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Πέμπτη 20 Ιουλίου 2017
Acquired External Auditory Canal Atresia: A Comparison of Acellular Dermal Matrix and Split-thickness Skin Grafting Techniques.
Objective: To describe the use of acellular dermal matrix (ADM) in the repair of acquired external auditory canal atresia (AEACA), and compare surgical results to AEACA repair by split-thickness skin grafting (STSG). Study Design: Retrospective chart review. Setting: Neurotology clinical practice. Patients and Intervention: From 2007 to 2015, 25 AEACA surgeries (8 ADM and 17 STSG) were identified meeting inclusion and exclusion criteria. Pre- and postoperative audiometric data with clinical follow-up were examined. Outcome Measures: Rate of external auditory canal restenosis, improvement of conductive hearing loss, and resolution of otorrhea. Results: Both surgical groups had similar preoperative air bone gaps (ABG). Mean follow-up was 24 months. There was no significant difference in restenosis rates between the ADM (13%, n = 1/8) and STSG (12%, n = 2/17) groups. ABG improved from 28 dB to 11 dB in the ADM group and from 24 dB to 9 dB in the STSG group. ABG closure with surgery was statistically significant (p
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Visual Processing Recruits the Auditory Cortices in Prelingually Deaf Children and Influences Cochlear Implant Outcomes.
Objective: Although visual processing recruitment of the auditory cortices has been reported previously in prelingually deaf children who have a rapidly developing brain and no auditory processing, the visual processing recruitment of auditory cortices might be different in processing different visual stimuli and may affect cochlear implant (CI) outcomes. Methods: Ten prelingually deaf children, 4 to 6 years old, were recruited for the study. Twenty prelingually deaf subjects, 4 to 6 years old with CIs for 1 year, were also recruited; 10 with well-performing CIs, 10 with poorly performing CIs. Ten age and sex-matched normal-hearing children were recruited as controls. Visual ("sound" photo [photograph with imaginative sound] and "nonsound" photo [photograph without imaginative sound]) evoked potentials were measured in all subjects. P1 at Oz and N1 at the bilateral temporal-frontal areas (FC3 and FC4) were compared. Results: N1 amplitudes were strongest in the deaf children, followed by those with poorly performing CIs, controls and those with well-performing CIs. There was no significant difference between controls and those with well-performing CIs. "Sound" photo stimuli evoked a stronger N1 than "nonsound" photo stimuli. Further analysis showed that only at FC4 in deaf subjects and those with poorly performing CIs were the N1 responses to "sound" photo stimuli stronger than those to "nonsound" photo stimuli. No significant difference was found for the FC3 and FC4 areas. No significant difference was found in N1 latencies and P1 amplitudes or latencies. Conclusion: The results indicate enhanced visual recruitment of the auditory cortices in prelingually deaf children. Additionally, the decrement in visual recruitment of auditory cortices was related to good CI outcomes. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Surgical Emphysema Following Canalplasty for Aural Exostoses.
Objective: To describe the presentation and management of surgical emphysema involving the temporomandibular joint and deep neck following exostoses removal. Patient: A 60-year-old male surfer presented with hearing loss and recurrent infections in the right ear. An examination revealed obstructing bony exostoses in the right external auditory canal. He underwent right canalplasty using a postauricular approach. At 5 weeks after surgery, he presented with right otalgia, swelling of the right face and neck, and complaints of a squeaking noise in the right ear with mandibular excursions. An otomicroscopic examination demonstrated a focal area of prolapsing soft tissue along the anterior bony external auditory canal with mandibular movement. The examination also revealed palpable crepitus of the right face and neck. Computed tomography was obtained of the temporal bones and neck confirming a focal anterior canal wall defect allowing communication between the glenoid fossa and external auditory canal with subcutaneous emphysema tracking around the temporomandibular joint into the masticator, parotid, and parapharyngeal spaces. Intervention: Maxillomandibular fixation for 2 weeks with revision canalplasty using a split tragal cartilage graft. Results: At 6 weeks after revision surgery, the patient reported complete resolution of all symptoms. Repeat imaging demonstrated complete resolution of subcutaneous and deep neck emphysema, and the otomicroscopic examination revealed a fully epithelialized external auditory canal with no further evidence of soft tissue prolapse. Conclusion: Maxillomandibular fixation with autologous cartilage graft is an effective management strategy for complications of canalplasty resulting in exposure of the temporomandibular joint capsule and surgical emphysema. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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JAAA CEU Program.
JAAA CEU Program.
J Am Acad Audiol. 2017 Jul/Aug;28(7):672-673
Authors:
PMID: 28722649 [PubMed - in process]
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Perspectives on the Pure-Tone Audiogram.
Perspectives on the Pure-Tone Audiogram.
J Am Acad Audiol. 2017 Jul/Aug;28(7):655-671
Authors: Musiek FE, Shinn J, Chermak GD, Bamiou DE
Abstract
BACKGROUND: The pure-tone audiogram, though fundamental to audiology, presents limitations, especially in the case of central auditory involvement. Advances in auditory neuroscience underscore the considerably larger role of the central auditory nervous system (CANS) in hearing and related disorders. Given the availability of behavioral audiological tests and electrophysiological procedures that can provide better insights as to the function of the various components of the auditory system, this perspective piece reviews the limitations of the pure-tone audiogram and notes some of the advantages of other tests and procedures used in tandem with the pure-tone threshold measurement.
PURPOSE: To review and synthesize the literature regarding the utility and limitations of the pure-tone audiogram in determining dysfunction of peripheral sensory and neural systems, as well as the CANS, and to identify other tests and procedures that can supplement pure-tone thresholds and provide enhanced diagnostic insight, especially regarding problems of the central auditory system.
RESEARCH DESIGN: A systematic review and synthesis of the literature.
DATA COLLECTION AND ANALYSIS: The authors independently searched and reviewed literature (journal articles, book chapters) pertaining to the limitations of the pure-tone audiogram.
RESULTS: The pure-tone audiogram provides information as to hearing sensitivity across a selected frequency range. Normal or near-normal pure-tone thresholds sometimes are observed despite cochlear damage. There are a surprising number of patients with acoustic neuromas who have essentially normal pure-tone thresholds. In cases of central deafness, depressed pure-tone thresholds may not accurately reflect the status of the peripheral auditory system. Listening difficulties are seen in the presence of normal pure-tone thresholds. Suprathreshold procedures and a variety of other tests can provide information regarding other and often more central functions of the auditory system.
CONCLUSIONS: The audiogram is a primary tool for determining type, degree, and configuration of hearing loss; however, it provides the clinician with information regarding only hearing sensitivity, and no information about central auditory processing or the auditory processing of real-world signals (i.e., speech, music). The pure-tone audiogram offers limited insight into functional hearing and should be viewed only as a test of hearing sensitivity. Given the limitations of the pure-tone audiogram, a brief overview is provided of available behavioral tests and electrophysiological procedures that are sensitive to the function and integrity of the central auditory system, which provide better diagnostic and rehabilitative information to the clinician and patient.
PMID: 28722648 [PubMed - in process]
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What Factors Are Associated with Autonomous and Controlled Motivation for Hearing Help-Seekers?
What Factors Are Associated with Autonomous and Controlled Motivation for Hearing Help-Seekers?
J Am Acad Audiol. 2017 Jul/Aug;28(7):644-654
Authors: Ridgway J, Hickson L, Lind C
Abstract
BACKGROUND: Hearing impairment is prevalent in older adults. Motivation is important in people's choice to seek help for their hearing and whether to adopt or not adopt hearing aids.
PURPOSE: To investigate associations between sociodemographic and audiometric characteristics and autonomous and controlled motivation among a sample of hearing help-seekers.
RESEARCH DESIGN: A quantitative approach was taken for this cross-sectional cohort study.
STUDY SAMPLE: A total of 253 adult first-time hearing help-seekers were recruited to the study.
DATA COLLECTION AND ANALYSIS: Participants provided sociodemographic information and completed questionnaires adapted from self-determination theory that measured autonomous motivation (motivation that originates from within the self and is aligned with personal values and beliefs) and controlled motivation (motivation that stems from external pressures such as rewards or punishment, or conflicted inner feelings such as guilt or shame).
RESULTS: Participants with higher autonomous motivation scores were younger, wanted hearing aids more, and reported greater hearing difficulty in everyday life than those with lower scores. Participants with higher controlled motivation scores were more often referred to the service by others and wanted hearing aids more than those with lower controlled motivation scores. Controlled motivation scores were not associated with perceptions of hearing difficulty in everyday life.
CONCLUSION: Relationships among motivation and sociodemographic factors highlight the importance of characterizing autonomous and controlled motivation in first-time hearing help-seekers. Attention to personal characteristics in order to understand motivational processes involved in rehabilitation decisions such as hearing aid adoption may aid in consultations.
PMID: 28722647 [PubMed - in process]
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Noncongruence between Audiologist and Patient Preferences for Patient-Centeredness.
Noncongruence between Audiologist and Patient Preferences for Patient-Centeredness.
J Am Acad Audiol. 2017 Jul/Aug;28(7):636-643
Authors: Manchaiah V, Dockens AL, Bellon-Harn M, Burns ES
Abstract
BACKGROUND: Trends in preferences of both healthcare providers and patients to patient-centeredness have been emphasized in research. However, an understanding of the nature of preferences to patient-centeredness within the context of the audiologist-patient relationship is needed.
PURPOSE: The purpose of this study is to explore the congruence between audiologist and patient preferences for patient-centeredness.
RESEARCH DESIGN: A cross-sectional survey design was used to gather data from audiologists and patients with hearing loss.
STUDY SAMPLE: Participants included 75 audiologists and 105 consecutive patients with hearing loss.
DATA COLLECTION AND ANALYSIS: Participants completed the modified Patient-Practitioner Orientation Scale (PPOS) and provided selected demographic information. Data were analyzed using an independent sample t test to evaluate the differences between audiologist and patient congruence. Regression analysis was performed to evaluate factors contributing to preferences for patient-centeredness.
RESULTS: Patients had significantly lower scores in PPOS full scale when compared to the audiologists [t(170) = 0.78; p ≤ 0.001] with a very large effect size (Cohen's d = 1.43). Patients also had significantly lower scores when compared to the audiologists on both the sharing [t(170) = 1.01; p ≤ 0.001] and caring [t(170) = 0.56; p ≤ 0.001] subscales. Statistically significant lower scores were noted for patients when compared to audiologists on 12 items on the PPOS. No relationship between any demographic factors and preferences for patient-centeredness were found.
CONCLUSIONS: The current study results indicated noncongruence in preferences for patient-centeredness among audiologists and patients with hearing loss. Results point toward the need for more research considering the nature and impact of patient-centered audiology practice.
PMID: 28722646 [PubMed - in process]
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Verification of a Proposed Clinical Electroacoustic Test Protocol for Personal Digital Modulation Receivers Coupled to Cochlear Implant Sound Processors.
Verification of a Proposed Clinical Electroacoustic Test Protocol for Personal Digital Modulation Receivers Coupled to Cochlear Implant Sound Processors.
J Am Acad Audiol. 2017 Jul/Aug;28(7):625-635
Authors: Nair EL, Sousa R, Wannagot S
Abstract
BACKGROUND: Guidelines established by the AAA currently recommend behavioral testing when fitting frequency modulated (FM) systems to individuals with cochlear implants (CIs). A protocol for completing electroacoustic measures has not yet been validated for personal FM systems or digital modulation (DM) systems coupled to CI sound processors. In response, some professionals have used or altered the AAA electroacoustic verification steps for fitting FM systems to hearing aids when fitting FM systems to CI sound processors. More recently steps were outlined in a proposed protocol.
PURPOSE: The purpose of this research is to review and compare the electroacoustic test measures outlined in a 2013 article by Schafer and colleagues in the Journal of the American Academy of Audiology titled "A Proposed Electroacoustic Test Protocol for Personal FM Receivers Coupled to Cochlear Implant Sound Processors" to the AAA electroacoustic verification steps for fitting FM systems to hearing aids when fitting DM systems to CI users.
RESEARCH DESIGN: Electroacoustic measures were conducted on 71 CI sound processors and Phonak Roger DM systems using a proposed protocol and an adapted AAA protocol. Phonak's recommended default receiver gain setting was used for each CI sound processor manufacturer and adjusted if necessary to achieve transparency.
STUDY SAMPLE: Electroacoustic measures were conducted on Cochlear and Advanced Bionics (AB) sound processors. In this study, 28 Cochlear Nucleus 5/CP810 sound processors, 26 Cochlear Nucleus 6/CP910 sound processors, and 17 AB Naida CI Q70 sound processors were coupled in various combinations to Phonak Roger DM dedicated receivers (25 Phonak Roger 14 receivers-Cochlear dedicated receiver-and 9 Phonak Roger 17 receivers-AB dedicated receiver) and 20 Phonak Roger Inspiro transmitters.
DATA COLLECTION AND ANALYSIS: Employing both the AAA and the Schafer et al protocols, electroacoustic measurements were conducted with the Audioscan Verifit in a clinical setting on 71 CI sound processors and Phonak Roger DM systems to determine transparency and verify FM advantage, comparing speech inputs (65 dB SPL) in an effort to achieve equal outputs. If transparency was not achieved at Phonak's recommended default receiver gain, adjustments were made to the receiver gain. The integrity of the signal was monitored with the appropriate manufacturer's monitor earphones.
RESULTS: Using the AAA hearing aid protocol, 50 of the 71 CI sound processors achieved transparency, and 59 of the 71 CI sound processors achieved transparency when using the proposed protocol at Phonak's recommended default receiver gain. After the receiver gain was adjusted, 3 of 21 CI sound processors still did not meet transparency using the AAA protocol, and 2 of 12 CI sound processors still did not meet transparency using the Schafer et al proposed protocol.
CONCLUSIONS: Both protocols were shown to be effective in taking reliable electroacoustic measurements and demonstrate transparency. Both protocols are felt to be clinically feasible and to address the needs of populations that are unable to reliably report regarding the integrity of their personal DM systems.
PMID: 28722645 [PubMed - in process]
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Children Diagnosed with Auditory Processing Disorder and Their Parents: A Qualitative Study about Perceptions of Living with APD.
Children Diagnosed with Auditory Processing Disorder and Their Parents: A Qualitative Study about Perceptions of Living with APD.
J Am Acad Audiol. 2017 Jul/Aug;28(7):610-624
Authors: Lawton S, Purdy SC, Kalathottukaren RT
Abstract
BACKGROUND: Negative psychosocial consequences have been reported for children with auditory processing disorder (APD). The current literature surrounding APD does not sufficiently address the emotional and psychological consequences of living with the disorder. It is recommended that data be collected from multiple sources, including the child living with APD. Subjective reports of the perceptions of children with APD and their families have real-life validity and can inform clinical decisions and guide future research.
PURPOSE: The aims of this study were to explore the psychosocial consequences of APD as perceived by children with the disorder and their parents.
RESEARCH DESIGN: Qualitative cross-sectional study.
STUDY SAMPLE: Thirteen participants were interviewed: six children with APD, aged 10-12 yr, and one parent for each child (in one case, two parents participated in the interview).
DATA COLLECTION AND ANALYSIS: Semistructured interviews were used to examine the social, emotional, and educational well-being of children with APD. Inductive thematic analysis was conducted to develop themes that illustrated the experiences of living with APD.
RESULTS: Three themes were identified forming a causal network conceptual framework that is reciprocal in nature: (1) external factors, (2) internal problems, and (3) coping. The themes revealed how APD impacted negatively on children's psychosocial well-being (internal problems: covert thoughts, overt behaviors) and described the basis for these outcomes (external factors: environmentally based problems, dissatisfaction with support) and the ability of children and their parent(s) to manage the impact of APD (coping: positive, negative).
CONCLUSIONS: The three themes identified in this research provide a novel understanding of the experience of APD. The themes reflect the psychosocial consequences of external factors that are created internally through "thought" and expressed externally through "behavior." Pathways to support positive coping strategies while discouraging negative coping strategies will enable children to overcome problems and improve their psychosocial well-being.
PMID: 28722644 [PubMed - in process]
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Aural Rehabilitation for Older Adults with Hearing Loss: Impacts on Quality of Life-A Systematic Review of Randomized Controlled Trials.
Aural Rehabilitation for Older Adults with Hearing Loss: Impacts on Quality of Life-A Systematic Review of Randomized Controlled Trials.
J Am Acad Audiol. 2017 Jul/Aug;28(7):596-609
Authors: Michaud HN, Duchesne L
Abstract
BACKGROUND: Few systematic reviews have been conducted regarding aural rehabilitation for adults with hearing loss, with none specifically targeting the older adult population. With prevalence rates of hearing loss being highest in older adults, examining the effects of aural rehabilitation on this population is warranted.
PURPOSE: To evaluate the effects of aural rehabilitation on quality of life in an older adult population presenting with hearing loss.
ELIGIBILITY CRITERIA: Studies with adults presenting with hearing loss, ≥50 yr of age, with or without hearing aids, receiving interventions such as auditory training, speech-reading, communication strategies training, speech tracking, counseling, or a combination of approaches, and measuring outcomes related to quality of life, in an individual or group format, with or without significant others and with no limitations as to year of publication.
STUDY SELECTION: Searches in six databases, as well as results from hand-searching, gray literature, and cross-referencing of articles, yielded 386 articles. Of the 145 assessed as full-text articles for eligibility, 8 studies met inclusion criteria.
STUDY APPRAISAL: A component-based risk of bias assessment, as recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
RESULTS: No effect sizes were found in group interventions measuring outcomes related to quality of life, such as mental and emotional functions, environmental factors, participation restrictions, and activity limitations. An intervention effect regarding participation was found for a self-administered home training program, but an effect size was unavailable. Small-to-medium effect sizes were found in one of two individual communication training programs, for which outcomes related to quality of life, such as emotional functions, activities, participation, and environmental factors were measured. The results of the component-based risk of bias assessment indicated that the quality of reporting was poor, thus compromising the internal validity of included primary studies.
CONCLUSIONS: Our results indicate that the combined body of evidence in support of aural rehabilitation for older adults with hearing loss is not sufficient to draw any firm conclusions. We identify a need for more rigorous research to guide clinical decision-making.
PMID: 28722643 [PubMed - in process]
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The Traditional Audiogram-Can We Do Better?
The Traditional Audiogram-Can We Do Better?
J Am Acad Audiol. 2017 Jul/Aug;28(7):594-595
Authors: McCaslin DL
PMID: 28722642 [PubMed - in process]
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JAAA CEU Program.
JAAA CEU Program.
J Am Acad Audiol. 2017 Jul/Aug;28(7):672-673
Authors:
PMID: 28722649 [PubMed - in process]
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Perspectives on the Pure-Tone Audiogram.
Perspectives on the Pure-Tone Audiogram.
J Am Acad Audiol. 2017 Jul/Aug;28(7):655-671
Authors: Musiek FE, Shinn J, Chermak GD, Bamiou DE
Abstract
BACKGROUND: The pure-tone audiogram, though fundamental to audiology, presents limitations, especially in the case of central auditory involvement. Advances in auditory neuroscience underscore the considerably larger role of the central auditory nervous system (CANS) in hearing and related disorders. Given the availability of behavioral audiological tests and electrophysiological procedures that can provide better insights as to the function of the various components of the auditory system, this perspective piece reviews the limitations of the pure-tone audiogram and notes some of the advantages of other tests and procedures used in tandem with the pure-tone threshold measurement.
PURPOSE: To review and synthesize the literature regarding the utility and limitations of the pure-tone audiogram in determining dysfunction of peripheral sensory and neural systems, as well as the CANS, and to identify other tests and procedures that can supplement pure-tone thresholds and provide enhanced diagnostic insight, especially regarding problems of the central auditory system.
RESEARCH DESIGN: A systematic review and synthesis of the literature.
DATA COLLECTION AND ANALYSIS: The authors independently searched and reviewed literature (journal articles, book chapters) pertaining to the limitations of the pure-tone audiogram.
RESULTS: The pure-tone audiogram provides information as to hearing sensitivity across a selected frequency range. Normal or near-normal pure-tone thresholds sometimes are observed despite cochlear damage. There are a surprising number of patients with acoustic neuromas who have essentially normal pure-tone thresholds. In cases of central deafness, depressed pure-tone thresholds may not accurately reflect the status of the peripheral auditory system. Listening difficulties are seen in the presence of normal pure-tone thresholds. Suprathreshold procedures and a variety of other tests can provide information regarding other and often more central functions of the auditory system.
CONCLUSIONS: The audiogram is a primary tool for determining type, degree, and configuration of hearing loss; however, it provides the clinician with information regarding only hearing sensitivity, and no information about central auditory processing or the auditory processing of real-world signals (i.e., speech, music). The pure-tone audiogram offers limited insight into functional hearing and should be viewed only as a test of hearing sensitivity. Given the limitations of the pure-tone audiogram, a brief overview is provided of available behavioral tests and electrophysiological procedures that are sensitive to the function and integrity of the central auditory system, which provide better diagnostic and rehabilitative information to the clinician and patient.
PMID: 28722648 [PubMed - in process]
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What Factors Are Associated with Autonomous and Controlled Motivation for Hearing Help-Seekers?
What Factors Are Associated with Autonomous and Controlled Motivation for Hearing Help-Seekers?
J Am Acad Audiol. 2017 Jul/Aug;28(7):644-654
Authors: Ridgway J, Hickson L, Lind C
Abstract
BACKGROUND: Hearing impairment is prevalent in older adults. Motivation is important in people's choice to seek help for their hearing and whether to adopt or not adopt hearing aids.
PURPOSE: To investigate associations between sociodemographic and audiometric characteristics and autonomous and controlled motivation among a sample of hearing help-seekers.
RESEARCH DESIGN: A quantitative approach was taken for this cross-sectional cohort study.
STUDY SAMPLE: A total of 253 adult first-time hearing help-seekers were recruited to the study.
DATA COLLECTION AND ANALYSIS: Participants provided sociodemographic information and completed questionnaires adapted from self-determination theory that measured autonomous motivation (motivation that originates from within the self and is aligned with personal values and beliefs) and controlled motivation (motivation that stems from external pressures such as rewards or punishment, or conflicted inner feelings such as guilt or shame).
RESULTS: Participants with higher autonomous motivation scores were younger, wanted hearing aids more, and reported greater hearing difficulty in everyday life than those with lower scores. Participants with higher controlled motivation scores were more often referred to the service by others and wanted hearing aids more than those with lower controlled motivation scores. Controlled motivation scores were not associated with perceptions of hearing difficulty in everyday life.
CONCLUSION: Relationships among motivation and sociodemographic factors highlight the importance of characterizing autonomous and controlled motivation in first-time hearing help-seekers. Attention to personal characteristics in order to understand motivational processes involved in rehabilitation decisions such as hearing aid adoption may aid in consultations.
PMID: 28722647 [PubMed - in process]
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Noncongruence between Audiologist and Patient Preferences for Patient-Centeredness.
Noncongruence between Audiologist and Patient Preferences for Patient-Centeredness.
J Am Acad Audiol. 2017 Jul/Aug;28(7):636-643
Authors: Manchaiah V, Dockens AL, Bellon-Harn M, Burns ES
Abstract
BACKGROUND: Trends in preferences of both healthcare providers and patients to patient-centeredness have been emphasized in research. However, an understanding of the nature of preferences to patient-centeredness within the context of the audiologist-patient relationship is needed.
PURPOSE: The purpose of this study is to explore the congruence between audiologist and patient preferences for patient-centeredness.
RESEARCH DESIGN: A cross-sectional survey design was used to gather data from audiologists and patients with hearing loss.
STUDY SAMPLE: Participants included 75 audiologists and 105 consecutive patients with hearing loss.
DATA COLLECTION AND ANALYSIS: Participants completed the modified Patient-Practitioner Orientation Scale (PPOS) and provided selected demographic information. Data were analyzed using an independent sample t test to evaluate the differences between audiologist and patient congruence. Regression analysis was performed to evaluate factors contributing to preferences for patient-centeredness.
RESULTS: Patients had significantly lower scores in PPOS full scale when compared to the audiologists [t(170) = 0.78; p ≤ 0.001] with a very large effect size (Cohen's d = 1.43). Patients also had significantly lower scores when compared to the audiologists on both the sharing [t(170) = 1.01; p ≤ 0.001] and caring [t(170) = 0.56; p ≤ 0.001] subscales. Statistically significant lower scores were noted for patients when compared to audiologists on 12 items on the PPOS. No relationship between any demographic factors and preferences for patient-centeredness were found.
CONCLUSIONS: The current study results indicated noncongruence in preferences for patient-centeredness among audiologists and patients with hearing loss. Results point toward the need for more research considering the nature and impact of patient-centered audiology practice.
PMID: 28722646 [PubMed - in process]
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Verification of a Proposed Clinical Electroacoustic Test Protocol for Personal Digital Modulation Receivers Coupled to Cochlear Implant Sound Processors.
Verification of a Proposed Clinical Electroacoustic Test Protocol for Personal Digital Modulation Receivers Coupled to Cochlear Implant Sound Processors.
J Am Acad Audiol. 2017 Jul/Aug;28(7):625-635
Authors: Nair EL, Sousa R, Wannagot S
Abstract
BACKGROUND: Guidelines established by the AAA currently recommend behavioral testing when fitting frequency modulated (FM) systems to individuals with cochlear implants (CIs). A protocol for completing electroacoustic measures has not yet been validated for personal FM systems or digital modulation (DM) systems coupled to CI sound processors. In response, some professionals have used or altered the AAA electroacoustic verification steps for fitting FM systems to hearing aids when fitting FM systems to CI sound processors. More recently steps were outlined in a proposed protocol.
PURPOSE: The purpose of this research is to review and compare the electroacoustic test measures outlined in a 2013 article by Schafer and colleagues in the Journal of the American Academy of Audiology titled "A Proposed Electroacoustic Test Protocol for Personal FM Receivers Coupled to Cochlear Implant Sound Processors" to the AAA electroacoustic verification steps for fitting FM systems to hearing aids when fitting DM systems to CI users.
RESEARCH DESIGN: Electroacoustic measures were conducted on 71 CI sound processors and Phonak Roger DM systems using a proposed protocol and an adapted AAA protocol. Phonak's recommended default receiver gain setting was used for each CI sound processor manufacturer and adjusted if necessary to achieve transparency.
STUDY SAMPLE: Electroacoustic measures were conducted on Cochlear and Advanced Bionics (AB) sound processors. In this study, 28 Cochlear Nucleus 5/CP810 sound processors, 26 Cochlear Nucleus 6/CP910 sound processors, and 17 AB Naida CI Q70 sound processors were coupled in various combinations to Phonak Roger DM dedicated receivers (25 Phonak Roger 14 receivers-Cochlear dedicated receiver-and 9 Phonak Roger 17 receivers-AB dedicated receiver) and 20 Phonak Roger Inspiro transmitters.
DATA COLLECTION AND ANALYSIS: Employing both the AAA and the Schafer et al protocols, electroacoustic measurements were conducted with the Audioscan Verifit in a clinical setting on 71 CI sound processors and Phonak Roger DM systems to determine transparency and verify FM advantage, comparing speech inputs (65 dB SPL) in an effort to achieve equal outputs. If transparency was not achieved at Phonak's recommended default receiver gain, adjustments were made to the receiver gain. The integrity of the signal was monitored with the appropriate manufacturer's monitor earphones.
RESULTS: Using the AAA hearing aid protocol, 50 of the 71 CI sound processors achieved transparency, and 59 of the 71 CI sound processors achieved transparency when using the proposed protocol at Phonak's recommended default receiver gain. After the receiver gain was adjusted, 3 of 21 CI sound processors still did not meet transparency using the AAA protocol, and 2 of 12 CI sound processors still did not meet transparency using the Schafer et al proposed protocol.
CONCLUSIONS: Both protocols were shown to be effective in taking reliable electroacoustic measurements and demonstrate transparency. Both protocols are felt to be clinically feasible and to address the needs of populations that are unable to reliably report regarding the integrity of their personal DM systems.
PMID: 28722645 [PubMed - in process]
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Children Diagnosed with Auditory Processing Disorder and Their Parents: A Qualitative Study about Perceptions of Living with APD.
Children Diagnosed with Auditory Processing Disorder and Their Parents: A Qualitative Study about Perceptions of Living with APD.
J Am Acad Audiol. 2017 Jul/Aug;28(7):610-624
Authors: Lawton S, Purdy SC, Kalathottukaren RT
Abstract
BACKGROUND: Negative psychosocial consequences have been reported for children with auditory processing disorder (APD). The current literature surrounding APD does not sufficiently address the emotional and psychological consequences of living with the disorder. It is recommended that data be collected from multiple sources, including the child living with APD. Subjective reports of the perceptions of children with APD and their families have real-life validity and can inform clinical decisions and guide future research.
PURPOSE: The aims of this study were to explore the psychosocial consequences of APD as perceived by children with the disorder and their parents.
RESEARCH DESIGN: Qualitative cross-sectional study.
STUDY SAMPLE: Thirteen participants were interviewed: six children with APD, aged 10-12 yr, and one parent for each child (in one case, two parents participated in the interview).
DATA COLLECTION AND ANALYSIS: Semistructured interviews were used to examine the social, emotional, and educational well-being of children with APD. Inductive thematic analysis was conducted to develop themes that illustrated the experiences of living with APD.
RESULTS: Three themes were identified forming a causal network conceptual framework that is reciprocal in nature: (1) external factors, (2) internal problems, and (3) coping. The themes revealed how APD impacted negatively on children's psychosocial well-being (internal problems: covert thoughts, overt behaviors) and described the basis for these outcomes (external factors: environmentally based problems, dissatisfaction with support) and the ability of children and their parent(s) to manage the impact of APD (coping: positive, negative).
CONCLUSIONS: The three themes identified in this research provide a novel understanding of the experience of APD. The themes reflect the psychosocial consequences of external factors that are created internally through "thought" and expressed externally through "behavior." Pathways to support positive coping strategies while discouraging negative coping strategies will enable children to overcome problems and improve their psychosocial well-being.
PMID: 28722644 [PubMed - in process]
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Aural Rehabilitation for Older Adults with Hearing Loss: Impacts on Quality of Life-A Systematic Review of Randomized Controlled Trials.
Aural Rehabilitation for Older Adults with Hearing Loss: Impacts on Quality of Life-A Systematic Review of Randomized Controlled Trials.
J Am Acad Audiol. 2017 Jul/Aug;28(7):596-609
Authors: Michaud HN, Duchesne L
Abstract
BACKGROUND: Few systematic reviews have been conducted regarding aural rehabilitation for adults with hearing loss, with none specifically targeting the older adult population. With prevalence rates of hearing loss being highest in older adults, examining the effects of aural rehabilitation on this population is warranted.
PURPOSE: To evaluate the effects of aural rehabilitation on quality of life in an older adult population presenting with hearing loss.
ELIGIBILITY CRITERIA: Studies with adults presenting with hearing loss, ≥50 yr of age, with or without hearing aids, receiving interventions such as auditory training, speech-reading, communication strategies training, speech tracking, counseling, or a combination of approaches, and measuring outcomes related to quality of life, in an individual or group format, with or without significant others and with no limitations as to year of publication.
STUDY SELECTION: Searches in six databases, as well as results from hand-searching, gray literature, and cross-referencing of articles, yielded 386 articles. Of the 145 assessed as full-text articles for eligibility, 8 studies met inclusion criteria.
STUDY APPRAISAL: A component-based risk of bias assessment, as recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
RESULTS: No effect sizes were found in group interventions measuring outcomes related to quality of life, such as mental and emotional functions, environmental factors, participation restrictions, and activity limitations. An intervention effect regarding participation was found for a self-administered home training program, but an effect size was unavailable. Small-to-medium effect sizes were found in one of two individual communication training programs, for which outcomes related to quality of life, such as emotional functions, activities, participation, and environmental factors were measured. The results of the component-based risk of bias assessment indicated that the quality of reporting was poor, thus compromising the internal validity of included primary studies.
CONCLUSIONS: Our results indicate that the combined body of evidence in support of aural rehabilitation for older adults with hearing loss is not sufficient to draw any firm conclusions. We identify a need for more rigorous research to guide clinical decision-making.
PMID: 28722643 [PubMed - in process]
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The Traditional Audiogram-Can We Do Better?
The Traditional Audiogram-Can We Do Better?
J Am Acad Audiol. 2017 Jul/Aug;28(7):594-595
Authors: McCaslin DL
PMID: 28722642 [PubMed - in process]
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Reflexiones para mejorar la práctica logopédica
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 3
Author(s): Víctor M. Acosta Rodríguez
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Reflexiones para mejorar la práctica logopédica
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 3
Author(s): Víctor M. Acosta Rodríguez
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Reflexiones para mejorar la práctica logopédica
Source:Revista de Logopedia, Foniatría y Audiología, Volume 37, Issue 3
Author(s): Víctor M. Acosta Rodríguez
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Occupational Hearing Loss from Non-Gaussian Noise
Semin Hear 2017; 38: 223-224
DOI: 10.1055/s-0037-1603690
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Full text
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Occupational Hearing Loss from Non-Gaussian Noise
Semin Hear 2017; 38: 225-262
DOI: 10.1055/s-0037-1603726
Noise levels are truly continuous in relatively few occupations, with some degree of intermittency the most common condition. The sound levels of intermittent noise are often referred to as non-Gaussian in that they are not normally distributed in the time domain. In some conditions, intermittent noise affects the ear differently from continuous noise, and it is this assumption that underlies the selection of the 5-dB exchange rate (ER). The scientific and professional communities have debated this assumption over recent decades. This monograph explores the effect of non-Gaussian noise on the auditory system. It begins by summarizing an earlier report by the same author concentrating on the subject of the ER. The conclusions of the earlier report supported the more conservative 3-dB ER with possible adjustments to the permissible exposure limit for certain working conditions. The current document has expanded on the earlier report in light of the relevant research accomplished in the intervening decades. Although some of the animal research has supported the mitigating effect of intermittency, a closer look at many of these studies reveals certain weaknesses, along with the fact that these noise exposures were not usually representative of the conditions under which people actually work. The more recent animal research on complex noise shows that intermittencies do not protect the cochlea and that many of the previous assumptions about the ameliorative effect of intermittencies are no longer valid, lending further support to the 3-dB ER. The neurologic effects of noise on hearing have gained increasing attention in recent years because of improvements in microscopy and immunostaining techniques. Animal experiments showing damage to auditory synapses from noise exposures previously considered harmless may signify the need for a more conservative approach to the assessment of noise-induced hearing loss and consequently the practice of hearing conservation programs.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Self-Assessment Questions
Semin Hear 2017; 38: C1-C10
DOI: 10.1055/s-0037-1603759
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA
Article in Thieme eJournals:
Table of contents | Full text
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Occupational Hearing Loss from Non-Gaussian Noise
Semin Hear 2017; 38: 223-224
DOI: 10.1055/s-0037-1603690
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Full text
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Occupational Hearing Loss from Non-Gaussian Noise
Semin Hear 2017; 38: 225-262
DOI: 10.1055/s-0037-1603726
Noise levels are truly continuous in relatively few occupations, with some degree of intermittency the most common condition. The sound levels of intermittent noise are often referred to as non-Gaussian in that they are not normally distributed in the time domain. In some conditions, intermittent noise affects the ear differently from continuous noise, and it is this assumption that underlies the selection of the 5-dB exchange rate (ER). The scientific and professional communities have debated this assumption over recent decades. This monograph explores the effect of non-Gaussian noise on the auditory system. It begins by summarizing an earlier report by the same author concentrating on the subject of the ER. The conclusions of the earlier report supported the more conservative 3-dB ER with possible adjustments to the permissible exposure limit for certain working conditions. The current document has expanded on the earlier report in light of the relevant research accomplished in the intervening decades. Although some of the animal research has supported the mitigating effect of intermittency, a closer look at many of these studies reveals certain weaknesses, along with the fact that these noise exposures were not usually representative of the conditions under which people actually work. The more recent animal research on complex noise shows that intermittencies do not protect the cochlea and that many of the previous assumptions about the ameliorative effect of intermittencies are no longer valid, lending further support to the 3-dB ER. The neurologic effects of noise on hearing have gained increasing attention in recent years because of improvements in microscopy and immunostaining techniques. Animal experiments showing damage to auditory synapses from noise exposures previously considered harmless may signify the need for a more conservative approach to the assessment of noise-induced hearing loss and consequently the practice of hearing conservation programs.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Self-Assessment Questions
Semin Hear 2017; 38: C1-C10
DOI: 10.1055/s-0037-1603759
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA
Article in Thieme eJournals:
Table of contents | Full text
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Occupational Hearing Loss from Non-Gaussian Noise
Semin Hear 2017; 38: 223-224
DOI: 10.1055/s-0037-1603690
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Full text
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via IFTTT
Occupational Hearing Loss from Non-Gaussian Noise
Semin Hear 2017; 38: 225-262
DOI: 10.1055/s-0037-1603726
Noise levels are truly continuous in relatively few occupations, with some degree of intermittency the most common condition. The sound levels of intermittent noise are often referred to as non-Gaussian in that they are not normally distributed in the time domain. In some conditions, intermittent noise affects the ear differently from continuous noise, and it is this assumption that underlies the selection of the 5-dB exchange rate (ER). The scientific and professional communities have debated this assumption over recent decades. This monograph explores the effect of non-Gaussian noise on the auditory system. It begins by summarizing an earlier report by the same author concentrating on the subject of the ER. The conclusions of the earlier report supported the more conservative 3-dB ER with possible adjustments to the permissible exposure limit for certain working conditions. The current document has expanded on the earlier report in light of the relevant research accomplished in the intervening decades. Although some of the animal research has supported the mitigating effect of intermittency, a closer look at many of these studies reveals certain weaknesses, along with the fact that these noise exposures were not usually representative of the conditions under which people actually work. The more recent animal research on complex noise shows that intermittencies do not protect the cochlea and that many of the previous assumptions about the ameliorative effect of intermittencies are no longer valid, lending further support to the 3-dB ER. The neurologic effects of noise on hearing have gained increasing attention in recent years because of improvements in microscopy and immunostaining techniques. Animal experiments showing damage to auditory synapses from noise exposures previously considered harmless may signify the need for a more conservative approach to the assessment of noise-induced hearing loss and consequently the practice of hearing conservation programs.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Self-Assessment Questions
Semin Hear 2017; 38: C1-C10
DOI: 10.1055/s-0037-1603759
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA
Article in Thieme eJournals:
Table of contents | Full text
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Population rCharacteristics and Progressive Disability in Neuofibromatosis Type 2.
| Related Articles |
Population rCharacteristics and Progressive Disability in Neuofibromatosis Type 2.
World Neurosurg. 2017 Jul 15;:
Authors: Iwatate K, Yokoo T, Iwatate E, Ichikawa M, Sato T, Fujii M, Sakuma J, Saito K
Abstract
OBJECTIVE: To characterize the clinical features of the NF2 population and determine prognostic risk factors for progressive disabilities.
METHODS: In this retrospective cohort study of the Japanese national NF2 registry between 2009-2013, various clinical data (demographic, history, oncological, and neurological) of 807 patients with diagnosis of NF2 were analyzed. The overall severity of neurological disability was assessed using a comprehensive 25-point scoring system encompassing a wide variety of neurological deficits. In 587 patients in whom longitudinal disability data were available, multivariate logistic regression was performed to identify risk factors of significant disability progression.
RESULTS: The clinical characteristics of the Japanese NF2 population were heterogeneous Median onset age [range] of 24 years [1-80]; male-to-female ratio 1:1.29; initial severity score 4 [0-22] out of 25-points. Family history was present in 33%. Most frequent clinical features were bilateral cranial nerve VIII nerve sheath tumor (CN8 NST, 87%), spinal NST (80%), hearing loss (65%), spinal dysfunction (50%), intracranial meningioma (49%), and facial paresis (36%). Disability score progressed by ≥5-points in 6.1% of patients over the study period. Based on multivariate logistic regression analyses, the significant independent risk factors of progression (p-value) included: onset age <25 years (p=0.015), positive family history (p=0.007), positive treatment history (p=0.026) hearing loss (p=0.014), facial paresis (p=0.015), blindness (p=0.011), hemiparesis (p=0.025).
CONCLUSIONS: The NF2 population in Japan is heterogeneous in clinical features. Risk factors of progressive disability include younger age of onset, positive family history, positive treatment history, and specific neurological deficits.
PMID: 28720529 [PubMed - as supplied by publisher]
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Autosomal Recessive Keratoderma-Ichthyosis-Deafness (ARKID) Syndrome Is Caused by VPS33B Mutations Affecting Rab Protein Interaction and Collagen Modification.
   |
Related Articles |
Autosomal Recessive Keratoderma-Ichthyosis-Deafness (ARKID) Syndrome Is Caused by VPS33B Mutations Affecting Rab Protein Interaction and Collagen Modification.
J Invest Dermatol. 2017 Apr;137(4):845-854
Authors: Gruber R, Rogerson C, Windpassinger C, Banushi B, Straatman-Iwanowska A, Hanley J, Forneris F, Strohal R, Ulz P, Crumrine D, Menon GK, Blunder S, Schmuth M, Müller T, Smith H, Mills K, Kroisel P, Janecke AR, Gissen P
Abstract
In this paper, we report three patients with severe palmoplantar keratoderma associated with ichthyosis and sensorineural deafness. Biallelic mutations were found in VPS33B, encoding VPS33B, a Sec1/Munc18 family protein that interacts with Rab11a and Rab25 proteins and is involved in trafficking of the collagen-modifying enzyme LH3. Two patients were homozygous for the missense variant p.Gly131Glu, whereas one patient was compound heterozygous for p.Gly131Glu and the splice site mutation c.240-1G>C, previously reported in patients with arthrogryposis renal dysfunction and cholestasis syndrome. We demonstrated the pathogenicity of variant p.Gly131Glu by assessing the interactions of the mutant VPS33B construct and its ability to traffic LH3. Compared with wild-type VPS33B, the p.Gly131Glu mutant VPS33B had reduced coimmunoprecipitation and colocalization with Rab11a and Rab25 and did not rescue LH3 trafficking. Confirming the cell-based experiments, we found deficient LH3-specific collagen lysine modifications in patients' urine and skin fibroblasts. Additionally, the epidermal ultrastructure of the p.Gly131Glu patients mirrored defects in tamoxifen-inducible VPS33B-deficient Vps33b(fl/fl)-ER(T2) mice. Both patients and murine models revealed an impaired epidermal structure, ascribed to aberrant secretion of lamellar bodies, which are essential for epidermal barrier formation. Our results demonstrate that p.Gly131Glu mutant VPS33B causes an autosomal recessive keratoderma-ichthyosis-deafness syndrome.
PMID: 28017832 [PubMed - indexed for MEDLINE]
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