Objectives: The aim of the study was to investigate the link between temporal fine structure (TFS) processing, pitch, and speech perception performance in adult cochlear implant (CI) recipients, including bimodal listeners who may benefit better low-frequency (LF) temporal coding in the contralateral ear. Design: The study participants were 43 adult CI recipients (23 unilateral, 6 bilateral, and 14 bimodal listeners). Two new LF pitch perception tests—harmonic intonation (HI) and disharmonic intonation (DI)—were used to evaluate TFS sensitivity. HI and DI were designed to estimate a difference limen for discrimination of tone changes based on harmonic or inharmonic pitch glides. Speech perception was assessed using the newly developed Italian Sentence Test with Adaptive Randomized Roving level (STARR) test where sentences relevant to everyday contexts were presented at low, medium, and high levels in a fluctuating background noise to estimate a speech reception threshold (SRT). Results: Although TFS and STARR performances in the majority of CI recipients were much poorer than those of hearing people reported in the literature, a considerable intersubject variability was observed. For CI listeners, median just noticeable differences were 27.0 and 147.0 Hz for HI and DI, respectively. HI outcomes were significantly better than those for DI. Median STARR score was 14.8 dB. Better performers with speech reception thresholds less than 20 dB had a median score of 8.6 dB. A significant effect of age was observed for both HI/DI tests, suggesting that TFS sensitivity tended to worsen with increasing age. CI pure-tone thresholds and duration of profound deafness were significantly correlated with STARR performance. Bimodal users showed significantly better TFS and STARR performance for bimodal listening than for their CI-only condition. Median bimodal gains were 33.0 Hz for the HI test and 95.0 Hz for the DI test. DI outcomes in bimodal users revealed a significant correlation with unaided hearing thresholds for octave frequencies lower than 1000 Hz. Median STARR scores were 17.3 versus 8.1 dB for CI only and bimodal listening, respectively. STARR performance was significantly correlated with HI findings for CI listeners and with those of DI for bimodal listeners. Conclusions: LF pitch perception was found to be abnormal in the majority of adult CI recipients, confirming poor TFS processing of CIs. Similarly, the STARR findings reflected a common performance deterioration with the HI/DI tests, suggesting the cause probably being a lack of access to TFS information. Contralateral hearing aid users obtained a remarkable bimodal benefit for all tests. Such results highlighted the importance of TFS cues for challenging speech perception and the relevance to everyday listening conditions. HI/DI and STARR tests show promise for gaining insights into how TFS and speech perception are being limited and may guide the customization of CI program parameters and support the fine tuning of bimodal listening. ACKNOWLEDGMENTS: We thank all participants who took part in this study. The authors declare that they have no conflicts of interest. Address for correspondence: Hilal Dincer D’Alessandro, Sapienza University of Rome, Department of Sense Organs, Viale dell’Università 31, 00161 Rome, Italy. E-mail: hilal.dincer@uniroma1.it or dincer.hilal@gmail.com Received January 9, 2017; accepted October 5, 2017. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Παρασκευή 1 Δεκεμβρίου 2017
Cochlear Implantation in a Patient With Sickle Cell Disease With Early Cochlear Sclerosis
Objective: We report a case of bilateral sudden sensorineural hearing loss (SNHL) and early cochlear sclerosis in a patient with sickle cell disease. Methods: A 19-year-old female presented with sequential bilateral sudden SNHL and early cochlear sclerosis. Cochlear implantation was performed. Results: Early cochlear fibrosis in the hook region and basal turn was encountered within a few months of deafness. Implantation required serial dilation using various insertion guides. Postsurgical telemetry readings revealed 19 electrodes (7 paired basal electrodes, 5 single apical electrodes) in a good working order with low impedances in bilateral ears. Activation of the processors successfully provided access to the speech frequency range in both the ears. Conclusion: This is the first case of intraoperative documentation of rapid cochlear sclerosis in a patient with SNHL caused by sickle cell disease. Early cochlear implantation should be considered in these patients, and otolaryngologists should be aware of the possibility of rapid cochlear sclerosis without ossification in these patients. Address correspondence and reprint requests to Seon Jeong Kim, George Washington University School of Medicine, 2150 Pennsylvania Ave. NW, Washington, DC, 20037; E-mail: skim2017@gwu.edu The authors disclose no conflicts of interest. Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Hearing Outcomes After Stereotactic Radiosurgery for Jugular Paraganglioma
Objective: To describe audiometric outcomes following stereotactic radiosurgery (SRS) for jugular paraganglioma (JP). Study Design: Retrospective review. Setting: Tertiary referral center. Patients: Patients with pretreatment serviceable hearing (American Academy of Otolaryngology—Head and Neck Surgery [AAO-HNS] Class A or B) and serial post-SRS audiometric follow-up who underwent Gamma Knife SRS for JP between 1990 and 2017. Intervention(s): Gamma Knife SRS. Main Outcome Measures: Progression to nonserviceable hearing; correlation between baseline hearing and treatment parameters with audiometric outcomes. Results: Of 85 patients with JP who underwent SRS during the study period, 35 (66% female, median age 53) had pretreatment serviceable hearing and serial post-treatment audiometry available for review. Median tumor volume at the time of treatment was 7,080 mm3, median cochlear point dose was 5.8 Gy (interquartile range [IQR] 4.1 to 7.3 Gy), and median marginal and maximum tumor doses were 16 and 32 Gy, respectively. After a median follow-up of 37 months (IQR 16 to 77 mo), the median change in pure-tone average and speech discrimination score in the treated ear was −1.2 dB HL/yr (IQR −4.5 to 0.3) and 0%/yr (IQR 0–3.5%), compared with 0.07 dB HL/yr (IQR −0.03 to 0.12) and 0 %/yr (IQR 0 to 0%) in the contralateral untreated ear. Seven patients developed nonserviceable hearing (AAO-HNS Class C or D) at a median of 13.2 months following SRS (IQR 4.8 to 24 mo). Among those who maintained serviceable hearing, median audiometric follow-up was 42 months (IQR 18 to 77 mo). The Kaplan–Meier estimated rates of serviceable hearing at 1, 3, and 5 years following SRS were 91%, 80%, and 80%, respectively. Sixty percent of patients with pulsatile tinnitus who underwent SRS experienced varying levels of symptomatic improvement following treatment. Conclusion: The short- and intermediate-term risk of progression to nonserviceable hearing following SRS for JP is low. Data regarding the impact of cochlear dose from the vestibular schwannoma literature should not be freely applied to JP, since the impact of SRS parameters on hearing preservation seems to be less significant. Address correspondence and reprint requests to Matthew L. Carlson, M.D., Department of Otolaryngology—Head and Neck Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905; E-mail: carlson.matthew@mayo.edu Internal departmental funding was used without commercial sponsorship or support. M.L.C. and C.L.W.D. are consultants for Advanced Bionics Corp., Cochlear Corp., and MED-EL GmbH. Institutional Review Board Approval: Mayo Clinic IRB Approval 16-002291. The authors disclose no conflicts of interest. Supplemental digital content is available in the text. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://ift.tt/2i6WMKr). Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Survey of the American Neurotology Society on Cochlear Implantation: Part 1, Candidacy Assessment and Expanding Indications
Objective: To examine practice variance of cochlear implant candidacy assessment and off-label indications across centers in the United States. Methods: Cross-sectional survey of the American Neurotology Society (ANS). Results: A total of 81 surveys were returned from ANS members who report regular involvement in cochlear implant care. Overall there was a broad distribution in age and clinical experience, with most respondents reporting ACGME accreditation in neurotology and employment at an academic center. The annual volume of cochlear implant surgeries varied considerably across centers. Seventy-eight percent of respondents performed cochlear implantation for at least one of the following indications within the last 2 years: profound hearing loss in children less than 12 months of age (35, 43%), children with asymmetrical hearing loss where at least one ear was better than performance cutoff for age (25, 31%), adults with asymmetrical hearing where at least one ear was better than the performance cutoff for adult criteria (49, 61%), single-sided deafness (37, 46%), and ipsilateral vestibular schwannoma (28, 35%). Centers with a higher annual implant volume more frequently performed off-label implantation in all queried populations (all, p≤0.001), and performed surgery on infants with congenital deafness at a younger age (p = 0.013), compared with centers with lower surgical volume. When surveyed regarding speech perception testing practices for adult candidacy assessment, 75 (100%) respondents who answered this question reported routine use of AzBio sentences, 42 (56%) CNC word scores, and 26 (35%) HINT testing; only 7 (9%) reported using BKB-SIN testing and 6 (8%) reported using CUNY scores. Fifty-one (68%) reported routine use of speech-in-noise testing to determine adult cochlear implant candidacy, 21 (28%) reported selective use only when patient scores were borderline in quiet, and 3 (4%) reported that their center does not currently use testing in noise for candidacy determination. Nineteen (26%) solely used +10 dB signal-to-noise ratio (SNR), 12 (16%) solely used +5 dB SNR, and 41 (55%) used both +10 and +5 dB SNR. Overall, 19% (N = 14) only perform unilateral implantation in the Medicare population, while 81% (N = 58) consider bilateral implantation. Conclusion: Significant variation in cochlear implant candidacy assessment and off-label implantation exists across centers and providers in the United States resulting in healthcare inequities. The high percentage of surgeons performing implantations for off-label or nontraditional indications reflects the overly restrictive and dated status of current implant guidelines. With greater adoption of more difficult speech perception testing in noise, careful clinical judgment is needed to maintain a favorable risk–benefit balance for prospective implant candidates. Address correspondence and reprint requests to Matthew L. Carlson, M.D., Department of Otolaryngology—Head and Neck Surgery, Mayo Clinic, 200 1st St SW, Rochester, MN 55905; E-mail: carlson.matthew@mayo.edu Internal departmental funding was utilized without commercial sponsorship or support. MLC and CLD are consultants for Advanced Bionics Corp., Cochlear Corp., and MED-EL GmbH. Institutional Review Board Approval: IRB exempt study. The authors disclose no conflicts of interest. Supplemental digital content is available in the text. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://ift.tt/2i6WMKr). Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Success Rate of Tympanic Membrane Closure in the Elderly Compared to Younger Adults
Objective: To assess the effectiveness and safety of tympanoplasty in elderly patients and the effect of frailty on the results. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: Thirty-one ears in 30 patients aged 65 years and older were included and matched with 31 controls, based on the type of surgery, of a pool of 133 patients aged 35 to 55 years. Intervention: Therapeutic. Main Outcome Measure: Success was defined as tympanic membrane closure and resolution of presenting complaints. Complications were assessed. Frailty was defined by assessing multimorbidity and polypharmacy. Fisher's exact test was used to compare success and complication rates between the age groups. Linear logistic regression analysis using generalized linear models was performed on success and complication rate. Results: Success rates in both the groups were 84%. Complication rate in the elderly group was 16% versus 6% in the control group. This difference was not statistically significant in the Fisher's exact test. In the generalized linear model analysis age group, multimorbidity and polypharmacy had no significant influence on both success and complication rate. Conclusion: There was no difference in success and complication rate in elderly undergoing tympanoplasty compared with younger adults. Having multimorbidity or polypharmacy did not correlate with failure of the tympanic membrane closure or a higher complication rate. Address correspondence and reprint requests to Casper Jolink, M.D., Department of Otorhinolaryngology Head and Neck Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; E-mail: c.jolink@amc.nl The authors disclose no conflicts of interest. Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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A Population Based Analysis of Melanoma of the External Ear
Objective: Malignant melanoma accounts for nearly 75% of all skin cancer deaths, and the incidence is on the rise in the United States. External ear melanoma (EEM) is rare, and there is little long-term data regarding the clinical behavior of this melanoma site. This study analyzes the demographic, clinicopathologic, and survival characteristics of EEM. Methods: The SEER database was queried for EEM cases from 1973 to 2012 (8,982 cases). Data analyzed included patient demographics, incidence trends, and survival outcomes. Results: External ear melanoma occurred most frequently in the sixth and seventh decades of life. Mean age at diagnosis was 65.5 (±16.8) years. However, the incidence of EEM in adolescents and young adults (ages 15–39 yr) has increased by 111.9% from 1973 to 2012. There was a strong male predilection with a male-to-female ratio of 6.40:1. The most common histologic subtype was malignant melanoma, NOS (46.8%), followed by superficial spreading melanoma (21.4%), and lentigo maligna melanoma (17.9%). The majority of cases were localized at the time of presentation (88.0%), with rare distant metastasis (1.9%). The most common treatment modality was surgery alone (97.6%), followed by surgery with radiotherapy (2.3%). Ten-year disease-specific survival was better among those treated with surgery alone (90.7%), than those treated with surgery with radiotherapy (37.1%) (p
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Publishing Trends in Otology and Neurotology
Objectives: 1) Describe publishing trends for otologic/neurotologic disorders over a 35-year span. 2) Compare trends in publishing with disease prevalence. 3) Evaluate changes in topic and journal specific ranking scores over time. Methods: PubMed searches were performed on 35 otologic/neurotologic disorders using medical subject headings (MeSH) terms from 1980 to 2015. Searches were limited in scope to the English language. A Mann–Kendall trend analysis evaluated changes in publication frequency as a discrete variable while correcting for total number of articles published per year. Scopus was used to identify SCImago Country and Journal Rank (SJR) indicator scores and weighted-averages used to calculate changes over time. Results: The total number of publications on the 35 topics increased from 853 in 1980 to a peak of 3,068 in 2013. Otitis media (τ = −0.799, p
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A Prospective Study of Pain From Magnetic Resonance Imaging With Cochlear Implant Magnets In Situ
Objective: To describe changes in pain associated with magnetic resonance imaging (MRI) with cochlear implant magnets in place. Study Design: Prospective, single-arm study. Setting: Tertiary referral center. Subjects: Adults with cochlear implants requiring MRI. Intervention: Tight head wrapping over internal device during MRI. Main Outcome Measures: Change in pain score using an 11-point visual analogue scale, duration/completion of MRI, body mass index (BMI), quality of pain, status of the skin, functioning of implant, displacement/polarity change of magnet, willingness to repeat MRI without magnet removal. Results: A total of 27 subjects obtained 42 MRI scans. Subjects were 59% male with age range of 21 to 80 years. All three manufacturers were represented. Forty-eight percent of scans imaged the brain/head while 52% imaged other sites. The mean individual change in pain was 3.9 (SD 3.5, range 0–10). The pain was most commonly described as “pressure”, “heat”, or “sharp”. There was no significant correlation between change in pain and scan duration, BMI, or body part imaged. Eighty-eight percent of the scans were completed. There were no skin complications except temporary erythema (29%) and there were no magnet/device complications. Eighty-eight percent said they would undergo MRI without magnet removal again. Conclusion: The pain associated with obtaining an MRI without cochlear implant magnet removal is highly variable. Increase in pain is not related to duration of MRI scan, body part imaged, or BMI. Despite the pain, almost all patients prefer MRI scanning with the magnet in place, to avoid two surgical procedures. Address correspondence and reprint requests to Bryan K. Ward, M.D., 601 N. Caroline Street, 6th Floor, Baltimore, MD 21287-0910; E-mail: bward15@jhmi.edu Sources of Support: Departmental Funds. Institutional Review Board: IRB00089337. The authors disclose no conflicts of interest. Supplemental digital content is available in the text. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://ift.tt/2i6WMKr). Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Evaluation of Mitoquinone for Protecting Against Amikacin-Induced Ototoxicity in Guinea Pigs
Hypothesis: Mitoquinone (MitoQ) attenuates amikacin ototoxicity in guinea pigs. Background: MitoQ, a mitochondria-targeted derivative of the antioxidant ubiquinone, has improved bioavailability and demonstrated safety in humans. Thus, MitoQ is a promising therapeutic approach for protecting against amikacin-induced ototoxicity. Methods: Both oral and subcutaneous administrations of MitoQ were tested. Amikacin-treated guinea pigs (n = 12–18 per group) received water alone (control) or MitoQ 30 mg/l-supplemented drinking water; or injected subcutaneously with 3 to 5 mg/kg MitoQ or saline (control). Auditory brainstem responses and distortion product otoacoustic emissions were measured before MitoQ or control solution administration and after amikacin injections. Cochlear hair cell damage was assessed using scanning electron microscopy and Western blotting. Results: With oral administration, animals that received 30 mg/l MitoQ had better hearing than controls at only 24 kHz at 3-week (p = 0.017) and 6-week (p = 0.027) post-amikacin. With subcutaneous administration, MitoQ-injected guinea pigs had better hearing than controls at only 24 kHz, 2-week post-amikacin (p = 0.013). Distortion product otoacoustic emission (DPOAE) amplitudes were decreased after amikacin injections, but were not different between treatments (p > 0.05). Electron microscopy showed minor difference in outer hair cell loss between treatments. Western blotting demonstrated limited attenuation of oxidative stress in the cochlea of MitoQ-supplemented guinea pigs. Conclusions: Oral or subcutaneous MitoQ provided limited protection against amikacin-induced hearing loss and cochlear damage in guinea pigs. Other strategies for attenuating aminoglycoside-induced ototoxicity should be explored. Address correspondence and reprint requests to Carolyn O. Dirain, Ph.D., 1345 Center Dr, M2-228, Gainesville, FL 32610; E-mail: ojanoc@ent.ufl.edu Financial Support: This research was funded by the National Institute on Deafness and Other Communicative Disorder (NIDCD) of the National Institutes of Health (NIH) under award number R03DC013659 to C.O.D. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have no financial conflicts to disclose. Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Prediction of Vestibular Imbalance in Acute Peripheral Vestibulopathy by Measuring Horizontal Ocular Deviation on Magnetic Resonance Imaging
Objectives: The aim of the study is to evaluate whether horizontal ocular deviation (OD) from MR imaging in the emergency room (ER) reflects vestibular imbalance, by comparing the horizontal OD in patients with acute vestibulopathy to controls. Study Design: Retrospective review. Patients and Methods: A total of 69 patients with acute unilateral peripheral vestibulopathy and 30 healthy subjects were included. Horizontal OD was quantified by using the axial T2-weighted fast-spin echo (FSE) images of the brain at 1.5 T. In the study group, the results of VFTs (videonystagmography [VNG], caloric test, rotary chair test, and cervical vestibular evoked myogenic potentials [cVEMP]) were also reviewed. The averaged angle of right and left horizontal ODs was compared between patients with acute unilateral vestibulopathy and healthy controls. Also, the correlation between horizontal OD and results of VFTs was analyzed in the study group. Results: The averaged angle of horizontal OD in study group (23.7° ± 11.6°) was significantly greater than that of control group (4.27° ± 3.7°) (p
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Toward Optimizing Cervical Vestibular Evoked Myogenic Potentials (cVEMP): Combining Air-Bone Gap and cVEMP Thresholds to Improve Diagnosis of Superior Canal Dehiscence
Objective: To develop a novel approach combining low-frequency air-bone gap (ABG) and cervical vestibular evoked myogenic potential (cVEMP) thresholds to improve screening for superior canal dehiscence (SCD) syndrome. Study Design: Retrospective study. Setting: Tertiary care center. Patients: One hundred forty patients with SCD and 21 healthy age-matched controls were included. Ears for each patient were divided into three groups based on computed tomography (CT) findings: 1) dehiscent, 2) thin, or 3) unaffected. Main Outcome Measures: cVEMP and audiometric thresholds were analyzed and differences among groups were evaluated. Results: We define the third window indicator (TWI) as the cVEMP thresholds at 500, 750, and 1000 Hz adjusted for the ABG at 250 Hz (i.e., subtracting ABG from cVEMP threshold). The TWI differentiates between dehiscent and nondehiscent control ears with a sensitivity of 82% and specificity of 100%, corresponding to a positive predictive value of 100%. ABGs and cVEMP thresholds were similar for healthy controls and patients with thin bone over the superior canal. Conclusion: This is the largest study to date examining the usefulness of cVEMPs in the diagnosis of SCD. Our “third window indicator” (TWI) combines cVEMP thresholds with the ABG at 250 Hz to improve the ability to screen patients with SCD symptoms Address correspondence and reprint requests to Steven D. Rauch, M.D., 243 Charles Street, Boston, MA 02114. E-mail: Steven_Rauch@meei.harvard.edu D.J.L. and S.D.R. are principal investigators. This study was approved by the Human Studies Committee of the Massachusetts Eye and Ear Infirmary. Protocol numbers: 13-005H and 13-097H. The authors disclose no conflicts of interest. Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Cochlear Implant Insertion Axis Into the Basal Turn: a Critical Factor in Electrode Array Translocation
Hypothesis: An inappropriate insertion axis leads to intracochlear trauma during cochlear implantation (CI). Background: Few studies assessed the relationship between the insertion axis and the electrode scalar location. Methods: Preimplantation cone-beam CT (CBCT) was performed on 12 human temporal bones. In five temporal bones, an optimal insertion axis was planned, due to the impossibility to attain the ST centerline from the posterior tympanotomy, because of facial canal position. In the seven other temporal bones, an inaccurate insertion axis was intentionally planned (optimal axis+15 degrees). Automated CI array insertion according to the planned axis was performed with a motorized insertion tool driven by a navigated robot-based arm. The cochlea and basilar membrane were segmented from the preimplantation CBCT and the array segmented from the postimplantation CBCT to construct a merged final three-dimensional (3D) model. Microscopical and 3D analysis were performed to determine the intracochlear trauma at the level of each electrode. Results: A good agreement was observed in determining electrode position between microscopic analysis and the 3D model (Cohen's kappa k = 0.67). The angle of approach to the ST centerline was associated with the number of electrodes inserted into the ST (r = −0.65, p = 0.02, [95% CI −0.90 to −0.11] Spearman's rank correlation). Conclusion: A 3D reconstruction model was effective in determining the array position in the cochlea scalae. Our data indicate that the angle of approach to the ST centerline is a critical factor in intracochlear trauma. Additional studies should be conducted to assess the importance of the insertion axis with other array designs. Address correspondence and reprint requests to Renato Torres, M.D., Inserm, Paris 6: Unité “Réhabilitation chirurgicale mini-invasive et robotisée de l’audition”, 16, rue Henri Huchard, 75018 Paris, France; E-mail: renato.torres@inserm.fr This work was supported by Cifre grant (No 269/2015 ANRT/Oticon Medical) and Agir pour l’Audition Foundation (Grant No APA RD-2014-2/R14104DD RAK14030DA). The authors disclose no conflicts of interest. Supplemental digital content is available in the text. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://ift.tt/2i6WMKr). Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Clinical Characteristics and Treatment Outcomes for Patients With External Auditory Canal Cholesteatoma
Objective: We aimed to evaluate the clinical features and treatment outcomes for patients with idiopathic and secondary external auditory canal cholesteatoma (EACC), and to validate the treatment strategy from the perspective of hearing as well as etiology and staging. Study Design: Retrospective case series. Setting: Tertiary referral center and affiliated hospitals. Patients: Fifty-eight patients with idiopathic EACC and 14 patients with secondary EACC. Intervention: Conservative management and surgery. Main Outcome Measure: Air conduction (AC) pure-tone averages (PTAs) and mean air-bone gaps (ABGs). Results: There were no significant differences between hearing values before and after conservative management for idiopathic EACC patients with stages I–III, indicating that hearing abilities were preserved. For idiopathic EACC patients with stage IV disease treated with surgery, the AC PTA threshold and mean ABG significantly improved from a preoperative value of 60.3 dB HL to a postoperative value of 32.4 dB HL (p = 0.013), and from 34.3 to 9.5 dB HL (p
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Auditory Related Resting State fMRI Functional Connectivity in Tinnitus Patients: Tinnitus Diagnosis Performance
Objective: The purpose of the present study was to investigate functional connectivity in tinnitus patients with and without hearing loss, and design the tinnitus diagnosis performance by resting state functional magnetic resonance imaging (rs-fMRI). Subjects and Methods: Nineteen volunteers with normal hearing without tinnitus, 18 tinnitus patients with hearing loss, and 11 tinnitus patients without hearing loss were enrolled in this study. The subjects were evaluated with rs-fMRI, and region of interests (ROIs) based correlation analyses were performed using the CONN toolbox version 16 and SPM version 8. The correlation coefficients from individual level results were converted into beta values. Results: With a beta threshold of more than 0.2, 91% of all possible connections between auditory-related ROIs (Heschl's gyrus, planum temporale, planum polare, operculum, insular cortex, superior temporal gyrus) in the control group remained intact, whereas 83 and 66% of such connections were present in the hearing loss and the normal-hearing tinnitus group. However, between non-auditory-related ROIs, the rates of intact connections at a beta threshold of more than 0.2 were 17% in the control group, and 16 and 15% in the tinnitus groups. When resting state fMRI positive is defined as less than 9% of all possible connections between auditory-related ROIs with a beta threshold of more than 0.7, the sensitivity and specificity of tinnitus diagnosis is 86 and 74%, respectively. Conclusions: The associations between auditory-related networks are weakened in tinnitus patients, even if they have normal hearing. It is possible that rs-fMRI can be a tool for objective examination of tinnitus, by focusing the auditory-related areas. Address correspondence and reprint requests to Shujiro B. Minami, M.D., Ph.D., National Tokyo Medical Center, National Institute of Sensory Organs, 2-5-1 Higashigaoka, Meguro, Tokyo 152-8902, Japan; E-mail: shujirominami@me.com This work was supported by JSPS KAKENHI Grant Number 25462657, and research grants from Suzuken Memorial Foundation and Mitsubishi Tanabe Pharma Corporation. The authors disclose no conflicts of interest. The authors alone are responsible for the content and writing of the paper. Supplemental digital content is available in the text. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://ift.tt/2i6WMKr). Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company
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Health Burden and Socioeconomic Disparities From Hearing Loss: A Global Perspective
Objectives/Hypothesis: To characterize the disability-related health burden of hearing loss (HL) at a global level, with a focus on socioeconomic health disparities. Methods: The global burden of HL, as calculated by disability-adjusted life years (DALYs) per 100,000 individuals, was evaluated for 184 countries. Data from 5-year intervals encompassing 1990 to 2015 were organized by human development index (HDI) categorizations as specified by the U.N. Development Program (UNDP). Gini coefficients and concentration indices were used to evaluate global inequality in HL burden over this time period. Results: There was a global lack of improvement in hearing loss burden over 25 years. National HL burden, as measured by age-standardized DALYs, had an inverse relationship with successive level of development (p
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Survey of the American Neurotology Society on Cochlear Implantation: Part 2, Surgical and Device-Related Practice Patterns
Objective: To examine surgical and device-related cochlear implant practice patterns across centers in the United States. Methods: Cross-sectional survey of the American Neurotology Society (ANS). Results: A total of 81 surveys were returned from ANS members who report regular involvement in cochlear implant care. Overall there was a broad distribution in age and clinical experience, with most respondents reporting Accreditation Council for Graduate Medical Education (ACGME) accreditation in neurotology and employment at an academic center. The annual volume of cochlear implant surgeries varied considerably across centers. Eighty percent of respondents report to offer all three Food and Drug Administration (FDA) approved device brands at their center. In cases where hearing preservation is not a goal, 56% of respondents prefer a perimodiolar electrode design, while 44% prefer a lateral wall electrode. With regard to insertion technique for scala tympani access, 64% prefer inserting through the round window (RW) membrane, 26% prefer an extended round window (ERW) approach, while only 10% prefer a cochleostomy. In cases where hearing preservation is a goal of surgery, 86% of respondents prefer a lateral wall electrode design, while only 14% prefer a perimodiolar electrode design. With regard to insertion technique, 86% prefer RW insertion, while only 9% prefer an ERW approach, and only 5% prefer a cochleostomy. Respondents who prefer RW electrode insertion more commonly use a lateral wall electrode, whereas those who prefer an ERW or cochleostomy approach more commonly use a periomodiolar electrode (p
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Temporal Fine Structure Processing, Pitch, and Speech Perception in Adult Cochlear Implant Recipients
Objectives: The aim of the study was to investigate the link between temporal fine structure (TFS) processing, pitch, and speech perception performance in adult cochlear implant (CI) recipients, including bimodal listeners who may benefit better low-frequency (LF) temporal coding in the contralateral ear. Design: The study participants were 43 adult CI recipients (23 unilateral, 6 bilateral, and 14 bimodal listeners). Two new LF pitch perception tests—harmonic intonation (HI) and disharmonic intonation (DI)—were used to evaluate TFS sensitivity. HI and DI were designed to estimate a difference limen for discrimination of tone changes based on harmonic or inharmonic pitch glides. Speech perception was assessed using the newly developed Italian Sentence Test with Adaptive Randomized Roving level (STARR) test where sentences relevant to everyday contexts were presented at low, medium, and high levels in a fluctuating background noise to estimate a speech reception threshold (SRT). Results: Although TFS and STARR performances in the majority of CI recipients were much poorer than those of hearing people reported in the literature, a considerable intersubject variability was observed. For CI listeners, median just noticeable differences were 27.0 and 147.0 Hz for HI and DI, respectively. HI outcomes were significantly better than those for DI. Median STARR score was 14.8 dB. Better performers with speech reception thresholds less than 20 dB had a median score of 8.6 dB. A significant effect of age was observed for both HI/DI tests, suggesting that TFS sensitivity tended to worsen with increasing age. CI pure-tone thresholds and duration of profound deafness were significantly correlated with STARR performance. Bimodal users showed significantly better TFS and STARR performance for bimodal listening than for their CI-only condition. Median bimodal gains were 33.0 Hz for the HI test and 95.0 Hz for the DI test. DI outcomes in bimodal users revealed a significant correlation with unaided hearing thresholds for octave frequencies lower than 1000 Hz. Median STARR scores were 17.3 versus 8.1 dB for CI only and bimodal listening, respectively. STARR performance was significantly correlated with HI findings for CI listeners and with those of DI for bimodal listeners. Conclusions: LF pitch perception was found to be abnormal in the majority of adult CI recipients, confirming poor TFS processing of CIs. Similarly, the STARR findings reflected a common performance deterioration with the HI/DI tests, suggesting the cause probably being a lack of access to TFS information. Contralateral hearing aid users obtained a remarkable bimodal benefit for all tests. Such results highlighted the importance of TFS cues for challenging speech perception and the relevance to everyday listening conditions. HI/DI and STARR tests show promise for gaining insights into how TFS and speech perception are being limited and may guide the customization of CI program parameters and support the fine tuning of bimodal listening. ACKNOWLEDGMENTS: We thank all participants who took part in this study. The authors declare that they have no conflicts of interest. Address for correspondence: Hilal Dincer D’Alessandro, Sapienza University of Rome, Department of Sense Organs, Viale dell’Università 31, 00161 Rome, Italy. E-mail: hilal.dincer@uniroma1.it or dincer.hilal@gmail.com Received January 9, 2017; accepted October 5, 2017. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Temporal Fine Structure Processing, Pitch, and Speech Perception in Adult Cochlear Implant Recipients
Objectives: The aim of the study was to investigate the link between temporal fine structure (TFS) processing, pitch, and speech perception performance in adult cochlear implant (CI) recipients, including bimodal listeners who may benefit better low-frequency (LF) temporal coding in the contralateral ear. Design: The study participants were 43 adult CI recipients (23 unilateral, 6 bilateral, and 14 bimodal listeners). Two new LF pitch perception tests—harmonic intonation (HI) and disharmonic intonation (DI)—were used to evaluate TFS sensitivity. HI and DI were designed to estimate a difference limen for discrimination of tone changes based on harmonic or inharmonic pitch glides. Speech perception was assessed using the newly developed Italian Sentence Test with Adaptive Randomized Roving level (STARR) test where sentences relevant to everyday contexts were presented at low, medium, and high levels in a fluctuating background noise to estimate a speech reception threshold (SRT). Results: Although TFS and STARR performances in the majority of CI recipients were much poorer than those of hearing people reported in the literature, a considerable intersubject variability was observed. For CI listeners, median just noticeable differences were 27.0 and 147.0 Hz for HI and DI, respectively. HI outcomes were significantly better than those for DI. Median STARR score was 14.8 dB. Better performers with speech reception thresholds less than 20 dB had a median score of 8.6 dB. A significant effect of age was observed for both HI/DI tests, suggesting that TFS sensitivity tended to worsen with increasing age. CI pure-tone thresholds and duration of profound deafness were significantly correlated with STARR performance. Bimodal users showed significantly better TFS and STARR performance for bimodal listening than for their CI-only condition. Median bimodal gains were 33.0 Hz for the HI test and 95.0 Hz for the DI test. DI outcomes in bimodal users revealed a significant correlation with unaided hearing thresholds for octave frequencies lower than 1000 Hz. Median STARR scores were 17.3 versus 8.1 dB for CI only and bimodal listening, respectively. STARR performance was significantly correlated with HI findings for CI listeners and with those of DI for bimodal listeners. Conclusions: LF pitch perception was found to be abnormal in the majority of adult CI recipients, confirming poor TFS processing of CIs. Similarly, the STARR findings reflected a common performance deterioration with the HI/DI tests, suggesting the cause probably being a lack of access to TFS information. Contralateral hearing aid users obtained a remarkable bimodal benefit for all tests. Such results highlighted the importance of TFS cues for challenging speech perception and the relevance to everyday listening conditions. HI/DI and STARR tests show promise for gaining insights into how TFS and speech perception are being limited and may guide the customization of CI program parameters and support the fine tuning of bimodal listening. ACKNOWLEDGMENTS: We thank all participants who took part in this study. The authors declare that they have no conflicts of interest. Address for correspondence: Hilal Dincer D’Alessandro, Sapienza University of Rome, Department of Sense Organs, Viale dell’Università 31, 00161 Rome, Italy. E-mail: hilal.dincer@uniroma1.it or dincer.hilal@gmail.com Received January 9, 2017; accepted October 5, 2017. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
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The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.
The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.
Int J Audiol. 2017 Nov 30;:1-14
Authors: Arts RAGJ, George ELJ, Janssen MAML, Griessner A, Zierhofer C, Stokroos RJ
Abstract
OBJECTIVES: Previous studies show that intracochlear electrical stimulation independent of environmental sounds appears to suppress tinnitus, even long-term. In order to assess the viability of this potential treatment option it is essential to study the effects of this tinnitus specific electrical stimulation on speech perception.
DESIGN: A randomised, prospective crossover design.
STUDY SAMPLE: Ten patients with unilateral or asymmetric hearing loss and severe tinnitus complaints.
RESULTS: The audiological effects of standard clinical CI, formal auditory training and tinnitus specific electrical stimulation were investigated. Results show that standard clinical CI in unilateral or asymmetric hearing loss is shown to be beneficial for speech perception in quiet, speech perception in noise and subjective hearing ability. Formal auditory training does not appear to improve speech perception performance. However, CI-related discomfort reduces significantly more rapidly during CI rehabilitation in subjects receiving formal auditory training. Furthermore, tinnitus specific electrical stimulation has neither positive nor negative effects on speech perception.
CONCLUSIONS: In combination with the findings from previous studies on tinnitus suppression using intracochlear electrical stimulation independent of environmental sounds, the results of this study contribute to the viability of cochlear implantation based on tinnitus complaints.
PMID: 29188740 [PubMed - as supplied by publisher]
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Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus.
Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus.
Int J Audiol. 2017 Nov 30;:1-11
Authors: Sahlsten H, Taiminen T, Karukivi M, Sjösten N, Nikkilä J, Virtanen J, Paavola J, Joutsa J, Niinivirta-Joutsa K, Takala M, Holm A, Rauhala E, Löyttyniemi E, Johansson R, Jääskeläinen SK
Abstract
OBJECTIVE: Chronic tinnitus has been associated with several psychiatric disorders. Only few studies have investigated these disorders using validated diagnostic interviews. The aims were to diagnose psychiatric and personality disorders with structured interviews, to assess self-rated psychiatric symptoms and elucidate temporal relations between psychiatric disorders and tinnitus.
DESIGN: Current and lifetime DSM-IV diagnoses of axis-I (psychiatric disorders) and axis-II (personality disorders) were assessed using structured clinical interviews (SCID-I and -II). Current subjective psychiatric symptoms were evaluated via self-rating instruments: the Symptom Check List-90 (SCL-90), the Beck Depression Inventory, and the Dissociative Experiences Scale (DES).
STUDY SAMPLE: 83 patients (mean age 51.7, 59% men) with chronic, disturbing tinnitus and a median Tinnitus Handicap Inventory score of 32.
RESULTS: The rates of lifetime and current major depression were 26.5% and 2.4%. The lifetime rate of obsessive-compulsive personality disorder (type C) was 8.4%. None of the patients had cluster B personality disorder or psychotic symptoms. The SCL-90 subscales did not differ from the general population, and median DES score was low, 2.4.
CONCLUSIONS: Tinnitus patients are prone to episodes of major depression and often also have obsessive-compulsive personality features. Psychiatric disorders seem to be comorbid or predisposing conditions rather than consequences of tinnitus. Clinical trial reference: ClinicalTrials.gov (ID NCT 01929837).
PMID: 29188734 [PubMed - as supplied by publisher]
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Audiology answers for otolaryngologists.
Audiology answers for otolaryngologists.
Int J Audiol. 2017 Nov 29;:1
Authors: Hudson M
PMID: 29187010 [PubMed - as supplied by publisher]
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Double tinnitus in a single ear.
Double tinnitus in a single ear.
Int J Audiol. 2017 Nov 29;:1-4
Authors: Zagólski O, Stręk P
Abstract
OBJECTIVE: To search for distinctive clinical features of patients with double tinnitus in a single ear. Design retrospective: Study sample: Six hundred and fourteen tinnitus patients were interviewed using a detailed questionnaire. They underwent thorough audiological evaluation. Records of seven patients reporting double tinnitus in 10 ears were identified and analysed. There were three women and four men in the group (mean age 40, range 29-49 years).
RESULTS: All but two individuals declared sudden onset of the complaints. Three patients had been diagnosed with sudden sensorineural hearing loss. In all the patients, the components of double tinnitus were compared both to a pure tone and to a narrow band noise. The sounds were considered by the patients to be primary (more prominent) or secondary. All but one patient declared hypersensitivity to loud sounds. Vertigo was present in only two of the double tinnitus sufferers. Abnormal DPOAEs frequency values and audiogram notch frequencies were closer to the primary than the secondary tinnitus matches.
CONCLUSIONS: In our study, double tinnitus was rare, mostly perceived by patients with a sudden onset of tinnitus. This is the first report presenting audiological findings in patients with double tinnitus in a single ear. Prospective search of cohorts of tinnitus sufferers for such patients and functional neuroimaging of their auditory pathways for determining underlying mechanisms of the complaints is advocated.
PMID: 29187006 [PubMed - as supplied by publisher]
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Speech perception of Chinese-speaking cochlear implantees.
Speech perception of Chinese-speaking cochlear implantees.
Int J Audiol. 2017;56(sup2):S1-S2
Authors: Cheng F, Wong L
PMID: 29185386 [PubMed - in process]
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Int J Audiol. 2017;56(sup2):S3-S6 Authors: Chen Y, Wong LLN Abstract...
Int J Audiol. 2017;56(sup2):S3-S6
Authors: Chen Y, Wong LLN
Abstract
:。:。: PubMed, Scopus, Wiley 。:14, 。, , , , 。, , , 。, , 。:, 。.
PMID: 29185385 [PubMed - in process]
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The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.
The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.
Int J Audiol. 2017 Nov 30;:1-14
Authors: Arts RAGJ, George ELJ, Janssen MAML, Griessner A, Zierhofer C, Stokroos RJ
Abstract
OBJECTIVES: Previous studies show that intracochlear electrical stimulation independent of environmental sounds appears to suppress tinnitus, even long-term. In order to assess the viability of this potential treatment option it is essential to study the effects of this tinnitus specific electrical stimulation on speech perception.
DESIGN: A randomised, prospective crossover design.
STUDY SAMPLE: Ten patients with unilateral or asymmetric hearing loss and severe tinnitus complaints.
RESULTS: The audiological effects of standard clinical CI, formal auditory training and tinnitus specific electrical stimulation were investigated. Results show that standard clinical CI in unilateral or asymmetric hearing loss is shown to be beneficial for speech perception in quiet, speech perception in noise and subjective hearing ability. Formal auditory training does not appear to improve speech perception performance. However, CI-related discomfort reduces significantly more rapidly during CI rehabilitation in subjects receiving formal auditory training. Furthermore, tinnitus specific electrical stimulation has neither positive nor negative effects on speech perception.
CONCLUSIONS: In combination with the findings from previous studies on tinnitus suppression using intracochlear electrical stimulation independent of environmental sounds, the results of this study contribute to the viability of cochlear implantation based on tinnitus complaints.
PMID: 29188740 [PubMed - as supplied by publisher]
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Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus.
Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus.
Int J Audiol. 2017 Nov 30;:1-11
Authors: Sahlsten H, Taiminen T, Karukivi M, Sjösten N, Nikkilä J, Virtanen J, Paavola J, Joutsa J, Niinivirta-Joutsa K, Takala M, Holm A, Rauhala E, Löyttyniemi E, Johansson R, Jääskeläinen SK
Abstract
OBJECTIVE: Chronic tinnitus has been associated with several psychiatric disorders. Only few studies have investigated these disorders using validated diagnostic interviews. The aims were to diagnose psychiatric and personality disorders with structured interviews, to assess self-rated psychiatric symptoms and elucidate temporal relations between psychiatric disorders and tinnitus.
DESIGN: Current and lifetime DSM-IV diagnoses of axis-I (psychiatric disorders) and axis-II (personality disorders) were assessed using structured clinical interviews (SCID-I and -II). Current subjective psychiatric symptoms were evaluated via self-rating instruments: the Symptom Check List-90 (SCL-90), the Beck Depression Inventory, and the Dissociative Experiences Scale (DES).
STUDY SAMPLE: 83 patients (mean age 51.7, 59% men) with chronic, disturbing tinnitus and a median Tinnitus Handicap Inventory score of 32.
RESULTS: The rates of lifetime and current major depression were 26.5% and 2.4%. The lifetime rate of obsessive-compulsive personality disorder (type C) was 8.4%. None of the patients had cluster B personality disorder or psychotic symptoms. The SCL-90 subscales did not differ from the general population, and median DES score was low, 2.4.
CONCLUSIONS: Tinnitus patients are prone to episodes of major depression and often also have obsessive-compulsive personality features. Psychiatric disorders seem to be comorbid or predisposing conditions rather than consequences of tinnitus. Clinical trial reference: ClinicalTrials.gov (ID NCT 01929837).
PMID: 29188734 [PubMed - as supplied by publisher]
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Audiology answers for otolaryngologists.
Audiology answers for otolaryngologists.
Int J Audiol. 2017 Nov 29;:1
Authors: Hudson M
PMID: 29187010 [PubMed - as supplied by publisher]
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Double tinnitus in a single ear.
Double tinnitus in a single ear.
Int J Audiol. 2017 Nov 29;:1-4
Authors: Zagólski O, Stręk P
Abstract
OBJECTIVE: To search for distinctive clinical features of patients with double tinnitus in a single ear. Design retrospective: Study sample: Six hundred and fourteen tinnitus patients were interviewed using a detailed questionnaire. They underwent thorough audiological evaluation. Records of seven patients reporting double tinnitus in 10 ears were identified and analysed. There were three women and four men in the group (mean age 40, range 29-49 years).
RESULTS: All but two individuals declared sudden onset of the complaints. Three patients had been diagnosed with sudden sensorineural hearing loss. In all the patients, the components of double tinnitus were compared both to a pure tone and to a narrow band noise. The sounds were considered by the patients to be primary (more prominent) or secondary. All but one patient declared hypersensitivity to loud sounds. Vertigo was present in only two of the double tinnitus sufferers. Abnormal DPOAEs frequency values and audiogram notch frequencies were closer to the primary than the secondary tinnitus matches.
CONCLUSIONS: In our study, double tinnitus was rare, mostly perceived by patients with a sudden onset of tinnitus. This is the first report presenting audiological findings in patients with double tinnitus in a single ear. Prospective search of cohorts of tinnitus sufferers for such patients and functional neuroimaging of their auditory pathways for determining underlying mechanisms of the complaints is advocated.
PMID: 29187006 [PubMed - as supplied by publisher]
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Speech perception of Chinese-speaking cochlear implantees.
Speech perception of Chinese-speaking cochlear implantees.
Int J Audiol. 2017;56(sup2):S1-S2
Authors: Cheng F, Wong L
PMID: 29185386 [PubMed - in process]
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Int J Audiol. 2017;56(sup2):S3-S6 Authors: Chen Y, Wong LLN Abstract...
Int J Audiol. 2017;56(sup2):S3-S6
Authors: Chen Y, Wong LLN
Abstract
:。:。: PubMed, Scopus, Wiley 。:14, 。, , , , 。, , , 。, , 。:, 。.
PMID: 29185385 [PubMed - in process]
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The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.
The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.
Int J Audiol. 2017 Nov 30;:1-14
Authors: Arts RAGJ, George ELJ, Janssen MAML, Griessner A, Zierhofer C, Stokroos RJ
Abstract
OBJECTIVES: Previous studies show that intracochlear electrical stimulation independent of environmental sounds appears to suppress tinnitus, even long-term. In order to assess the viability of this potential treatment option it is essential to study the effects of this tinnitus specific electrical stimulation on speech perception.
DESIGN: A randomised, prospective crossover design.
STUDY SAMPLE: Ten patients with unilateral or asymmetric hearing loss and severe tinnitus complaints.
RESULTS: The audiological effects of standard clinical CI, formal auditory training and tinnitus specific electrical stimulation were investigated. Results show that standard clinical CI in unilateral or asymmetric hearing loss is shown to be beneficial for speech perception in quiet, speech perception in noise and subjective hearing ability. Formal auditory training does not appear to improve speech perception performance. However, CI-related discomfort reduces significantly more rapidly during CI rehabilitation in subjects receiving formal auditory training. Furthermore, tinnitus specific electrical stimulation has neither positive nor negative effects on speech perception.
CONCLUSIONS: In combination with the findings from previous studies on tinnitus suppression using intracochlear electrical stimulation independent of environmental sounds, the results of this study contribute to the viability of cochlear implantation based on tinnitus complaints.
PMID: 29188740 [PubMed - as supplied by publisher]
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Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus.
Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus.
Int J Audiol. 2017 Nov 30;:1-11
Authors: Sahlsten H, Taiminen T, Karukivi M, Sjösten N, Nikkilä J, Virtanen J, Paavola J, Joutsa J, Niinivirta-Joutsa K, Takala M, Holm A, Rauhala E, Löyttyniemi E, Johansson R, Jääskeläinen SK
Abstract
OBJECTIVE: Chronic tinnitus has been associated with several psychiatric disorders. Only few studies have investigated these disorders using validated diagnostic interviews. The aims were to diagnose psychiatric and personality disorders with structured interviews, to assess self-rated psychiatric symptoms and elucidate temporal relations between psychiatric disorders and tinnitus.
DESIGN: Current and lifetime DSM-IV diagnoses of axis-I (psychiatric disorders) and axis-II (personality disorders) were assessed using structured clinical interviews (SCID-I and -II). Current subjective psychiatric symptoms were evaluated via self-rating instruments: the Symptom Check List-90 (SCL-90), the Beck Depression Inventory, and the Dissociative Experiences Scale (DES).
STUDY SAMPLE: 83 patients (mean age 51.7, 59% men) with chronic, disturbing tinnitus and a median Tinnitus Handicap Inventory score of 32.
RESULTS: The rates of lifetime and current major depression were 26.5% and 2.4%. The lifetime rate of obsessive-compulsive personality disorder (type C) was 8.4%. None of the patients had cluster B personality disorder or psychotic symptoms. The SCL-90 subscales did not differ from the general population, and median DES score was low, 2.4.
CONCLUSIONS: Tinnitus patients are prone to episodes of major depression and often also have obsessive-compulsive personality features. Psychiatric disorders seem to be comorbid or predisposing conditions rather than consequences of tinnitus. Clinical trial reference: ClinicalTrials.gov (ID NCT 01929837).
PMID: 29188734 [PubMed - as supplied by publisher]
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Audiology answers for otolaryngologists.
Audiology answers for otolaryngologists.
Int J Audiol. 2017 Nov 29;:1
Authors: Hudson M
PMID: 29187010 [PubMed - as supplied by publisher]
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via IFTTT
Double tinnitus in a single ear.
Double tinnitus in a single ear.
Int J Audiol. 2017 Nov 29;:1-4
Authors: Zagólski O, Stręk P
Abstract
OBJECTIVE: To search for distinctive clinical features of patients with double tinnitus in a single ear. Design retrospective: Study sample: Six hundred and fourteen tinnitus patients were interviewed using a detailed questionnaire. They underwent thorough audiological evaluation. Records of seven patients reporting double tinnitus in 10 ears were identified and analysed. There were three women and four men in the group (mean age 40, range 29-49 years).
RESULTS: All but two individuals declared sudden onset of the complaints. Three patients had been diagnosed with sudden sensorineural hearing loss. In all the patients, the components of double tinnitus were compared both to a pure tone and to a narrow band noise. The sounds were considered by the patients to be primary (more prominent) or secondary. All but one patient declared hypersensitivity to loud sounds. Vertigo was present in only two of the double tinnitus sufferers. Abnormal DPOAEs frequency values and audiogram notch frequencies were closer to the primary than the secondary tinnitus matches.
CONCLUSIONS: In our study, double tinnitus was rare, mostly perceived by patients with a sudden onset of tinnitus. This is the first report presenting audiological findings in patients with double tinnitus in a single ear. Prospective search of cohorts of tinnitus sufferers for such patients and functional neuroimaging of their auditory pathways for determining underlying mechanisms of the complaints is advocated.
PMID: 29187006 [PubMed - as supplied by publisher]
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via IFTTT
Speech perception of Chinese-speaking cochlear implantees.
Speech perception of Chinese-speaking cochlear implantees.
Int J Audiol. 2017;56(sup2):S1-S2
Authors: Cheng F, Wong L
PMID: 29185386 [PubMed - in process]
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via IFTTT
Int J Audiol. 2017;56(sup2):S3-S6 Authors: Chen Y, Wong LLN Abstract...
Int J Audiol. 2017;56(sup2):S3-S6
Authors: Chen Y, Wong LLN
Abstract
:。:。: PubMed, Scopus, Wiley 。:14, 。, , , , 。, , , 。, , 。:, 。.
PMID: 29185385 [PubMed - in process]
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via IFTTT
The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.
The effect of tinnitus specific intracochlear stimulation on speech perception in patients with unilateral or asymmetric hearing loss accompanied with tinnitus and the effect of formal auditory training.
Int J Audiol. 2017 Nov 30;:1-14
Authors: Arts RAGJ, George ELJ, Janssen MAML, Griessner A, Zierhofer C, Stokroos RJ
Abstract
OBJECTIVES: Previous studies show that intracochlear electrical stimulation independent of environmental sounds appears to suppress tinnitus, even long-term. In order to assess the viability of this potential treatment option it is essential to study the effects of this tinnitus specific electrical stimulation on speech perception.
DESIGN: A randomised, prospective crossover design.
STUDY SAMPLE: Ten patients with unilateral or asymmetric hearing loss and severe tinnitus complaints.
RESULTS: The audiological effects of standard clinical CI, formal auditory training and tinnitus specific electrical stimulation were investigated. Results show that standard clinical CI in unilateral or asymmetric hearing loss is shown to be beneficial for speech perception in quiet, speech perception in noise and subjective hearing ability. Formal auditory training does not appear to improve speech perception performance. However, CI-related discomfort reduces significantly more rapidly during CI rehabilitation in subjects receiving formal auditory training. Furthermore, tinnitus specific electrical stimulation has neither positive nor negative effects on speech perception.
CONCLUSIONS: In combination with the findings from previous studies on tinnitus suppression using intracochlear electrical stimulation independent of environmental sounds, the results of this study contribute to the viability of cochlear implantation based on tinnitus complaints.
PMID: 29188740 [PubMed - as supplied by publisher]
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via IFTTT
Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus.
Psychiatric (Axis I) and personality (Axis II) disorders and subjective psychiatric symptoms in chronic tinnitus.
Int J Audiol. 2017 Nov 30;:1-11
Authors: Sahlsten H, Taiminen T, Karukivi M, Sjösten N, Nikkilä J, Virtanen J, Paavola J, Joutsa J, Niinivirta-Joutsa K, Takala M, Holm A, Rauhala E, Löyttyniemi E, Johansson R, Jääskeläinen SK
Abstract
OBJECTIVE: Chronic tinnitus has been associated with several psychiatric disorders. Only few studies have investigated these disorders using validated diagnostic interviews. The aims were to diagnose psychiatric and personality disorders with structured interviews, to assess self-rated psychiatric symptoms and elucidate temporal relations between psychiatric disorders and tinnitus.
DESIGN: Current and lifetime DSM-IV diagnoses of axis-I (psychiatric disorders) and axis-II (personality disorders) were assessed using structured clinical interviews (SCID-I and -II). Current subjective psychiatric symptoms were evaluated via self-rating instruments: the Symptom Check List-90 (SCL-90), the Beck Depression Inventory, and the Dissociative Experiences Scale (DES).
STUDY SAMPLE: 83 patients (mean age 51.7, 59% men) with chronic, disturbing tinnitus and a median Tinnitus Handicap Inventory score of 32.
RESULTS: The rates of lifetime and current major depression were 26.5% and 2.4%. The lifetime rate of obsessive-compulsive personality disorder (type C) was 8.4%. None of the patients had cluster B personality disorder or psychotic symptoms. The SCL-90 subscales did not differ from the general population, and median DES score was low, 2.4.
CONCLUSIONS: Tinnitus patients are prone to episodes of major depression and often also have obsessive-compulsive personality features. Psychiatric disorders seem to be comorbid or predisposing conditions rather than consequences of tinnitus. Clinical trial reference: ClinicalTrials.gov (ID NCT 01929837).
PMID: 29188734 [PubMed - as supplied by publisher]
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Audiology answers for otolaryngologists.
Audiology answers for otolaryngologists.
Int J Audiol. 2017 Nov 29;:1
Authors: Hudson M
PMID: 29187010 [PubMed - as supplied by publisher]
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Double tinnitus in a single ear.
Double tinnitus in a single ear.
Int J Audiol. 2017 Nov 29;:1-4
Authors: Zagólski O, Stręk P
Abstract
OBJECTIVE: To search for distinctive clinical features of patients with double tinnitus in a single ear. Design retrospective: Study sample: Six hundred and fourteen tinnitus patients were interviewed using a detailed questionnaire. They underwent thorough audiological evaluation. Records of seven patients reporting double tinnitus in 10 ears were identified and analysed. There were three women and four men in the group (mean age 40, range 29-49 years).
RESULTS: All but two individuals declared sudden onset of the complaints. Three patients had been diagnosed with sudden sensorineural hearing loss. In all the patients, the components of double tinnitus were compared both to a pure tone and to a narrow band noise. The sounds were considered by the patients to be primary (more prominent) or secondary. All but one patient declared hypersensitivity to loud sounds. Vertigo was present in only two of the double tinnitus sufferers. Abnormal DPOAEs frequency values and audiogram notch frequencies were closer to the primary than the secondary tinnitus matches.
CONCLUSIONS: In our study, double tinnitus was rare, mostly perceived by patients with a sudden onset of tinnitus. This is the first report presenting audiological findings in patients with double tinnitus in a single ear. Prospective search of cohorts of tinnitus sufferers for such patients and functional neuroimaging of their auditory pathways for determining underlying mechanisms of the complaints is advocated.
PMID: 29187006 [PubMed - as supplied by publisher]
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Speech perception of Chinese-speaking cochlear implantees.
Speech perception of Chinese-speaking cochlear implantees.
Int J Audiol. 2017;56(sup2):S1-S2
Authors: Cheng F, Wong L
PMID: 29185386 [PubMed - in process]
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Int J Audiol. 2017;56(sup2):S3-S6 Authors: Chen Y, Wong LLN Abstract...
Int J Audiol. 2017;56(sup2):S3-S6
Authors: Chen Y, Wong LLN
Abstract
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PMID: 29185385 [PubMed - in process]
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Intra- and interpersonal effects of coping on the psychological well-being of adults with sensory loss and their spouses.
Intra- and interpersonal effects of coping on the psychological well-being of adults with sensory loss and their spouses.
Disabil Rehabil. 2017 Nov 30;:1-12
Authors: Lehane CM, Dammeyer J, Wittich W
Abstract
PURPOSE: The aim of the current study was to examine the associations between coping and psychological well-being among adults with sensory loss and their spouses.
METHODS: A total of 183 adults with sensory loss and 133 spouses participated in an online survey and were followed up six months later. Coping and well-being were measured using the Brief Coping Orientation to Problems Experienced Scale (Brief COPE) and the five-item World Health Organization Well-Being Index (WHO-5), respectively. Cross-sectional and longitudinal intra- and interpersonal effects of coping on psychological well-being were analyzed using a structural equation modeling approach.
RESULTS: Results showed that a significant portion of adults with sensory loss (32.4%) and spouses (23.8%) had poor well-being, and this remained stable over the six-month period. Coping styles associated with the well-being of adults with sensory loss included active coping, avoidance, distraction, venting and spouse support seeking. Coping styles associated with the well-being of spouses included support seeking, distraction, venting, avoidance (by partner) and humor (by partner).
CONCLUSION: The results highlight the need to support the well-being of adults with sensory loss and their spouses in rehabilitation, and the importance of both intra- and interpersonal coping in the adjustment process. Implications for rehabilitation Rehabilitation specialists and social workers working with adults with sensory loss should, where possible, incorporate family members into support plans. Rehabilitation specialists and social workers working in sensory rehabilitation should be mindful of how the coping styles of one partner can impact the well-being of their significant other. In addition to promoting positive coping behaviors, such as planning and support seeking, rehabilitation specialists and social workers should also take care to identify and reduce maladaptive coping behaviors such as avoidance and distraction. Online and print information for spouses on how to cope with a partner's sensory loss should be available and accessible for couples attending sensory rehabilitation clinics.
PMID: 29189088 [PubMed - as supplied by publisher]
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[A case of hereditary sensory and autonomic neuropathy type 1E with frontal lobe dysfunction as an initial symptom].
[A case of hereditary sensory and autonomic neuropathy type 1E with frontal lobe dysfunction as an initial symptom].
Rinsho Shinkeigaku. 2017 Nov 28;:
Authors: Watanabe M, Matsumoto Y, Okamoto K, Okuda B, Mizuta I, Mizuno T
Abstract
A 49-year-old man had developed gradually personality change, gait disturbance, and hearing loss for five years. On admission, he presented with frontal release signs, stuttering, vertical gaze palsy, sensorineural deafness, muscle rigidity, ataxia, and sensory disturbance with areflexia in the lower extremities. Brain MRI demonstrated atrophy in the cerebellum and midbrain tegmentum as well as cerebral atrophy, predominantly in the frontal lobe. He was tentatively diagnosed as progressive supranuclear palsy on the basis of clinical features and imagings. On nerve conduction study, no sensory nerve action potentials were elicited in the upper and lower extremities. Details of family history revealed a hereditary sensory neuropathy with autosomal dominant inheritance in his relatives. Because genetic analysis showed a rare missense mutation (c.1483T>C, p.Y495H) in DNA methyltransferase 1 gene, we diagnosed him as having hereditary sensory and autonomic neuropathy type 1E (HSAN1E). In addition, p.M232R mutation in prion protein gene was detected. It should be kept in mind that there are some patients with HSAN1E presenting with frontal lobe dysfunction as an initial symptom and with clinical features mimicking progressive supranuclear palsy.
PMID: 29187684 [PubMed - as supplied by publisher]
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Simplified Summative Temporal Bone Dissection Scale Demonstrates Equivalence to Existing Measures.
Simplified Summative Temporal Bone Dissection Scale Demonstrates Equivalence to Existing Measures.
Ann Otol Rhinol Laryngol. 2017 Nov 01;:3489417745090
Authors: Pisa J, Gousseau M, Mowat S, Westerberg B, Unger B, Hochman JB
Abstract
INTRODUCTION: Emphasis on patient safety has created the need for quality assessment of fundamental surgical skills. Existing temporal bone rating scales are laborious, subject to evaluator fatigue, and contain inconsistencies when conferring points. To address these deficiencies, a novel binary assessment tool was designed and validated against a well-established rating scale.
METHODS: Residents completed a mastoidectomy with posterior tympanotomy on identical 3D-printed temporal bone models. Four neurotologists evaluated each specimen using a validated scale (Welling) and a newly developed "CanadaWest" scale, with scoring repeated after a 4-week interval.
RESULTS: Nineteen participants were clustered into junior, intermediate, and senior cohorts. An ANOVA found significant differences between performance of the junior-intermediate and junior-senior cohorts for both Welling and CanadaWest scales ( P < .05). Neither scale found a significant difference between intermediate-senior resident performance ( P > .05). Cohen's kappa found strong intrarater reliability (0.711) with a high degree of interrater reliability of (0.858) for the CanadaWest scale, similar to scores on the Welling scale of (0.713) and (0.917), respectively.
CONCLUSION: The CanadaWest scale was facile and delineated performance by experience level with strong intrarater reliability. Comparable to the validated Welling Scale, it distinguished junior from senior trainees but was challenged in differentiating intermediate and senior trainee performance.
PMID: 29185358 [PubMed - as supplied by publisher]
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Simplified Summative Temporal Bone Dissection Scale Demonstrates Equivalence to Existing Measures.
Simplified Summative Temporal Bone Dissection Scale Demonstrates Equivalence to Existing Measures.
Ann Otol Rhinol Laryngol. 2017 Nov 01;:3489417745090
Authors: Pisa J, Gousseau M, Mowat S, Westerberg B, Unger B, Hochman JB
Abstract
INTRODUCTION: Emphasis on patient safety has created the need for quality assessment of fundamental surgical skills. Existing temporal bone rating scales are laborious, subject to evaluator fatigue, and contain inconsistencies when conferring points. To address these deficiencies, a novel binary assessment tool was designed and validated against a well-established rating scale.
METHODS: Residents completed a mastoidectomy with posterior tympanotomy on identical 3D-printed temporal bone models. Four neurotologists evaluated each specimen using a validated scale (Welling) and a newly developed "CanadaWest" scale, with scoring repeated after a 4-week interval.
RESULTS: Nineteen participants were clustered into junior, intermediate, and senior cohorts. An ANOVA found significant differences between performance of the junior-intermediate and junior-senior cohorts for both Welling and CanadaWest scales ( P < .05). Neither scale found a significant difference between intermediate-senior resident performance ( P > .05). Cohen's kappa found strong intrarater reliability (0.711) with a high degree of interrater reliability of (0.858) for the CanadaWest scale, similar to scores on the Welling scale of (0.713) and (0.917), respectively.
CONCLUSION: The CanadaWest scale was facile and delineated performance by experience level with strong intrarater reliability. Comparable to the validated Welling Scale, it distinguished junior from senior trainees but was challenged in differentiating intermediate and senior trainee performance.
PMID: 29185358 [PubMed - as supplied by publisher]
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