genes involved in congenital deafness in the Maghreb.

PMID: 27368438 [PubMed - indexed for MEDLINE]



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Speech perception in Mandarin-speaking children with cochlear implants: A systematic review.

Speech perception in Mandarin-speaking children with cochlear implants: A systematic review.

Int J Audiol. 2017 Mar 15;:1-10

Authors: Chen Y, Wong LL

Abstract
OBJECTIVE: This paper reviewed the literature on the trajectories and the factors significantly affecting post-implantation speech perception development in Mandarin-speaking children with cochlear implants (CIs).
DESIGN: A systematic literature search of textbooks and peer-reviewed published journal articles in online bibliographic databases was conducted.
STUDY SAMPLE: PubMed, Scopus and Wiley online library were searched for eligible studies based on predefined inclusion and exclusion criteria.
RESULTS: A total of 14 journal articles were selected for this review. A number of consistent results were found. That is, children with CIs, as a group, exhibited steep improvement in early speech perception, from exhibiting few prelingual auditory behaviours before implantation to identifying sentences in noise after one year of CI use. After one to three years of CI use, children are expected to identify tones above chance and recognition of words in noise. In addition, early age at implantation, longer duration of CI use and higher maternal education level contributed to greater improvements in speech perception.
CONCLUSIONS: Findings from this review will contribute to the establishment of appropriate short-term developmental goals for Mandarin-speaking children with CIs in mainland China and clinicians could use them to determine whether children have made appropriate progress with CIs.

PMID: 28296526 [PubMed - as supplied by publisher]



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Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing.

Related Articles

Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing.

Int J Audiol. 2017 Mar 14;:1-9

Authors: Rønne FM, Laugesen S, Jensen NS

Abstract
OBJECTIVE: To investigate the magnitude of the change in speech-reception threshold (SRT) provided by altering four different test-setup parameters. Furthermore, to determine whether these changes in SRT are of a sufficient magnitude, such that they can be used to design a test-setup in future experiments that target a predefined signal-to-noise ratio (SNR) region. This could be particularly important if the test contrast investigated is confounded with test SNR.
DESIGN: The investigated test-setup parameters were: Spatial separation between target (0°) and maskers (±15°, ±30°, ±45°, or ±75°), number of maskers (two, four or six), scoring method (scoring percent-correct words or sentences) and masker gender (same or opposite to target). Twenty SRTs were measured per test subject.
STUDY SAMPLE: Twenty hearing-impaired test subjects participated over two visits.
RESULTS: Alteration of masker gender, spatial separation between target and masker (±15°, ±30°, ± 45°), and scoring method was shown to offer SRT changes of a sufficient magnitude. The different test setups resulted in average SRTs ranging from -4.0 to 3.3 dB.
CONCLUSION: Deliberately selecting test setup parameters can change the overall difficulty of the test by up to 7.3 dB SRT. Thus, a future experiment can, to this extent, be designed to target a specific SNR region.

PMID: 28290709 [PubMed - as supplied by publisher]



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Speech perception in Mandarin-speaking children with cochlear implants: A systematic review.

Speech perception in Mandarin-speaking children with cochlear implants: A systematic review.

Int J Audiol. 2017 Mar 15;:1-10

Authors: Chen Y, Wong LL

Abstract
OBJECTIVE: This paper reviewed the literature on the trajectories and the factors significantly affecting post-implantation speech perception development in Mandarin-speaking children with cochlear implants (CIs).
DESIGN: A systematic literature search of textbooks and peer-reviewed published journal articles in online bibliographic databases was conducted.
STUDY SAMPLE: PubMed, Scopus and Wiley online library were searched for eligible studies based on predefined inclusion and exclusion criteria.
RESULTS: A total of 14 journal articles were selected for this review. A number of consistent results were found. That is, children with CIs, as a group, exhibited steep improvement in early speech perception, from exhibiting few prelingual auditory behaviours before implantation to identifying sentences in noise after one year of CI use. After one to three years of CI use, children are expected to identify tones above chance and recognition of words in noise. In addition, early age at implantation, longer duration of CI use and higher maternal education level contributed to greater improvements in speech perception.
CONCLUSIONS: Findings from this review will contribute to the establishment of appropriate short-term developmental goals for Mandarin-speaking children with CIs in mainland China and clinicians could use them to determine whether children have made appropriate progress with CIs.

PMID: 28296526 [PubMed - as supplied by publisher]



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Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing.

Related Articles

Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing.

Int J Audiol. 2017 Mar 14;:1-9

Authors: Rønne FM, Laugesen S, Jensen NS

Abstract
OBJECTIVE: To investigate the magnitude of the change in speech-reception threshold (SRT) provided by altering four different test-setup parameters. Furthermore, to determine whether these changes in SRT are of a sufficient magnitude, such that they can be used to design a test-setup in future experiments that target a predefined signal-to-noise ratio (SNR) region. This could be particularly important if the test contrast investigated is confounded with test SNR.
DESIGN: The investigated test-setup parameters were: Spatial separation between target (0°) and maskers (±15°, ±30°, ±45°, or ±75°), number of maskers (two, four or six), scoring method (scoring percent-correct words or sentences) and masker gender (same or opposite to target). Twenty SRTs were measured per test subject.
STUDY SAMPLE: Twenty hearing-impaired test subjects participated over two visits.
RESULTS: Alteration of masker gender, spatial separation between target and masker (±15°, ±30°, ± 45°), and scoring method was shown to offer SRT changes of a sufficient magnitude. The different test setups resulted in average SRTs ranging from -4.0 to 3.3 dB.
CONCLUSION: Deliberately selecting test setup parameters can change the overall difficulty of the test by up to 7.3 dB SRT. Thus, a future experiment can, to this extent, be designed to target a specific SNR region.

PMID: 28290709 [PubMed - as supplied by publisher]



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Speech perception in Mandarin-speaking children with cochlear implants: A systematic review.

Speech perception in Mandarin-speaking children with cochlear implants: A systematic review.

Int J Audiol. 2017 Mar 15;:1-10

Authors: Chen Y, Wong LL

Abstract
OBJECTIVE: This paper reviewed the literature on the trajectories and the factors significantly affecting post-implantation speech perception development in Mandarin-speaking children with cochlear implants (CIs).
DESIGN: A systematic literature search of textbooks and peer-reviewed published journal articles in online bibliographic databases was conducted.
STUDY SAMPLE: PubMed, Scopus and Wiley online library were searched for eligible studies based on predefined inclusion and exclusion criteria.
RESULTS: A total of 14 journal articles were selected for this review. A number of consistent results were found. That is, children with CIs, as a group, exhibited steep improvement in early speech perception, from exhibiting few prelingual auditory behaviours before implantation to identifying sentences in noise after one year of CI use. After one to three years of CI use, children are expected to identify tones above chance and recognition of words in noise. In addition, early age at implantation, longer duration of CI use and higher maternal education level contributed to greater improvements in speech perception.
CONCLUSIONS: Findings from this review will contribute to the establishment of appropriate short-term developmental goals for Mandarin-speaking children with CIs in mainland China and clinicians could use them to determine whether children have made appropriate progress with CIs.

PMID: 28296526 [PubMed - as supplied by publisher]



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Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing.

Related Articles

Selection of test-setup parameters to target specific signal-to-noise regions in speech-on-speech intelligibility testing.

Int J Audiol. 2017 Mar 14;:1-9

Authors: Rønne FM, Laugesen S, Jensen NS

Abstract
OBJECTIVE: To investigate the magnitude of the change in speech-reception threshold (SRT) provided by altering four different test-setup parameters. Furthermore, to determine whether these changes in SRT are of a sufficient magnitude, such that they can be used to design a test-setup in future experiments that target a predefined signal-to-noise ratio (SNR) region. This could be particularly important if the test contrast investigated is confounded with test SNR.
DESIGN: The investigated test-setup parameters were: Spatial separation between target (0°) and maskers (±15°, ±30°, ±45°, or ±75°), number of maskers (two, four or six), scoring method (scoring percent-correct words or sentences) and masker gender (same or opposite to target). Twenty SRTs were measured per test subject.
STUDY SAMPLE: Twenty hearing-impaired test subjects participated over two visits.
RESULTS: Alteration of masker gender, spatial separation between target and masker (±15°, ±30°, ± 45°), and scoring method was shown to offer SRT changes of a sufficient magnitude. The different test setups resulted in average SRTs ranging from -4.0 to 3.3 dB.
CONCLUSION: Deliberately selecting test setup parameters can change the overall difficulty of the test by up to 7.3 dB SRT. Thus, a future experiment can, to this extent, be designed to target a specific SNR region.

PMID: 28290709 [PubMed - as supplied by publisher]



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mHealth Products Made Signia CES 2017 Innovation Awards Honoree

Signia (https:/​/www.signiausa.com/) was chosen as a CES 2017 Innovation Awards Honoree for two of its wireless and mobile hearing health care products, the Cellion hearing aid and the myHearing app. Honoree titles are given to products that a panel of independent industry designers and engineers consider to be the most cutting edge consumer electronics products in a category.

Signia-CES.jpg

Cellion, a lithium-ion inductive and rechargeable hearing aid, boasts a high-capacity power cell that provides up to 24 hours of continued use. The instrument offers Bluetooth streaming and can be adjusted discretely from smartphones without any intermediary device. Another one of Signia's mHealth products, myHearing app, connects hearing aid patients and hearing health care providers. It allows hearing aid users to ask questions and complete training exercises, while it gives hearing health professionals access to their patients' progress and ability to remotely adjust their patients' hearing aid settings when needed.

The two hearing products were displayed at CES 2017, which took place on Jan. 5 to 8 in Las Vegas. Select honorees will also be displayed at CES Unveiled New York on Nov. 10. 


Published: 1/13/2017 9:10:00 AM


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iHEAR Partners with Ameritas to Expand Access to Low-Cost Hearing Care

iHear Medical Inc. is partnering with insurance company Ameritas to offer next-generation, invisible hearing aids at a lower cost. The details of the partnership are unclear, but the two companies said they hope "to break through persisting barriers preventing people from obtaining clinically effective hearing solutions, including overpricing of hearing aids, the stigma of wearing visible hearing devices, and the cumbersome process of accessing hearing care through traditional channels" in a joint press release announcing the partnership.

The hearing aid products by iHear are priced at $299 before reimbursement and support online self-programming. The venture-backed startup offers two invisible behind-the-ear hearing aids, iHEARHD and iHEARMAX, and an FDA-approved home hearing screener, iHEARTEST, for direct purchase online.​

Published: 1/3/2017 10:45:00 AM


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mHealth Products Made Signia CES 2017 Innovation Awards Honoree

Signia (https:/​/www.signiausa.com/) was chosen as a CES 2017 Innovation Awards Honoree for two of its wireless and mobile hearing health care products, the Cellion hearing aid and the myHearing app. Honoree titles are given to products that a panel of independent industry designers and engineers consider to be the most cutting edge consumer electronics products in a category.

Signia-CES.jpg

Cellion, a lithium-ion inductive and rechargeable hearing aid, boasts a high-capacity power cell that provides up to 24 hours of continued use. The instrument offers Bluetooth streaming and can be adjusted discretely from smartphones without any intermediary device. Another one of Signia's mHealth products, myHearing app, connects hearing aid patients and hearing health care providers. It allows hearing aid users to ask questions and complete training exercises, while it gives hearing health professionals access to their patients' progress and ability to remotely adjust their patients' hearing aid settings when needed.

The two hearing products were displayed at CES 2017, which took place on Jan. 5 to 8 in Las Vegas. Select honorees will also be displayed at CES Unveiled New York on Nov. 10. 


Published: 1/13/2017 9:10:00 AM


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iHEAR Partners with Ameritas to Expand Access to Low-Cost Hearing Care

iHear Medical Inc. is partnering with insurance company Ameritas to offer next-generation, invisible hearing aids at a lower cost. The details of the partnership are unclear, but the two companies said they hope "to break through persisting barriers preventing people from obtaining clinically effective hearing solutions, including overpricing of hearing aids, the stigma of wearing visible hearing devices, and the cumbersome process of accessing hearing care through traditional channels" in a joint press release announcing the partnership.

The hearing aid products by iHear are priced at $299 before reimbursement and support online self-programming. The venture-backed startup offers two invisible behind-the-ear hearing aids, iHEARHD and iHEARMAX, and an FDA-approved home hearing screener, iHEARTEST, for direct purchase online.​

Published: 1/3/2017 10:45:00 AM


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mHealth Products Made Signia CES 2017 Innovation Awards Honoree

Signia (https:/​/www.signiausa.com/) was chosen as a CES 2017 Innovation Awards Honoree for two of its wireless and mobile hearing health care products, the Cellion hearing aid and the myHearing app. Honoree titles are given to products that a panel of independent industry designers and engineers consider to be the most cutting edge consumer electronics products in a category.

Signia-CES.jpg

Cellion, a lithium-ion inductive and rechargeable hearing aid, boasts a high-capacity power cell that provides up to 24 hours of continued use. The instrument offers Bluetooth streaming and can be adjusted discretely from smartphones without any intermediary device. Another one of Signia's mHealth products, myHearing app, connects hearing aid patients and hearing health care providers. It allows hearing aid users to ask questions and complete training exercises, while it gives hearing health professionals access to their patients' progress and ability to remotely adjust their patients' hearing aid settings when needed.

The two hearing products were displayed at CES 2017, which took place on Jan. 5 to 8 in Las Vegas. Select honorees will also be displayed at CES Unveiled New York on Nov. 10. 


Published: 1/13/2017 9:10:00 AM


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iHEAR Partners with Ameritas to Expand Access to Low-Cost Hearing Care

iHear Medical Inc. is partnering with insurance company Ameritas to offer next-generation, invisible hearing aids at a lower cost. The details of the partnership are unclear, but the two companies said they hope "to break through persisting barriers preventing people from obtaining clinically effective hearing solutions, including overpricing of hearing aids, the stigma of wearing visible hearing devices, and the cumbersome process of accessing hearing care through traditional channels" in a joint press release announcing the partnership.

The hearing aid products by iHear are priced at $299 before reimbursement and support online self-programming. The venture-backed startup offers two invisible behind-the-ear hearing aids, iHEARHD and iHEARMAX, and an FDA-approved home hearing screener, iHEARTEST, for direct purchase online.​

Published: 1/3/2017 10:45:00 AM


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Masticator Space Abscess Arising From a Spontaneous External Auditory Canal Cholesteatoma

imageNo abstract available

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“Dickkopf-Related Protein 3 as a Sensitive and Specific Marker for Cerebrospinal Fluid Leaks. Otology & Neurotology 2016;37: 299–303”

No abstract available

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Efficacy of Bone-Anchored Hearing Aids in Single-Sided Deafness: A Systematic Review

imageObjectives: Bone-anchored hearing aids (BAHAs) have been known to partially restore some of the functions lost in subjects with single-sided deafness (SSD). Our aims in this systemic review were to analyze the present capabilities of BAHAs in the context of SSD, and to evaluate the efficacy of BAHAs in improving speech recognition in noisy conditions, sound localization, and subjective outcomes. Design: A systematic search was undertaken until August 2015 by two independent reviewers, with disagreements resolved by consensus. Among 286 references, we analyzed 14 studies that used both subjective and objective indicators to assess the capabilities of a total of 296 patients in the unaided and aided situations. Results: Although there was “no benefit” of BAHA implantation for sound localization, BAHAs certainly improved subjects’ speech discrimination in noisy circumstances. In the six studies that dealt with sound localization, no significant difference was found after the implantation. Twelve studies showed the benefits of BAHAs for speech discrimination in noise. Regarding subjective outcomes of using the prosthesis in patients with SSD (abbreviated profile of hearing aid benefit [APHAB] and the Glasgow hearing aid benefit profile [GHABP], etc.), we noticed an improvement in the quality of life. Conclusions: This systematic review has indicated that BAHAs may successfully rehabilitate patients with SSD by alleviating the hearing handicap to a certain degree, which could improve patients’ quality of life. This report has presented additional evidence of effective auditory rehabilitation for SSD and will be helpful to clinicians counseling patients regarding treatment options for SSD.

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Assessment of Cochlea Endolymphatic Hydrops Using 3-D FLAIR and 3-D Real IR Sequence in Guinea Pigs via 3T MRI After Intratympanic Gadolinium: A Histopathological Comparison

imageObjective: We assessed whether the three-dimensional fluid-attenuated inversion-recovery (3-D FLAIR) and three-dimensional inversion-recovery with real reconstruction (3-D real IR) sequences can be used to detect cochlea endolymphatic hydrops (EHs) in guinea pigs using 3 Tesla magnetic resonance imaging (3T MRI). The results of 3-D real IR imaging were compared with histopathological outcomes. Materials and Methods: Fourteen healthy men and women albino guinea pigs were used in this study. Their right ears received procedures that promoted EHs, and their left ears were used as untreated controls. High-resolution 3T MRI, combined with the intratympanic injection of gadolinium (Gd) in both ears, was performed 8 to 12 weeks after surgery. Both sides of the cochlea midmodiolar sections were observed under a light microscope and saved as the histopathological images. The signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) between the T2-weighted 3-D FLAIR and T2-weighted 3-D real IR sequences were compared. The appearance of EHs in the basal, second, third, and apical turns of the cochlea was further evaluated using 3-D FLAIR, 3-D real IR, and the histopathological images. Moreover, the maximum scala media area ratios (SMRs) on the histopathological sections were compared with the grading of the EHs on the 3-D real IR sequence with regard to each turn of the cochlea. Results: Significant differences were found between the 3-D FLAIR and 3-D-real IR sequences with regard to the SNRs and CNRs (p 

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Improvements in Gait With Hearing Aids and Cochlear Implants

imageObjective: To evaluate whether wearing auditory assistive devices can improve gait and dynamic balance. Patients: Three adult users of bilateral hearing assistive devices: one with cytomegalovirus exposure wearing cochlear implants, one with Ménière's disease wearing hearing aids, and one with presbystasis wearing hearing aids. Intervention: Rehabilitative intervention involved participants performing gait and dynamic posture tasks with and without their hearing assistive devices. Main Outcome Measures: Gait velocity and Mini-BESTest score. Results: The participant with Ménière's disease showed a clinically significant improvement in gait in the aided versus the unaided condition (20.5 cm/s higher velocity and five point better Mini-BESTest score). The other two participants also improved with augmented audition, but to a lesser degree. Conclusions: Bilateral hearing augmentation may promote clinically significant improvements in gait, although the effects are not uniform among patients. Hearing aids or cochlear implants may be important interventions for improving stability during walking in some people with hearing loss.

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American Neurotology Society: 52nd Annual Meeting Preliminary Program

No abstract available

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Combined Intratympanic and Systemic Use of Steroids as a First-Line Treatment for Sudden Sensorineural Hearing Loss: A Meta-Analysis of Randomized, Controlled Trials

imageObjective: To compare the efficacy of combination therapy (combined intratympanic and systemic use of steroids, CT) with systemic steroid therapy (SST) as a primary treatment for sudden sensorineural hearing loss (SSNHL). Methods: An electronic database search (PubMed, Embase, Cochrane Library, and CNKI databases) was performed. Review Manger 5.3 was used for data synthesis. Data were collected on the following outcomes of interest: the proportion of patients with hearing improvement, changes in pure tone averages (PTA), and speech discrimination score (SDS). Results: A total of 14 RCTs including 756 subjects allocated to CT and 638 to SST were selected. The proportion of patients with hearing improvement as outcome measure was observed in 13 studies, which resulted in an odds ratio (OR) of 2.50 (95% confidence interval [CI]: 1.95–2.1). The PTA changes (in dB) as outcome measure was observed in 12 studies, which resulted in mean difference (MD) 13 (95% CI: 9.24–16.77). SDS changes (in %) as outcome measure were reported in five studies, which resulted in MD 15.72 (95% CI: 5.11–26.33). Conclusion: CT seems to confer a certain degree of benefit as a primary treatment of SSNHL as compared with SST. Further validation based on high quality studies is required.

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Is Serial Electroneuronography Indicated Following Temporal Bone Trauma?

imageObjective: Contemporary guidelines advise facial nerve (FN) decompression within 2 weeks of temporal bone trauma if a single electroneuronography (ENoG) demonstrates more than 90% degeneration of the FN. We report a case series demonstrating the potential of serial ENoG to guide FN management more than 2 weeks following injury. Patients: Adults with traumatic temporal bone fractures and resultant ipsilateral FN paresis. Intervention: Serial ENoG followed by observation or decompression of the FN. Main Outcome Measure: House–Brackmann (HB) graded FN function. Results: Nine cases of blunt temporal bone trauma resulting in ispilateral FN paralysis were identified and reviewed. Two patients were women, and average age at the time of trauma was 30 years (range, 17–52). Immediate paralysis occurred in four cases, while five were delayed. A single ENoG was performed in seven patients and was predictive of final function in six, while one patient had an initially reassuring ENoG but did not obtain full recovery of FN function (HB 4). Two patients underwent serial ENoG on a weekly basis which, while initially reassuring, demonstrated declining FN function on subsequent testing. Decompression was performed in both patients with excellent recovery of FN function (HB1 and HB2). Conclusions: The majority of ENoGs performed within 2 weeks of temporal bone trauma provide sufficient prognostic data for treatment decisions; however, in selected cases, a single ENoG may not adequately predict long-term FN outcomes. For patients failing to improve with observation alone, serial ENoG may capture declining FN function, identifying patients that may benefit from late decompression.

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Cochlear Implantation in Children With Congenital Single-Sided Deafness

imageObjective: To determine audiological and clinical results of cochlear implantation in children with congenital single sided deafness (SSD), with an emphasis on children implanted before and after 6 years of age. Study Design: Retrospective study. Setting: Tertiary referral center. Subjects: Twenty one children with congenital SSD who were implanted aged 10 months to 11;3 years. Intervention: Unilateral cochlear implantation. Main Outcome Measures: Speech recognition in noise via the German Oldenburg Sentence Test for Children (OlKiSa), lateralization ability, and subjective evaluation of hearing results using self- and third-party assessment questionnaires. Results: Significant improvements of all three aspects of true binaural hearing were found. The most striking improvement was the combined head shadow effect by 2.11 dB (squelch effect: 0.95 dB, summation effect 0.98 dB). An improvement of lateralization ability was also demonstrated. Parents had a high overall level of satisfaction with their children's cochlear implantation. Subjective benefit was verified in all three subscales of the Speech, Spatial, and Qualities of Hearing Questionnaire. No significant difference was found between subjects implanted before the age of 6 with those implanted later. Three of the five subjects with a follow-up of greater than 3 years were limited users or nonusers. Conclusions: Cochlear implant (CI) provision provides children with congenital SSD with significant audiological and subjective benefits which can be seen even in children implanted after the age of 3;6. The problem of limited use and nonuser, however, should not be ignored and has to be considered for further studies.

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Isosorbide-Induced Decompression Effect on the Scala Media: Participation of Plasma Osmolality and Plasma Arginine Vasopressin

imageObjective: The correlation between the isosorbide-induced decompression effect on the endolymphatic space and plasma osmolality (p-OSM) or plasma arginine vasopressin (p-AVP) was investigated on comparing two different dosages of isosorbide (2.8 and 1.4 g/kg) to elucidate why the decompression effect is delayed with a large dose of isosorbide. Materials and Methods: Two experiments were performed using 80 guinea pigs. Experiment 1 was designed to morphologically investigate the sequential influence of the oral intake of 1.4- and 2.8-g/kg doses of isosorbide on the endolymphatic volume. The animals used were 50 guinea pigs (control: 10, experimental: 40). All animals underwent surgical obliteration of the endolymphatic sac of the left ear. One month after the surgery, control animals were sacrificed 3 hours after the intake of distilled water, and experimental animals were sacrificed 3 and 6 hours after the isosorbide intake. All of the left temporal bone served for the quantitative assessment of changes in the endolymphatic space, and the cross-sectional area of the scala media was measured from the mid-modiolar sections of the cochlea. Experiment 2 was designed to investigate changes in p-OSM and p-AVP levels 3 hours after the oral intake of isosorbide. Animals used were 15 guinea pigs (control: 5, experimental: 10). The control group received the oral administration of distilled water (4 ml/kg), and the experimental animals were subdivided into two groups consisting of 10 animals each by the dosage of isosorbide (1.4 or 2.8 g/kg). All animals were sacrificed for the measurement of p-OSM and p-AVP concentrations 3 hours after the intake of water or 70% isosorbide solution. Results: Morphologically, an isosorbide-induced decompression effect was noted in animals with both 1.4- and 2.8-g/kg doses of isosorbide. According to the regression analysis, however, the volumetric decrease of the endolymphatic space was more evident in cases with the small dose (1.4 g/kg) 3 hours after the intake (analysis of covariance [ANCOVA], p 

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Development and Validation of the Cochlear Implant Surgical Competency Assessment Instrument

imageObjective: We present a new instrument for evaluation of cochlear implant (CI) surgical skills and review its validation process. Methods: An instrument to assess CI surgical competency incorporated results of structured surveys of comprehensiveness sent to 30 international CI experts and US trainees. One-hundred evaluations of 28 residents, fellows, and practicing CI surgeons were completed. Surgical skills were evaluated by four experienced neurotologists (two raters per subject) using two temporal bones per subject. A training session was completed by 24 subjects between the first and second procedure. Comparison of two blinded rater's scores per subject provided information on interrater reliability. Correlation of competency scores with degree of training and with improvement after a training session provided information on construct validity. Results: High levels of interrater reliability were confirmed by using the intraclass correlation coefficient. Construct validity was demonstrated by correlation of higher performance scores with increasing years of training, board certification, and fellowship training. Construct validity is also supported by improvement in scores after a CI training session as well as by acceptability surveys. Discussion: Data indicate that this instrument is an objective, accurate, and dependable procedure-specific instrument for evaluating CI surgical competency. Conclusion: The cochlear implant surgical competency assessment (CI-SCA) can be used to establish CI surgical competency, identify surgical skills that require remediation and demonstrate progress during training.

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Letter to the Editor Regarding Oyewumi M, Wolter NE, Heon E, Gordon KA, Papsin BC, Cushing SL. “Using Balance Function to Screen for Vestibular Impairment in Children with Sensorineural Hearing Loss and Cochlear Implants”

No abstract available

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Long-Term Hearing Results After Ossiculoplasty

imageObjectives: To determine if the OOPS index is predictive of long-term hearing results after ossiculoplasty. Study Design: Case series with retrospective chart review. Setting: Tertiary care otology practice. Patients: Adult and pediatric patients (3–88 years of age). Interventions: Ossiculoplasty with cartilage tympanoplasty, with or without mastoidectomy. Outcome Measures: Primary outcome measures included short-term hearing results (pure-tone average air-bone gap [PTA-ABG] measured between 60 days and 1 year after surgery), long-term hearing results (PTA-ABG measured ≥5 years after surgery), and the rate of successful ABG closure to ≤20 dB. Secondary measures included the need for revision surgery, delayed tympanic membrane graft failure, worsening conductive hearing loss (after an initially satisfactory hearing result), and recurrence of cholesteatoma. Results: There was no significant difference between adults and children for short-term hearing results (average post-op PTA-ABG was 18.9 dB vs. 19.8 dB, respectively; p = 0.544), long-term hearing results (average final PTA-ABG was 19.3 dB vs. 19.4 dB, respectively; p = 0.922), or rate of ABG closure to less than 20 dB (63.1% vs. 58.0%, p = 0.282). Spearman's rank-order correlation (ρ) identified a strong positive correlation between OOPS index score and average post-operative PTA-ABG (ρ = 0.983; p 

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Facial Nerve Bifurcation in Congenital Oval Window Atresia

imageNo abstract available

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The Role of Rho/Rho-Kinase Pathway in the Pathogenesis of Cholesteatoma

imageObjective: To assess the role of Rho/Rho-kinase pathway in the pathogenesis of cholesteatoma. Materials and Methods: Thirty-eight patients with cholesteatoma, who had gone mastoidectomies were enrolled in this prospective study. Cholesteatomas matrix (CM) and a piece of the external ear canal skin (EECS as control) were taken and transferred to the liquid nitrogen and kept at −86 °C for Rho A and Rho-kinase (ROCK) analysis with Western blotting and commercial ELISA kits (Cell Biolabs Inc., San Diego, CA). The tissues were homogenized by an appropriate ice-cold lysis buffer. Following centrifugation, the supernatant was taken and total protein amount was detected by the Bradford method. Thereafter, tissue homogenates were subjected to sodium dodecyl sulphate (SDS)-polyacrylamide gel electrophoresis electrophoresis then transferred to nitrocellulose membrane where it was treated with specific monoclonal primary antibody against to ROCK-2 and HRP-conjugated seconder antibody, respectively. The protein blots were visualized with commercial x-ray film and dansitometrically analyzed by the Scion Image Program (Cell Biolabs Inc., San Diego, CA). In another series of experiments, Rho-kinase activities were assessed by ROCK-2 ELISA kits. Results: There were no statistical differences in Rho A translocation between CM and EECS. However, ROCK activity was found to be lower in CM than EECS as detected by ELISA kits. Furthermore, ROCK protein expression was also significantly lower in CM than EECS as demonstrated by Western blotting. Conclusion: Given Rho-kinase could take essential roles in cell differentiation, the results of this study implicate that down-regulated Rho-kinase could be responsible for the keratinocyte undifferentiation seen in cholesteatoma pathogenesis.

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Surgery for Cochlear and Other Auditory Implants: Mario Sanna, Rolien Free, Paul Merkus, and Maurizio Falcioni, eds; Stuttgart: Thieme, 2016

No abstract available

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A Meta-Analysis on the Diagnostic Performance of Non-Echoplanar Diffusion-Weighted Imaging in Detecting Middle Ear Cholesteatoma: 10 Years On

imageObjective: To describe via a meta-analysis of the published literature, the performance of non-echo-planar diffusion weighted imaging (DWI) in detecting middle ear cholesteatoma. Methodology: A systematic review of the published literature was performed to identify original studies evaluating the diagnostic performance of non-echo-planar DWI in detecting middle ear cholesteatoma. Only studies with surgical correlation were included. A bi-variate meta-analysis and hierarchical summary receiver operating characteristic model was performed. Results: A total of 26 studies (1,152 patient episodes) were included. Pooled sensitivity and specificity of 0.91 (95% CI: 0.87–0.95) and 0.92 (95% CI: 0.86–0.96), respectively were obtained. Separate subgroup analysis performed for primary cholesteatoma, postoperative cholesteatoma, pediatric cases, and adult cases all showed high sensitivities (range, 0.86–0.93) and specificities (0.88–0.97). There was a statistically significant degree of heterogeneity in terms of sensitivity between all studies (I2 value 46%) and in the pediatric subgroup (I2 value 78%). There was no evidence of significant heterogeneity between the specificity measurements. Conclusions: Non-echo-planar DWI is highly sensitive and specific in detecting cholesteatoma. A large prospective multicentre randomized controlled study could validate the findings and evaluate the cost-effectiveness of DWI as an alternative for second-look surgery (control arm) in managing cases of postoperative cholesteatoma.

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Middle-Ear Sound Transmission Under Normal, Damaged, Repaired, and Reconstructed Conditions

imageHypothesis: We hypothesize that current clinical treatment strategies for the disarticulated or eroded incus have the effect of combining the incus and stapes of the human middle ear (ME) into one rigid structure, which, while capable of adequately transmitting lower-frequency sounds, fails for higher frequencies. Background: ME damage causes conductive hearing loss (CHL) and while great progress has been made in repairing or reconstructing damaged MEs, the outcomes are often far from ideal. Methods: Temporal bones (TBs) from human cadavers, a laser Doppler vibrometer (LDV), and a fiber-optic based micro-pressure sensor were used to characterize ME transmission under various ME conditions: normal; with a disarticulated incus; repaired using medical glue; or reconstructed using a partial ossicular replacement prosthesis (PORP). Results: Repairing the disarticulated incus using medical glue, or replacing the incus using a commercial PORP, provided similar restoration of ME function including almost perfect function at frequencies below 4 kHz, but with more than a 20-dB loss at higher frequencies. Associated phase responses under these conditions sometimes varied and seemed dependent on the degree of coupling of the PORP to the remaining ME structure. A new ME-prosthesis design may be required to allow the stapes to move in three-dimensional (3-D) space to correct this deficiency at higher frequencies. Conclusions: Fixation of the incus to the stapes or ossicular reconstruction using a PORP limited the efficiency of sound transmission at high frequencies.

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Intraoperative Bleeding and the Risk of Residual Cholesteatoma: A Multivariate Analysis

imageObjective: Residual cholesteatoma most frequently occurs where visualization and surgical access are restricted by anatomic constraints. Other factors that compromise surgical field visualization might also increase rates of residual cholesteatoma. We evaluated whether impaired surgical field clarity from bleeding increases rates of residual cholesteatoma. Study Design: Prospective cohort study. Setting: Tertiary care hospital. Patients: Consecutive series of children having intact canal wall surgery for cholesteatoma. Interventions: Impact of bleeding on surgical field clarity was assessed intraoperatively on a six-point scale. Main Outcome Measures: Presence of residual cholesteatoma was established at follow up clinical encounters, second stage procedures, and with magnetic resonance imaging. Multiple logistic regression was used to determine the influence of surgical field clarity and other factors on rates of residual cholesteatoma. Results: Surgery was completed on 232 ears and residual cholesteatoma found in 45 (19%) ears. Multivariate regression analysis of cases completed with atticotomy or tympanoplasty demonstrated that surgical field clarity was a significant predictor of residual cholesteatoma (OR [odds ratio] 4, 95%CI 1.05–15; p = 0.04). Cholesteatoma extent was the most significant predictor of residual cholesteatoma when including cases requiring combined approach tympanomastoidectomy (OR 2.2, 95%CI 1.4–3.3; p 

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Internal Jugular Vein Compression: A Novel Approach to Mitigate Blast Induced Hearing Injury

imageHypothesis: Internal jugular vein (IJV) compression before blast injury will lead to reduced risk of traumatic hearing injury following exposure to a blast injury. Background: IJV compression and its effects on not only intracranial, but also intracochlear pressure may potentiate blast induced hearing injury, therefore, precluding its use as a prophylactic therapy for blast induced traumatic brain injury. Methods: Twenty Sprague Dawley rats were exposed to a 17.9 ± 0.4 PSI (195.8 dB SPL) right sided shock wave in which 10 had application of a custom IJV compression collar before injury. All rodents received baseline and post blast injury otoacoustic emission (OAE) and auditory brainstem response (ABR) testing followed by cochlear histology. Results: IJV compression was shown to significantly reduce ABR and OAE threshold shifts in comparison to the non-intervention group by: 14.9 ± 4.8 dB (right ear ABR 0.5 kHz Day 1 post blast, p = 0.01), 13.1 ± 4.9 dB (right ear ABR 4 kHz Day 1 post blast, p = 0.04), 16.5 ± 4.5 dB (right ear ABR click Day 1 post blast, p = 0.003), 12.1 ± 4.6 dB (right ear ABR click Day 6 post blast, p = 0.04), and 14.0 ± 3.2 dB (both ears OAE 3.2–10 kHz, p 

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