Objective: An amplitude growth function (AGF) shows the amplitude of an electrically evoked compound action potential (eCAP) as a function of the stimulation current. AGFs can be used to derive the eCAP threshold, which represents the minimum amount of current needed to elicit a measurable eCAP. eCAP thresholds have been widely used clinically to, for example, assist with sound processor programming. However, no eCAP precision has been included to date. The aim of this study was to investigate the precision of eCAP thresholds and determine whether they are precise enough for clinical use. Design: The study is retrospective, and the data comprised 826 AGFs, intraoperatively measured in 111 patients implanted with a HiRes90K cochlear implant (Advanced Bionics). For each AGF, the eCAP threshold was determined using two commonly used methods: linear extrapolation (LE) toward the x axis and detection of the last visible (LV) eCAP. Subsequently, the threshold confidence interval (TCI) of each eCAP threshold was calculated to serve as a metric for precision, whereby a larger TCI means a lower precision or reliability. Additionally, the eCAP thresholds results were compared with most recent behavioral fitting thresholds (T profile) to put the eCAP threshold analysis in clinical context. Thereby, the association between eCAP and behavioral thresholds was calculated, both for all subjects together (group analysis) and, in contrast to previous studies, within individual subjects. Results: Our data show that the TCIs were larger with the LE method than with the LV method. The eCAP thresholds estimated by the LE method were systematically smaller than those estimated by the LV method, while the LE thresholds with the smallest TCIs correlated best with the LV thresholds. Correlation analysis between eCAP and behavioral thresholds revealed correlation coefficients of r = 0.44 and r = 0.54 for the group analysis of LE and LV thresholds, respectively. Within individual subjects, however, the correlation coefficients varied from approximately −1 to +1 for both LE and LV thresholds. Further analysis showed that across subjects, the behavioral thresholds fell within the TCIs of the eCAP threshold profiles. Conclusion: This study shows that eCAP thresholds have an uncertainty that can be estimated using TCIs. The size of the TCI depends on several factors, for example, the threshold estimation method and measurement conditions, but it is often larger than one would expect when just looking at the threshold values. Given these large TCIs, future research on eCAP thresholds should be accompanied by a measure of precision to correctly apply eCAP thresholds in clinical practice. Comparing our eCAP threshold results with T profiles indicates that the eCAP thresholds are possibly not precise enough to predict T profiles. ACKNOWLEDGMENTS: This study was supported by the Dutch Technology Foundation STW and Advanced Bionics. The authors have no conflicts of interest to disclose. Address for correspondence: Johan H. M. Frijns, ENT Department, Leiden University Medical Centre, PO BOX 9600, 2300 RC Leiden, The Netherlands. E-mail: j.h.m.frijns@lumc.nl Received October 24, 2016; accepted October 7, 2017. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
from #Audiology via ola Kala on Inoreader http://ift.tt/2nKkQJ5
via IFTTT
Πέμπτη 7 Δεκεμβρίου 2017
The Precision of eCAP Thresholds Derived From Amplitude Growth Functions
Objective: An amplitude growth function (AGF) shows the amplitude of an electrically evoked compound action potential (eCAP) as a function of the stimulation current. AGFs can be used to derive the eCAP threshold, which represents the minimum amount of current needed to elicit a measurable eCAP. eCAP thresholds have been widely used clinically to, for example, assist with sound processor programming. However, no eCAP precision has been included to date. The aim of this study was to investigate the precision of eCAP thresholds and determine whether they are precise enough for clinical use. Design: The study is retrospective, and the data comprised 826 AGFs, intraoperatively measured in 111 patients implanted with a HiRes90K cochlear implant (Advanced Bionics). For each AGF, the eCAP threshold was determined using two commonly used methods: linear extrapolation (LE) toward the x axis and detection of the last visible (LV) eCAP. Subsequently, the threshold confidence interval (TCI) of each eCAP threshold was calculated to serve as a metric for precision, whereby a larger TCI means a lower precision or reliability. Additionally, the eCAP thresholds results were compared with most recent behavioral fitting thresholds (T profile) to put the eCAP threshold analysis in clinical context. Thereby, the association between eCAP and behavioral thresholds was calculated, both for all subjects together (group analysis) and, in contrast to previous studies, within individual subjects. Results: Our data show that the TCIs were larger with the LE method than with the LV method. The eCAP thresholds estimated by the LE method were systematically smaller than those estimated by the LV method, while the LE thresholds with the smallest TCIs correlated best with the LV thresholds. Correlation analysis between eCAP and behavioral thresholds revealed correlation coefficients of r = 0.44 and r = 0.54 for the group analysis of LE and LV thresholds, respectively. Within individual subjects, however, the correlation coefficients varied from approximately −1 to +1 for both LE and LV thresholds. Further analysis showed that across subjects, the behavioral thresholds fell within the TCIs of the eCAP threshold profiles. Conclusion: This study shows that eCAP thresholds have an uncertainty that can be estimated using TCIs. The size of the TCI depends on several factors, for example, the threshold estimation method and measurement conditions, but it is often larger than one would expect when just looking at the threshold values. Given these large TCIs, future research on eCAP thresholds should be accompanied by a measure of precision to correctly apply eCAP thresholds in clinical practice. Comparing our eCAP threshold results with T profiles indicates that the eCAP thresholds are possibly not precise enough to predict T profiles. ACKNOWLEDGMENTS: This study was supported by the Dutch Technology Foundation STW and Advanced Bionics. The authors have no conflicts of interest to disclose. Address for correspondence: Johan H. M. Frijns, ENT Department, Leiden University Medical Centre, PO BOX 9600, 2300 RC Leiden, The Netherlands. E-mail: j.h.m.frijns@lumc.nl Received October 24, 2016; accepted October 7, 2017. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
from #Audiology via ola Kala on Inoreader http://ift.tt/2nKkQJ5
via IFTTT
from #Audiology via ola Kala on Inoreader http://ift.tt/2nKkQJ5
via IFTTT
The Precision of eCAP Thresholds Derived From Amplitude Growth Functions
Objective: An amplitude growth function (AGF) shows the amplitude of an electrically evoked compound action potential (eCAP) as a function of the stimulation current. AGFs can be used to derive the eCAP threshold, which represents the minimum amount of current needed to elicit a measurable eCAP. eCAP thresholds have been widely used clinically to, for example, assist with sound processor programming. However, no eCAP precision has been included to date. The aim of this study was to investigate the precision of eCAP thresholds and determine whether they are precise enough for clinical use. Design: The study is retrospective, and the data comprised 826 AGFs, intraoperatively measured in 111 patients implanted with a HiRes90K cochlear implant (Advanced Bionics). For each AGF, the eCAP threshold was determined using two commonly used methods: linear extrapolation (LE) toward the x axis and detection of the last visible (LV) eCAP. Subsequently, the threshold confidence interval (TCI) of each eCAP threshold was calculated to serve as a metric for precision, whereby a larger TCI means a lower precision or reliability. Additionally, the eCAP thresholds results were compared with most recent behavioral fitting thresholds (T profile) to put the eCAP threshold analysis in clinical context. Thereby, the association between eCAP and behavioral thresholds was calculated, both for all subjects together (group analysis) and, in contrast to previous studies, within individual subjects. Results: Our data show that the TCIs were larger with the LE method than with the LV method. The eCAP thresholds estimated by the LE method were systematically smaller than those estimated by the LV method, while the LE thresholds with the smallest TCIs correlated best with the LV thresholds. Correlation analysis between eCAP and behavioral thresholds revealed correlation coefficients of r = 0.44 and r = 0.54 for the group analysis of LE and LV thresholds, respectively. Within individual subjects, however, the correlation coefficients varied from approximately −1 to +1 for both LE and LV thresholds. Further analysis showed that across subjects, the behavioral thresholds fell within the TCIs of the eCAP threshold profiles. Conclusion: This study shows that eCAP thresholds have an uncertainty that can be estimated using TCIs. The size of the TCI depends on several factors, for example, the threshold estimation method and measurement conditions, but it is often larger than one would expect when just looking at the threshold values. Given these large TCIs, future research on eCAP thresholds should be accompanied by a measure of precision to correctly apply eCAP thresholds in clinical practice. Comparing our eCAP threshold results with T profiles indicates that the eCAP thresholds are possibly not precise enough to predict T profiles. ACKNOWLEDGMENTS: This study was supported by the Dutch Technology Foundation STW and Advanced Bionics. The authors have no conflicts of interest to disclose. Address for correspondence: Johan H. M. Frijns, ENT Department, Leiden University Medical Centre, PO BOX 9600, 2300 RC Leiden, The Netherlands. E-mail: j.h.m.frijns@lumc.nl Received October 24, 2016; accepted October 7, 2017. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
from #Audiology via xlomafota13 on Inoreader http://ift.tt/2nKkQJ5
via IFTTT
from #Audiology via xlomafota13 on Inoreader http://ift.tt/2nKkQJ5
via IFTTT
Audiological Assessment of Word Recognition Skills in Persons With Aphasia
Purpose
The purpose of this study was to evaluate the ability of persons with aphasia, with and without hearing loss, to complete a commonly used open-set word recognition test that requires a verbal response. Furthermore, phonotactic probabilities and neighborhood densities of word recognition errors were assessed to explore potential underlying linguistic complexities that might differentially influence performance among groups.
Method
Four groups of adult participants were tested: participants with no brain injury with normal hearing, participants with no brain injury with hearing loss, participants with brain injury with aphasia and normal hearing, and participants with brain injury with aphasia and hearing loss. The Northwestern University Auditory Test No. 6 (NU-6; Tillman & Carhart, 1966) was administered. Those participants who were unable to respond orally (repeating words as heard) were assessed with the Picture Identification Task (Wilson & Antablin, 1980), permitting a picture-pointing response instead. Error patterns from the NU-6 were assessed to determine whether phonotactic probability influenced performance.
Results
All participants with no brain injury and 72.7% of the participants with aphasia (24 out of 33) completed the NU-6. Furthermore, all participants who were unable to complete the NU-6 were able to complete the Picture Identification Task. There were significant group differences on NU-6 performance. The 2 groups with normal hearing had significantly higher scores than the 2 groups with hearing loss, but the 2 groups with normal hearing and the 2 groups with hearing loss did not differ from one another, implying that their performance was largely determined by hearing loss rather than by brain injury or aphasia. The neighborhood density, but not phonotactic probabilities, of the participants' errors differed across groups with and without aphasia.
Conclusions
Because the vast majority of the participants with aphasia examined could be tested readily using an instrument such as the NU-6, clinicians should not be reticent to use this test if patients are able to repeat single words, but routine use of alternative tests is encouraged for populations of people with brain injuries.from #Audiology via ola Kala on Inoreader http://ift.tt/2zZ7sCq
via IFTTT
Enhanced Identification of Long Versus Short Voice Onset Time Consonant–Vowel Syllables in a Dichotic Listening Task
Purpose
This study investigated the influence of voice onset time (VOT) on the perception of consonant–vowel (CV) signals during a dichotic listening (DL) task.
Method
Sixty-two young adults with normal hearing were tested with the English language version of the Hugdahl Dichotic CV (DCV) Test. They were asked to identify 1 CV syllable during 3 DL conditions: free recall (report the syllable heard most clearly), forced right (report the syllable in the right ear), and forced left (report the syllable in the left ear). Averages for number and percent correct syllables were recorded under each condition and across the entire test.
Results
All subjects demonstrated an overall right-ear advantage (REA) when scores from all 3 listening conditions were averaged. The REA occurred for all VOT pairings except when the long VOT was presented to the left ear, whereas the short VOT was presented to the right ear when subjects produced an average left-ear advantage. The left-ear advantage overcame the structural advantage of the right ear even when subjects were directed to attend to the right ear. This result was consistent with findings of earlier studies done with Norwegian and Australian subjects.
Conclusions
Listeners' REA may be overcome by interaural temporal differences that favor processing in the listener's nondominant ear during the DCV test. Balanced VOT conditions across the DCV test prevent this effect from producing an overall bias toward the left ear, but clinical DL tests with consonant–vowel–consonant words should be examined for effects of the long VOT on laterality of performance.from #Audiology via ola Kala on Inoreader http://ift.tt/2nC6EBH
via IFTTT
Factors Associated With Depression in Patients With Tinnitus and Hyperacusis
Purpose
The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.
Method
Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.
Results
One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.
Conclusion
Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.from #Audiology via ola Kala on Inoreader http://ift.tt/2zYfdIB
via IFTTT
The First Step to Early Intervention Following Diagnosis: Communication in Pediatric Hearing Aid Orientation Sessions
Purpose
This preliminary study aimed to explore communication processes and information exchange in pediatric hearing aid orientation (HAO) sessions. Effective information exchange in such sessions is crucial to support appropriate hearing aid use.
Method
Using a qualitative sociolinguistic framework, we recorded and analyzed 5 HAO sessions between 2 audiologists and 5 caregivers of children who had just been fitted with hearing aids. We also conducted semistructured interviews with the audiologists and caregivers and analyzed these using content analysis.
Results
By necessity, audiologists provide a significant amount of information about hearing aids to caregivers in HAO sessions. Although caregivers in our study recalled and understood certain points such as the importance of not getting the hearing aids wet, crucial information about insertion and cleaning was often not recalled. Some caregivers misunderstood how the hearing aids would assist their child.
Conclusions
Caregivers need time to practice and absorb the information given, particularly given the emotional aspects associated with the diagnosis and “switch-on.” There is a need to revisit approaches to information giving, which align with the ongoing early intervention process. We offer some suggestions for improving HAO sessions and information giving about hearing aids.from #Audiology via ola Kala on Inoreader http://ift.tt/2nGLJgC
via IFTTT
Audiological Assessment of Word Recognition Skills in Persons With Aphasia
Purpose
The purpose of this study was to evaluate the ability of persons with aphasia, with and without hearing loss, to complete a commonly used open-set word recognition test that requires a verbal response. Furthermore, phonotactic probabilities and neighborhood densities of word recognition errors were assessed to explore potential underlying linguistic complexities that might differentially influence performance among groups.
Method
Four groups of adult participants were tested: participants with no brain injury with normal hearing, participants with no brain injury with hearing loss, participants with brain injury with aphasia and normal hearing, and participants with brain injury with aphasia and hearing loss. The Northwestern University Auditory Test No. 6 (NU-6; Tillman & Carhart, 1966) was administered. Those participants who were unable to respond orally (repeating words as heard) were assessed with the Picture Identification Task (Wilson & Antablin, 1980), permitting a picture-pointing response instead. Error patterns from the NU-6 were assessed to determine whether phonotactic probability influenced performance.
Results
All participants with no brain injury and 72.7% of the participants with aphasia (24 out of 33) completed the NU-6. Furthermore, all participants who were unable to complete the NU-6 were able to complete the Picture Identification Task. There were significant group differences on NU-6 performance. The 2 groups with normal hearing had significantly higher scores than the 2 groups with hearing loss, but the 2 groups with normal hearing and the 2 groups with hearing loss did not differ from one another, implying that their performance was largely determined by hearing loss rather than by brain injury or aphasia. The neighborhood density, but not phonotactic probabilities, of the participants' errors differed across groups with and without aphasia.
Conclusions
Because the vast majority of the participants with aphasia examined could be tested readily using an instrument such as the NU-6, clinicians should not be reticent to use this test if patients are able to repeat single words, but routine use of alternative tests is encouraged for populations of people with brain injuries.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2zZ7sCq
via IFTTT
Enhanced Identification of Long Versus Short Voice Onset Time Consonant–Vowel Syllables in a Dichotic Listening Task
Purpose
This study investigated the influence of voice onset time (VOT) on the perception of consonant–vowel (CV) signals during a dichotic listening (DL) task.
Method
Sixty-two young adults with normal hearing were tested with the English language version of the Hugdahl Dichotic CV (DCV) Test. They were asked to identify 1 CV syllable during 3 DL conditions: free recall (report the syllable heard most clearly), forced right (report the syllable in the right ear), and forced left (report the syllable in the left ear). Averages for number and percent correct syllables were recorded under each condition and across the entire test.
Results
All subjects demonstrated an overall right-ear advantage (REA) when scores from all 3 listening conditions were averaged. The REA occurred for all VOT pairings except when the long VOT was presented to the left ear, whereas the short VOT was presented to the right ear when subjects produced an average left-ear advantage. The left-ear advantage overcame the structural advantage of the right ear even when subjects were directed to attend to the right ear. This result was consistent with findings of earlier studies done with Norwegian and Australian subjects.
Conclusions
Listeners' REA may be overcome by interaural temporal differences that favor processing in the listener's nondominant ear during the DCV test. Balanced VOT conditions across the DCV test prevent this effect from producing an overall bias toward the left ear, but clinical DL tests with consonant–vowel–consonant words should be examined for effects of the long VOT on laterality of performance.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2nC6EBH
via IFTTT
Factors Associated With Depression in Patients With Tinnitus and Hyperacusis
Purpose
The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.
Method
Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.
Results
One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.
Conclusion
Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2zYfdIB
via IFTTT
The First Step to Early Intervention Following Diagnosis: Communication in Pediatric Hearing Aid Orientation Sessions
Purpose
This preliminary study aimed to explore communication processes and information exchange in pediatric hearing aid orientation (HAO) sessions. Effective information exchange in such sessions is crucial to support appropriate hearing aid use.
Method
Using a qualitative sociolinguistic framework, we recorded and analyzed 5 HAO sessions between 2 audiologists and 5 caregivers of children who had just been fitted with hearing aids. We also conducted semistructured interviews with the audiologists and caregivers and analyzed these using content analysis.
Results
By necessity, audiologists provide a significant amount of information about hearing aids to caregivers in HAO sessions. Although caregivers in our study recalled and understood certain points such as the importance of not getting the hearing aids wet, crucial information about insertion and cleaning was often not recalled. Some caregivers misunderstood how the hearing aids would assist their child.
Conclusions
Caregivers need time to practice and absorb the information given, particularly given the emotional aspects associated with the diagnosis and “switch-on.” There is a need to revisit approaches to information giving, which align with the ongoing early intervention process. We offer some suggestions for improving HAO sessions and information giving about hearing aids.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2nGLJgC
via IFTTT
Audiological Assessment of Word Recognition Skills in Persons With Aphasia
Purpose
The purpose of this study was to evaluate the ability of persons with aphasia, with and without hearing loss, to complete a commonly used open-set word recognition test that requires a verbal response. Furthermore, phonotactic probabilities and neighborhood densities of word recognition errors were assessed to explore potential underlying linguistic complexities that might differentially influence performance among groups.
Method
Four groups of adult participants were tested: participants with no brain injury with normal hearing, participants with no brain injury with hearing loss, participants with brain injury with aphasia and normal hearing, and participants with brain injury with aphasia and hearing loss. The Northwestern University Auditory Test No. 6 (NU-6; Tillman & Carhart, 1966) was administered. Those participants who were unable to respond orally (repeating words as heard) were assessed with the Picture Identification Task (Wilson & Antablin, 1980), permitting a picture-pointing response instead. Error patterns from the NU-6 were assessed to determine whether phonotactic probability influenced performance.
Results
All participants with no brain injury and 72.7% of the participants with aphasia (24 out of 33) completed the NU-6. Furthermore, all participants who were unable to complete the NU-6 were able to complete the Picture Identification Task. There were significant group differences on NU-6 performance. The 2 groups with normal hearing had significantly higher scores than the 2 groups with hearing loss, but the 2 groups with normal hearing and the 2 groups with hearing loss did not differ from one another, implying that their performance was largely determined by hearing loss rather than by brain injury or aphasia. The neighborhood density, but not phonotactic probabilities, of the participants' errors differed across groups with and without aphasia.
Conclusions
Because the vast majority of the participants with aphasia examined could be tested readily using an instrument such as the NU-6, clinicians should not be reticent to use this test if patients are able to repeat single words, but routine use of alternative tests is encouraged for populations of people with brain injuries.from #Audiology via ola Kala on Inoreader http://ift.tt/2zZ7sCq
via IFTTT
Enhanced Identification of Long Versus Short Voice Onset Time Consonant–Vowel Syllables in a Dichotic Listening Task
Purpose
This study investigated the influence of voice onset time (VOT) on the perception of consonant–vowel (CV) signals during a dichotic listening (DL) task.
Method
Sixty-two young adults with normal hearing were tested with the English language version of the Hugdahl Dichotic CV (DCV) Test. They were asked to identify 1 CV syllable during 3 DL conditions: free recall (report the syllable heard most clearly), forced right (report the syllable in the right ear), and forced left (report the syllable in the left ear). Averages for number and percent correct syllables were recorded under each condition and across the entire test.
Results
All subjects demonstrated an overall right-ear advantage (REA) when scores from all 3 listening conditions were averaged. The REA occurred for all VOT pairings except when the long VOT was presented to the left ear, whereas the short VOT was presented to the right ear when subjects produced an average left-ear advantage. The left-ear advantage overcame the structural advantage of the right ear even when subjects were directed to attend to the right ear. This result was consistent with findings of earlier studies done with Norwegian and Australian subjects.
Conclusions
Listeners' REA may be overcome by interaural temporal differences that favor processing in the listener's nondominant ear during the DCV test. Balanced VOT conditions across the DCV test prevent this effect from producing an overall bias toward the left ear, but clinical DL tests with consonant–vowel–consonant words should be examined for effects of the long VOT on laterality of performance.from #Audiology via ola Kala on Inoreader http://ift.tt/2nC6EBH
via IFTTT
Factors Associated With Depression in Patients With Tinnitus and Hyperacusis
Purpose
The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.
Method
Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.
Results
One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.
Conclusion
Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.from #Audiology via ola Kala on Inoreader http://ift.tt/2zYfdIB
via IFTTT
The First Step to Early Intervention Following Diagnosis: Communication in Pediatric Hearing Aid Orientation Sessions
Purpose
This preliminary study aimed to explore communication processes and information exchange in pediatric hearing aid orientation (HAO) sessions. Effective information exchange in such sessions is crucial to support appropriate hearing aid use.
Method
Using a qualitative sociolinguistic framework, we recorded and analyzed 5 HAO sessions between 2 audiologists and 5 caregivers of children who had just been fitted with hearing aids. We also conducted semistructured interviews with the audiologists and caregivers and analyzed these using content analysis.
Results
By necessity, audiologists provide a significant amount of information about hearing aids to caregivers in HAO sessions. Although caregivers in our study recalled and understood certain points such as the importance of not getting the hearing aids wet, crucial information about insertion and cleaning was often not recalled. Some caregivers misunderstood how the hearing aids would assist their child.
Conclusions
Caregivers need time to practice and absorb the information given, particularly given the emotional aspects associated with the diagnosis and “switch-on.” There is a need to revisit approaches to information giving, which align with the ongoing early intervention process. We offer some suggestions for improving HAO sessions and information giving about hearing aids.from #Audiology via ola Kala on Inoreader http://ift.tt/2nGLJgC
via IFTTT
The Effects of Palate Features and Glossectomy Surgery on /s/ Production
Purpose
The aims of this article were to determine the effects of hard palate morphology and glossectomy surgery on tongue position and shape during /s/ for patients with small tumors. The first expectation was that laminal /s/ would be more prevalent in patients, than apical, due to reduced tongue tip control after surgery. The second was that patients would hold the tongue more anteriorly than controls to compensate for reduced tongue mass.
Method
Three-dimensional tongue volumes were calculated from magnetic resonance imaging for the whole tongue and the portion anterior to the first molar during the /s/ in /əsuk/ for 21 controls and 14 patients. These volumes were used to calculate tongue anteriority and cross-sectional shape. Dental casts were used to measure palate perimeter, height, and width of the hard palate.
Results
Palate height correlated with tongue height in controls (p < .05), but not patients. In patients, tongue anteriority correlated negatively with canine width and cross-sectional tongue shape (p < .05). Controls with a high palate favored laminal /s/. Patients preferred laminal /s/ regardless of palate height (p < .01).
Conclusions
For controls, hard palate height affected tongue height; a higher palate yielded a higher tongue. For patients, hard palate width affected tongue width; a narrower palate yielded a more anterior tongue. Tongue shape was unaffected by any palate features. Preference for /s/ showed an interaction effect between subject and palate height. Controls with high palates preferred a laminal /s/. All patients preferred a laminal /s/; glossectomy surgery may reduce tongue tip control.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2nEOSOa
via IFTTT
The Potential of Past Tense Marking in Oral Reading as a Clinical Marker of Specific Language Impairment in School-Age Children
Purpose
The purpose of this study was twofold. The first aim was to explore differences in profiles of past tense marking in oral reading of school-age children with specific language impairment (SLI). The second aim was to explore the potential of past tense marking in oral reading as a clinical marker of SLI in school-age children.
Method
This study examined oral readings of connected text to describe the frequency and type of reading errors on regular and irregular past tense verbs for 21 children with SLI as compared to 30 children with typical language in Grades 2 and 3. Each past tense verb token was categorized into 1 of 6 mutually exclusive response types: (a) correctly marked past tense, (b) overmarked past tense, (c) bare stem, (d) other verb inflection, (e) nonverb, or (f) no response. Performance across groups was compared. Additionally, classification statistics were calculated at several cutoffs for regular past tense accuracy and regular past tense finiteness marking.
Results
For regular past tense, there was a significant group difference on accuracy. Children with SLI were less accurate at marking past tense when in oral reading than typical language peers; other response types did not differ. For irregular past tense, there were no group differences. In addition, there was a significant group difference on finiteness marking; this difference was driven by regular but not irregular verbs. A cutoff of 90% for regular past tense accuracy yielded moderate sensitivity and specificity; no cutoff for regular past tense finiteness marking yielded sensitivity above 70%.
Conclusions
Regular past tense accuracy in oral reading provides promise as a clinical marker for diagnosing SLI in school-age children.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2zXWltn
via IFTTT
Word Processing in Children With Autism Spectrum Disorders: Evidence From Event-Related Potentials
Purpose
This investigation was conducted to determine whether young children with autism spectrum disorders exhibited a canonical neural response to word stimuli and whether putative event-related potential (ERP) measures of word processing were correlated with a concurrent measure of receptive language. Additional exploratory analyses were used to examine whether the magnitude of the association between ERP measures of word processing and receptive language varied as a function of the number of word stimuli the participants reportedly understood.
Method
Auditory ERPs were recorded in response to spoken words and nonwords presented with equal probability in 34 children aged 2–5 years with a diagnosis of autism spectrum disorder who were in the early stages of language acquisition. Average amplitudes and amplitude differences between word and nonword stimuli within 200–500 ms were examined at left temporal (T3) and parietal (P3) electrode clusters. Receptive vocabulary size and the number of experimental stimuli understood were concurrently measured using the MacArthur–Bates Communicative Development Inventories.
Results
Across the entire participant group, word–nonword amplitude differences were diminished. The average word–nonword amplitude difference at T3 was related to receptive vocabulary only if 5 or more word stimuli were understood.
Conclusions
If ERPs are to ever have clinical utility, their construct validity must be established by investigations that confirm their associations with predictably related constructs. These results contribute to accruing evidence, suggesting that a valid measure of auditory word processing can be derived from the left temporal response to words and nonwords. In addition, this measure can be useful even for participants who do not reportedly understand all of the words presented as experimental stimuli, though it will be important for researchers to track familiarity with word stimuli in future investigations.
Supplemental Material
http://ift.tt/2zXWcGlfrom #Audiology via xlomafota13 on Inoreader http://ift.tt/2nJA8Of
via IFTTT
False Belief Development in Children Who Are Hard of Hearing Compared With Peers With Normal Hearing
Purpose
This study investigates false belief (FB) understanding in children who are hard of hearing (CHH) compared with children with normal hearing (CNH) at ages 5 and 6 years and at 2nd grade. Research with this population has theoretical significance, given that the early auditory–linguistic experiences of CHH are less restricted compared with children who are deaf but not as complete as those of CNH.
Method
Participants included CHH and CNH who had completed FB tasks as part of a larger multicenter, longitudinal study on outcomes of children with mild-to-severe hearing loss. Both cross-sectional and longitudinal data were analyzed.
Results
At age 5 years, CHH demonstrated significant delays in FB understanding relative to CNH. Both hearing status and spoken-language abilities contributed to FB performance in 5-year-olds. A subgroup of CHH showed protracted delays at 6 years, suggesting that some CHH are at risk for longer term delays in FB understanding. By 2nd grade, performance on 1st- and 2nd-order FBs did not differ between CHH and CNH.
Conclusions
Preschool-age CHH are at risk for delays in understanding others' beliefs, which has consequences for their social interactions and pragmatic communication. Research related to FB in children with hearing loss has the potential to inform our understanding of mechanisms that support social–cognitive development, including the roles of language and conversational access.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2nAXipI
via IFTTT
Sentence-Level Movements in Parkinson's Disease: Loud, Clear, and Slow Speech
Purpose
To further understand the effect of Parkinson's disease (PD) on articulatory movements in speech and to expand our knowledge of therapeutic treatment strategies, this study examined movements of the jaw, tongue blade, and tongue dorsum during sentence production with respect to speech intelligibility and compared the effect of varying speaking styles on these articulatory movements.
Method
Twenty-one speakers with PD and 20 healthy controls produced 3 sentences under normal, loud, clear, and slow speaking conditions. Speech intelligibility was rated for each speaker. A 3-dimensional electromagnetic articulograph tracked movements of the articulators. Measures included articulatory working spaces, ranges along the first principal component, average speeds, and sentence durations.
Results
Speakers with PD demonstrated significantly smaller jaw movements as well as shorter than normal sentence durations. Between-speaker variation in movement size of the jaw, tongue blade, and tongue dorsum was associated with speech intelligibility. Analysis of speaking conditions revealed similar patterns of change in movement measures across groups and articulators: larger than normal movement sizes and faster speeds for loud speech, increased movement sizes for clear speech, and larger than normal movement sizes and slower speeds for slow speech.
Conclusions
Sentence-level measures of articulatory movements are sensitive to both disease-related changes in PD and speaking-style manipulations.from #Audiology via xlomafota13 on Inoreader http://ift.tt/2A0Iq5L
via IFTTT
The Effects of Palate Features and Glossectomy Surgery on /s/ Production
Purpose
The aims of this article were to determine the effects of hard palate morphology and glossectomy surgery on tongue position and shape during /s/ for patients with small tumors. The first expectation was that laminal /s/ would be more prevalent in patients, than apical, due to reduced tongue tip control after surgery. The second was that patients would hold the tongue more anteriorly than controls to compensate for reduced tongue mass.
Method
Three-dimensional tongue volumes were calculated from magnetic resonance imaging for the whole tongue and the portion anterior to the first molar during the /s/ in /əsuk/ for 21 controls and 14 patients. These volumes were used to calculate tongue anteriority and cross-sectional shape. Dental casts were used to measure palate perimeter, height, and width of the hard palate.
Results
Palate height correlated with tongue height in controls (p < .05), but not patients. In patients, tongue anteriority correlated negatively with canine width and cross-sectional tongue shape (p < .05). Controls with a high palate favored laminal /s/. Patients preferred laminal /s/ regardless of palate height (p < .01).
Conclusions
For controls, hard palate height affected tongue height; a higher palate yielded a higher tongue. For patients, hard palate width affected tongue width; a narrower palate yielded a more anterior tongue. Tongue shape was unaffected by any palate features. Preference for /s/ showed an interaction effect between subject and palate height. Controls with high palates preferred a laminal /s/. All patients preferred a laminal /s/; glossectomy surgery may reduce tongue tip control.from #Audiology via ola Kala on Inoreader http://ift.tt/2nEOSOa
via IFTTT
The Potential of Past Tense Marking in Oral Reading as a Clinical Marker of Specific Language Impairment in School-Age Children
Purpose
The purpose of this study was twofold. The first aim was to explore differences in profiles of past tense marking in oral reading of school-age children with specific language impairment (SLI). The second aim was to explore the potential of past tense marking in oral reading as a clinical marker of SLI in school-age children.
Method
This study examined oral readings of connected text to describe the frequency and type of reading errors on regular and irregular past tense verbs for 21 children with SLI as compared to 30 children with typical language in Grades 2 and 3. Each past tense verb token was categorized into 1 of 6 mutually exclusive response types: (a) correctly marked past tense, (b) overmarked past tense, (c) bare stem, (d) other verb inflection, (e) nonverb, or (f) no response. Performance across groups was compared. Additionally, classification statistics were calculated at several cutoffs for regular past tense accuracy and regular past tense finiteness marking.
Results
For regular past tense, there was a significant group difference on accuracy. Children with SLI were less accurate at marking past tense when in oral reading than typical language peers; other response types did not differ. For irregular past tense, there were no group differences. In addition, there was a significant group difference on finiteness marking; this difference was driven by regular but not irregular verbs. A cutoff of 90% for regular past tense accuracy yielded moderate sensitivity and specificity; no cutoff for regular past tense finiteness marking yielded sensitivity above 70%.
Conclusions
Regular past tense accuracy in oral reading provides promise as a clinical marker for diagnosing SLI in school-age children.from #Audiology via ola Kala on Inoreader http://ift.tt/2zXWltn
via IFTTT
Word Processing in Children With Autism Spectrum Disorders: Evidence From Event-Related Potentials
Purpose
This investigation was conducted to determine whether young children with autism spectrum disorders exhibited a canonical neural response to word stimuli and whether putative event-related potential (ERP) measures of word processing were correlated with a concurrent measure of receptive language. Additional exploratory analyses were used to examine whether the magnitude of the association between ERP measures of word processing and receptive language varied as a function of the number of word stimuli the participants reportedly understood.
Method
Auditory ERPs were recorded in response to spoken words and nonwords presented with equal probability in 34 children aged 2–5 years with a diagnosis of autism spectrum disorder who were in the early stages of language acquisition. Average amplitudes and amplitude differences between word and nonword stimuli within 200–500 ms were examined at left temporal (T3) and parietal (P3) electrode clusters. Receptive vocabulary size and the number of experimental stimuli understood were concurrently measured using the MacArthur–Bates Communicative Development Inventories.
Results
Across the entire participant group, word–nonword amplitude differences were diminished. The average word–nonword amplitude difference at T3 was related to receptive vocabulary only if 5 or more word stimuli were understood.
Conclusions
If ERPs are to ever have clinical utility, their construct validity must be established by investigations that confirm their associations with predictably related constructs. These results contribute to accruing evidence, suggesting that a valid measure of auditory word processing can be derived from the left temporal response to words and nonwords. In addition, this measure can be useful even for participants who do not reportedly understand all of the words presented as experimental stimuli, though it will be important for researchers to track familiarity with word stimuli in future investigations.
Supplemental Material
http://ift.tt/2zXWcGlfrom #Audiology via ola Kala on Inoreader http://ift.tt/2nJA8Of
via IFTTT
False Belief Development in Children Who Are Hard of Hearing Compared With Peers With Normal Hearing
Purpose
This study investigates false belief (FB) understanding in children who are hard of hearing (CHH) compared with children with normal hearing (CNH) at ages 5 and 6 years and at 2nd grade. Research with this population has theoretical significance, given that the early auditory–linguistic experiences of CHH are less restricted compared with children who are deaf but not as complete as those of CNH.
Method
Participants included CHH and CNH who had completed FB tasks as part of a larger multicenter, longitudinal study on outcomes of children with mild-to-severe hearing loss. Both cross-sectional and longitudinal data were analyzed.
Results
At age 5 years, CHH demonstrated significant delays in FB understanding relative to CNH. Both hearing status and spoken-language abilities contributed to FB performance in 5-year-olds. A subgroup of CHH showed protracted delays at 6 years, suggesting that some CHH are at risk for longer term delays in FB understanding. By 2nd grade, performance on 1st- and 2nd-order FBs did not differ between CHH and CNH.
Conclusions
Preschool-age CHH are at risk for delays in understanding others' beliefs, which has consequences for their social interactions and pragmatic communication. Research related to FB in children with hearing loss has the potential to inform our understanding of mechanisms that support social–cognitive development, including the roles of language and conversational access.from #Audiology via ola Kala on Inoreader http://ift.tt/2nAXipI
via IFTTT
Sentence-Level Movements in Parkinson's Disease: Loud, Clear, and Slow Speech
Purpose
To further understand the effect of Parkinson's disease (PD) on articulatory movements in speech and to expand our knowledge of therapeutic treatment strategies, this study examined movements of the jaw, tongue blade, and tongue dorsum during sentence production with respect to speech intelligibility and compared the effect of varying speaking styles on these articulatory movements.
Method
Twenty-one speakers with PD and 20 healthy controls produced 3 sentences under normal, loud, clear, and slow speaking conditions. Speech intelligibility was rated for each speaker. A 3-dimensional electromagnetic articulograph tracked movements of the articulators. Measures included articulatory working spaces, ranges along the first principal component, average speeds, and sentence durations.
Results
Speakers with PD demonstrated significantly smaller jaw movements as well as shorter than normal sentence durations. Between-speaker variation in movement size of the jaw, tongue blade, and tongue dorsum was associated with speech intelligibility. Analysis of speaking conditions revealed similar patterns of change in movement measures across groups and articulators: larger than normal movement sizes and faster speeds for loud speech, increased movement sizes for clear speech, and larger than normal movement sizes and slower speeds for slow speech.
Conclusions
Sentence-level measures of articulatory movements are sensitive to both disease-related changes in PD and speaking-style manipulations.from #Audiology via ola Kala on Inoreader http://ift.tt/2A0Iq5L
via IFTTT
The Effects of Palate Features and Glossectomy Surgery on /s/ Production
Purpose
The aims of this article were to determine the effects of hard palate morphology and glossectomy surgery on tongue position and shape during /s/ for patients with small tumors. The first expectation was that laminal /s/ would be more prevalent in patients, than apical, due to reduced tongue tip control after surgery. The second was that patients would hold the tongue more anteriorly than controls to compensate for reduced tongue mass.
Method
Three-dimensional tongue volumes were calculated from magnetic resonance imaging for the whole tongue and the portion anterior to the first molar during the /s/ in /əsuk/ for 21 controls and 14 patients. These volumes were used to calculate tongue anteriority and cross-sectional shape. Dental casts were used to measure palate perimeter, height, and width of the hard palate.
Results
Palate height correlated with tongue height in controls (p < .05), but not patients. In patients, tongue anteriority correlated negatively with canine width and cross-sectional tongue shape (p < .05). Controls with a high palate favored laminal /s/. Patients preferred laminal /s/ regardless of palate height (p < .01).
Conclusions
For controls, hard palate height affected tongue height; a higher palate yielded a higher tongue. For patients, hard palate width affected tongue width; a narrower palate yielded a more anterior tongue. Tongue shape was unaffected by any palate features. Preference for /s/ showed an interaction effect between subject and palate height. Controls with high palates preferred a laminal /s/. All patients preferred a laminal /s/; glossectomy surgery may reduce tongue tip control.from #Audiology via ola Kala on Inoreader http://ift.tt/2nEOSOa
via IFTTT
The Potential of Past Tense Marking in Oral Reading as a Clinical Marker of Specific Language Impairment in School-Age Children
Purpose
The purpose of this study was twofold. The first aim was to explore differences in profiles of past tense marking in oral reading of school-age children with specific language impairment (SLI). The second aim was to explore the potential of past tense marking in oral reading as a clinical marker of SLI in school-age children.
Method
This study examined oral readings of connected text to describe the frequency and type of reading errors on regular and irregular past tense verbs for 21 children with SLI as compared to 30 children with typical language in Grades 2 and 3. Each past tense verb token was categorized into 1 of 6 mutually exclusive response types: (a) correctly marked past tense, (b) overmarked past tense, (c) bare stem, (d) other verb inflection, (e) nonverb, or (f) no response. Performance across groups was compared. Additionally, classification statistics were calculated at several cutoffs for regular past tense accuracy and regular past tense finiteness marking.
Results
For regular past tense, there was a significant group difference on accuracy. Children with SLI were less accurate at marking past tense when in oral reading than typical language peers; other response types did not differ. For irregular past tense, there were no group differences. In addition, there was a significant group difference on finiteness marking; this difference was driven by regular but not irregular verbs. A cutoff of 90% for regular past tense accuracy yielded moderate sensitivity and specificity; no cutoff for regular past tense finiteness marking yielded sensitivity above 70%.
Conclusions
Regular past tense accuracy in oral reading provides promise as a clinical marker for diagnosing SLI in school-age children.from #Audiology via ola Kala on Inoreader http://ift.tt/2zXWltn
via IFTTT
Word Processing in Children With Autism Spectrum Disorders: Evidence From Event-Related Potentials
Purpose
This investigation was conducted to determine whether young children with autism spectrum disorders exhibited a canonical neural response to word stimuli and whether putative event-related potential (ERP) measures of word processing were correlated with a concurrent measure of receptive language. Additional exploratory analyses were used to examine whether the magnitude of the association between ERP measures of word processing and receptive language varied as a function of the number of word stimuli the participants reportedly understood.
Method
Auditory ERPs were recorded in response to spoken words and nonwords presented with equal probability in 34 children aged 2–5 years with a diagnosis of autism spectrum disorder who were in the early stages of language acquisition. Average amplitudes and amplitude differences between word and nonword stimuli within 200–500 ms were examined at left temporal (T3) and parietal (P3) electrode clusters. Receptive vocabulary size and the number of experimental stimuli understood were concurrently measured using the MacArthur–Bates Communicative Development Inventories.
Results
Across the entire participant group, word–nonword amplitude differences were diminished. The average word–nonword amplitude difference at T3 was related to receptive vocabulary only if 5 or more word stimuli were understood.
Conclusions
If ERPs are to ever have clinical utility, their construct validity must be established by investigations that confirm their associations with predictably related constructs. These results contribute to accruing evidence, suggesting that a valid measure of auditory word processing can be derived from the left temporal response to words and nonwords. In addition, this measure can be useful even for participants who do not reportedly understand all of the words presented as experimental stimuli, though it will be important for researchers to track familiarity with word stimuli in future investigations.
Supplemental Material
http://ift.tt/2zXWcGlfrom #Audiology via ola Kala on Inoreader http://ift.tt/2nJA8Of
via IFTTT
False Belief Development in Children Who Are Hard of Hearing Compared With Peers With Normal Hearing
Purpose
This study investigates false belief (FB) understanding in children who are hard of hearing (CHH) compared with children with normal hearing (CNH) at ages 5 and 6 years and at 2nd grade. Research with this population has theoretical significance, given that the early auditory–linguistic experiences of CHH are less restricted compared with children who are deaf but not as complete as those of CNH.
Method
Participants included CHH and CNH who had completed FB tasks as part of a larger multicenter, longitudinal study on outcomes of children with mild-to-severe hearing loss. Both cross-sectional and longitudinal data were analyzed.
Results
At age 5 years, CHH demonstrated significant delays in FB understanding relative to CNH. Both hearing status and spoken-language abilities contributed to FB performance in 5-year-olds. A subgroup of CHH showed protracted delays at 6 years, suggesting that some CHH are at risk for longer term delays in FB understanding. By 2nd grade, performance on 1st- and 2nd-order FBs did not differ between CHH and CNH.
Conclusions
Preschool-age CHH are at risk for delays in understanding others' beliefs, which has consequences for their social interactions and pragmatic communication. Research related to FB in children with hearing loss has the potential to inform our understanding of mechanisms that support social–cognitive development, including the roles of language and conversational access.from #Audiology via ola Kala on Inoreader http://ift.tt/2nAXipI
via IFTTT
Sentence-Level Movements in Parkinson's Disease: Loud, Clear, and Slow Speech
Purpose
To further understand the effect of Parkinson's disease (PD) on articulatory movements in speech and to expand our knowledge of therapeutic treatment strategies, this study examined movements of the jaw, tongue blade, and tongue dorsum during sentence production with respect to speech intelligibility and compared the effect of varying speaking styles on these articulatory movements.
Method
Twenty-one speakers with PD and 20 healthy controls produced 3 sentences under normal, loud, clear, and slow speaking conditions. Speech intelligibility was rated for each speaker. A 3-dimensional electromagnetic articulograph tracked movements of the articulators. Measures included articulatory working spaces, ranges along the first principal component, average speeds, and sentence durations.
Results
Speakers with PD demonstrated significantly smaller jaw movements as well as shorter than normal sentence durations. Between-speaker variation in movement size of the jaw, tongue blade, and tongue dorsum was associated with speech intelligibility. Analysis of speaking conditions revealed similar patterns of change in movement measures across groups and articulators: larger than normal movement sizes and faster speeds for loud speech, increased movement sizes for clear speech, and larger than normal movement sizes and slower speeds for slow speech.
Conclusions
Sentence-level measures of articulatory movements are sensitive to both disease-related changes in PD and speaking-style manipulations.from #Audiology via ola Kala on Inoreader http://ift.tt/2A0Iq5L
via IFTTT
Real-Ear Measures
Real-ear measures (REM) are recommended in hearing aid fitting. However, reports suggest that only approximately 30 percent of audiologists routinely perform REM. Rationale (or excuses) for not performing REM are numerous, but little peer-reviewed research has been conducted to support or refute the use of REM in regards to benefit in speech understanding and subjective quality of fitting.
from #Audiology via xlomafota13 on Inoreader http://ift.tt/2j3rWXc
via IFTTT
Survey of the American Neurotology Society on Cochlear Implantation: Part 1, Candidacy Assessment and Expanding Indications.
Survey of the American Neurotology Society on Cochlear Implantation: Part 1, Candidacy Assessment and Expanding Indications.
Otol Neurotol. 2017 Nov 28;:
Authors: Carlson ML, Sladen DP, Gurgel RK, Tombers NM, Lohse CM, Driscoll CL
Abstract
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.
PMID: 29210952 [PubMed - as supplied by publisher]
from #Audiology via ola Kala on Inoreader http://ift.tt/2AZQkQD
via IFTTT
Survey of the American Neurotology Society on Cochlear Implantation: Part 1, Candidacy Assessment and Expanding Indications.
Survey of the American Neurotology Society on Cochlear Implantation: Part 1, Candidacy Assessment and Expanding Indications.
Otol Neurotol. 2017 Nov 28;:
Authors: Carlson ML, Sladen DP, Gurgel RK, Tombers NM, Lohse CM, Driscoll CL
Abstract
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.
PMID: 29210952 [PubMed - as supplied by publisher]
from #Audiology via ola Kala on Inoreader http://ift.tt/2AZQkQD
via IFTTT
A novel mutation in SLC1A3 causes episodic ataxia.
| Related Articles |
A novel mutation in SLC1A3 causes episodic ataxia.
J Hum Genet. 2017 Dec 05;:
Authors: Iwama K, Iwata A, Shiina M, Mitsuhashi S, Miyatake S, Takata A, Miyake N, Ogata K, Ito S, Mizuguchi T, Matsumoto N
Abstract
Episodic ataxias (EAs) are rare channelopathies characterized by recurrent ataxia and vertigo, having eight subtypes. Mutated genes were found in four of these eight subtypes (EA1, EA2, EA5, and EA6). To date, only four missense mutations in the Solute Carrier Family 1 Member 3 gene (SLC1A3) have been reported to cause EA6. SLC1A3 encodes excitatory amino-acid transporter 1, which is a trimeric transmembrane protein responsible for glutamate transport in the synaptic cleft. In this study, we found a novel missense mutation, c.383T>G (p.Met128Arg) in SLC1A3, in an EA patient by whole-exome sequencing. The modeled structural analysis suggested that p.Met128Arg may affect the hydrophobic transmembrane environment and protein function. Analysis of the pathogenicity of all mutations found in SLC1A3 to date using multiple prediction tools showed some advantage of using the Mendelian Clinically Applicable Pathogenicity (M-CAP) score. Various types of SLC1A3 variants, including nonsense mutations and indels, in the ExAC database suggest that the loss-of-function mechanism by SLC1A3 mutations is unlikely in EA6. The current mutation (p.Med128Arg) presumably has a gain-of-function effect as described in a previous report.
PMID: 29208948 [PubMed - as supplied by publisher]
from #Audiology via xlomafota13 on Inoreader http://ift.tt/2iZzE4V
via IFTTT
Clinical Features, Familial History, and Migraine Precursors in Patients With Definite Vestibular Migraine: The VM-Phenotypes Projects.
 |
Related Articles |
Clinical Features, Familial History, and Migraine Precursors in Patients With Definite Vestibular Migraine: The VM-Phenotypes Projects.
Headache. 2017 Dec 04;:
Authors: Teggi R, Colombo B, Albera R, Asprella Libonati G, Balzanelli C, Batuecas Caletrio A, Casani A, Espinoza-Sanchez JM, Gamba P, Lopez-Escamez JA, Lucisano S, Mandalà M, Neri G, Nuti D, Pecci R, Russo A, Martin-Sanz E, Sanz R, Tedeschi G, Torelli P, Vannucchi P, Comi G, Bussi M
Abstract
OBJECTIVE: The aim of this work was to assess through a questionnaire the features of vertiginous episodes, accompanying symptoms, familial history, and migraine precursors in a sample of 252 subjects with a diagnosis of definite vestibular migraine.
BACKGROUND: Migraine is a common neurological disorder characterized by episodic headaches with specific features. About two-thirds of cases run in families, and patients may refer symptoms occurring in infancy and childhood, defined as episodic syndromes that may be associated with migraine. Migraine is associated with episodic vertigo, called vestibular migraine, whose diagnosis mainly relies on clinical history showing a temporary association of symptoms.
METHODS: In this cross-sectional multicentric study, 252 subjects were recruited in different centers; a senior specialist through a structured questionnaire assessed features of vestibular symptoms and accompanying symptoms.
RESULTS: The age of onset of migraine was 23 years, while onset of vertigo was at 38 years. One hundred and eighty-four subjects reported internal vertigo (73%), while 63 subjects (25%) reported external vertigo. The duration of vertigo attacks was less than 5 minutes in 58 subjects (23%), between 6 and 60 minutes in 55 (21.8%), between 1 and 4 hours in 29 (11.5%), 5 and 24 hours in 44 (17.5%), up to 3 days in 14 (5.5%), and more than 3 days in seven (2.8%); 14 subjects (5.5%) referred attacks lasting from less than 5 minutes and up to 1 hour, nine (3.6%) referred attacks lasting from less than 5 minutes and up to 1 to 4 hours, six (2.4%) referred attacks lasting from less than 5 minutes and up to 5 to 24 hours, and five (2%) cases referred attacks lasting from less than 5 minutes and up to days. Among accompanying symptoms, patients referred the following usually occurring, in order of frequency: nausea (59.9%), photophobia (44.4%), phonophobia (38.9%), vomiting (17.8%), palpitations (11.5%), tinnitus (10.7%), fullness of the ear (8.7%), and hearing loss (4%). In total, 177 subjects referred a positive family history of migraine (70.2%), while 167 (66.3%) reported a positive family history of vertigo. In the sample, 69% of patients referred at least one of the pediatric precursors, in particular, 42.8% of subjects referred motion sickness. The age of onset of the first headache was lower in the subsample with a familial history of migraine than in the total sample. Among the pediatric precursors, benign paroxysmal vertigo - BPV, benign paroxysmal torticollis, and motion sickness were predictive of a lower age of onset of vertigo in adulthood; cyclic vomiting was predictive for vomiting during vertigo attacks in adults.
CONCLUSIONS: Our results may indicate that vestibular symptoms in pediatric patients may act as a predisposing factor to develop vestibular migraine at an earlier age in adulthood.
PMID: 29205326 [PubMed - as supplied by publisher]
from #Audiology via xlomafota13 on Inoreader http://ift.tt/2AY0T6S
via IFTTT
Εγγραφή σε:
Αναρτήσεις (Atom)