Objective: To highlight Noonan syndrome as a clinically recognizable cause of severe to profound sensorineural hearing impairment. Study Design: New clinical cases and review. Setting: Patients evaluated for etiological diagnosis by a medical geneticist in a reference center for hearing impairment. Patients: Five patients presenting with confirmed Noonan syndrome and profound sensorineural hearing impairment. Interventions: Diagnostic and review of the literature. Results: Five patients presented with profound sensorineural hearing impairment and molecularly confirmed Noonan syndrome. Sensorineural hearing impairment has been progressive for three patients. Cardiac echography identified pulmonary stenosis in two patients and was normal for the three other patients. Short stature was found in two patients. Mild intellectual disability was found in one patient. Inconspicuous clinical features as facial dysmorphism, cryptorchidism, or easy bruising were of peculiar interest to reach the diagnosis of Noonan syndrome. Conclusion: Profound sensorineural hearing impairment can be the main feature of Noonan syndrome. Associated features are highly variable; thus, detailed medical history and careful physical examination are mandatory to consider the diagnosis in case of a sensorineural hearing impairment. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Τρίτη 25 Ιουλίου 2017
Unique Case of Hearing Recovery After Otic Capsule Destruction and Complete Sensorineural Hearing Loss Caused by Langerhans Cell Histiocytosis.
: A 14-year-old woman presented with right-sided otologic and vestibular symptoms after presenting with hormonal disturbances earlier that year. Imaging showed a gross destruction of the temporal bone, mastoid air cells, and external acoustic meatus with invasion into the otic capsule. The patient experienced complete sensorineural hearing loss in the right ear. Biopsy diagnosed Langerhans cell histiocytosis (LCH) and the patient was treated with chemotherapy. After 1 year of treatment, the patient's hearing partially recovered and imaging showed reconstitution of the temporal bone including the otic capsule. Our case is the first report of complete sensorineural hearing loss with partial recovery after LCH treatment. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Vestibular Function in Adults With Epilepsy of Unknown Etiology.
Objective: This study aimed to evaluate vestibular function in adults with chronic epilepsy of unknown etiology in the inter-ictal period. Background: Epilepsy is a chronic medical disorder. Life-long therapy may be required in one-third of patients. Epilepsy is associated with comorbid somatic conditions which impairs patients' quality of life. Methods: This cross-sectional study included 28 with generalized tonic clonic (GTC) convulsions and 14 and 3 with temporal (TLE) and frontal lobe (FLE) epilepsies with secondary generalization (all were on regular carbamazepine therapy) and 40 healthy control subjects. The patients' mean age was 34.97 +/- 7.35 years and the duration of illness was 18.75 +/- 7.99 years. All underwent videonystagmography (VNG). Results: Compared with controls, patients had frequent vestibular symptoms including dizziness (62.22%) (p = 0.0001) and sense of imbalance (44.44%) (p = 0.0001). Eleven patients (24.44%) had central vestibular dysfunction (p = 0.0001); 9 (20%) had mixed vestibular dysfunction and one (2.22%) had peripheral vestibular dysfunction (p = 0.0001). Abnormalities were observed in saccadic (44.4%) and pursuit (42.2%) eye movements, optokinetic nystagmus (42.2%) and positioning/positional (11.11%) and caloric (13.33%) testing. TLE and FLE were associated with more VNG abnormalities than GTC. No significant differences were observed in the demographic and clinical characteristics between patients with and without VNG abnormalities. Conclusion: Vestibular manifestations are frequent in patients with epilepsy. This may be a result of the permanent damaging effect of chronic epilepsy on the vestibular cortical areas and/or a toxic effect from prolonged carbamazepine therapy on the peripheral and central vestibular systems. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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The Middle Ear Cleft Status in a "Natural" Cohort With Eustachian Tube Dysfunction.
Background: The Eustachian tube (ET) has a major role in the middle ear (ME) pressure homeostasis. ET dysfunction is the accepted paradigm for pressure-related ME disorders. We studied the ME status in patients with severely diminished ET opening abilities, and anticipated to find ME disorders in most of them. Patients and Methods: ME status was evaluated in unconscious adults, who were hospitalized in a rehabilitation center with severe brain damage, requiring tracheotomy and gastrostomy. These patients were unable to swallow, produce valsalva, yawn, and needed oral suctioning. Examination included fiberoptic nasopharyngoscopy, gag reflex and soft palate assessments, otoscopy, and tympanometry. Results: Nineteen patients (38 ears) were evaluated: 14 men and 5 women, aged 18 to 93 years (average 59). Duration of gastrostomy and tracheotomy were between 3 months and 18 years. All the patients lacked gag reflex, palatal movements, or supraglottic sensation. Eighteen ears (47%) had otitis media with effusion (OME) (versus ~3% in the general population, p = 0.00001), none had significant tympanic membrane atelectasis, but 20 (53%) ears were normal. Twenty-two ears (59%) had tympanometry types B/C and 16 (41%) had type A. Cerumen impaction incidence (26 ears, 68%) was significantly higher than in normal adults (10%), mentally retarded (36%), and nursing homes residents (57%). Conclusions: A dysfunctional ET predisposed ME disorders. Yet, ~50% of the ears were normal, in contrast to the current paradigm. This implies that ME pressure homeostasis is maintained by factors that can compensate for ET dysfunction. Treating cerumen impaction and OME may be beneficial for rehabilitation. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Stable Longitudinal Performance of Adult Cochlear Implant Users for More Than 10 Years.
Objective: To analyze the long-term performance of cochlear implant patients. Study Design: Retrospective longitudinal study. Setting: Tertiary referral center with a large cochlear implant program. Main Outcome Measure: Speech perception scores in quiet and in background noise in the short-term (1.12 +/- 0.15 yr) and long-term (12.61 +/- 2.34 yr) after implantation. Patients: Fifty-eight implanted ears from 55 patients with a mean age of 51.80 +/- 1.757 years at the time of implantation were included. Results: Speech perception scores were stable in the long-term for up to 20 years postimplantation. When alteration of speech perception over time was investigated in relation to the age at implantation, there was a deterioration of the scores in quiet in older patients (>60 years old at the time of surgery). In addition the speech comprehension in noise was negatively correlated with the age at the time of the test. Conclusion: The speech perception abilities of cochlear implant users are stable in the long-term and at the most may be affected by the age of the patients, as it is known from acoustic hearing. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Fingolimod (FTY-720) is Capable of Reversing Tumor Necrosis Factor Induced Decreases in Cochlear Blood Flow.
Hypothesis: The potential of Fingolimod (FTY-720), a sphingosine-1-phosphate analogue, to revoke the changes in cochlear blood flow induced by tumor necrosis factor (TNF) was investigated. Background: Impairment of cochlear blood flow has often been considered as the common final pathway of various inner ear pathologies. TNF, an ubiquitous cytokine, plays a major role in these pathologies, reducing cochlear blood flow via sphingosine-1-phosphate-signaling. Methods: Fifteen Dunkin-Hartley guinea pigs were randomly assigned to one of three groups (placebo/placebo, TNF/placebo, TNF/FTY-720). Cochlear microcirculation was quantified over 60 minutes by in vivo fluorescence microscopy before and after topical application of placebo or TNF (5 ng/ml) and after subsequent application of placebo or FTY-720 (200 [mu]g/ml). Results: Treatment with TNF led to a significant decrease of cochlear blood flow. Following this, application of placebo caused no significant changes while application of FTY-720 caused a significant rise in cochlear blood flow. Conclusions: FTY-720 is capable of reversing changes in cochlear blood flow induced by application of TNF. This makes FTY-720 a valid candidate for potential treatment of numerous inner ear pathologies. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company
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Latest Research Link Hearing Loss with Cognitive Decline, Alzheimer’s
Researchers found that hearing loss, hospitalizations, and decreases in verbal fluency are associated with cognitive decline. These findings were presented at the Alzheimer's Association International Conference (AAIC) in London earlier this month.
A University of Wisconsin study that included 783 middle-aged adults in the Wisconsin Registry for Alzheimer's Prevention (WRAP)—a registry of adults with a maternal history of Alzheimer's disease—found that 9.2 percent of the participants reported having hearing loss at baseline. These participants performed worse on cognitive tests four years after baseline assessment than those who did not report any hearing loss. They also had more than doubled risk of developing mild cognitive impairment (MCI) in five years. Based on this prospective cohort study, researchers concluded that hearing loss may not only be a risk factor for MCI, but its identification and treatment may also help detect and manage MCI earlier, thereby reducing future cases of Alzheimer's.
The study, entitled "Self-Reported Hearing Loss, Cognitive Performance, and Risk of MCI: Findings from the Wisconsin Registry for Alzheimer's Prevention," was presented last July 17.
In another University of Wisconsin study, researchers found that changes in speech such as increases in the use of non-specific language (more pronouns), hesitations, and fillers were associated with early onset of MCI. In this study, researchers analyzed two speech samples taken two years apart from 264 middle-aged adults enrolled in the WRAP. Those who had early MCI were found to have reduced verbal fluency that declined faster based on the samples collected.
Other risk factors of cognitive impairment were also discussed at AAIC, including those posed by unplanned visits to emergency units. Bryan James, PhD, of the Rush Alzheimer's Disease Center at Rush University Medical Center explained that emergency or urgent hospital visits, as opposed to planned visits, are associated with significant acceleration (about 60 percent) of mental decline in older adults.
Author information: Noah Glenn
Published: 7/25/2017 5:03:00 PM
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Latest Research Link Hearing Loss with Cognitive Decline, Alzheimer’s
Researchers found that hearing loss, hospitalizations, and decreases in verbal fluency are associated with cognitive decline. These findings were presented at the Alzheimer's Association International Conference (AAIC) in London earlier this month.
A University of Wisconsin study that included 783 middle-aged adults in the Wisconsin Registry for Alzheimer's Prevention (WRAP)—a registry of adults with a maternal history of Alzheimer's disease—found that 9.2 percent of the participants reported having hearing loss at baseline. These participants performed worse on cognitive tests four years after baseline assessment than those who did not report any hearing loss. They also had more than doubled risk of developing mild cognitive impairment (MCI) in five years. Based on this prospective cohort study, researchers concluded that hearing loss may not only be a risk factor for MCI, but its identification and treatment may also help detect and manage MCI earlier, thereby reducing future cases of Alzheimer's.
The study, entitled "Self-Reported Hearing Loss, Cognitive Performance, and Risk of MCI: Findings from the Wisconsin Registry for Alzheimer's Prevention," was presented last July 17.
In another University of Wisconsin study, researchers found that changes in speech such as increases in the use of non-specific language (more pronouns), hesitations, and fillers were associated with early onset of MCI. In this study, researchers analyzed two speech samples taken two years apart from 264 middle-aged adults enrolled in the WRAP. Those who had early MCI were found to have reduced verbal fluency that declined faster based on the samples collected.
Other risk factors of cognitive impairment were also discussed at AAIC, including those posed by unplanned visits to emergency units. Bryan James, PhD, of the Rush Alzheimer's Disease Center at Rush University Medical Center explained that emergency or urgent hospital visits, as opposed to planned visits, are associated with significant acceleration (about 60 percent) of mental decline in older adults.
Author information: Noah Glenn
Published: 7/25/2017 5:03:00 PM
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Latest Research Link Hearing Loss with Cognitive Decline, Alzheimer’s
Researchers found that hearing loss, hospitalizations, and decreases in verbal fluency are associated with cognitive decline. These findings were presented at the Alzheimer's Association International Conference (AAIC) in London earlier this month.
A University of Wisconsin study that included 783 middle-aged adults in the Wisconsin Registry for Alzheimer's Prevention (WRAP)—a registry of adults with a maternal history of Alzheimer's disease—found that 9.2 percent of the participants reported having hearing loss at baseline. These participants performed worse on cognitive tests four years after baseline assessment than those who did not report any hearing loss. They also had more than doubled risk of developing mild cognitive impairment (MCI) in five years. Based on this prospective cohort study, researchers concluded that hearing loss may not only be a risk factor for MCI, but its identification and treatment may also help detect and manage MCI earlier, thereby reducing future cases of Alzheimer's.
The study, entitled "Self-Reported Hearing Loss, Cognitive Performance, and Risk of MCI: Findings from the Wisconsin Registry for Alzheimer's Prevention," was presented last July 17.
In another University of Wisconsin study, researchers found that changes in speech such as increases in the use of non-specific language (more pronouns), hesitations, and fillers were associated with early onset of MCI. In this study, researchers analyzed two speech samples taken two years apart from 264 middle-aged adults enrolled in the WRAP. Those who had early MCI were found to have reduced verbal fluency that declined faster based on the samples collected.
Other risk factors of cognitive impairment were also discussed at AAIC, including those posed by unplanned visits to emergency units. Bryan James, PhD, of the Rush Alzheimer's Disease Center at Rush University Medical Center explained that emergency or urgent hospital visits, as opposed to planned visits, are associated with significant acceleration (about 60 percent) of mental decline in older adults.
Author information: Noah Glenn
Published: 7/25/2017 5:03:00 PM
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Working Memory and Speech Recognition in Noise Under Ecologically Relevant Listening Conditions: Effects of Visual Cues and Noise Type Among Adults With Hearing Loss
Purpose
This study evaluated the relationship between working memory (WM) and speech recognition in noise with different noise types as well as in the presence of visual cues.
Method
Seventy-six adults with bilateral, mild to moderately severe sensorineural hearing loss (mean age: 69 years) participated. Using a cross-sectional design, 2 measures of WM were taken: a reading span measure, and Word Auditory Recognition and Recall Measure (Smith, Pichora-Fuller, & Alexander, 2016). Speech recognition was measured with the Multi-Modal Lexical Sentence Test for Adults (Kirk et al., 2012) in steady-state noise and 4-talker babble, with and without visual cues. Testing was under unaided conditions.
Results
A linear mixed model revealed visual cues and pure-tone average as the only significant predictors of Multi-Modal Lexical Sentence Test outcomes. Neither WM measure nor noise type showed a significant effect.
Conclusion
The contribution of WM in explaining unaided speech recognition in noise was negligible and not influenced by noise type or visual cues. We anticipate that with audibility partially restored by hearing aids, the effects of WM will increase. For clinical practice to be affected, more significant effect sizes are needed.from #Audiology via ola Kala on Inoreader http://ift.tt/2vYtd2R
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Working Memory and Speech Recognition in Noise Under Ecologically Relevant Listening Conditions: Effects of Visual Cues and Noise Type Among Adults With Hearing Loss
Purpose
This study evaluated the relationship between working memory (WM) and speech recognition in noise with different noise types as well as in the presence of visual cues.
Method
Seventy-six adults with bilateral, mild to moderately severe sensorineural hearing loss (mean age: 69 years) participated. Using a cross-sectional design, 2 measures of WM were taken: a reading span measure, and Word Auditory Recognition and Recall Measure (Smith, Pichora-Fuller, & Alexander, 2016). Speech recognition was measured with the Multi-Modal Lexical Sentence Test for Adults (Kirk et al., 2012) in steady-state noise and 4-talker babble, with and without visual cues. Testing was under unaided conditions.
Results
A linear mixed model revealed visual cues and pure-tone average as the only significant predictors of Multi-Modal Lexical Sentence Test outcomes. Neither WM measure nor noise type showed a significant effect.
Conclusion
The contribution of WM in explaining unaided speech recognition in noise was negligible and not influenced by noise type or visual cues. We anticipate that with audibility partially restored by hearing aids, the effects of WM will increase. For clinical practice to be affected, more significant effect sizes are needed.from #Audiology via ola Kala on Inoreader http://ift.tt/2vYtd2R
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Working Memory and Speech Recognition in Noise Under Ecologically Relevant Listening Conditions: Effects of Visual Cues and Noise Type Among Adults With Hearing Loss
Purpose
This study evaluated the relationship between working memory (WM) and speech recognition in noise with different noise types as well as in the presence of visual cues.
Method
Seventy-six adults with bilateral, mild to moderately severe sensorineural hearing loss (mean age: 69 years) participated. Using a cross-sectional design, 2 measures of WM were taken: a reading span measure, and Word Auditory Recognition and Recall Measure (Smith, Pichora-Fuller, & Alexander, 2016). Speech recognition was measured with the Multi-Modal Lexical Sentence Test for Adults (Kirk et al., 2012) in steady-state noise and 4-talker babble, with and without visual cues. Testing was under unaided conditions.
Results
A linear mixed model revealed visual cues and pure-tone average as the only significant predictors of Multi-Modal Lexical Sentence Test outcomes. Neither WM measure nor noise type showed a significant effect.
Conclusion
The contribution of WM in explaining unaided speech recognition in noise was negligible and not influenced by noise type or visual cues. We anticipate that with audibility partially restored by hearing aids, the effects of WM will increase. For clinical practice to be affected, more significant effect sizes are needed.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2vYtd2R
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Fit-to-Targets for the Desired Sensation Level Version 5.0a Hearing Aid Prescription Method for Children
Purpose
The purpose of this study was to measure the range of fit to Desired Sensation Level version 5.0 (DSL v5.0) targets in pediatric practice environments. Results will be used in the future to develop clinical-aided speech intelligibility index typical performance data.
Method
Clinical partners collected data from 161 final hearing aid settings for children aged ≤ 10 years. Measured data were obtained by performing 2-cm3 coupler-simulated real-ear measurements using the DSL v5.0 implementation on the Audioscan VF-1 (Etymonic Design Inc., Dorchester, ON, Canada) for soft, average, and loud speech inputs and maximum hearing aid output levels.
Results
Fittings were within ± 5-dB root-mean-square (RMS) error of target for 77%, 80%, and 82% of fittings for the soft, medium, and loud speech test levels, respectively. Aided maximum power output measures were within ± 5-dB RMS error in 72% of cases. Degree of hearing loss, test frequency, and frequency by test level were significant factors in deviation from target. The range of aided speech intelligibility index values exhibited a strong correlation with the hearing levels of the children tested.
Conclusion
This study provides evidence that typical hearing aid fittings for children can be achieved within ± 5-dB RMS error of the DSL v5.0 target. Greater target deviations were observed at extreme frequencies and as the severity of hearing loss increased.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2vGv1xZ
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Fit-to-Targets for the Desired Sensation Level Version 5.0a Hearing Aid Prescription Method for Children
Purpose
The purpose of this study was to measure the range of fit to Desired Sensation Level version 5.0 (DSL v5.0) targets in pediatric practice environments. Results will be used in the future to develop clinical-aided speech intelligibility index typical performance data.
Method
Clinical partners collected data from 161 final hearing aid settings for children aged ≤ 10 years. Measured data were obtained by performing 2-cm3 coupler-simulated real-ear measurements using the DSL v5.0 implementation on the Audioscan VF-1 (Etymonic Design Inc., Dorchester, ON, Canada) for soft, average, and loud speech inputs and maximum hearing aid output levels.
Results
Fittings were within ± 5-dB root-mean-square (RMS) error of target for 77%, 80%, and 82% of fittings for the soft, medium, and loud speech test levels, respectively. Aided maximum power output measures were within ± 5-dB RMS error in 72% of cases. Degree of hearing loss, test frequency, and frequency by test level were significant factors in deviation from target. The range of aided speech intelligibility index values exhibited a strong correlation with the hearing levels of the children tested.
Conclusion
This study provides evidence that typical hearing aid fittings for children can be achieved within ± 5-dB RMS error of the DSL v5.0 target. Greater target deviations were observed at extreme frequencies and as the severity of hearing loss increased.from #Audiology via ola Kala on Inoreader http://ift.tt/2vGv1xZ
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Fit-to-Targets for the Desired Sensation Level Version 5.0a Hearing Aid Prescription Method for Children
Purpose
The purpose of this study was to measure the range of fit to Desired Sensation Level version 5.0 (DSL v5.0) targets in pediatric practice environments. Results will be used in the future to develop clinical-aided speech intelligibility index typical performance data.
Method
Clinical partners collected data from 161 final hearing aid settings for children aged ≤ 10 years. Measured data were obtained by performing 2-cm3 coupler-simulated real-ear measurements using the DSL v5.0 implementation on the Audioscan VF-1 (Etymonic Design Inc., Dorchester, ON, Canada) for soft, average, and loud speech inputs and maximum hearing aid output levels.
Results
Fittings were within ± 5-dB root-mean-square (RMS) error of target for 77%, 80%, and 82% of fittings for the soft, medium, and loud speech test levels, respectively. Aided maximum power output measures were within ± 5-dB RMS error in 72% of cases. Degree of hearing loss, test frequency, and frequency by test level were significant factors in deviation from target. The range of aided speech intelligibility index values exhibited a strong correlation with the hearing levels of the children tested.
Conclusion
This study provides evidence that typical hearing aid fittings for children can be achieved within ± 5-dB RMS error of the DSL v5.0 target. Greater target deviations were observed at extreme frequencies and as the severity of hearing loss increased.from #Audiology via ola Kala on Inoreader http://ift.tt/2vGv1xZ
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Recovery from TBI
A recent study suggests that recovery from TBI (traumatic brain injury) may be different between males and female subjects. Historically, TBI studies have used predominately male subjects, whether they be mice or men. However, investigating the effects of injury, disease, and pharmacological treatments in both male and female subjects has led to significant changes to clinical practice across numerous disciplines.
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Genes for spinocerebellar ataxia with blindness and deafness (SCABD/SCAR3, MIM# 271250 and SCABD2).
 |
Related Articles |
Genes for spinocerebellar ataxia with blindness and deafness (SCABD/SCAR3, MIM# 271250 and SCABD2).
Eur J Hum Genet. 2016 Aug;24(8):1154-9
Authors: Guissart C, Drouot N, Oncel I, Leheup B, Gershoni-Barush R, Muller J, Ferdinandusse S, Larrieu L, Anheim M, Arslan EA, Claustres M, Tranchant C, Topaloglu H, Koenig M
Abstract
Ataxia is a symptom that is often associated with syndromic inherited diseases. We previously reported the linkage of a novel syndrome, ataxia with blindness and deafness (SCAR3/SCABD, OMIM# 271250), to chromosome 6p21-p23 by linkage mapping of an Arab Israeli consanguineous family. We have now identified by whole-exome sequencing a homozygous missense mutation in the Arab Israeli family in the SLC52A2 gene located in 8qter, therefore excluding linkage of this family to 6p. We confirmed the involvement of SLC52A2 by the identification of a second mutation in an independent family with an identical syndromic presentation, which we suggest to name SCABD2. SCABD2 is therefore allelic to Brown-Vialleto-Van Laere syndrome type 2 defined by prominent motoneuronopathy and deafness, and also caused by SLC52A2 mutations. In the course of this project, we identified a clinically similar family with a homozygous missense mutation in PEX6, which is located in 6p21. Therefore, despite false linkage in the initial family, SCABD1/SCAR3 is located in 6p21 and is caused by PEX6 mutations. Both SLC52A2 and PEX6 should be included in screening panels for the diagnosis of syndromic inherited ataxias, particularly as patients with mutations in SLC52A2 can be ameliorated by riboflavin supplementation.
PMID: 26669662 [PubMed - indexed for MEDLINE]
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Ototoxicity monitoring in children treated with platinum chemotherapy.
Ototoxicity monitoring in children treated with platinum chemotherapy.
Int J Audiol. 2017 Jul 24;:1-7
Authors: Brooks B, Knight K
Abstract
OBJECTIVE: To review the prevalence, mechanisms, clinical presentation, risk factors and implications of platinum-induced ototoxicity in paediatric cancer patients based on published evidence, discuss options for monitoring hearing in young children during treatment and review long-term follow-up guidelines.
DESIGN: Narrative literature review.
RESULTS: Children treated with cisplatin are at high risk of hearing loss and early, accurate identification of ototoxicity is important for medical decision making and hearing rehabilitation. Challenges of monitoring hearing in young children during cancer treatment and options for monitoring hearing are discussed.
CONCLUSION: Hearing loss has important consequences for the survivors of childhood cancer including communication, learning, cognition and quality of life. Due to the presentation and configuration of ototoxic hearing loss, the test frequencies that are prioritised and the sequence of testing may differ from standard paediatric hearing evaluations. Hearing should be monitored during treatment and after completion of therapy.
PMID: 28737048 [PubMed - as supplied by publisher]
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Ototoxicity monitoring in children treated with platinum chemotherapy.
Ototoxicity monitoring in children treated with platinum chemotherapy.
Int J Audiol. 2017 Jul 24;:1-7
Authors: Brooks B, Knight K
Abstract
OBJECTIVE: To review the prevalence, mechanisms, clinical presentation, risk factors and implications of platinum-induced ototoxicity in paediatric cancer patients based on published evidence, discuss options for monitoring hearing in young children during treatment and review long-term follow-up guidelines.
DESIGN: Narrative literature review.
RESULTS: Children treated with cisplatin are at high risk of hearing loss and early, accurate identification of ototoxicity is important for medical decision making and hearing rehabilitation. Challenges of monitoring hearing in young children during cancer treatment and options for monitoring hearing are discussed.
CONCLUSION: Hearing loss has important consequences for the survivors of childhood cancer including communication, learning, cognition and quality of life. Due to the presentation and configuration of ototoxic hearing loss, the test frequencies that are prioritised and the sequence of testing may differ from standard paediatric hearing evaluations. Hearing should be monitored during treatment and after completion of therapy.
PMID: 28737048 [PubMed - as supplied by publisher]
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Dizziness: Approach to Evaluation and Management.
 |
Related Articles |
Dizziness: Approach to Evaluation and Management.
Am Fam Physician. 2017 Feb 01;95(3):154-162
Authors: Muncie HL, Sirmans SM, James E
Abstract
Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient's history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have difficulty describing the quality of their symptoms but can more consistently identify the timing and triggers. Episodic vertigo triggered by head motion may be due to benign paroxysmal positional vertigo. Vertigo with unilateral hearing loss suggests Meniere disease. Episodic vertigo not associated with any trigger may be a symptom of vestibular neuritis. Evaluation focuses on determining whether the etiology is peripheral or central. Peripheral etiologies are usually benign. Central etiologies often require urgent treatment. The HINTS (head-impulse, nystagmus, test of skew) examination can help distinguish peripheral from central etiologies. The physical examination includes orthostatic blood pressure measurement, a full cardiac and neurologic examination, assessment for nystagmus, and the Dix-Hallpike maneuver. Laboratory testing and imaging are not required and are usually not helpful. Benign paroxysmal positional vertigo can be treated with a canalith repositioning procedure (e.g., Epley maneuver). Treatment of Meniere disease includes salt restriction and diuretics. Symptoms of vestibular neuritis are relieved with vestibular suppressant medications and vestibular rehabilitation.
PMID: 28145669 [PubMed - indexed for MEDLINE]
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Dizziness: Approach to Evaluation and Management.
|
Related Articles |
Dizziness: Approach to Evaluation and Management.
Am Fam Physician. 2017 Feb 01;95(3):154-162
Authors: Muncie HL, Sirmans SM, James E
Abstract
Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient's history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have difficulty describing the quality of their symptoms but can more consistently identify the timing and triggers. Episodic vertigo triggered by head motion may be due to benign paroxysmal positional vertigo. Vertigo with unilateral hearing loss suggests Meniere disease. Episodic vertigo not associated with any trigger may be a symptom of vestibular neuritis. Evaluation focuses on determining whether the etiology is peripheral or central. Peripheral etiologies are usually benign. Central etiologies often require urgent treatment. The HINTS (head-impulse, nystagmus, test of skew) examination can help distinguish peripheral from central etiologies. The physical examination includes orthostatic blood pressure measurement, a full cardiac and neurologic examination, assessment for nystagmus, and the Dix-Hallpike maneuver. Laboratory testing and imaging are not required and are usually not helpful. Benign paroxysmal positional vertigo can be treated with a canalith repositioning procedure (e.g., Epley maneuver). Treatment of Meniere disease includes salt restriction and diuretics. Symptoms of vestibular neuritis are relieved with vestibular suppressant medications and vestibular rehabilitation.
PMID: 28145669 [PubMed - indexed for MEDLINE]
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Ototoxicity monitoring in children treated with platinum chemotherapy.
Ototoxicity monitoring in children treated with platinum chemotherapy.
Int J Audiol. 2017 Jul 24;:1-7
Authors: Brooks B, Knight K
Abstract
OBJECTIVE: To review the prevalence, mechanisms, clinical presentation, risk factors and implications of platinum-induced ototoxicity in paediatric cancer patients based on published evidence, discuss options for monitoring hearing in young children during treatment and review long-term follow-up guidelines.
DESIGN: Narrative literature review.
RESULTS: Children treated with cisplatin are at high risk of hearing loss and early, accurate identification of ototoxicity is important for medical decision making and hearing rehabilitation. Challenges of monitoring hearing in young children during cancer treatment and options for monitoring hearing are discussed.
CONCLUSION: Hearing loss has important consequences for the survivors of childhood cancer including communication, learning, cognition and quality of life. Due to the presentation and configuration of ototoxic hearing loss, the test frequencies that are prioritised and the sequence of testing may differ from standard paediatric hearing evaluations. Hearing should be monitored during treatment and after completion of therapy.
PMID: 28737048 [PubMed - as supplied by publisher]
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Ototoxicity monitoring in children treated with platinum chemotherapy.
Ototoxicity monitoring in children treated with platinum chemotherapy.
Int J Audiol. 2017 Jul 24;:1-7
Authors: Brooks B, Knight K
Abstract
OBJECTIVE: To review the prevalence, mechanisms, clinical presentation, risk factors and implications of platinum-induced ototoxicity in paediatric cancer patients based on published evidence, discuss options for monitoring hearing in young children during treatment and review long-term follow-up guidelines.
DESIGN: Narrative literature review.
RESULTS: Children treated with cisplatin are at high risk of hearing loss and early, accurate identification of ototoxicity is important for medical decision making and hearing rehabilitation. Challenges of monitoring hearing in young children during cancer treatment and options for monitoring hearing are discussed.
CONCLUSION: Hearing loss has important consequences for the survivors of childhood cancer including communication, learning, cognition and quality of life. Due to the presentation and configuration of ototoxic hearing loss, the test frequencies that are prioritised and the sequence of testing may differ from standard paediatric hearing evaluations. Hearing should be monitored during treatment and after completion of therapy.
PMID: 28737048 [PubMed - as supplied by publisher]
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Vibrotactile Thresholds on the Mastoid and Forehead Position of Deaf Patients Using Radioear B71 and B81.
Objectives: The main objective of this study was to measure the vibrotactile thresholds on the mastoid process and forehead positions using patients with bilateral deafness and to compare the results from the two bone conduction vibrators Radioear B71 and B81. Design: There is a possibility that the vibrotactile sensation on the skin makes it difficult to discriminate between sound and vibration. The risk is highest for patients who have bone conduction hearing thresholds in proximity to or worse than their vibrotactile thresholds. All measurements were performed similar to regular bone conduction threshold testing using an audiometer-driven bone conduction vibrator and pulsed warble tones, but the patients were instructed to respond only when feeling vibrations of the bone conduction vibrator instead of when hearing sound. Both the posterior forehead position and the mastoid process position on the temporal bone were tested for comparative reasons. In total, 16 patients participated in the study, 31% females and 69% males of age 29 to 77 years. All subjects were cochlear implant recipients, either uni- or bilaterally implanted. They were selected based on their audiogram data showing unmeasurable unaided hearing. Results: The force level at which the vibrotactile thresholds were reached, increased with frequency from 125 up to 500 Hz, but remained constant for higher frequencies up to 2 kHz. A statistically significant difference was found between the 2 devices at 125 Hz at both the mastoid process and forehead position, where the vibrotactile threshold seem to be more sensitive for B71, possibly due to contribution of distortion components. There was no statistically significant difference in vibrotactile thresholds between the mastoid process and forehead position in absolute values (force level in dB re 1 [micro]N), but in terms of hearing levels (dB HL) there was an average difference of 10 and 9 dB for B71 and B81, respectively. Conclusions: The results indicate that the vibrotactile thresholds can be confounded with bone conduction hearing thresholds measurements up to 500 Hz when using a standard audiometer and in particular when measuring on the forehead position. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Vibrotactile Thresholds on the Mastoid and Forehead Position of Deaf Patients Using Radioear B71 and B81.
Objectives: The main objective of this study was to measure the vibrotactile thresholds on the mastoid process and forehead positions using patients with bilateral deafness and to compare the results from the two bone conduction vibrators Radioear B71 and B81. Design: There is a possibility that the vibrotactile sensation on the skin makes it difficult to discriminate between sound and vibration. The risk is highest for patients who have bone conduction hearing thresholds in proximity to or worse than their vibrotactile thresholds. All measurements were performed similar to regular bone conduction threshold testing using an audiometer-driven bone conduction vibrator and pulsed warble tones, but the patients were instructed to respond only when feeling vibrations of the bone conduction vibrator instead of when hearing sound. Both the posterior forehead position and the mastoid process position on the temporal bone were tested for comparative reasons. In total, 16 patients participated in the study, 31% females and 69% males of age 29 to 77 years. All subjects were cochlear implant recipients, either uni- or bilaterally implanted. They were selected based on their audiogram data showing unmeasurable unaided hearing. Results: The force level at which the vibrotactile thresholds were reached, increased with frequency from 125 up to 500 Hz, but remained constant for higher frequencies up to 2 kHz. A statistically significant difference was found between the 2 devices at 125 Hz at both the mastoid process and forehead position, where the vibrotactile threshold seem to be more sensitive for B71, possibly due to contribution of distortion components. There was no statistically significant difference in vibrotactile thresholds between the mastoid process and forehead position in absolute values (force level in dB re 1 [micro]N), but in terms of hearing levels (dB HL) there was an average difference of 10 and 9 dB for B71 and B81, respectively. Conclusions: The results indicate that the vibrotactile thresholds can be confounded with bone conduction hearing thresholds measurements up to 500 Hz when using a standard audiometer and in particular when measuring on the forehead position. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
from #Audiology via ola Kala on Inoreader http://ift.tt/2vVeMwi
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from #Audiology via ola Kala on Inoreader http://ift.tt/2vVeMwi
via IFTTT
Vibrotactile Thresholds on the Mastoid and Forehead Position of Deaf Patients Using Radioear B71 and B81.
Objectives: The main objective of this study was to measure the vibrotactile thresholds on the mastoid process and forehead positions using patients with bilateral deafness and to compare the results from the two bone conduction vibrators Radioear B71 and B81. Design: There is a possibility that the vibrotactile sensation on the skin makes it difficult to discriminate between sound and vibration. The risk is highest for patients who have bone conduction hearing thresholds in proximity to or worse than their vibrotactile thresholds. All measurements were performed similar to regular bone conduction threshold testing using an audiometer-driven bone conduction vibrator and pulsed warble tones, but the patients were instructed to respond only when feeling vibrations of the bone conduction vibrator instead of when hearing sound. Both the posterior forehead position and the mastoid process position on the temporal bone were tested for comparative reasons. In total, 16 patients participated in the study, 31% females and 69% males of age 29 to 77 years. All subjects were cochlear implant recipients, either uni- or bilaterally implanted. They were selected based on their audiogram data showing unmeasurable unaided hearing. Results: The force level at which the vibrotactile thresholds were reached, increased with frequency from 125 up to 500 Hz, but remained constant for higher frequencies up to 2 kHz. A statistically significant difference was found between the 2 devices at 125 Hz at both the mastoid process and forehead position, where the vibrotactile threshold seem to be more sensitive for B71, possibly due to contribution of distortion components. There was no statistically significant difference in vibrotactile thresholds between the mastoid process and forehead position in absolute values (force level in dB re 1 [micro]N), but in terms of hearing levels (dB HL) there was an average difference of 10 and 9 dB for B71 and B81, respectively. Conclusions: The results indicate that the vibrotactile thresholds can be confounded with bone conduction hearing thresholds measurements up to 500 Hz when using a standard audiometer and in particular when measuring on the forehead position. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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