Objectives: This study was designed to evaluate binaural temporal processing in young and older adults using a binaural masking level difference (BMLD) paradigm. Using behavioral and electrophysiological measures within the same listeners, a series of stimulus manipulations was used to evaluate the relative contribution of binaural temporal fine-structure and temporal envelope cues. We evaluated the hypotheses that age-related declines in the BMLD task would be more strongly associated with temporal fine-structure than envelope cues and that age-related declines in behavioral measures would be correlated with cortical auditory evoked potential (CAEP) measures. Design: Thirty adults participated in the study, including 10 young normal-hearing, 10 older normal-hearing, and 10 older hearing-impaired adults with bilaterally symmetric, mild-to-moderate sensorineural hearing loss. Behavioral and CAEP thresholds were measured for diotic (So) and dichotic (S[pi]) tonal signals presented in continuous diotic (No) narrowband noise (50-Hz wide) maskers. Temporal envelope cues were manipulated by using two different narrowband maskers; Gaussian noise (GN) with robust envelope fluctuations and low-noise noise (LNN) with minimal envelope fluctuations. The potential to use temporal fine-structure cues was controlled by varying the signal frequency (500 or 4000 Hz), thereby relying on the natural decline in phase-locking with increasing frequency. Results: Behavioral and CAEP thresholds were similar across groups for diotic conditions, while the masking release in dichotic conditions was larger for younger than for older participants. Across all participants, BMLDs were larger for GN than LNN and for 500-Hz than for 4000-Hz conditions, where envelope and fine-structure cues were most salient, respectively. Specific age-related differences were demonstrated for 500-Hz dichotic conditions in GN and LNN, reflecting reduced binaural temporal fine-structure coding. No significant age effects were observed for 4000-Hz dichotic conditions, consistent with similar use of binaural temporal envelope cues across age in these conditions. For all groups, thresholds and derived BMLD values obtained using the behavioral and CAEP methods were strongly correlated, supporting the notion that CAEP measures may be useful as an objective index of age-related changes in binaural temporal processing. Conclusions: These results demonstrate an age-related decline in the processing of binaural temporal fine-structure cues with preserved temporal envelope coding that was similar with and without mild-to-moderate peripheral hearing loss. Such age-related changes can be reliably indexed by both behavioral and CAEP measures in young and older adults. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Παρασκευή 10 Νοεμβρίου 2017
Olivocochlear Efferent Activity Is Associated With the Slope of the Psychometric Function of Speech Recognition in Noise.
Objectives: The medial olivocochlear (MOC) efferent system can modify cochlear function to improve sound detection in noise, but its role in speech perception in noise is unclear. The purpose of this study was to determine the association between MOC efferent activity and performance on two speech-in-noise tasks at two signal-to-noise ratios (SNRs). It was hypothesized that efferent activity would be more strongly correlated with performance at the more challenging SNR, relative to performance at the less challenging SNR. Design: Sixteen adults aged 35 to 73 years participated. Subjects had pure-tone averages 0.05), contrary to hypothesis. However, contralateral suppression was significantly correlated with the slope of the psychometric function, computed as the difference between performance levels at the two SNRs divided by 3 (decibel difference between the 2 SNRs) for the coordinate response measure task (partial rs = 0.59; p = 0.04) and for the Institute of Electrical and Electronics Engineers task (partial rs = 0.60; p = 0.03). Conclusions: In a group of primarily older adults with normal hearing or mild hearing loss, olivocochlear efferent activity assessed using contralateral suppression of TEOAEs was not associated with speech-in-noise performance at a single SNR. However, auditory efferent activity appears to be associated with the slope of the psychometric function for both a word and sentence recognition task in noise. Results suggest that individuals with stronger MOC efferent activity tend to be more responsive to changes in SNR, where small increases in SNR result in better speech-in-noise performance relative to individuals with weaker MOC efferent activity. Additionally, the results suggest that the slope of the psychometric function may be a more useful metric than performance at a single SNR when examining the relationship between speech recognition in noise and MOC efferent activity. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Cortical Correlates of Binaural Temporal Processing Deficits in Older Adults.
Objectives: This study was designed to evaluate binaural temporal processing in young and older adults using a binaural masking level difference (BMLD) paradigm. Using behavioral and electrophysiological measures within the same listeners, a series of stimulus manipulations was used to evaluate the relative contribution of binaural temporal fine-structure and temporal envelope cues. We evaluated the hypotheses that age-related declines in the BMLD task would be more strongly associated with temporal fine-structure than envelope cues and that age-related declines in behavioral measures would be correlated with cortical auditory evoked potential (CAEP) measures. Design: Thirty adults participated in the study, including 10 young normal-hearing, 10 older normal-hearing, and 10 older hearing-impaired adults with bilaterally symmetric, mild-to-moderate sensorineural hearing loss. Behavioral and CAEP thresholds were measured for diotic (So) and dichotic (S[pi]) tonal signals presented in continuous diotic (No) narrowband noise (50-Hz wide) maskers. Temporal envelope cues were manipulated by using two different narrowband maskers; Gaussian noise (GN) with robust envelope fluctuations and low-noise noise (LNN) with minimal envelope fluctuations. The potential to use temporal fine-structure cues was controlled by varying the signal frequency (500 or 4000 Hz), thereby relying on the natural decline in phase-locking with increasing frequency. Results: Behavioral and CAEP thresholds were similar across groups for diotic conditions, while the masking release in dichotic conditions was larger for younger than for older participants. Across all participants, BMLDs were larger for GN than LNN and for 500-Hz than for 4000-Hz conditions, where envelope and fine-structure cues were most salient, respectively. Specific age-related differences were demonstrated for 500-Hz dichotic conditions in GN and LNN, reflecting reduced binaural temporal fine-structure coding. No significant age effects were observed for 4000-Hz dichotic conditions, consistent with similar use of binaural temporal envelope cues across age in these conditions. For all groups, thresholds and derived BMLD values obtained using the behavioral and CAEP methods were strongly correlated, supporting the notion that CAEP measures may be useful as an objective index of age-related changes in binaural temporal processing. Conclusions: These results demonstrate an age-related decline in the processing of binaural temporal fine-structure cues with preserved temporal envelope coding that was similar with and without mild-to-moderate peripheral hearing loss. Such age-related changes can be reliably indexed by both behavioral and CAEP measures in young and older adults. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Olivocochlear Efferent Activity Is Associated With the Slope of the Psychometric Function of Speech Recognition in Noise.
Objectives: The medial olivocochlear (MOC) efferent system can modify cochlear function to improve sound detection in noise, but its role in speech perception in noise is unclear. The purpose of this study was to determine the association between MOC efferent activity and performance on two speech-in-noise tasks at two signal-to-noise ratios (SNRs). It was hypothesized that efferent activity would be more strongly correlated with performance at the more challenging SNR, relative to performance at the less challenging SNR. Design: Sixteen adults aged 35 to 73 years participated. Subjects had pure-tone averages 0.05), contrary to hypothesis. However, contralateral suppression was significantly correlated with the slope of the psychometric function, computed as the difference between performance levels at the two SNRs divided by 3 (decibel difference between the 2 SNRs) for the coordinate response measure task (partial rs = 0.59; p = 0.04) and for the Institute of Electrical and Electronics Engineers task (partial rs = 0.60; p = 0.03). Conclusions: In a group of primarily older adults with normal hearing or mild hearing loss, olivocochlear efferent activity assessed using contralateral suppression of TEOAEs was not associated with speech-in-noise performance at a single SNR. However, auditory efferent activity appears to be associated with the slope of the psychometric function for both a word and sentence recognition task in noise. Results suggest that individuals with stronger MOC efferent activity tend to be more responsive to changes in SNR, where small increases in SNR result in better speech-in-noise performance relative to individuals with weaker MOC efferent activity. Additionally, the results suggest that the slope of the psychometric function may be a more useful metric than performance at a single SNR when examining the relationship between speech recognition in noise and MOC efferent activity. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Cortical Correlates of Binaural Temporal Processing Deficits in Older Adults.
Objectives: This study was designed to evaluate binaural temporal processing in young and older adults using a binaural masking level difference (BMLD) paradigm. Using behavioral and electrophysiological measures within the same listeners, a series of stimulus manipulations was used to evaluate the relative contribution of binaural temporal fine-structure and temporal envelope cues. We evaluated the hypotheses that age-related declines in the BMLD task would be more strongly associated with temporal fine-structure than envelope cues and that age-related declines in behavioral measures would be correlated with cortical auditory evoked potential (CAEP) measures. Design: Thirty adults participated in the study, including 10 young normal-hearing, 10 older normal-hearing, and 10 older hearing-impaired adults with bilaterally symmetric, mild-to-moderate sensorineural hearing loss. Behavioral and CAEP thresholds were measured for diotic (So) and dichotic (S[pi]) tonal signals presented in continuous diotic (No) narrowband noise (50-Hz wide) maskers. Temporal envelope cues were manipulated by using two different narrowband maskers; Gaussian noise (GN) with robust envelope fluctuations and low-noise noise (LNN) with minimal envelope fluctuations. The potential to use temporal fine-structure cues was controlled by varying the signal frequency (500 or 4000 Hz), thereby relying on the natural decline in phase-locking with increasing frequency. Results: Behavioral and CAEP thresholds were similar across groups for diotic conditions, while the masking release in dichotic conditions was larger for younger than for older participants. Across all participants, BMLDs were larger for GN than LNN and for 500-Hz than for 4000-Hz conditions, where envelope and fine-structure cues were most salient, respectively. Specific age-related differences were demonstrated for 500-Hz dichotic conditions in GN and LNN, reflecting reduced binaural temporal fine-structure coding. No significant age effects were observed for 4000-Hz dichotic conditions, consistent with similar use of binaural temporal envelope cues across age in these conditions. For all groups, thresholds and derived BMLD values obtained using the behavioral and CAEP methods were strongly correlated, supporting the notion that CAEP measures may be useful as an objective index of age-related changes in binaural temporal processing. Conclusions: These results demonstrate an age-related decline in the processing of binaural temporal fine-structure cues with preserved temporal envelope coding that was similar with and without mild-to-moderate peripheral hearing loss. Such age-related changes can be reliably indexed by both behavioral and CAEP measures in young and older adults. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Olivocochlear Efferent Activity Is Associated With the Slope of the Psychometric Function of Speech Recognition in Noise.
Objectives: The medial olivocochlear (MOC) efferent system can modify cochlear function to improve sound detection in noise, but its role in speech perception in noise is unclear. The purpose of this study was to determine the association between MOC efferent activity and performance on two speech-in-noise tasks at two signal-to-noise ratios (SNRs). It was hypothesized that efferent activity would be more strongly correlated with performance at the more challenging SNR, relative to performance at the less challenging SNR. Design: Sixteen adults aged 35 to 73 years participated. Subjects had pure-tone averages 0.05), contrary to hypothesis. However, contralateral suppression was significantly correlated with the slope of the psychometric function, computed as the difference between performance levels at the two SNRs divided by 3 (decibel difference between the 2 SNRs) for the coordinate response measure task (partial rs = 0.59; p = 0.04) and for the Institute of Electrical and Electronics Engineers task (partial rs = 0.60; p = 0.03). Conclusions: In a group of primarily older adults with normal hearing or mild hearing loss, olivocochlear efferent activity assessed using contralateral suppression of TEOAEs was not associated with speech-in-noise performance at a single SNR. However, auditory efferent activity appears to be associated with the slope of the psychometric function for both a word and sentence recognition task in noise. Results suggest that individuals with stronger MOC efferent activity tend to be more responsive to changes in SNR, where small increases in SNR result in better speech-in-noise performance relative to individuals with weaker MOC efferent activity. Additionally, the results suggest that the slope of the psychometric function may be a more useful metric than performance at a single SNR when examining the relationship between speech recognition in noise and MOC efferent activity. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Oticon’s HearingFitness App Wins CES Innovation Award
Oticon's (https://www.oticon.com/) HearingFitness app, a tracker that monitors the impact of hearing on its wearer's overall health, won a Consumer Electronics Show Innovation Award. Used in conjunction with Oticon's internet-connected hearing aids, Oticon Opn, the HearingFitness app tracks hearing aid use, listening environments, and other data. It then collates those data with measurements of heart rate, sleep patterns, and other health markers from other wearable devices to give hearing aid users advice and encouragement on ways to hear better, protect their hearing, and stay healthy.
Dom Schum, PhD, vice president of audiology at Oticon, said the HearingFitness app empowers users to learn about their hearing and take charge of their long-term health and well-being through their hearing habits. "They gain a sense of belonging to a new generation that's on top of their hearing and health, instead of being defined by it," Schum said. "But most importantly, HearingFitness encourages users to wear their hearing aids more and helps generate data that will lead to better hearing care and, ultimately, better and more rewarding lives." Oticon will demo the HearingFitness app and Oticon Opn on Jan. 9-12 at CES 2018 in Las Vegas.
Published: 11/10/2017 1:19:00 PM
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Oticon’s HearingFitness App Wins CES Innovation Award
Oticon's (https://www.oticon.com/) HearingFitness app, a tracker that monitors the impact of hearing on its wearer's overall health, won a Consumer Electronics Show Innovation Award. Used in conjunction with Oticon's internet-connected hearing aids, Oticon Opn, the HearingFitness app tracks hearing aid use, listening environments, and other data. It then collates those data with measurements of heart rate, sleep patterns, and other health markers from other wearable devices to give hearing aid users advice and encouragement on ways to hear better, protect their hearing, and stay healthy.
Dom Schum, PhD, vice president of audiology at Oticon, said the HearingFitness app empowers users to learn about their hearing and take charge of their long-term health and well-being through their hearing habits. "They gain a sense of belonging to a new generation that's on top of their hearing and health, instead of being defined by it," Schum said. "But most importantly, HearingFitness encourages users to wear their hearing aids more and helps generate data that will lead to better hearing care and, ultimately, better and more rewarding lives." Oticon will demo the HearingFitness app and Oticon Opn on Jan. 9-12 at CES 2018 in Las Vegas.
Published: 11/10/2017 1:19:00 PM
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Oticon’s HearingFitness App Wins CES Innovation Award
Oticon's (https://www.oticon.com/) HearingFitness app, a tracker that monitors the impact of hearing on its wearer's overall health, won a Consumer Electronics Show Innovation Award. Used in conjunction with Oticon's internet-connected hearing aids, Oticon Opn, the HearingFitness app tracks hearing aid use, listening environments, and other data. It then collates those data with measurements of heart rate, sleep patterns, and other health markers from other wearable devices to give hearing aid users advice and encouragement on ways to hear better, protect their hearing, and stay healthy.
Dom Schum, PhD, vice president of audiology at Oticon, said the HearingFitness app empowers users to learn about their hearing and take charge of their long-term health and well-being through their hearing habits. "They gain a sense of belonging to a new generation that's on top of their hearing and health, instead of being defined by it," Schum said. "But most importantly, HearingFitness encourages users to wear their hearing aids more and helps generate data that will lead to better hearing care and, ultimately, better and more rewarding lives." Oticon will demo the HearingFitness app and Oticon Opn on Jan. 9-12 at CES 2018 in Las Vegas.
Published: 11/10/2017 1:19:00 PM
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Development and Validation of the Voice Catastrophization Index
Publication date: Available online 10 November 2017
Source:Journal of Voice
Author(s): Hagit Shoffel-Havakuk, Steven Chau, Edie R. Hapner, Madeleine Pethan, Michael M. Johns
IntroductionCatastrophization is a cognitive distortion that has been studied in pain patients and found to be a significant factor in their disability and response to treatment. Dysphonia patients may demonstrate a similar behavior, suggesting the existence of voice catastrophization.ObjectiveTo establish the validity of the Voice Catastrophization Index (VCI), a new instrument estimating voice symptoms catastrophization.MethodsA prospective study. Patients with and without voice conditions were administered with the VCI, Voice-Related Quality of Life (V-RQOL), and the Generalized Anxiety Disorder-7 (GAD-7)questionnaires. Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) rating was determined for patients with voice conditions.ResultsNinety-one patients participated, 65 with voice conditions and 26 without. 61.5% were females; mean age was 49.8 ± 15.7 years. The VCI score for patients with voice conditions was significantly higher, 22.46 ± 16.56, compared with 3.96 ± 10.79, respectively (P value < 0.0001). The VCI demonstrated moderate correlation with both V-RQOL and GAD-7 scores: −0.562 and 0.560, respectively (P value < 0.000001); however, it showed no correlation with the CAPE-V. The VCI's internal consistency with each of its three dimensions and 13 items was acceptable to strong. The reproducibility and stability was demonstrated in a subgroup of 26 patients; 81% of these patients had a difference of 10 or less points between the two evaluations.ConclusionsThe VCI accomplished the requirements of a scale's validity for estimation of voice symptoms catastrophization in voice patients. The potential role of voice catastrophization as a predictor of treatment response and tailoring can now be investigated using the VCI.
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Source:Journal of Voice
Author(s): Hagit Shoffel-Havakuk, Steven Chau, Edie R. Hapner, Madeleine Pethan, Michael M. Johns
IntroductionCatastrophization is a cognitive distortion that has been studied in pain patients and found to be a significant factor in their disability and response to treatment. Dysphonia patients may demonstrate a similar behavior, suggesting the existence of voice catastrophization.ObjectiveTo establish the validity of the Voice Catastrophization Index (VCI), a new instrument estimating voice symptoms catastrophization.MethodsA prospective study. Patients with and without voice conditions were administered with the VCI, Voice-Related Quality of Life (V-RQOL), and the Generalized Anxiety Disorder-7 (GAD-7)questionnaires. Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) rating was determined for patients with voice conditions.ResultsNinety-one patients participated, 65 with voice conditions and 26 without. 61.5% were females; mean age was 49.8 ± 15.7 years. The VCI score for patients with voice conditions was significantly higher, 22.46 ± 16.56, compared with 3.96 ± 10.79, respectively (P value < 0.0001). The VCI demonstrated moderate correlation with both V-RQOL and GAD-7 scores: −0.562 and 0.560, respectively (P value < 0.000001); however, it showed no correlation with the CAPE-V. The VCI's internal consistency with each of its three dimensions and 13 items was acceptable to strong. The reproducibility and stability was demonstrated in a subgroup of 26 patients; 81% of these patients had a difference of 10 or less points between the two evaluations.ConclusionsThe VCI accomplished the requirements of a scale's validity for estimation of voice symptoms catastrophization in voice patients. The potential role of voice catastrophization as a predictor of treatment response and tailoring can now be investigated using the VCI.
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Bilateral Vocal Fold Medialization: A Treatment for Abductor Spasmodic Dysphonia
Publication date: Available online 10 November 2017
Source:Journal of Voice
Author(s): Karuna Dewan, Gerald S. Berke
IntroductionAbductor spasmodic dysphonia, a difficult-to-treat laryngologic condition, is characterized by spasms causing the vocal folds to remain abducted despite efforts to adduct them during phonation. Traditional treatment for abductor spasmodic dysphonia—botulinum toxin injection into the posterior cricoarytenoid muscle—can be both technically challenging and uncomfortable. Due to the difficulty of needle placement, it is often unsuccessful. The purpose of this investigation is to present a previously undescribed treatment for abductor spasmodic dysphonia—bilateral vocal fold medialization.MethodsA retrospective case review of all cases of abductor spasmodic dysphonia treated in a tertiary care laryngology practice with bilateral vocal fold medialization over a 10-year period was performed. The Voice Handicap Index and the Voice-Related Quality of Life surveys were utilized to assess patient satisfaction with voice outcome.ResultsSix patients with abductor spasmodic dysphonia treated with bilateral vocal fold medialization were identified. Disease severity ranged from mild to severe. All six patients reported statistically significant improvement in nearly all Voice Handicap Index and Voice-Related Quality of Life parameters. They reported fewer voice breaks and greater ease of communication. Results were noted immediately and symptoms continue to be well controlled for many years following medialization.ConclusionsBilateral vocal fold medialization is a safe and effective treatment for abductor spasmodic dysphonia. It is performed under local anesthesia and provides phonation improvement in the short and long term.
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Source:Journal of Voice
Author(s): Karuna Dewan, Gerald S. Berke
IntroductionAbductor spasmodic dysphonia, a difficult-to-treat laryngologic condition, is characterized by spasms causing the vocal folds to remain abducted despite efforts to adduct them during phonation. Traditional treatment for abductor spasmodic dysphonia—botulinum toxin injection into the posterior cricoarytenoid muscle—can be both technically challenging and uncomfortable. Due to the difficulty of needle placement, it is often unsuccessful. The purpose of this investigation is to present a previously undescribed treatment for abductor spasmodic dysphonia—bilateral vocal fold medialization.MethodsA retrospective case review of all cases of abductor spasmodic dysphonia treated in a tertiary care laryngology practice with bilateral vocal fold medialization over a 10-year period was performed. The Voice Handicap Index and the Voice-Related Quality of Life surveys were utilized to assess patient satisfaction with voice outcome.ResultsSix patients with abductor spasmodic dysphonia treated with bilateral vocal fold medialization were identified. Disease severity ranged from mild to severe. All six patients reported statistically significant improvement in nearly all Voice Handicap Index and Voice-Related Quality of Life parameters. They reported fewer voice breaks and greater ease of communication. Results were noted immediately and symptoms continue to be well controlled for many years following medialization.ConclusionsBilateral vocal fold medialization is a safe and effective treatment for abductor spasmodic dysphonia. It is performed under local anesthesia and provides phonation improvement in the short and long term.
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Compensation Strategies in Voice Production With Glottal Insufficiency
Publication date: Available online 10 November 2017
Source:Journal of Voice
Author(s): Zhaoyan Zhang
ObjectivesThis study evaluates potential compensation strategies under conditions of glottal insufficiency.MethodsUsing a numerical respiratory-laryngeal model of voice production, voice production under conditions of glottal insufficiency is investigated across a large range of voice conditions, and compared with normal voice production.ResultsThis study shows that glottal insufficiency leads to increased noise production, reduced fundamental frequency range, and inability to produce very low-intensity voice. Glottal insufficiency also leads to significantly increased respiratory effort of phonation and difficulty in maintaining a normal breath group duration, which restricts high-intensity voice production and falsetto-like voice production. Although compensation strategies exist to alleviate these undesirable voice changes, they often require hyperfunctional laryngeal and respiratory muscle activities and thus are more likely to result in vocal fatigue.ConclusionsThe laryngeal and respiratory subsystems need to be considered as a whole to fully understand the effect of glottal insufficiency on voice production. Strategies that compensate for laryngeal weakness at the cost of compromising the normal function of the respiratory subsystem are undesirable and may impose additional constraints on voice production and the effectiveness of available compensation strategies.
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Source:Journal of Voice
Author(s): Zhaoyan Zhang
ObjectivesThis study evaluates potential compensation strategies under conditions of glottal insufficiency.MethodsUsing a numerical respiratory-laryngeal model of voice production, voice production under conditions of glottal insufficiency is investigated across a large range of voice conditions, and compared with normal voice production.ResultsThis study shows that glottal insufficiency leads to increased noise production, reduced fundamental frequency range, and inability to produce very low-intensity voice. Glottal insufficiency also leads to significantly increased respiratory effort of phonation and difficulty in maintaining a normal breath group duration, which restricts high-intensity voice production and falsetto-like voice production. Although compensation strategies exist to alleviate these undesirable voice changes, they often require hyperfunctional laryngeal and respiratory muscle activities and thus are more likely to result in vocal fatigue.ConclusionsThe laryngeal and respiratory subsystems need to be considered as a whole to fully understand the effect of glottal insufficiency on voice production. Strategies that compensate for laryngeal weakness at the cost of compromising the normal function of the respiratory subsystem are undesirable and may impose additional constraints on voice production and the effectiveness of available compensation strategies.
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Tinnitus and Hearing Survey: A Polish Study of Validity and Reliability in a Clinical Population
Audiol Neurotol 2017;22:197-204
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Vestibular short latency evoked potential (VsEP) is abolished by low frequency noise exposure in rats.
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Vestibular short latency evoked potential (VsEP) is abolished by low frequency noise exposure in rats.
J Neurophysiol. 2017 Nov 08;:jn.00668.2017
Authors: Stewart CE, Kanicki AC, Altschuler RA, King WM
Abstract
The vestibular system plays a critical role in detection of head movements and is essential for normal postural control. Because of their anatomical proximity to the cochlea, the otolith organs are selectively exposed to sound pressure and are at risk for noise overstimulation. Clinical reports suggest a link between noise exposure and balance problems, but the structural and physiological basis for this linkage is not well understood. The goal of this study is to determine the effects of low frequency noise (LFN), on the otolith organs by correlating changes in vestibular short latency evoked potentials, (VsEPs), with changes in saccular afferent endings following noise exposure. LFN exposure transiently abolished the VsEP and reduced the number of stained calyces within the sacculus. Although some recovery of the VsEP waveform could be observed within three days post-noise, at three weeks, recovery was only partial in most animals, consistent with a reduced number of afferents with calyceal endings. These data show that a single intense noise exposure is capable of causing a vestibular deficit that appears to mirror the synaptic deficit associated with hidden hearing loss after noise-induced cochlear injury.
PMID: 29118200 [PubMed - as supplied by publisher]
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Sudden onset of static equilibrium dysfunction in patients receiving a cochlear implant.
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Related Articles |
Sudden onset of static equilibrium dysfunction in patients receiving a cochlear implant.
Medicine (Baltimore). 2017 Nov;96(44):e8465
Authors: Gao Y, Zhang Q, Yan J, Niu X, Han P, Yuan H, Hu J, Liu B, Xu M
Abstract
BACKGROUND: We investigated the sudden onset of static equilibrium dysfunction caused by cochlear implantation (CI) in congenital hearing loss patients.
METHOD: Twenty-five patients were selected from a cohort of unilateral CI recipients to form the CI group. Static posturography was performed 1 to 3 days before and 3 to 5 days after CI. Each patient underwent the test with eyes open (EO) and eyes closed (EC) for 30 seconds, separately. Another group of age- and sex-matched patients with no history of hearing impairment undergoing unrelated surgeries formed the control group, and were examined with the same tests pre- and post-surgery. A third group of patients undergoing middle ear surgery formed the otitis media (OM) group. Postural sway parameters including sway velocity (SV) in the X-axis, SV in the Y-axis, length of sway locus length (LNG), and environmental area (ENV) were measured and recorded.
RESULTS: Comparison of pre-surgery posturographical parameters between the CI and control groups revealed no significant differences. Significant differences were found in most parameters in pre- and post-surgery comparisons in the CI group. Mean SV values in the X-axis pre- and post-surgery were 8.48 and 11.52 mm/s, respectively, in the EO condition (P < .05), and 14.94 and 20.16 mm/s, respectively, in the EC condition (P < .05). In the Y-axis, mean SV values were 15.36 and 20.24 mm/s pre- and post-surgery, respectively, in the EC condition (P < .05). The LNG values in the CI group pre- and post-surgery were 319.60 and 469.88 mm in the EO condition (P < .05), and 571.40 and 764.12 mm in the EC condition (P < .05). No significant functional equilibrium change was observed in the control group between pre- and post-surgery (P > .05) except SV in the X-axis and LNG in the EO condition (P < .05). No significant pre- and post-surgery differences were found in the OM group.
CONCLUSION: CI appeared to influence static equilibrium function within 1 week post-surgery. This influence was greater when eyes were closed.
PMID: 29095298 [PubMed - indexed for MEDLINE]
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The influence of the acoustic stimulus on postural stability.
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The influence of the acoustic stimulus on postural stability.
Acta Bioeng Biomech. 2017;19(2):113-119
Authors: Majewska A, Kawałkiewicz W, Hojan-Jezierska D, Jezierska A, Kubisz L
Abstract
PURPOSE: The purpose of this study was to assess if 65 dB and 4000 Hz stimuli affect postural stability of young normally hearing people.
METHODS: Posturography examinations belong to clinical tests which evaluate the motor skills. Posturography can be divided into static posturography and dynamic posturography. In both static and dynamic posturography patient stays on the platform with opened and closed eyes, but in the case of dynamic one, platform is unstable. In this study the Multitest Equilibre platform produced by FRAMIRAL was used. Patients took part in tests with opened and closed eyes, on stable and unstable platform. Additionally, patients were exposed to 65 dB and 4000 Hz acoustic stimuli. The sound pressure level, and frequency was belonging to the best audibly frequency range.
RESULTS: Parameters such as velocity and surface were examined. The difference between velocity measured with acoustic stimuli and without acoustic stimuli was observed. On the other hand there was no difference in surface results.
CONCLUSIONS: The statistically significant difference between velocity of patients center of gravity movements, measured on unstable platform, in the presence of 4000 Hz, 65 dB acoustic stimulus and without additional disturbances was observed.
PMID: 28869628 [PubMed - indexed for MEDLINE]
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Vestibular short latency evoked potential (VsEP) is abolished by low frequency noise exposure in rats.
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Vestibular short latency evoked potential (VsEP) is abolished by low frequency noise exposure in rats.
J Neurophysiol. 2017 Nov 08;:jn.00668.2017
Authors: Stewart CE, Kanicki AC, Altschuler RA, King WM
Abstract
The vestibular system plays a critical role in detection of head movements and is essential for normal postural control. Because of their anatomical proximity to the cochlea, the otolith organs are selectively exposed to sound pressure and are at risk for noise overstimulation. Clinical reports suggest a link between noise exposure and balance problems, but the structural and physiological basis for this linkage is not well understood. The goal of this study is to determine the effects of low frequency noise (LFN), on the otolith organs by correlating changes in vestibular short latency evoked potentials, (VsEPs), with changes in saccular afferent endings following noise exposure. LFN exposure transiently abolished the VsEP and reduced the number of stained calyces within the sacculus. Although some recovery of the VsEP waveform could be observed within three days post-noise, at three weeks, recovery was only partial in most animals, consistent with a reduced number of afferents with calyceal endings. These data show that a single intense noise exposure is capable of causing a vestibular deficit that appears to mirror the synaptic deficit associated with hidden hearing loss after noise-induced cochlear injury.
PMID: 29118200 [PubMed - as supplied by publisher]
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Sudden onset of static equilibrium dysfunction in patients receiving a cochlear implant.
|
Related Articles |
Sudden onset of static equilibrium dysfunction in patients receiving a cochlear implant.
Medicine (Baltimore). 2017 Nov;96(44):e8465
Authors: Gao Y, Zhang Q, Yan J, Niu X, Han P, Yuan H, Hu J, Liu B, Xu M
Abstract
BACKGROUND: We investigated the sudden onset of static equilibrium dysfunction caused by cochlear implantation (CI) in congenital hearing loss patients.
METHOD: Twenty-five patients were selected from a cohort of unilateral CI recipients to form the CI group. Static posturography was performed 1 to 3 days before and 3 to 5 days after CI. Each patient underwent the test with eyes open (EO) and eyes closed (EC) for 30 seconds, separately. Another group of age- and sex-matched patients with no history of hearing impairment undergoing unrelated surgeries formed the control group, and were examined with the same tests pre- and post-surgery. A third group of patients undergoing middle ear surgery formed the otitis media (OM) group. Postural sway parameters including sway velocity (SV) in the X-axis, SV in the Y-axis, length of sway locus length (LNG), and environmental area (ENV) were measured and recorded.
RESULTS: Comparison of pre-surgery posturographical parameters between the CI and control groups revealed no significant differences. Significant differences were found in most parameters in pre- and post-surgery comparisons in the CI group. Mean SV values in the X-axis pre- and post-surgery were 8.48 and 11.52 mm/s, respectively, in the EO condition (P < .05), and 14.94 and 20.16 mm/s, respectively, in the EC condition (P < .05). In the Y-axis, mean SV values were 15.36 and 20.24 mm/s pre- and post-surgery, respectively, in the EC condition (P < .05). The LNG values in the CI group pre- and post-surgery were 319.60 and 469.88 mm in the EO condition (P < .05), and 571.40 and 764.12 mm in the EC condition (P < .05). No significant functional equilibrium change was observed in the control group between pre- and post-surgery (P > .05) except SV in the X-axis and LNG in the EO condition (P < .05). No significant pre- and post-surgery differences were found in the OM group.
CONCLUSION: CI appeared to influence static equilibrium function within 1 week post-surgery. This influence was greater when eyes were closed.
PMID: 29095298 [PubMed - indexed for MEDLINE]
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The influence of the acoustic stimulus on postural stability.
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The influence of the acoustic stimulus on postural stability.
Acta Bioeng Biomech. 2017;19(2):113-119
Authors: Majewska A, Kawałkiewicz W, Hojan-Jezierska D, Jezierska A, Kubisz L
Abstract
PURPOSE: The purpose of this study was to assess if 65 dB and 4000 Hz stimuli affect postural stability of young normally hearing people.
METHODS: Posturography examinations belong to clinical tests which evaluate the motor skills. Posturography can be divided into static posturography and dynamic posturography. In both static and dynamic posturography patient stays on the platform with opened and closed eyes, but in the case of dynamic one, platform is unstable. In this study the Multitest Equilibre platform produced by FRAMIRAL was used. Patients took part in tests with opened and closed eyes, on stable and unstable platform. Additionally, patients were exposed to 65 dB and 4000 Hz acoustic stimuli. The sound pressure level, and frequency was belonging to the best audibly frequency range.
RESULTS: Parameters such as velocity and surface were examined. The difference between velocity measured with acoustic stimuli and without acoustic stimuli was observed. On the other hand there was no difference in surface results.
CONCLUSIONS: The statistically significant difference between velocity of patients center of gravity movements, measured on unstable platform, in the presence of 4000 Hz, 65 dB acoustic stimulus and without additional disturbances was observed.
PMID: 28869628 [PubMed - indexed for MEDLINE]
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Limits on normal cochlear ‘third’ windows provided by previous investigations of additional sound paths into and out of the cat inner ear
Source:Hearing Research
Author(s): John J. Rosowski, Peter Bowers, Hideko H. Nakajima
While most models of cochlear function assume the presence of only two windows into the mammalian cochlea (the oval and round windows), a position that is generally supported by several lines of data, there is evidence for additional sound paths into and out of the inner ear in normal mammals. In this report we review the existing evidence for and against the ‘two-window’ hypothesis. We then determine how existing data and inner-ear anatomy restrict transmission of sound through these additional sound pathways in cat by utilizing a well-tested model of the cat inner ear, together with anatomical descriptions of the cat cochlear and vestibular aqueduct (potential additional windows to the cochlea). We conclude: (1) The existing data place limits on the size of the cochlear and vestibular aqueducts in cat and are consistent with small volume-velocities through these ducts during ossicular stimulation of the cochlea, (2) the predicted volume velocities produced by aqueducts with diameters half the size of the bony diameters match the functional data within ±10 dB, and (3) these additional volume velocity paths contribute to the inner ear's response to non-acoustic stimulation and conductive pathology.
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Quasi-static and dynamic motions of the columellar footplate in ostrich (Struthio camelus) measured ex vivo
Source:Hearing Research
Author(s): Pieter G.G. Muyshondt, Raf Claes, Peter Aerts, Joris J.J. Dirckx
The nature of the movement of the columellar footplate (CFP) in birds is still matter of ongoing debate. Some sources claim that rocking motion is dominant, while others propose a largely piston-like motion. In this study, motions of the CFP are experimentally investigated in the ostrich using a post-mortem approach. For quasi-static loads, micro-CT scans of ostrich heads were made under positive and negative middle-ear pressures of 1 kPa. For dynamic loads, laser Doppler vibrometry was used to measure the velocity on multiple locations of the CFP as a function of excitation frequency from 0.125 to 4 kHz, and digital stroboscopic holography was used to assess the 1D full-field out-of-plane displacement of the CFP at different excitation frequencies. To expose the CFP in the experiments, measurements were made from the medial side of the CFP after opening and draining the inner ear. To determine the influence of the inner-ear load on CFP motions, a finite element model was created of the intact ostrich middle ear with inner-ear load included. For quasi-static loads, the CFP performed largely piston-like motions under positive ME pressure, while under negative ME pressure the difference between piston and rocking motion was smaller. For dynamic loads, the CFP motion was almost completely piston-like for frequencies below 1 kHz. For higher frequencies, the motions became more complicated with an increase of the rocking components, although they never exceeded the piston component. When including the inner-ear load to the model, the rocking components started to increase relative to the piston component when compared to the result of the model with unloaded CFP, but only at high frequencies above 1 kHz. In this frequency range, the motion could no longer be identified as purely piston-like or rocking. As a conclusion, the current results suggest that CFP motion is predominantly piston-like below 1 kHz, while at higher frequencies the motion becomes too complicated to be described as purely piston-like or rocking.
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Effects of noise overexposure on tone detection in noise in nonhuman primates
Source:Hearing Research
Author(s): Samantha N. Hauser, Jane A. Burton, Evan T. Mercer, Ramnarayan Ramachandran
This report explores the consequences of acoustic overexposures on hearing in noisy environments for two macaque monkeys trained to perform a reaction time detection task using a Go/No-Go lever release paradigm. Behavioral and non-invasive physiological assessments were obtained before and after narrowband noise exposure. Physiological measurements showed elevated auditory brainstem response (ABR) thresholds and absent distortion product otoacoustic emissions (DPOAEs) post-exposure relative to pre-exposure. Audiograms revealed frequency specific increases in tone detection thresholds, with the greatest increases at the exposure band frequency and higher. Masked detection was affected in a similar frequency specific manner: threshold shift rates (change of masked threshold per dB increase in noise level) were lower than pre-exposure values at frequencies higher than the exposure band. Detection thresholds in sinusoidally amplitude modulated (SAM) noise post-exposure showed no difference from those in unmodulated noise, whereas pre-exposure masked detection thresholds were lower in the presence of SAM noise compared to unmodulated noise. These frequency dependent results were correlated with cochlear histopathological changes in monkeys that underwent similar noise exposure. These results reveal that behavioral and physiological effects of noise exposure in macaques are similar to those seen in humans and provide preliminary information on the relationship between noise exposure, cochlear pathology and perceptual changes in hearing within individual subjects.
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Intraoperative force and electrocochleography measurements in an animal model of cochlear implantation
Source:Hearing Research
Author(s): J. Lo, C. Bester, A. Collins, C. Newbold, A. Hampson, S. Chambers, H. Eastwood, S. O'Leary
To preserve residual hearing, techniques for monitoring and reducing the effects of trauma during cochlear implant surgery are being developed. This study examines the relationships between intraoperative recordings (electrode insertion force and electrocochleography), trauma, and hearing loss after cochlear implantation. The study also evaluated the efficacy of intravenous steroids for reducing hearing loss after implantation. Thirty-two normal-hearing guinea pigs were randomly implanted with electrode arrays of differing stiffness (‘hard’ or ‘soft’). These arrays used an intracochlear electrode to record electrode insertion force and electrocochleography responses to a multi-frequency acoustic stimulus during implantation. Additionally, sub-cohorts of animals were administered intravenous saline (‘control’) or dexamethasone (‘steroid’) prior to surgery. Subsequent hearing loss was assessed using electrocochleography recordings from the round window membrane prior to surgery and 4 weeks after implantation. After 4 weeks, cochleae were harvested and imaged with thin sheet laser imaging microscopy. After 4 weeks, compound action potential (CAP) thresholds did not differ between steroid and control groups. The CAP amplitude at low-mid frequencies decreased after implantation with a hard electrode, an effect which was partly negated by administering steroids. A decrease in the ‘intraoperative’ CAP amplitude preceded the reporting of insertion resistance by the surgeon by 5.94 s (±4.03 s SEM). Intraoperative CAP declines were also correlated with higher grades of trauma (r = 0.56, p < 0.01) and greater hearing loss (r = 0.56, p < 0.01). This relationship was not repeated with intraoperative cochlear microphonics. A rise in intraoperative force, which preceded the reporting of resistance by 0.71 s (±0.15 s SEM), was correlated with trauma (r = 0.400, p = 0.04) but not hearing loss (r = 0.297, p = 0.27). Preserving intraoperative CAP amplitudes during implantation was predictive of an atraumatic insertion and reduced post-implantation hearing loss. A rise in force usually preceded the reporting of resistance, although by less than 1 s. These results suggest that intraoperative CAPs may offer a more robust feedback mechanism for improving hearing preservation rates than cochlear microphonic and electrode insertion force recordings, especially considering the rapid changes in insertion force and relatively slow human reaction times. Pre-operative steroids were effective in reversing loss of CAP amplitude with hard electrodes and evoked by lower frequency tones, which suggests a possible role in reducing synaptopathy.
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Effects of middle ear quasi-static stiffness on sound transmission quantified by a novel 3-axis optical force sensor
Source:Hearing Research
Author(s): Ivo Dobrev, Jae Hoon Sim, Baktash Aqtashi, Alexander M. Huber, Thomas Linder, Christof Röösli
BackgroundIntra-operative quantification of the ossicle mobility could provide valuable feedback for the current status of the patient's conductive hearing. However, current methods for evaluation of middle ear mobility are mostly limited to the surgeon's subjective impression through manual palpation of the ossicles. This study investigates how middle ear transfer function is affected by stapes quasi-static stiffness of the ossicular chain. The stiffness of the middle ear is induced by a) using a novel fiber-optic 3-axis force sensor to quantify the quasi-static stiffness of the middle ear, and b) by artificial reduction of stapes mobility due to drying of the middle ear.MethodsMiddle ear transfer function, defined as the ratio of the stapes footplate velocity versus the ear canal sound pressure, was measured with a single point LDV in two conditions. First, a controlled palpation force was applied at the stapes head in two in-plane (superior-inferior or posterior-anterior) directions, and at the incus lenticular process near the incudostapedial joint in the piston (lateral-medial) direction with a novel 3-axis PalpEar force sensor (Sensoptic, Losone, Switzerland), while the corresponding quasi-static displacement of the contact point was measured via a 3-axis micrometer stage. The palpation force was applied sequentially, step-wise in the range of 0.1–20 gF (1–200 mN). Second, measurements were repeated with various stages of stapes fixation, simulated by pre-load on the stapes head or drying of the temporal bone, and with severe ossicle immobilization, simulated by gluing of the stapes footplate.ResultsSimulated stapes fixation (forced drying of 5–15 min) severely decreases (20–30 dB) the low frequency (<1 kHz) response of the middle ear, while increasing (5–10 dB) the high frequency (>4 kHz) response. Stapes immobilization (gluing of the footplate) severely reduces (20–40 dB) the low and mid frequency response (<4 kHz) but has lesser effect (<10 dB) at higher frequencies. Even moderate levels of palpation force (<3gF, <30 mN), regardless of direction, have negative effect (10–20 dB) on the low frequency (<2 kHz) response, but with less significant (5–10 dB) effect at higher frequencies. Force-displacement measurements around the incudostapedial joint showed quasi-static stiffness in the range of 200–500 N/m for normal middle ears, and 1000–2500 N/m (5–8-fold increase) after artificially (through forced drying) reducing the middle ear transfer function with 10–25 dB at 1 kHz.ConclusionEffects of the palpation force level and direction, as well as stapes fixation and immobilization have been analyzed based on the measurement of the stapes footplate motion, and controlled application of 3D force and displacement.
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Performance of the Tinnitus Functional Index as a diagnostic instrument in a UK clinical population
Source:Hearing Research
Author(s): Kathryn Fackrell, Deborah A. Hall, Johanna G. Barry, Derek J. Hoare
ObjectivesThe Tinnitus Functional Index (TFI) has been optimised as a diagnostic tool for quantifying the functional impact of tinnitus in US veteran and civilian groups. However, the TFI has not been fully evaluated for use in other English-speaking clinical populations despite its increasingly popular uptake. Here, a prospective multi-site longitudinal validation study was conducted to evaluate psychometric properties relevant to the UK clinical population. Guided by quality criteria for the measurement properties of health-related questionnaires, we specifically evaluated three diagnostic properties relating to the degree to which the TFI (i) covers the eight dimensions proposed to be important for diagnosis, (ii) reliably distinguishes individual differences in severity of tinnitus, and (iii) reliably measures the functional impact of tinnitus. We also examine whether clinically meaningful interpretations of the scores can be produced for the UK population.MethodsTwelve National Health Service audiology clinics across the UK recruited 255 tinnitus patients to complete questionnaires at four time-intervals, from initial clinical assessment and then over a nine-month period. Patients completed the TFI, the Tinnitus Handicap Inventory (THI), tinnitus case history questions, a Global rating of Perceived Problem with tinnitus and a Clinical Global Impression of perceived change in tinnitus. Baseline TFI data were used to examine the factor structure, construct validity and interpretability of the TFI. Follow-up TFI data were used to examine reliability.ResultsConfirmatory factor analysis suggested that of the eight subscales (factors) initially established for the TFI, the ‘Auditory’ subscale did not contribute to the overall construct ‘functional impact of tinnitus’, and a modified seven-factor model (TFI-22) better fit the variance in the patient scores. Both the global 25-item TFI and the global TFI-22 scores showed exceptionally high internal consistency (α ≥ 0.95), high construct validity with the THI (r = 0.80) and high test-retest reliability (ICC = 0.87). Test-retest agreement however was only deemed to be borderline acceptable (89%). Receiver Operator Characteristic analysis indicated the 25-item TFI and TFI-22 has excellent ability to distinguish between different levels of impact (Area under the curve > 0.7).ConclusionThe TFI was confirmed to cover multiple symptom domains, measuring a multi-domain construct of tinnitus, and satisfies a range of psychometric requirements for a good clinical measure, including having excellent reliability, stability over time and sensitivity to individual differences in tinnitus severity. However, a modified seven-factor structure without the Auditory subscale (TFI-22) is recommended for calculating a global composite score for UK patients. Using patients' experience and Receiver Operator Characteristic analysis, a grading system was presented which identifies the distinct grades of tinnitus impact in the UK clinical population that is broadly comparable to the US-based system.
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Limits on normal cochlear ‘third’ windows provided by previous investigations of additional sound paths into and out of the cat inner ear
Source:Hearing Research
Author(s): John J. Rosowski, Peter Bowers, Hideko H. Nakajima
While most models of cochlear function assume the presence of only two windows into the mammalian cochlea (the oval and round windows), a position that is generally supported by several lines of data, there is evidence for additional sound paths into and out of the inner ear in normal mammals. In this report we review the existing evidence for and against the ‘two-window’ hypothesis. We then determine how existing data and inner-ear anatomy restrict transmission of sound through these additional sound pathways in cat by utilizing a well-tested model of the cat inner ear, together with anatomical descriptions of the cat cochlear and vestibular aqueduct (potential additional windows to the cochlea). We conclude: (1) The existing data place limits on the size of the cochlear and vestibular aqueducts in cat and are consistent with small volume-velocities through these ducts during ossicular stimulation of the cochlea, (2) the predicted volume velocities produced by aqueducts with diameters half the size of the bony diameters match the functional data within ±10 dB, and (3) these additional volume velocity paths contribute to the inner ear's response to non-acoustic stimulation and conductive pathology.
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Quasi-static and dynamic motions of the columellar footplate in ostrich (Struthio camelus) measured ex vivo
Source:Hearing Research
Author(s): Pieter G.G. Muyshondt, Raf Claes, Peter Aerts, Joris J.J. Dirckx
The nature of the movement of the columellar footplate (CFP) in birds is still matter of ongoing debate. Some sources claim that rocking motion is dominant, while others propose a largely piston-like motion. In this study, motions of the CFP are experimentally investigated in the ostrich using a post-mortem approach. For quasi-static loads, micro-CT scans of ostrich heads were made under positive and negative middle-ear pressures of 1 kPa. For dynamic loads, laser Doppler vibrometry was used to measure the velocity on multiple locations of the CFP as a function of excitation frequency from 0.125 to 4 kHz, and digital stroboscopic holography was used to assess the 1D full-field out-of-plane displacement of the CFP at different excitation frequencies. To expose the CFP in the experiments, measurements were made from the medial side of the CFP after opening and draining the inner ear. To determine the influence of the inner-ear load on CFP motions, a finite element model was created of the intact ostrich middle ear with inner-ear load included. For quasi-static loads, the CFP performed largely piston-like motions under positive ME pressure, while under negative ME pressure the difference between piston and rocking motion was smaller. For dynamic loads, the CFP motion was almost completely piston-like for frequencies below 1 kHz. For higher frequencies, the motions became more complicated with an increase of the rocking components, although they never exceeded the piston component. When including the inner-ear load to the model, the rocking components started to increase relative to the piston component when compared to the result of the model with unloaded CFP, but only at high frequencies above 1 kHz. In this frequency range, the motion could no longer be identified as purely piston-like or rocking. As a conclusion, the current results suggest that CFP motion is predominantly piston-like below 1 kHz, while at higher frequencies the motion becomes too complicated to be described as purely piston-like or rocking.
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Effects of noise overexposure on tone detection in noise in nonhuman primates
Source:Hearing Research
Author(s): Samantha N. Hauser, Jane A. Burton, Evan T. Mercer, Ramnarayan Ramachandran
This report explores the consequences of acoustic overexposures on hearing in noisy environments for two macaque monkeys trained to perform a reaction time detection task using a Go/No-Go lever release paradigm. Behavioral and non-invasive physiological assessments were obtained before and after narrowband noise exposure. Physiological measurements showed elevated auditory brainstem response (ABR) thresholds and absent distortion product otoacoustic emissions (DPOAEs) post-exposure relative to pre-exposure. Audiograms revealed frequency specific increases in tone detection thresholds, with the greatest increases at the exposure band frequency and higher. Masked detection was affected in a similar frequency specific manner: threshold shift rates (change of masked threshold per dB increase in noise level) were lower than pre-exposure values at frequencies higher than the exposure band. Detection thresholds in sinusoidally amplitude modulated (SAM) noise post-exposure showed no difference from those in unmodulated noise, whereas pre-exposure masked detection thresholds were lower in the presence of SAM noise compared to unmodulated noise. These frequency dependent results were correlated with cochlear histopathological changes in monkeys that underwent similar noise exposure. These results reveal that behavioral and physiological effects of noise exposure in macaques are similar to those seen in humans and provide preliminary information on the relationship between noise exposure, cochlear pathology and perceptual changes in hearing within individual subjects.
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Intraoperative force and electrocochleography measurements in an animal model of cochlear implantation
Source:Hearing Research
Author(s): J. Lo, C. Bester, A. Collins, C. Newbold, A. Hampson, S. Chambers, H. Eastwood, S. O'Leary
To preserve residual hearing, techniques for monitoring and reducing the effects of trauma during cochlear implant surgery are being developed. This study examines the relationships between intraoperative recordings (electrode insertion force and electrocochleography), trauma, and hearing loss after cochlear implantation. The study also evaluated the efficacy of intravenous steroids for reducing hearing loss after implantation. Thirty-two normal-hearing guinea pigs were randomly implanted with electrode arrays of differing stiffness (‘hard’ or ‘soft’). These arrays used an intracochlear electrode to record electrode insertion force and electrocochleography responses to a multi-frequency acoustic stimulus during implantation. Additionally, sub-cohorts of animals were administered intravenous saline (‘control’) or dexamethasone (‘steroid’) prior to surgery. Subsequent hearing loss was assessed using electrocochleography recordings from the round window membrane prior to surgery and 4 weeks after implantation. After 4 weeks, cochleae were harvested and imaged with thin sheet laser imaging microscopy. After 4 weeks, compound action potential (CAP) thresholds did not differ between steroid and control groups. The CAP amplitude at low-mid frequencies decreased after implantation with a hard electrode, an effect which was partly negated by administering steroids. A decrease in the ‘intraoperative’ CAP amplitude preceded the reporting of insertion resistance by the surgeon by 5.94 s (±4.03 s SEM). Intraoperative CAP declines were also correlated with higher grades of trauma (r = 0.56, p < 0.01) and greater hearing loss (r = 0.56, p < 0.01). This relationship was not repeated with intraoperative cochlear microphonics. A rise in intraoperative force, which preceded the reporting of resistance by 0.71 s (±0.15 s SEM), was correlated with trauma (r = 0.400, p = 0.04) but not hearing loss (r = 0.297, p = 0.27). Preserving intraoperative CAP amplitudes during implantation was predictive of an atraumatic insertion and reduced post-implantation hearing loss. A rise in force usually preceded the reporting of resistance, although by less than 1 s. These results suggest that intraoperative CAPs may offer a more robust feedback mechanism for improving hearing preservation rates than cochlear microphonic and electrode insertion force recordings, especially considering the rapid changes in insertion force and relatively slow human reaction times. Pre-operative steroids were effective in reversing loss of CAP amplitude with hard electrodes and evoked by lower frequency tones, which suggests a possible role in reducing synaptopathy.
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Effects of middle ear quasi-static stiffness on sound transmission quantified by a novel 3-axis optical force sensor
Source:Hearing Research
Author(s): Ivo Dobrev, Jae Hoon Sim, Baktash Aqtashi, Alexander M. Huber, Thomas Linder, Christof Röösli
BackgroundIntra-operative quantification of the ossicle mobility could provide valuable feedback for the current status of the patient's conductive hearing. However, current methods for evaluation of middle ear mobility are mostly limited to the surgeon's subjective impression through manual palpation of the ossicles. This study investigates how middle ear transfer function is affected by stapes quasi-static stiffness of the ossicular chain. The stiffness of the middle ear is induced by a) using a novel fiber-optic 3-axis force sensor to quantify the quasi-static stiffness of the middle ear, and b) by artificial reduction of stapes mobility due to drying of the middle ear.MethodsMiddle ear transfer function, defined as the ratio of the stapes footplate velocity versus the ear canal sound pressure, was measured with a single point LDV in two conditions. First, a controlled palpation force was applied at the stapes head in two in-plane (superior-inferior or posterior-anterior) directions, and at the incus lenticular process near the incudostapedial joint in the piston (lateral-medial) direction with a novel 3-axis PalpEar force sensor (Sensoptic, Losone, Switzerland), while the corresponding quasi-static displacement of the contact point was measured via a 3-axis micrometer stage. The palpation force was applied sequentially, step-wise in the range of 0.1–20 gF (1–200 mN). Second, measurements were repeated with various stages of stapes fixation, simulated by pre-load on the stapes head or drying of the temporal bone, and with severe ossicle immobilization, simulated by gluing of the stapes footplate.ResultsSimulated stapes fixation (forced drying of 5–15 min) severely decreases (20–30 dB) the low frequency (<1 kHz) response of the middle ear, while increasing (5–10 dB) the high frequency (>4 kHz) response. Stapes immobilization (gluing of the footplate) severely reduces (20–40 dB) the low and mid frequency response (<4 kHz) but has lesser effect (<10 dB) at higher frequencies. Even moderate levels of palpation force (<3gF, <30 mN), regardless of direction, have negative effect (10–20 dB) on the low frequency (<2 kHz) response, but with less significant (5–10 dB) effect at higher frequencies. Force-displacement measurements around the incudostapedial joint showed quasi-static stiffness in the range of 200–500 N/m for normal middle ears, and 1000–2500 N/m (5–8-fold increase) after artificially (through forced drying) reducing the middle ear transfer function with 10–25 dB at 1 kHz.ConclusionEffects of the palpation force level and direction, as well as stapes fixation and immobilization have been analyzed based on the measurement of the stapes footplate motion, and controlled application of 3D force and displacement.
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Performance of the Tinnitus Functional Index as a diagnostic instrument in a UK clinical population
Source:Hearing Research
Author(s): Kathryn Fackrell, Deborah A. Hall, Johanna G. Barry, Derek J. Hoare
ObjectivesThe Tinnitus Functional Index (TFI) has been optimised as a diagnostic tool for quantifying the functional impact of tinnitus in US veteran and civilian groups. However, the TFI has not been fully evaluated for use in other English-speaking clinical populations despite its increasingly popular uptake. Here, a prospective multi-site longitudinal validation study was conducted to evaluate psychometric properties relevant to the UK clinical population. Guided by quality criteria for the measurement properties of health-related questionnaires, we specifically evaluated three diagnostic properties relating to the degree to which the TFI (i) covers the eight dimensions proposed to be important for diagnosis, (ii) reliably distinguishes individual differences in severity of tinnitus, and (iii) reliably measures the functional impact of tinnitus. We also examine whether clinically meaningful interpretations of the scores can be produced for the UK population.MethodsTwelve National Health Service audiology clinics across the UK recruited 255 tinnitus patients to complete questionnaires at four time-intervals, from initial clinical assessment and then over a nine-month period. Patients completed the TFI, the Tinnitus Handicap Inventory (THI), tinnitus case history questions, a Global rating of Perceived Problem with tinnitus and a Clinical Global Impression of perceived change in tinnitus. Baseline TFI data were used to examine the factor structure, construct validity and interpretability of the TFI. Follow-up TFI data were used to examine reliability.ResultsConfirmatory factor analysis suggested that of the eight subscales (factors) initially established for the TFI, the ‘Auditory’ subscale did not contribute to the overall construct ‘functional impact of tinnitus’, and a modified seven-factor model (TFI-22) better fit the variance in the patient scores. Both the global 25-item TFI and the global TFI-22 scores showed exceptionally high internal consistency (α ≥ 0.95), high construct validity with the THI (r = 0.80) and high test-retest reliability (ICC = 0.87). Test-retest agreement however was only deemed to be borderline acceptable (89%). Receiver Operator Characteristic analysis indicated the 25-item TFI and TFI-22 has excellent ability to distinguish between different levels of impact (Area under the curve > 0.7).ConclusionThe TFI was confirmed to cover multiple symptom domains, measuring a multi-domain construct of tinnitus, and satisfies a range of psychometric requirements for a good clinical measure, including having excellent reliability, stability over time and sensitivity to individual differences in tinnitus severity. However, a modified seven-factor structure without the Auditory subscale (TFI-22) is recommended for calculating a global composite score for UK patients. Using patients' experience and Receiver Operator Characteristic analysis, a grading system was presented which identifies the distinct grades of tinnitus impact in the UK clinical population that is broadly comparable to the US-based system.
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Limits on normal cochlear ‘third’ windows provided by previous investigations of additional sound paths into and out of the cat inner ear
Source:Hearing Research
Author(s): John J. Rosowski, Peter Bowers, Hideko H. Nakajima
While most models of cochlear function assume the presence of only two windows into the mammalian cochlea (the oval and round windows), a position that is generally supported by several lines of data, there is evidence for additional sound paths into and out of the inner ear in normal mammals. In this report we review the existing evidence for and against the ‘two-window’ hypothesis. We then determine how existing data and inner-ear anatomy restrict transmission of sound through these additional sound pathways in cat by utilizing a well-tested model of the cat inner ear, together with anatomical descriptions of the cat cochlear and vestibular aqueduct (potential additional windows to the cochlea). We conclude: (1) The existing data place limits on the size of the cochlear and vestibular aqueducts in cat and are consistent with small volume-velocities through these ducts during ossicular stimulation of the cochlea, (2) the predicted volume velocities produced by aqueducts with diameters half the size of the bony diameters match the functional data within ±10 dB, and (3) these additional volume velocity paths contribute to the inner ear's response to non-acoustic stimulation and conductive pathology.
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Quasi-static and dynamic motions of the columellar footplate in ostrich (Struthio camelus) measured ex vivo
Source:Hearing Research
Author(s): Pieter G.G. Muyshondt, Raf Claes, Peter Aerts, Joris J.J. Dirckx
The nature of the movement of the columellar footplate (CFP) in birds is still matter of ongoing debate. Some sources claim that rocking motion is dominant, while others propose a largely piston-like motion. In this study, motions of the CFP are experimentally investigated in the ostrich using a post-mortem approach. For quasi-static loads, micro-CT scans of ostrich heads were made under positive and negative middle-ear pressures of 1 kPa. For dynamic loads, laser Doppler vibrometry was used to measure the velocity on multiple locations of the CFP as a function of excitation frequency from 0.125 to 4 kHz, and digital stroboscopic holography was used to assess the 1D full-field out-of-plane displacement of the CFP at different excitation frequencies. To expose the CFP in the experiments, measurements were made from the medial side of the CFP after opening and draining the inner ear. To determine the influence of the inner-ear load on CFP motions, a finite element model was created of the intact ostrich middle ear with inner-ear load included. For quasi-static loads, the CFP performed largely piston-like motions under positive ME pressure, while under negative ME pressure the difference between piston and rocking motion was smaller. For dynamic loads, the CFP motion was almost completely piston-like for frequencies below 1 kHz. For higher frequencies, the motions became more complicated with an increase of the rocking components, although they never exceeded the piston component. When including the inner-ear load to the model, the rocking components started to increase relative to the piston component when compared to the result of the model with unloaded CFP, but only at high frequencies above 1 kHz. In this frequency range, the motion could no longer be identified as purely piston-like or rocking. As a conclusion, the current results suggest that CFP motion is predominantly piston-like below 1 kHz, while at higher frequencies the motion becomes too complicated to be described as purely piston-like or rocking.
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Effects of noise overexposure on tone detection in noise in nonhuman primates
Source:Hearing Research
Author(s): Samantha N. Hauser, Jane A. Burton, Evan T. Mercer, Ramnarayan Ramachandran
This report explores the consequences of acoustic overexposures on hearing in noisy environments for two macaque monkeys trained to perform a reaction time detection task using a Go/No-Go lever release paradigm. Behavioral and non-invasive physiological assessments were obtained before and after narrowband noise exposure. Physiological measurements showed elevated auditory brainstem response (ABR) thresholds and absent distortion product otoacoustic emissions (DPOAEs) post-exposure relative to pre-exposure. Audiograms revealed frequency specific increases in tone detection thresholds, with the greatest increases at the exposure band frequency and higher. Masked detection was affected in a similar frequency specific manner: threshold shift rates (change of masked threshold per dB increase in noise level) were lower than pre-exposure values at frequencies higher than the exposure band. Detection thresholds in sinusoidally amplitude modulated (SAM) noise post-exposure showed no difference from those in unmodulated noise, whereas pre-exposure masked detection thresholds were lower in the presence of SAM noise compared to unmodulated noise. These frequency dependent results were correlated with cochlear histopathological changes in monkeys that underwent similar noise exposure. These results reveal that behavioral and physiological effects of noise exposure in macaques are similar to those seen in humans and provide preliminary information on the relationship between noise exposure, cochlear pathology and perceptual changes in hearing within individual subjects.
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Intraoperative force and electrocochleography measurements in an animal model of cochlear implantation
Source:Hearing Research
Author(s): J. Lo, C. Bester, A. Collins, C. Newbold, A. Hampson, S. Chambers, H. Eastwood, S. O'Leary
To preserve residual hearing, techniques for monitoring and reducing the effects of trauma during cochlear implant surgery are being developed. This study examines the relationships between intraoperative recordings (electrode insertion force and electrocochleography), trauma, and hearing loss after cochlear implantation. The study also evaluated the efficacy of intravenous steroids for reducing hearing loss after implantation. Thirty-two normal-hearing guinea pigs were randomly implanted with electrode arrays of differing stiffness (‘hard’ or ‘soft’). These arrays used an intracochlear electrode to record electrode insertion force and electrocochleography responses to a multi-frequency acoustic stimulus during implantation. Additionally, sub-cohorts of animals were administered intravenous saline (‘control’) or dexamethasone (‘steroid’) prior to surgery. Subsequent hearing loss was assessed using electrocochleography recordings from the round window membrane prior to surgery and 4 weeks after implantation. After 4 weeks, cochleae were harvested and imaged with thin sheet laser imaging microscopy. After 4 weeks, compound action potential (CAP) thresholds did not differ between steroid and control groups. The CAP amplitude at low-mid frequencies decreased after implantation with a hard electrode, an effect which was partly negated by administering steroids. A decrease in the ‘intraoperative’ CAP amplitude preceded the reporting of insertion resistance by the surgeon by 5.94 s (±4.03 s SEM). Intraoperative CAP declines were also correlated with higher grades of trauma (r = 0.56, p < 0.01) and greater hearing loss (r = 0.56, p < 0.01). This relationship was not repeated with intraoperative cochlear microphonics. A rise in intraoperative force, which preceded the reporting of resistance by 0.71 s (±0.15 s SEM), was correlated with trauma (r = 0.400, p = 0.04) but not hearing loss (r = 0.297, p = 0.27). Preserving intraoperative CAP amplitudes during implantation was predictive of an atraumatic insertion and reduced post-implantation hearing loss. A rise in force usually preceded the reporting of resistance, although by less than 1 s. These results suggest that intraoperative CAPs may offer a more robust feedback mechanism for improving hearing preservation rates than cochlear microphonic and electrode insertion force recordings, especially considering the rapid changes in insertion force and relatively slow human reaction times. Pre-operative steroids were effective in reversing loss of CAP amplitude with hard electrodes and evoked by lower frequency tones, which suggests a possible role in reducing synaptopathy.
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Effects of middle ear quasi-static stiffness on sound transmission quantified by a novel 3-axis optical force sensor
Source:Hearing Research
Author(s): Ivo Dobrev, Jae Hoon Sim, Baktash Aqtashi, Alexander M. Huber, Thomas Linder, Christof Röösli
BackgroundIntra-operative quantification of the ossicle mobility could provide valuable feedback for the current status of the patient's conductive hearing. However, current methods for evaluation of middle ear mobility are mostly limited to the surgeon's subjective impression through manual palpation of the ossicles. This study investigates how middle ear transfer function is affected by stapes quasi-static stiffness of the ossicular chain. The stiffness of the middle ear is induced by a) using a novel fiber-optic 3-axis force sensor to quantify the quasi-static stiffness of the middle ear, and b) by artificial reduction of stapes mobility due to drying of the middle ear.MethodsMiddle ear transfer function, defined as the ratio of the stapes footplate velocity versus the ear canal sound pressure, was measured with a single point LDV in two conditions. First, a controlled palpation force was applied at the stapes head in two in-plane (superior-inferior or posterior-anterior) directions, and at the incus lenticular process near the incudostapedial joint in the piston (lateral-medial) direction with a novel 3-axis PalpEar force sensor (Sensoptic, Losone, Switzerland), while the corresponding quasi-static displacement of the contact point was measured via a 3-axis micrometer stage. The palpation force was applied sequentially, step-wise in the range of 0.1–20 gF (1–200 mN). Second, measurements were repeated with various stages of stapes fixation, simulated by pre-load on the stapes head or drying of the temporal bone, and with severe ossicle immobilization, simulated by gluing of the stapes footplate.ResultsSimulated stapes fixation (forced drying of 5–15 min) severely decreases (20–30 dB) the low frequency (<1 kHz) response of the middle ear, while increasing (5–10 dB) the high frequency (>4 kHz) response. Stapes immobilization (gluing of the footplate) severely reduces (20–40 dB) the low and mid frequency response (<4 kHz) but has lesser effect (<10 dB) at higher frequencies. Even moderate levels of palpation force (<3gF, <30 mN), regardless of direction, have negative effect (10–20 dB) on the low frequency (<2 kHz) response, but with less significant (5–10 dB) effect at higher frequencies. Force-displacement measurements around the incudostapedial joint showed quasi-static stiffness in the range of 200–500 N/m for normal middle ears, and 1000–2500 N/m (5–8-fold increase) after artificially (through forced drying) reducing the middle ear transfer function with 10–25 dB at 1 kHz.ConclusionEffects of the palpation force level and direction, as well as stapes fixation and immobilization have been analyzed based on the measurement of the stapes footplate motion, and controlled application of 3D force and displacement.
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Performance of the Tinnitus Functional Index as a diagnostic instrument in a UK clinical population
Source:Hearing Research
Author(s): Kathryn Fackrell, Deborah A. Hall, Johanna G. Barry, Derek J. Hoare
ObjectivesThe Tinnitus Functional Index (TFI) has been optimised as a diagnostic tool for quantifying the functional impact of tinnitus in US veteran and civilian groups. However, the TFI has not been fully evaluated for use in other English-speaking clinical populations despite its increasingly popular uptake. Here, a prospective multi-site longitudinal validation study was conducted to evaluate psychometric properties relevant to the UK clinical population. Guided by quality criteria for the measurement properties of health-related questionnaires, we specifically evaluated three diagnostic properties relating to the degree to which the TFI (i) covers the eight dimensions proposed to be important for diagnosis, (ii) reliably distinguishes individual differences in severity of tinnitus, and (iii) reliably measures the functional impact of tinnitus. We also examine whether clinically meaningful interpretations of the scores can be produced for the UK population.MethodsTwelve National Health Service audiology clinics across the UK recruited 255 tinnitus patients to complete questionnaires at four time-intervals, from initial clinical assessment and then over a nine-month period. Patients completed the TFI, the Tinnitus Handicap Inventory (THI), tinnitus case history questions, a Global rating of Perceived Problem with tinnitus and a Clinical Global Impression of perceived change in tinnitus. Baseline TFI data were used to examine the factor structure, construct validity and interpretability of the TFI. Follow-up TFI data were used to examine reliability.ResultsConfirmatory factor analysis suggested that of the eight subscales (factors) initially established for the TFI, the ‘Auditory’ subscale did not contribute to the overall construct ‘functional impact of tinnitus’, and a modified seven-factor model (TFI-22) better fit the variance in the patient scores. Both the global 25-item TFI and the global TFI-22 scores showed exceptionally high internal consistency (α ≥ 0.95), high construct validity with the THI (r = 0.80) and high test-retest reliability (ICC = 0.87). Test-retest agreement however was only deemed to be borderline acceptable (89%). Receiver Operator Characteristic analysis indicated the 25-item TFI and TFI-22 has excellent ability to distinguish between different levels of impact (Area under the curve > 0.7).ConclusionThe TFI was confirmed to cover multiple symptom domains, measuring a multi-domain construct of tinnitus, and satisfies a range of psychometric requirements for a good clinical measure, including having excellent reliability, stability over time and sensitivity to individual differences in tinnitus severity. However, a modified seven-factor structure without the Auditory subscale (TFI-22) is recommended for calculating a global composite score for UK patients. Using patients' experience and Receiver Operator Characteristic analysis, a grading system was presented which identifies the distinct grades of tinnitus impact in the UK clinical population that is broadly comparable to the US-based system.
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Limits on normal cochlear ‘third’ windows provided by previous investigations of additional sound paths into and out of the cat inner ear
Publication date: Available online 10 November 2017
Source:Hearing Research
Author(s): John J. Rosowski, Peter Bowers, Hideko H. Nakajima
While most models of cochlear function assume the presence of only two windows into the mammalian cochlea (the oval and round windows), a position that is generally supported by several lines of data, there is evidence for additional sound paths into and out of the inner ear in normal mammals. In this report we review the existing evidence for and against the ‘two-window’ hypothesis. We then determine how existing data and inner-ear anatomy restrict transmission of sound through these additional sound pathways in cat by utilizing a well-tested model of the cat inner ear, together with anatomical descriptions of the cat cochlear and vestibular aqueduct (potential additional windows to the cochlea). We conclude: (1) The existing data place limits on the size of the cochlear and vestibular aqueducts in cat and are consistent with small volume-velocities through these ducts during ossicular stimulation of the cochlea, (2) the predicted volume velocities produced by aqueducts with diameters half the size of the bony diameters match the functional data within ±10 dB, and (3) these additional volume velocity paths contribute to the inner ear's response to non-acoustic stimulation and conductive pathology.
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Source:Hearing Research
Author(s): John J. Rosowski, Peter Bowers, Hideko H. Nakajima
While most models of cochlear function assume the presence of only two windows into the mammalian cochlea (the oval and round windows), a position that is generally supported by several lines of data, there is evidence for additional sound paths into and out of the inner ear in normal mammals. In this report we review the existing evidence for and against the ‘two-window’ hypothesis. We then determine how existing data and inner-ear anatomy restrict transmission of sound through these additional sound pathways in cat by utilizing a well-tested model of the cat inner ear, together with anatomical descriptions of the cat cochlear and vestibular aqueduct (potential additional windows to the cochlea). We conclude: (1) The existing data place limits on the size of the cochlear and vestibular aqueducts in cat and are consistent with small volume-velocities through these ducts during ossicular stimulation of the cochlea, (2) the predicted volume velocities produced by aqueducts with diameters half the size of the bony diameters match the functional data within ±10 dB, and (3) these additional volume velocity paths contribute to the inner ear's response to non-acoustic stimulation and conductive pathology.
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Quasi-static and dynamic motions of the columellar footplate in ostrich (Struthio camelus) measured ex vivo
Publication date: Available online 9 November 2017
Source:Hearing Research
Author(s): Pieter G.G. Muyshondt, Raf Claes, Peter Aerts, Joris J.J. Dirckx
The nature of the movement of the columellar footplate (CFP) in birds is still matter of ongoing debate. Some sources claim that rocking motion is dominant, while others propose a largely piston-like motion. In this study, motions of the CFP are experimentally investigated in the ostrich using a post-mortem approach. For quasi-static loads, micro-CT scans of ostrich heads were made under positive and negative middle-ear pressures of 1 kPa. For dynamic loads, laser Doppler vibrometry was used to measure the velocity on multiple locations of the CFP as a function of excitation frequency from 0.125 to 4 kHz, and digital stroboscopic holography was used to assess the 1D full-field out-of-plane displacement of the CFP at different excitation frequencies. To expose the CFP in the experiments, measurements were made from the medial side of the CFP after opening and draining the inner ear. To determine the influence of the inner-ear load on CFP motions, a finite element model was created of the intact ostrich middle ear with inner-ear load included. For quasi-static loads, the CFP performed largely piston-like motions under positive ME pressure, while under negative ME pressure the difference between piston and rocking motion was smaller. For dynamic loads, the CFP motion was almost completely piston-like for frequencies below 1 kHz. For higher frequencies, the motions became more complicated with an increase of the rocking components, although they never exceeded the piston component. When including the inner-ear load to the model, the rocking components started to increase relative to the piston component when compared to the result of the model with unloaded CFP, but only at high frequencies above 1 kHz. In this frequency range, the motion could no longer be identified as purely piston-like or rocking. As a conclusion, the current results suggest that CFP motion is predominantly piston-like below 1 kHz, while at higher frequencies the motion becomes too complicated to be described as purely piston-like or rocking.
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Source:Hearing Research
Author(s): Pieter G.G. Muyshondt, Raf Claes, Peter Aerts, Joris J.J. Dirckx
The nature of the movement of the columellar footplate (CFP) in birds is still matter of ongoing debate. Some sources claim that rocking motion is dominant, while others propose a largely piston-like motion. In this study, motions of the CFP are experimentally investigated in the ostrich using a post-mortem approach. For quasi-static loads, micro-CT scans of ostrich heads were made under positive and negative middle-ear pressures of 1 kPa. For dynamic loads, laser Doppler vibrometry was used to measure the velocity on multiple locations of the CFP as a function of excitation frequency from 0.125 to 4 kHz, and digital stroboscopic holography was used to assess the 1D full-field out-of-plane displacement of the CFP at different excitation frequencies. To expose the CFP in the experiments, measurements were made from the medial side of the CFP after opening and draining the inner ear. To determine the influence of the inner-ear load on CFP motions, a finite element model was created of the intact ostrich middle ear with inner-ear load included. For quasi-static loads, the CFP performed largely piston-like motions under positive ME pressure, while under negative ME pressure the difference between piston and rocking motion was smaller. For dynamic loads, the CFP motion was almost completely piston-like for frequencies below 1 kHz. For higher frequencies, the motions became more complicated with an increase of the rocking components, although they never exceeded the piston component. When including the inner-ear load to the model, the rocking components started to increase relative to the piston component when compared to the result of the model with unloaded CFP, but only at high frequencies above 1 kHz. In this frequency range, the motion could no longer be identified as purely piston-like or rocking. As a conclusion, the current results suggest that CFP motion is predominantly piston-like below 1 kHz, while at higher frequencies the motion becomes too complicated to be described as purely piston-like or rocking.
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Effects of noise overexposure on tone detection in noise in nonhuman primates
Publication date: Available online 9 November 2017
Source:Hearing Research
Author(s): Samantha N. Hauser, Jane A. Burton, Evan T. Mercer, Ramnarayan Ramachandran
This report explores the consequences of acoustic overexposures on hearing in noisy environments for two macaque monkeys trained to perform a reaction time detection task using a Go/No-Go lever release paradigm. Behavioral and non-invasive physiological assessments were obtained before and after narrowband noise exposure. Physiological measurements showed elevated auditory brainstem response (ABR) thresholds and absent distortion product otoacoustic emissions (DPOAEs) post-exposure relative to pre-exposure. Audiograms revealed frequency specific increases in tone detection thresholds, with the greatest increases at the exposure band frequency and higher. Masked detection was affected in a similar frequency specific manner: threshold shift rates (change of masked threshold per dB increase in noise level) were lower than pre-exposure values at frequencies higher than the exposure band. Detection thresholds in sinusoidally amplitude modulated (SAM) noise post-exposure showed no difference from those in unmodulated noise, whereas pre-exposure masked detection thresholds were lower in the presence of SAM noise compared to unmodulated noise. These frequency dependent results were correlated with cochlear histopathological changes in monkeys that underwent similar noise exposure. These results reveal that behavioral and physiological effects of noise exposure in macaques are similar to those seen in humans and provide preliminary information on the relationship between noise exposure, cochlear pathology and perceptual changes in hearing within individual subjects.
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Source:Hearing Research
Author(s): Samantha N. Hauser, Jane A. Burton, Evan T. Mercer, Ramnarayan Ramachandran
This report explores the consequences of acoustic overexposures on hearing in noisy environments for two macaque monkeys trained to perform a reaction time detection task using a Go/No-Go lever release paradigm. Behavioral and non-invasive physiological assessments were obtained before and after narrowband noise exposure. Physiological measurements showed elevated auditory brainstem response (ABR) thresholds and absent distortion product otoacoustic emissions (DPOAEs) post-exposure relative to pre-exposure. Audiograms revealed frequency specific increases in tone detection thresholds, with the greatest increases at the exposure band frequency and higher. Masked detection was affected in a similar frequency specific manner: threshold shift rates (change of masked threshold per dB increase in noise level) were lower than pre-exposure values at frequencies higher than the exposure band. Detection thresholds in sinusoidally amplitude modulated (SAM) noise post-exposure showed no difference from those in unmodulated noise, whereas pre-exposure masked detection thresholds were lower in the presence of SAM noise compared to unmodulated noise. These frequency dependent results were correlated with cochlear histopathological changes in monkeys that underwent similar noise exposure. These results reveal that behavioral and physiological effects of noise exposure in macaques are similar to those seen in humans and provide preliminary information on the relationship between noise exposure, cochlear pathology and perceptual changes in hearing within individual subjects.
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Intraoperative force and electrocochleography measurements in an animal model of cochlear implantation
Publication date: Available online 9 November 2017
Source:Hearing Research
Author(s): J. Lo, C. Bester, A. Collins, C. Newbold, A. Hampson, S. Chambers, H. Eastwood, S. O'Leary
To preserve residual hearing, techniques for monitoring and reducing the effects of trauma during cochlear implant surgery are being developed. This study examines the relationships between intraoperative recordings (electrode insertion force and electrocochleography), trauma, and hearing loss after cochlear implantation. The study also evaluated the efficacy of intravenous steroids for reducing hearing loss after implantation. Thirty-two normal-hearing guinea pigs were randomly implanted with electrode arrays of differing stiffness (‘hard’ or ‘soft’). These arrays used an intracochlear electrode to record electrode insertion force and electrocochleography responses to a multi-frequency acoustic stimulus during implantation. Additionally, sub-cohorts of animals were administered intravenous saline (‘control’) or dexamethasone (‘steroid’) prior to surgery. Subsequent hearing loss was assessed using electrocochleography recordings from the round window membrane prior to surgery and 4 weeks after implantation. After 4 weeks, cochleae were harvested and imaged with thin sheet laser imaging microscopy. After 4 weeks, compound action potential (CAP) thresholds did not differ between steroid and control groups. The CAP amplitude at low-mid frequencies decreased after implantation with a hard electrode, an effect which was partly negated by administering steroids. A decrease in the ‘intraoperative’ CAP amplitude preceded the reporting of insertion resistance by the surgeon by 5.94 s (±4.03 s SEM). Intraoperative CAP declines were also correlated with higher grades of trauma (r = 0.56, p < 0.01) and greater hearing loss (r = 0.56, p < 0.01). This relationship was not repeated with intraoperative cochlear microphonics. A rise in intraoperative force, which preceded the reporting of resistance by 0.71 s (±0.15 s SEM), was correlated with trauma (r = 0.400, p = 0.04) but not hearing loss (r = 0.297, p = 0.27). Preserving intraoperative CAP amplitudes during implantation was predictive of an atraumatic insertion and reduced post-implantation hearing loss. A rise in force usually preceded the reporting of resistance, although by less than 1 s. These results suggest that intraoperative CAPs may offer a more robust feedback mechanism for improving hearing preservation rates than cochlear microphonic and electrode insertion force recordings, especially considering the rapid changes in insertion force and relatively slow human reaction times. Pre-operative steroids were effective in reversing loss of CAP amplitude with hard electrodes and evoked by lower frequency tones, which suggests a possible role in reducing synaptopathy.
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Source:Hearing Research
Author(s): J. Lo, C. Bester, A. Collins, C. Newbold, A. Hampson, S. Chambers, H. Eastwood, S. O'Leary
To preserve residual hearing, techniques for monitoring and reducing the effects of trauma during cochlear implant surgery are being developed. This study examines the relationships between intraoperative recordings (electrode insertion force and electrocochleography), trauma, and hearing loss after cochlear implantation. The study also evaluated the efficacy of intravenous steroids for reducing hearing loss after implantation. Thirty-two normal-hearing guinea pigs were randomly implanted with electrode arrays of differing stiffness (‘hard’ or ‘soft’). These arrays used an intracochlear electrode to record electrode insertion force and electrocochleography responses to a multi-frequency acoustic stimulus during implantation. Additionally, sub-cohorts of animals were administered intravenous saline (‘control’) or dexamethasone (‘steroid’) prior to surgery. Subsequent hearing loss was assessed using electrocochleography recordings from the round window membrane prior to surgery and 4 weeks after implantation. After 4 weeks, cochleae were harvested and imaged with thin sheet laser imaging microscopy. After 4 weeks, compound action potential (CAP) thresholds did not differ between steroid and control groups. The CAP amplitude at low-mid frequencies decreased after implantation with a hard electrode, an effect which was partly negated by administering steroids. A decrease in the ‘intraoperative’ CAP amplitude preceded the reporting of insertion resistance by the surgeon by 5.94 s (±4.03 s SEM). Intraoperative CAP declines were also correlated with higher grades of trauma (r = 0.56, p < 0.01) and greater hearing loss (r = 0.56, p < 0.01). This relationship was not repeated with intraoperative cochlear microphonics. A rise in intraoperative force, which preceded the reporting of resistance by 0.71 s (±0.15 s SEM), was correlated with trauma (r = 0.400, p = 0.04) but not hearing loss (r = 0.297, p = 0.27). Preserving intraoperative CAP amplitudes during implantation was predictive of an atraumatic insertion and reduced post-implantation hearing loss. A rise in force usually preceded the reporting of resistance, although by less than 1 s. These results suggest that intraoperative CAPs may offer a more robust feedback mechanism for improving hearing preservation rates than cochlear microphonic and electrode insertion force recordings, especially considering the rapid changes in insertion force and relatively slow human reaction times. Pre-operative steroids were effective in reversing loss of CAP amplitude with hard electrodes and evoked by lower frequency tones, which suggests a possible role in reducing synaptopathy.
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Effects of middle ear quasi-static stiffness on sound transmission quantified by a novel 3-axis optical force sensor
Publication date: Available online 10 November 2017
Source:Hearing Research
Author(s): Ivo Dobrev, Jae Hoon Sim, Baktash Aqtashi, Alexander M. Huber, Thomas Linder, Christof Röösli
BackgroundIntra-operative quantification of the ossicle mobility could provide valuable feedback for the current status of the patient's conductive hearing. However, current methods for evaluation of middle ear mobility are mostly limited to the surgeon's subjective impression through manual palpation of the ossicles. This study investigates how middle ear transfer function is affected by stapes quasi-static stiffness of the ossicular chain. The stiffness of the middle ear is induced by a) using a novel fiber-optic 3-axis force sensor to quantify the quasi-static stiffness of the middle ear, and b) by artificial reduction of stapes mobility due to drying of the middle ear.MethodsMiddle ear transfer function, defined as the ratio of the stapes footplate velocity versus the ear canal sound pressure, was measured with a single point LDV in two conditions. First, a controlled palpation force was applied at the stapes head in two in-plane (superior-inferior or posterior-anterior) directions, and at the incus lenticular process near the incudostapedial joint in the piston (lateral-medial) direction with a novel 3-axis PalpEar force sensor (Sensoptic, Losone, Switzerland), while the corresponding quasi-static displacement of the contact point was measured via a 3-axis micrometer stage. The palpation force was applied sequentially, step-wise in the range of 0.1–20 gF (1–200 mN). Second, measurements were repeated with various stages of stapes fixation, simulated by pre-load on the stapes head or drying of the temporal bone, and with severe ossicle immobilization, simulated by gluing of the stapes footplate.ResultsSimulated stapes fixation (forced drying of 5–15 min) severely decreases (20–30 dB) the low frequency (<1 kHz) response of the middle ear, while increasing (5–10 dB) the high frequency (>4 kHz) response. Stapes immobilization (gluing of the footplate) severely reduces (20–40 dB) the low and mid frequency response (<4 kHz) but has lesser effect (<10 dB) at higher frequencies. Even moderate levels of palpation force (<3gF, <30 mN), regardless of direction, have negative effect (10–20 dB) on the low frequency (<2 kHz) response, but with less significant (5–10 dB) effect at higher frequencies. Force-displacement measurements around the incudostapedial joint showed quasi-static stiffness in the range of 200–500 N/m for normal middle ears, and 1000–2500 N/m (5–8-fold increase) after artificially (through forced drying) reducing the middle ear transfer function with 10–25 dB at 1 kHz.ConclusionEffects of the palpation force level and direction, as well as stapes fixation and immobilization have been analyzed based on the measurement of the stapes footplate motion, and controlled application of 3D force and displacement.
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Source:Hearing Research
Author(s): Ivo Dobrev, Jae Hoon Sim, Baktash Aqtashi, Alexander M. Huber, Thomas Linder, Christof Röösli
BackgroundIntra-operative quantification of the ossicle mobility could provide valuable feedback for the current status of the patient's conductive hearing. However, current methods for evaluation of middle ear mobility are mostly limited to the surgeon's subjective impression through manual palpation of the ossicles. This study investigates how middle ear transfer function is affected by stapes quasi-static stiffness of the ossicular chain. The stiffness of the middle ear is induced by a) using a novel fiber-optic 3-axis force sensor to quantify the quasi-static stiffness of the middle ear, and b) by artificial reduction of stapes mobility due to drying of the middle ear.MethodsMiddle ear transfer function, defined as the ratio of the stapes footplate velocity versus the ear canal sound pressure, was measured with a single point LDV in two conditions. First, a controlled palpation force was applied at the stapes head in two in-plane (superior-inferior or posterior-anterior) directions, and at the incus lenticular process near the incudostapedial joint in the piston (lateral-medial) direction with a novel 3-axis PalpEar force sensor (Sensoptic, Losone, Switzerland), while the corresponding quasi-static displacement of the contact point was measured via a 3-axis micrometer stage. The palpation force was applied sequentially, step-wise in the range of 0.1–20 gF (1–200 mN). Second, measurements were repeated with various stages of stapes fixation, simulated by pre-load on the stapes head or drying of the temporal bone, and with severe ossicle immobilization, simulated by gluing of the stapes footplate.ResultsSimulated stapes fixation (forced drying of 5–15 min) severely decreases (20–30 dB) the low frequency (<1 kHz) response of the middle ear, while increasing (5–10 dB) the high frequency (>4 kHz) response. Stapes immobilization (gluing of the footplate) severely reduces (20–40 dB) the low and mid frequency response (<4 kHz) but has lesser effect (<10 dB) at higher frequencies. Even moderate levels of palpation force (<3gF, <30 mN), regardless of direction, have negative effect (10–20 dB) on the low frequency (<2 kHz) response, but with less significant (5–10 dB) effect at higher frequencies. Force-displacement measurements around the incudostapedial joint showed quasi-static stiffness in the range of 200–500 N/m for normal middle ears, and 1000–2500 N/m (5–8-fold increase) after artificially (through forced drying) reducing the middle ear transfer function with 10–25 dB at 1 kHz.ConclusionEffects of the palpation force level and direction, as well as stapes fixation and immobilization have been analyzed based on the measurement of the stapes footplate motion, and controlled application of 3D force and displacement.
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