Barriers to pediatric cochlear implantation: A parental survey.

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Barriers to pediatric cochlear implantation: A parental survey.

Int J Pediatr Otorhinolaryngol. 2018 Jan;104:224-227

Authors: Yang CQ, Reilly BK, Preciado DA

Abstract
OBJECTIVE: This study aims to (1) determine barriers in the pediatric cochlear implantation process specific to publicly insured patients, wherein delayed implantation has been reported, and (2) compare the perceived barriers between publicly and privately insured patients.
SETTING: Tertiary care cochlear implantation center at academic pediatric hospital.
STUDY DESIGN: Cross-sectional survey, retrospective chart review.
METHODS: The validated, 39 item Barriers to Care Questionnaire was administered to the parents of 80 recipients of cochlear implantation by two surgeons between 2013 and 2016. Survey results and diagnosis to implant interval were compared based on public or private insurance status. Two-tailed Mann-Whitney and Fisher's exact test was used for statistical analysis.
RESULTS: Of 110 cochlear implants, 27 of 80 (34%) English-speaking parents completed the survey. 15 were privately insured and 12 were publicly insured. 23 of 27 respondents received cochlear implantation for pre-lingual sensorineural hearing loss. Publicly insured patients had significantly longer median time from diagnosis to implant than privately insured (19 vs. 8 mo, p = 0.01). The three worst scoring barrier categories for privately insured families in order were Pragmatics, Expectations, and Marginalization, whereas for publicly insured families it was Pragmatics, Skills, and Expectations. The worst scoring question for privately insured patients was "Having to take time off work". For the publicly insured, it was "Lack of communication."
CONCLUSION: Privately insured patients reported more barriers on the Barriers to Care Questionnaire than publicly insured patients did. Although pragmatics was the worst-scoring barrier category for both groups, difficulties found on the survey ranked differently for each group. This information can help providers address disparities and access barriers for vulnerable patients.

PMID: 29287873 [PubMed - in process]

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Perception of Cantonese Lexical Tones by Pediatric Cochlear Implant Users

Purpose

The purpose of this study is to assess Cantonese word recognition and the discrimination of Cantonese tones with manipulated contours by child and adolescent cochlear implant (CI) users and a group of peers with normal hearing (NH). It was hypothesized that the CI users would perform more poorly than their counterparts with NH in both tasks and that CI users implanted before 2 years of age would perform better than those implanted after 2 years.

Method

Forty-one participants were recruited from hospitals, schools, and kindergartens in Hong Kong: Ten CI users implanted at or before 2 years of age (“early” CI group), 13 CI users implanted after 2 years of age (“late” CI group), and 18 individuals with NH. The mean age at implantation of the early CI group was 1.5 years (SD = 0.3), and for the late CI group, it was 4.3 years (SD = 2.1). Participants were a mean of 13.3 years of age (SD = 3.7) at time of testing. Participants completed a Cantonese word recognition test and a discrimination task using Cantonese tones with modified fundamental frequency trajectories.

Results

Both CI user groups obtained significantly lower scores than the group with NH on the word recognition test. Mean percent correct scores for the word recognition test were 79% for the early CI group, 69% for the late CI group, and 97% for the group with NH. The group with NH consistently achieved higher scores than the CI user groups when discriminating manipulated Cantonese tones. Increasing the acoustic difference between tones improved discrimination performance for CI users for level tone contrasts only. CI users implanted at or before 2 years of age obtained higher scores than those implanted later.

Conclusions

The results of this study add further evidence that children using CIs do not perform as well as peers in perceiving Cantonese tones. Modification of tones to increase pitch range did not consistently improve the ability of children with implants to perceive the difference between tones. Further research is required to fully assess potential benefits of early implantation for speakers of tonal languages.

Supplemental Materials

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Acoustic Analysis of Voice in Singers: A Systematic Review

Purpose

Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers.

Method

A systematic review of studies on acoustic analysis of voice in singers (PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct, and Shodhganga) was carried out. Key words based on PIO (population–investigation–outcome) were used to develop search strings. Titles and abstracts were screened independently, and appropriate studies were read in full for data extraction.

Results

Of the 895 studies, 26 studies met the inclusion criteria. Great variability was noted in the instruments and task used. Different acoustic measures were employed, such as fundamental frequency, perturbation, cepstral, spectral, dysphonia severity index, singing power ratio, and so forth.

Conclusion

Overall, a great heterogeneity was noted regarding population, tasks, instruments, and parameters. There is a lack of standardized criteria for the evaluation of singing voice. In order to implement acoustic analysis as a part of comprehensive voice evaluation exclusively for singers, there is a certain need for methodical sound studies.

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Remote Microphone System Use at Home: Impact on Caregiver Talk

Purpose

The purpose of this study was to investigate the effects of home use of a remote microphone system (RMS) on the spoken language production of caregivers with young children who have hearing loss.

Method

Language Environment Analysis recorders were used with 10 families during 2 consecutive weekends (RMS weekend and No-RMS weekend). The amount of talk from a single caregiver that could be made accessible to children with hearing loss when using an RMS was estimated using Language Environment Analysis software. The total amount of caregiver talk (close and far talk) was also compared across both weekends. In addition, caregivers' perceptions of RMS use were gathered.

Results

Children, with the use of RMSs, could potentially have access to approximately 42% more words per day. In addition, although caregivers produced an equivalent number of words on both weekends, they tended to talk more from a distance when using the RMS than when not. Finally, caregivers reported positive perceived communication benefits of RMS use.

Conclusions

Findings from this investigation suggest that children with hearing loss have increased access to caregiver talk when using an RMS in the home environment. Clinical implications and future directions for research are discussed.

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Perception of Cantonese Lexical Tones by Pediatric Cochlear Implant Users

Purpose

The purpose of this study is to assess Cantonese word recognition and the discrimination of Cantonese tones with manipulated contours by child and adolescent cochlear implant (CI) users and a group of peers with normal hearing (NH). It was hypothesized that the CI users would perform more poorly than their counterparts with NH in both tasks and that CI users implanted before 2 years of age would perform better than those implanted after 2 years.

Method

Forty-one participants were recruited from hospitals, schools, and kindergartens in Hong Kong: Ten CI users implanted at or before 2 years of age (“early” CI group), 13 CI users implanted after 2 years of age (“late” CI group), and 18 individuals with NH. The mean age at implantation of the early CI group was 1.5 years (SD = 0.3), and for the late CI group, it was 4.3 years (SD = 2.1). Participants were a mean of 13.3 years of age (SD = 3.7) at time of testing. Participants completed a Cantonese word recognition test and a discrimination task using Cantonese tones with modified fundamental frequency trajectories.

Results

Both CI user groups obtained significantly lower scores than the group with NH on the word recognition test. Mean percent correct scores for the word recognition test were 79% for the early CI group, 69% for the late CI group, and 97% for the group with NH. The group with NH consistently achieved higher scores than the CI user groups when discriminating manipulated Cantonese tones. Increasing the acoustic difference between tones improved discrimination performance for CI users for level tone contrasts only. CI users implanted at or before 2 years of age obtained higher scores than those implanted later.

Conclusions

The results of this study add further evidence that children using CIs do not perform as well as peers in perceiving Cantonese tones. Modification of tones to increase pitch range did not consistently improve the ability of children with implants to perceive the difference between tones. Further research is required to fully assess potential benefits of early implantation for speakers of tonal languages.

Supplemental Materials

http://ift.tt/2ESM43L

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Acoustic Analysis of Voice in Singers: A Systematic Review

Purpose

Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers.

Method

A systematic review of studies on acoustic analysis of voice in singers (PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct, and Shodhganga) was carried out. Key words based on PIO (population–investigation–outcome) were used to develop search strings. Titles and abstracts were screened independently, and appropriate studies were read in full for data extraction.

Results

Of the 895 studies, 26 studies met the inclusion criteria. Great variability was noted in the instruments and task used. Different acoustic measures were employed, such as fundamental frequency, perturbation, cepstral, spectral, dysphonia severity index, singing power ratio, and so forth.

Conclusion

Overall, a great heterogeneity was noted regarding population, tasks, instruments, and parameters. There is a lack of standardized criteria for the evaluation of singing voice. In order to implement acoustic analysis as a part of comprehensive voice evaluation exclusively for singers, there is a certain need for methodical sound studies.

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Remote Microphone System Use at Home: Impact on Caregiver Talk

Purpose

The purpose of this study was to investigate the effects of home use of a remote microphone system (RMS) on the spoken language production of caregivers with young children who have hearing loss.

Method

Language Environment Analysis recorders were used with 10 families during 2 consecutive weekends (RMS weekend and No-RMS weekend). The amount of talk from a single caregiver that could be made accessible to children with hearing loss when using an RMS was estimated using Language Environment Analysis software. The total amount of caregiver talk (close and far talk) was also compared across both weekends. In addition, caregivers' perceptions of RMS use were gathered.

Results

Children, with the use of RMSs, could potentially have access to approximately 42% more words per day. In addition, although caregivers produced an equivalent number of words on both weekends, they tended to talk more from a distance when using the RMS than when not. Finally, caregivers reported positive perceived communication benefits of RMS use.

Conclusions

Findings from this investigation suggest that children with hearing loss have increased access to caregiver talk when using an RMS in the home environment. Clinical implications and future directions for research are discussed.

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Perception of Cantonese Lexical Tones by Pediatric Cochlear Implant Users

Purpose

The purpose of this study is to assess Cantonese word recognition and the discrimination of Cantonese tones with manipulated contours by child and adolescent cochlear implant (CI) users and a group of peers with normal hearing (NH). It was hypothesized that the CI users would perform more poorly than their counterparts with NH in both tasks and that CI users implanted before 2 years of age would perform better than those implanted after 2 years.

Method

Forty-one participants were recruited from hospitals, schools, and kindergartens in Hong Kong: Ten CI users implanted at or before 2 years of age (“early” CI group), 13 CI users implanted after 2 years of age (“late” CI group), and 18 individuals with NH. The mean age at implantation of the early CI group was 1.5 years (SD = 0.3), and for the late CI group, it was 4.3 years (SD = 2.1). Participants were a mean of 13.3 years of age (SD = 3.7) at time of testing. Participants completed a Cantonese word recognition test and a discrimination task using Cantonese tones with modified fundamental frequency trajectories.

Results

Both CI user groups obtained significantly lower scores than the group with NH on the word recognition test. Mean percent correct scores for the word recognition test were 79% for the early CI group, 69% for the late CI group, and 97% for the group with NH. The group with NH consistently achieved higher scores than the CI user groups when discriminating manipulated Cantonese tones. Increasing the acoustic difference between tones improved discrimination performance for CI users for level tone contrasts only. CI users implanted at or before 2 years of age obtained higher scores than those implanted later.

Conclusions

The results of this study add further evidence that children using CIs do not perform as well as peers in perceiving Cantonese tones. Modification of tones to increase pitch range did not consistently improve the ability of children with implants to perceive the difference between tones. Further research is required to fully assess potential benefits of early implantation for speakers of tonal languages.

Supplemental Materials

http://ift.tt/2ESM43L

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Acoustic Analysis of Voice in Singers: A Systematic Review

Purpose

Singers are vocal athletes having specific demands from their voice and require special consideration during voice evaluation. Presently, there is a lack of standards for acoustic evaluation in them. The aim of the present study was to systematically review the available literature on the acoustic analysis of voice in singers.

Method

A systematic review of studies on acoustic analysis of voice in singers (PubMed/MEDLINE, CINAHL, Scopus, ProQuest, Cochrane, Ovid, Science Direct, and Shodhganga) was carried out. Key words based on PIO (population–investigation–outcome) were used to develop search strings. Titles and abstracts were screened independently, and appropriate studies were read in full for data extraction.

Results

Of the 895 studies, 26 studies met the inclusion criteria. Great variability was noted in the instruments and task used. Different acoustic measures were employed, such as fundamental frequency, perturbation, cepstral, spectral, dysphonia severity index, singing power ratio, and so forth.

Conclusion

Overall, a great heterogeneity was noted regarding population, tasks, instruments, and parameters. There is a lack of standardized criteria for the evaluation of singing voice. In order to implement acoustic analysis as a part of comprehensive voice evaluation exclusively for singers, there is a certain need for methodical sound studies.

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Remote Microphone System Use at Home: Impact on Caregiver Talk

Purpose

The purpose of this study was to investigate the effects of home use of a remote microphone system (RMS) on the spoken language production of caregivers with young children who have hearing loss.

Method

Language Environment Analysis recorders were used with 10 families during 2 consecutive weekends (RMS weekend and No-RMS weekend). The amount of talk from a single caregiver that could be made accessible to children with hearing loss when using an RMS was estimated using Language Environment Analysis software. The total amount of caregiver talk (close and far talk) was also compared across both weekends. In addition, caregivers' perceptions of RMS use were gathered.

Results

Children, with the use of RMSs, could potentially have access to approximately 42% more words per day. In addition, although caregivers produced an equivalent number of words on both weekends, they tended to talk more from a distance when using the RMS than when not. Finally, caregivers reported positive perceived communication benefits of RMS use.

Conclusions

Findings from this investigation suggest that children with hearing loss have increased access to caregiver talk when using an RMS in the home environment. Clinical implications and future directions for research are discussed.

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Role of the Frontal Sinus in Mediating Ocular Vestibular-Evoked Myogenic Potentials by Bone Vibration Stimuli Applied to the Forehead

This study investigated ocular vestibular-evoked myogenic potential (oVEMP) tests via Fpz and Fz taps to assess the role of the frontal sinus in mediating oVEMP elicitation. Forty healthy subjects and 80 patients with Ménière disease (MD) underwent a series of oVEMP tests via a minishaker tapping at the Fpz and Fz sites in a randomized order. Response rates of oVEMP test via various tapping sites were compared. Dimensions of the frontal sinus were measured via CT scan. A significantly negative correlation between the age and height of the frontal sinus was noted, and the cutoff age for discriminating present and absent Fpz oVEMPs in MD patients was 52 years. Additionally, oVEMPs by Fpz tapping were more efficiently presented in males than females, likely because of the greater resonance by the larger height of the frontal sinus in males (3.88 ± 0.68 cm) than females (3.42 ± 0.67 cm). In conclusion, the height of the frontal sinus plays a role in mediating the elicitation of oVEMPs. The oVEMPs could be easily elicited by the first-order bone vibration (Fpz/Fz tapping) coupled with the second-order resonance effect (with a high extent of the frontal sinus). Thus, initial tapping at the Fpz site is suggested. If it fails, try the Fz site for screening the oVEMPs.
Audiol Neurotol 2017;22:272-281

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New Experimental Device Promises Tinnitus Relief

Millions of Americans suffer from tinnitus, which is defined by researchers at the Kresge Hearing Research Institute of the Department of Otolaryngology at the University of Michigan as the phantom perception of sound in the absence of external stimuli. About 2 million are incapacitated by the negative impacts of tinnitus. People with tinnitus experience varying severity of discomfort—some individuals are minimally disturbed while others sufferer sleep disturbances, poor concentration, depression, and anxiety. Fortunately, a recently published study entitled "Auditory-somatosensory bimodal stimulation desynchronizes brain circuitry to reduce tinnitus in guinea pigs and humans" reported that there is a promising technology that may help sufferers reduce their tinnitus.

Here's a technical explanation in the study: Tinnitus is believed to result from the impairment of physiological regulatory mechanism of neural synchrony from the dorsal cochlear nucleus (DNC) to the neural ensembles along the auditory pathway. The DNC is where the initial multisensory integration of neural inputs from the auditory nerve, auditory midbrain, auditory cortex, trigeminal and cervical ganglia, spinal trigeminal nucleus, and dorsal column nuclei happens. Research in animals reveals that increased instinctive cross-neural activity of DCN's output neurons, the fusiform cells, results in behavioral evidence of tinnitus.

University of Michigan Medical School professor Susan Shore, PhD, the lead researcher of the study, has a less technical answer. In an article, Shore said that the specific the region of the brainstem, the DNC, is the root of tinnitus. "When the main neurons in this region, called fusiform cells, become hyperactive and synchronize with one another, the phantom signal is transmitted into other centers where perception occurs," she explained.

"If we can stop these signals, we can stop tinnitus," said Shore. "That is what our approach attempts to do, and we're encouraged by these initial parallel results in animals and humans."

The research, which studied fusiform cells and their role in tinnitus perception, used a dual-stimulus approach called targeted bimodal auditory-somatosensory stimulation to incite long-term depression (LTD) in the cochlear nucleus and to beneficially reset the activity of the fusiform cells. The experimental approach was delivered to guinea pigs for 25 days. The same bimodal treatment was administered to 20 human subjects for 28 days. The results are encouraging. The study concludes that bimodal auditory-somatosensory stimulation may suppress chronic tinnitus in patients.

​While the tinnitus treatment offered by this research is promising, it remains to be experimental and commercially unavailable. The human test subjects were limited to those sufferers capable of temporarily altering their symptoms through clenching of jaws, sticking out of tongues, or turning/flexing of necks. There will be another clinical trial this year.

Published: 1/16/2018 3:16:00 PM

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Grason‐Stadler Launches GSI Novus

Grason‐Stadler released the new AABR/OAE screener, the GSI Novus™, a hand-held, comprehensive newborn hearing screening instrument. The Novus features a touchscreen display and intuitive software in a compact hardware design. The Novus may be configured with any combination of AABR, TEOAE, and DPOAE which allows for seamless two stage infant screening.

The Novus uses a fast rate ABR algorithm with the CE-Chirp stimulus. The CE-Chirp has been proven to produce Wave V responses that are 1.5 to 2 times larger than traditional ABR stimuli making CE-Chirp ideal for newborn screening. With larger responses, test times are reduced and more infants can be screened every day. Distortion Product Otoacoustic Emissions (DPOAE) and Transient Otoacoustic Emissions (TEOAE) protocols add the flexibility required for efficiency in newborn screening.

HearSIM data management software compliments the GSI Novus and offers everything required to manage your newborn screening program. Load patient names into the Novus or quickly determine which patients need additional testing with the intuitive database view. In addition to viewing, storing, and printing test results, it is possible to export data to XML or Hi-Track. Device settings such as screener names, security, and risk factors may be configured from HearSIM.

Published: 1/16/2018 8:35:00 AM

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A Potential Cure for Genetic Deafness

​Researchers from the Howard Hughes Medical Institute have successfully prevented genetic hearing loss in mice through the genome editing technology CRISPR-Cas9 in a recent study. (Nature 2017. doi: 10.1038/nature25164. [Epub ahead of print].) They injected a single treatment of a genome editing cocktail, which acted as molecular scissors and disrupted the mutation in the gene Tmc1, into the inner ears of infant mice with that mutation. The hair cells in treated ears resembled those in healthy animals after eight weeks, and treated ears could hear sounds about 15 dB lower than untreated ears. 

                                                       

Scientists can gauge mouse hearing by measuring how much noise (dB SPL) it takes to trigger an auditory brainstem response (ABR). Sounds starting at roughly 30 decibels can spark brain activity in normal mice (green/bottom line). Mice with the Tmc1 mutation lose their ability to hear and eventually become deaf. But injecting their inner ears with a genome editing agent made them more sensitive to sound (blue/middle line) than ears without an injection (red/top line). Credit: X. Gao, et al./Nature 2017 (http://bit.ly/2CZXbdR). ​

A single spelling error in Tmc1causes the loss of the inner ear's hair cells over time, and just one copy of a mutated Tmc1 gene causes progressive hearing loss leading to profound deafness in both humans and mice. Scientists at Howard Hughes snipped both strands of the DNA double helix with Cas9 to disable the gene. The challenge of the study lied in directing Cas9 to only the bad copy of Tmc1 and not the good one because the two copies differ by just one DNA letter. Researchers in this study packaged Cas9 and the guiding RNA into a greasy bundle that slips inside cells but doesn't stick around, allowing Cas9 to hit the bad gene copy and fade away before it could harm the good one. 

       

In the genome editing technology known as CRISPR-Cas9, RNA (blue) guides the protein Cas9 (large bumpy structure) to a target site in DNA (red). Cas9 unwinds the DNA double helix and acts as molecular scissors, snipping both strands of DNA. This animation is a preview of an interactive web feature that HHMI BioInteractive will debut in March of 2018. Credit: Howard Hughes Medical Institute (http://bit.ly/2CZXbdR).

​David Liu, PhD, a professor of chemistry and chemical biology at Harvard University and an investigator in the study, said the work is among the first to apply a genome editing approach to deafness in animals, and the positive change they observed in the mice could make a major difference in the quality of life for patients with hearing loss. "We hope that the work will one day inform the development of a cure for certain forms of genetic deafness in people," he said. 

Published: 1/14/2018 2:13:00 PM

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New Tool Enables Superior 3D Visualization of the Middle Ear

Imaging the middle-ear structure is problematic but researchers at the Canadian Light Source (CLS), Canada's national synchrotron light source facility, have made it possible to take complete, high-resolution 3D images.

In a recently published article, Western University biomedical engineering professor Hanif Ladak and his team detailed the methodology and findings of their comparison of commonly used imaging techniques, particularly micro-computed tomography (CT) and optical microscopy, with synchrotron radiation phase-contrast imaging (SR-PCI) in the visualization of structural details and soft-tissue contrast of the middle ear. The goal of their research was to study the biomechanical function of the middle ear, which is possible through finite-element (FE) modeling using high-resolution images.

Ladak explained that comprehensive unified three-dimensional images of both the bones and the soft tissue are necessary for designing prostheses or implants.

What makes generating three-dimensional images that capture of all the parts together problematic? The complexity and size of the organ. The middle ear has very small and complicated structure. It is made up of three microscopic bones, which measure only a few millimeters across, and even more microscopic soft tissues that connect these tiny bones. While there are facilities that can take 3D images of the middle ear's bones, they fail to capture the soft tissues. Ladak said that the biomedical imaging facility at CLS allowed his team to successfully image both.

Another advantage of SR-PCI is that unlike the widely used computed tomography (CT) and optical microscopy that require tedious sample preparation to achieve sufficient soft-tissue contrast, SR-PCI delivers superior images without the need for staining or decalcification.

The researchers concluded that SR-PCI provides superior visualization of microstructures over conventional micro-CT and that it is an exceptional device for simultaneously imagining both middle-ear bones and soft tissue. The article highlighted that SR-PCI's improved visualization, modeling accuracy, and simple sample preparation, make it a promising high-performance device for generating reliable FE models of the middle-ear structures.

​ 

Published: 1/9/2018 2:28:00 PM

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InnerScope to Distribute Universal Remote Hearing Aid Programming Software

​InnerScope Hearing Technologies (http://www.innd.com/) has entered into a letter of intent (LOI) for an exclusive worldwide licensing and distribution for the FlexiHub Software as it relates to remote programming of hearing aids. The FlexiHub Software, created by Eltima Software GmbH, is a USB-over-Ethernet technology that allows total secure access and connection remotely via the internet for sharing of USB port devices to any remote computers around the world or using an Android smartphone. Hearing care providers can use the FlexiHub to remotely program and adjust their patients' hearing aids remotely, reducing the number of clinic visits for fine-tuning adjustments of hearing aids. InnerScope plans to make the FlexiHub available through a monthly or yearly subscription for hearing professionals and hearing aid users. Under the LOI, the company will also be able to white label the software and sublicense the use for other teleaudiology software platforms to global retailers and manufactures of hearing aid devices and other hearing augmented technologies.​

Published: 1/5/2018 10:45:00 AM

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MED-EL Announces Winners of Its Ideas4Ears Competition

​MED-EL (http://ift.tt/1pfpn1t) has announced the winners of its global Ideas4Ears children's invention contest. Parker Welsh from Ozawkie, KS, won the grand prize with his entry involving inserting regenerative cells from salamanders, which are responsible for tissue repair and regeneration, into human macrophages. Welsh won a $1,000 college scholarship and a trip for two to MED-EL's international headquarters in Innsbruck, Austria. The Ideas4Ears competition challenged children to create a piece of artwork showcasing their invention to improve the quality of life for people living with hearing loss. More than 240 entries were received from around the world, and winners were selected from seven countries, including the United States, Austria, Brazil, Germany, Italy, New Zealand and the United Kingdom. Avery Bennett from Chicago, IL, was awarded the finalist prize.​

Published: 12/30/2017 5:23:00 PM

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Eosera Now Offers Earwax MD to Long-Term Care Facilities

​Eosera (https://earcaremd.com/), the maker of the topical cerumen dissolving drop Earwax MD, has established a partnership with nursing home and long-term care hospital health care product supplier VitalMedix to extend the availability of Earwax MD to long-term care facilities. Under this partnership, nursing homes and long-term care facilities in the United States will be able to purchase Earwax MD, which is already available in CVS nationwide, directly from VitalMedix to use in their offices starting this month. Elyse Dickerson, co-founder and CEO of Eosera, said hearing loss is common in the elderly, but it's largely avoidable. "Often, it is a direct result of severe earwax impaction, resulting from failure to keep the ears clean," Dickerson said. "In our ongoing conversations with health care professionals, we have identified this population as one that truly and urgently needs an effective solution to alleviate the discomfort related to earwax impaction, and they need it on premises." The dual-action Earwax MD solubilizes lipids and wax while simultaneously disrupting the sheets of keratinocytes that are continually shed from the ear canal. The product has won the company the 2017 Tech Fort Worth IMPACT Awards.​

Published: 12/22/2017 8:14:00 AM

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Hearing Loss May Be a Risk Factor for Dementia and Cognitive Decline

​Researchers found that hearing loss is significantly associated with dementia and other forms of cognitive decline in the first systematic review and meta-analysis of age-related hearing loss (ARHL) and cognitive decline using only pure-tone thresholds as the audiometric criteria ( JAMA Otolaryngol Head Neck Surg 2017. doi: 10.1001/jamaoto.2017.2513). Thirty-six unique studies found in PubMed, the Cochrane Library, EMBASE, and SCOPUS with about 20,264 participants were included in this study. The authors found a significant association between ARHL and dementia, and a small but statistically significant association between ARHL and all 10 cognitive domains that were investigated in this analyze, including global cognition, executive functions (attention, fluency, reasoning, and working memory), episodic memory (delayed and immediate recall), processing speed, semantic memory, and visuospatial ability. ARHL was also found to have a statistically significant association with cognitive impairment.

The authors said the causal mechanisms between ARHL and cognitive decline remain unclear, but one hypothesis is a common etiology like decline in the vascular system or a broader physiological decline. ARHL has been linked with multiple indicators of functional decline and is a biomarker for frailty syndrome, which has been causally linked to dementia. The authors also noted other hypotheses suggesting that ARHL may be causing cognitive decline through impaired speech perception. They recommended more randomized clinical trials exploring the cognitive benefit of hearing loss treatment and more research on whether treatment, alone or as part of a wider approach to risk factors, modifies dementia outcomes. 

Published: 12/15/2017 12:15:00 PM

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PSAPs and Hearing Products Now Available on InnerScope Hearing Technologies’ Online Store

​InnerScope Hearing Technologies (http://www.innd.com/) has added personal sound amplification products (PSAPs) and hearable or wearable hearing products to the offerings on its direct-to-consumer (DTC) online store. The store offers two ear-level PSAP products with the company's universal fitting earpiece. It also offers two hearable or wearable PSAP products that can be used to understand conversations better in a variety of situations and difficult listening environments. The hearable and wearable products are equipped with Bluetooth functionality: They can be adjusted by the user for more advanced hearing features using a smartphone with the Android app, and they have streaming capabilities via audio input for music or movies.

​Matthew Moore, president of InnerScope Hearing Technologies, said their new online store aims at combating the sticker shock of traditional hearing aids that dissuades people from seeking help. "We have built our e-commerce platform specifically for those individuals who are not receiving the help they need and deserve," Moore said. "The PSAPs and hearables/wearables technology products that we are offering through our DTC e-commerce store are fast becoming an alternative hearing solution over the high cost and inconvenience of hearing aids."

Published: 12/8/2017 10:25:00 AM

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Earwax MD Now Available in Canada

Eosera (https://earcaremd.com/) has made Earwax MD available in Canada through Amazon.ca, the first foreign market the company has brought its product to. On Amazon.ca, the product is available in a kit that includes a 15 mL bottle and rinsing bulb. Amazon Prime members can get Earwax MD with free shipping on Amazon.ca. The topical cerumen-dissolving drop has been stocked in CVS stores across the United States since August, and has been part of the U.S. Amazon Exclusives program since April 2017.

Elyse Dickerson, co-founder and CEO of Eosera, said they founded Eosera to develop solutions for unmet healthcare needs that would have a global impact, and since launching Earwax MD on Amazon.com in April, they have received considerable interest from Canadian consumers, audiologists, ENTs and other health care professionals. "We are thrilled to enter Canada on Amazon.ca, so that from the start, we are available to all Canadians," Dickerson said. "We are working towards a larger distribution channel in Canada, and anticipate availability in retail stores and additional distributors in the future."

Published: 11/30/2017 3:52:00 PM

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2018 World Congress of Audiology – A Historic Occasion

​By De Wet Swanepoel, PhD

The International Society of Audiology has been the global home of audiology since the very early beginnings of the profession, now almost 70 years ago. The society supports and advances audiology around the globe, and its biennial World Congress of Audiology (previously called the International Congress of Audiology) provides a unique platform to showcase audiological research from around the world.
 
A Historic Event
The World Congress of Audiology, held biennially since 1952 will be hosted in Cape Town, South Africa in October 2018. Held on every continent of the world, except for Africa, the 2018 meeting promises to be a truly historic occasion. Not only because of the iconic destination but as a platform showcasing clinical audiology science from around the world.
Having the 2018 World Congress of Audiology hosted on African soil for the first time creates a unique opportunity to advocate and promote audiology and hearing health across the continent. Close to 40 million people are living with a permanent disabling hearing loss in sub-Saharan Africa. Most of these persons have no access to hearing health care due to challenges that include a lack of human resources - with less than one audiologist to every million persons - and due to unavailable hearing health infrastructure. The 2018 World Congress of Audiology will, therefore, prioritise and use this historic event to stimulate awareness and growth in audiology across Africa.
 
A Diverse Global Program
The rich and varied heritage of the International Society of Audiology's (ISA) biennial congress is characteristic of its continued success, drawing leading researchers, academics and clinicians. ISA’s network of affiliate societies, representing audiological societies in more than 30 countries and on every continent (except Antarctica!), is central to the success of its World Congress of Audiology.
The scientific programme already covers a wide-range of areas including adult and pediatric hearing aids, diagnostic audiology, e-Health, electrophysiology, special populations and a focus on the future priorities for the profession and science of audiology. Leading experts from the USA, Europe, Australia, UK and other world regions will ensure a programme that will cover cutting-edge translational and clinical research.

Considering the ISA’s role as an official partner and financial supporter of the World Health Organization (WHO) and its initiatives in hearing healthcare the World Congress will  showcase global priorities in hearing care with a keynote session by Dr Shelly Chadha, WHO technical officer for prevention of deafness and hearing loss
 
A “Singularly Beautiful” Location
The 2018 World Congress of Audiology will be hosted in the “singularly beautiful city” of Cape Town at the tip of the African continent (Lonely Planet, 2017). Cape Town has been chosen as one of the Top 10 cities in the world for travellers in 2017 (Lonely Planet, 2017) – the latest in a series of accolades that have helped to cement the city’s reputation as a global giant among destinations. Cape Town features second on the list of top cities for 2017 after Bordeaux in France.
The Cape Town International Convention Centre regularly hosts world-class conferences and events and has become  the top convention centre in Africa and one of the leading convention centres in the southern hemisphere. Excellent accommodation, ranging from 5- to 2-star options, is available right at the convention centre to ensure everyone can be accommodated. The convention centre is walking distance from the famous waterfront area with a view of Table Mountain and the Atlantic Ocean. 
Tourist attractions are everywhere with Table Mountain, Robben Island and the Waterfront right on your doorstep. There is something for everyone, from the Winelands to shopping, nature reserves, hiking, and exquisite beaches. World Congress of Audiology 2018 delegates and their families can be sure that this promises to be an unforgettable experience.
 
Go Ahead #SaveTheDate
Make sure you save the dates of 28 – 31 October 2018 for this historic audiology event. Individual membership of the International Society of Audiology (http://ift.tt/2DhRo4c) includes discounted registration fees to the World Congress of Audiology, access to the International Journal of Audiology and to the society’s international community and networks. Abstract submissions are open until 16 April 2018. For more information please visit www.wca2018.co.za.

​

Published: 11/24/2017 9:02:00 AM

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FDA Approves the First Telehealth Option to Program Cochlear Implants Remotely

The U.S. Food and Drug Administration has approved a remote feature for follow-up programming of Cochlear's Nucleus Implant System through a telemedicine platform. The FDA evaluated data supporting this feature's effectiveness, including those from a clinical study of 39 patients aged 12 or older, each of whom had a cochlear implant for at least one year. Each patient had one in-person programming session and two remote programming sessions, and speech perception tests showed no significant difference between in-person and remote programing. The FDA also evaluated data from patients' self-assessment of their ability to hear speech in the presence of other sounds and sense the direction, distance, and motion of sound. Cybersecurity measures for the remote interaction were also assessed.

​This feature is designed for patients who have had six months of experience with their cochlear implant sound processor and are comfortable with the programming process. "Being able to have a qualified audiologist program the device via telemedicine from a remote location can greatly reduce the burden to patients and their families, especially those who must travel great distances or need frequent adjustments," said Malvina Eydelman, MD, director of the Division of Ophthalmic and Ear, Nose and Throat Devices in the FDA's Center for Devices and Radiological Health.

Published: 11/20/2017 2:26:00 PM

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Stem Cells Can Restore Hearing but May Pose Cancer Risk

A new study found that injecting stem cells into the inner ear can restore hearing, but the process could lead to cancer. (Stem Cell Reports 2017;9[5]:1516.) Researchers at Rutgers University-New Brunswick overexpressed the gene NEUROG1, which plays a role in spiral ganglion neuron and hair cell development, to turn inner ear stem cells into auditory neurons, which could reverse deafness. This, however, could can also make those cells divide too quickly, posing a cancer risk. To control this process, researchers used chromatin, DNA studded with histone proteins, to influence how NEUROG1 functions. Researchers discovered that chromatin may help reduce unwanted stem cell proliferation, and it can be achieved by adding drugs to experimental cultures in Petri dishes.

​Kelvin Kwan, PhD, a senior author of the study and an assistant professor in the department of cell biology and neuroscience at Rutgers University, said this is a cautionary tale. "People say, 'we'll just put stem cells in and we're going to replace lost neurons,'" Kwan said. "We're saying that 'yes, we can make neurons,' but you have other side effects that are unanticipated, such as increased proliferation of stem cells. So this will guide us toward a better strategy for cell replacement therapies."

Published: 11/17/2017 9:50:00 AM

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Oticon’s HearingFitness App Wins CES Innovation Award

Oticon's (https://www.oticon.com/) HearingFitness app, a tracker that monitors the impact of hearing on its wearer's overall health, won a Consumer Electronics Show Innovation Award. Used in conjunction with Oticon's internet-connected hearing aids, Oticon Opn, the HearingFitness app tracks hearing aid use, listening environments, and other data. It then collates those data with measurements of heart rate, sleep patterns, and other health markers from other wearable devices to give hearing aid users advice and encouragement on ways to hear better, protect their hearing, and stay healthy.

​Dom Schum, PhD, vice president of audiology at Oticon, said the HearingFitness app empowers users to learn about their hearing and take charge of their long-term health and well-being through their hearing habits. "They gain a sense of belonging to a new generation that's on top of their hearing and health, instead of being defined by it," Schum said. "But most importantly, HearingFitness encourages users to wear their hearing aids more and helps generate data that will lead to better hearing care and, ultimately, better and more rewarding lives." Oticon will demo the HearingFitness app and Oticon Opn on Jan. 9-12 at CES 2018 in Las Vegas.

Published: 11/10/2017 1:19:00 PM

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Spider Web Holds the Secret to Superior Microphones in Hearing Aids

A new study found that spider silk has the potential to enhance hearing aid microphones' sensitivity and ability to process low-frequency sounds. (Proc Natl Acad Sci U S A. 2017. doi: 10.1073/pnas.1710559114.) Spiders hear by using their hairs to detect the velocity of air. To see if they could harness these capabilities to improve the quality of microphones, researchers from Binghamton University coated spider silk with gold to add electrical conductivity to the fiber, and incorporated it into a microphone. They discovered that nanodimensional spider silk captures fluctuating airflow with maximum physical efficiency from 1 Hz to 50 kHz.

​Ron Miles, a mechanical engineer at Binghamton University who created the microphone, said the resulting microphone consists of super-thin fibers that move with the air in a sound field. "The fibers are driven by viscous forces in air, like those that cause tiny dust particles to float around in a slight breeze," he said. The researchers said adding spider silk to microphones is a miniature, directional, broadband, passive, low-cost approach to detecting airflow over a frequency bandwidth that spans the full range of human hearing.

Published: 11/3/2017 1:21:00 PM

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Hearing Aid Startup to Receive $45 Million Funding

​Eargo (https://eargo.com/), a direct-to-consumer hearing technology company, has announced the closing of the first tranche of an aggregate $45 million Series C investment round, which the company said will be used to accelerate their product innovation. The new investment was led by Nan Fung Life Sciences. New Enterprise Associates, Charles and Helen Schwab, and Maveron have also provided investments. Eargo is designed for consumers with on-the-go lifestyles and the desire for simplicity. Christian Gormsen, the CEO of Eargo, said, "We believe people shouldn't feel that they need a hearing aid.  They should feel that they want one.  Eargo was created with this in mind and we're just getting started."​

Published: 10/27/2017 2:07:00 PM

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Researchers Discover New Genes Critical for Understanding Hearing Loss

A study has identified new genes linked to hearing loss in mice, which will provide insights into the causes of hearing loss in humans (Nat Commun. 2017;8[1]:886). Scientists from Medical Research Council Hartwell who led the research found 67 genes that were associated with hearing loss, of which 52 had not been previously connected to hearing loss, by testing 3,006 strains of mice for signs of hearing loss. They assessed the hearing thresholds of these mice with rising volumes of sounds at different frequencies. Mice were considered hearing impaired if they could not hear the quieter sounds for two or more frequencies. The genes identified varied in how they affect hearing, with effects ranging from mild to severe hearing loss or hearing difficulties at lower or higher frequencies.

​​Steve Brown, PhD, senior author of this paper, said the results of the study increased the knowledge of the many genes and molecular mechanisms required for hearing and provide a short list of new genes to investigate to discover the genetic basis of many human hearing loss syndrome. "Further investigation of these hearing loss mouse models will increase understanding of how the auditory system develops, is maintained, and the pathological processes involved with its decline," Brown said. "In particular, we need to establish whether the genes impact on known hearing loss pathways or if they implicate new processes in the auditory system. A longer term benefit that could arise from studying these models might be the identification of critical cellular functions, which can then be targets for therapies."

 

 

Published: 10/20/2017 9:44:00 AM

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SonicCloud Builds Functionality of Hearing Aids Into iPhones

​The startup SonicCloud (https://soniccloud.com/) has launched an iOS app that allows those with moderate to severe hearing loss hear phone calls clearly by calibrating every mobile phone call for their unique hearing needs. The SonicCloud App users will be able to determine custom levels for their right and left ears by taking a quick hearing assessment on the app. Each user gets his or her own personal Hearing Fingerprint, which is driven by an algorithm in the cloud that adjusts to an individual's hearing needs. Incoming and outgoing calls are then processed through SonicCloud's "mixing board in the cloud," which optimizes voices and noisy environments. The SonicCloud App is the company's first step towards making hearing technology truly accessible to hearing-impaired individuals. SonicCloud was featured in Apple's 2017 Worldwide Developers Conference. 

               

Published: 10/13/2017 12:04:00 PM

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Therapies for Inner Ear Disorders Are One Step Closer to Reality

Spiral Therapeutics (http://ift.tt/2xooDek), a pre-clinical stage company developing first-in-class therapies targeting inner ear disorders, has received positive feedback from the U.S. Drug and Food Administration (FDA) regarding its first Pre-Investigational New Drug (Pre-IND) package submission.  The FDA answered Spiral's product development questions related to manufacturing and non-clinical testing, and concurred with the company's clinical development plans for its LPT99 program for preventing chemotherapy-induced hearing loss in pediatric patients. Pre-IND is a program through which the FDA's Office of Antimicrobial Products could provide advice on drug development before it begins. Spiral plans to raise additional funds for an initial Phase 1 trial, the development of new preclinical data, and the company's operations for the next 18 months.​

Published: 10/6/2017 1:51:00 PM

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iotaMotion Receives NIH Grant to Develop Robotics for Cochlear Implant Surgery

​The medical device startup iotaMotion (http://iotamotion.com/) has been awarded a $1.4 million grant from the National Institutes of Health (NIH) to develop its next-generation implantable robotic technology IOTA-Progress. The company will use this funding from the NIH's Small Business Innovation Research program to hone a robotic-assisted cochlear implant insertion system that will provide precise and controlled electrode advancement during hybrid cochlear implant surgeries. Marlan Hansen, MD, one of the founders of iotaMotion, said providing a more controlled, fine electrode insertion of the electrode should significantly enhance professionals' ability to preserve hearing. "Then we have what this grant is helping to fund for our company, which is the development of an implantable system allowing for electrode adjustments within the cochlea after the original surgery, without surgical intervention," Hansen said. "The goal here is optimal positioning within the cochlea to best match that patient's hearing, which often changes over time."

Published: 9/29/2017 9:16:00 AM

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New Experimental Device Promises Tinnitus Relief

Millions of Americans suffer from tinnitus, which is defined by researchers at the Kresge Hearing Research Institute of the Department of Otolaryngology at the University of Michigan as the phantom perception of sound in the absence of external stimuli. About 2 million are incapacitated by the negative impacts of tinnitus. People with tinnitus experience varying severity of discomfort—some individuals are minimally disturbed while others sufferer sleep disturbances, poor concentration, depression, and anxiety. Fortunately, a recently published study entitled "Auditory-somatosensory bimodal stimulation desynchronizes brain circuitry to reduce tinnitus in guinea pigs and humans" reported that there is a promising technology that may help sufferers reduce their tinnitus.

Here's a technical explanation in the study: Tinnitus is believed to result from the impairment of physiological regulatory mechanism of neural synchrony from the dorsal cochlear nucleus (DNC) to the neural ensembles along the auditory pathway. The DNC is where the initial multisensory integration of neural inputs from the auditory nerve, auditory midbrain, auditory cortex, trigeminal and cervical ganglia, spinal trigeminal nucleus, and dorsal column nuclei happens. Research in animals reveals that increased instinctive cross-neural activity of DCN's output neurons, the fusiform cells, results in behavioral evidence of tinnitus.

University of Michigan Medical School professor Susan Shore, PhD, the lead researcher of the study, has a less technical answer. In an article, Shore said that the specific the region of the brainstem, the DNC, is the root of tinnitus. "When the main neurons in this region, called fusiform cells, become hyperactive and synchronize with one another, the phantom signal is transmitted into other centers where perception occurs," she explained.

"If we can stop these signals, we can stop tinnitus," said Shore. "That is what our approach attempts to do, and we're encouraged by these initial parallel results in animals and humans."

The research, which studied fusiform cells and their role in tinnitus perception, used a dual-stimulus approach called targeted bimodal auditory-somatosensory stimulation to incite long-term depression (LTD) in the cochlear nucleus and to beneficially reset the activity of the fusiform cells. The experimental approach was delivered to guinea pigs for 25 days. The same bimodal treatment was administered to 20 human subjects for 28 days. The results are encouraging. The study concludes that bimodal auditory-somatosensory stimulation may suppress chronic tinnitus in patients.

​While the tinnitus treatment offered by this research is promising, it remains to be experimental and commercially unavailable. The human test subjects were limited to those sufferers capable of temporarily altering their symptoms through clenching of jaws, sticking out of tongues, or turning/flexing of necks. There will be another clinical trial this year.

Published: 1/16/2018 3:16:00 PM

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Grason‐Stadler Launches GSI Novus

Grason‐Stadler released the new AABR/OAE screener, the GSI Novus™, a hand-held, comprehensive newborn hearing screening instrument. The Novus features a touchscreen display and intuitive software in a compact hardware design. The Novus may be configured with any combination of AABR, TEOAE, and DPOAE which allows for seamless two stage infant screening.

The Novus uses a fast rate ABR algorithm with the CE-Chirp stimulus. The CE-Chirp has been proven to produce Wave V responses that are 1.5 to 2 times larger than traditional ABR stimuli making CE-Chirp ideal for newborn screening. With larger responses, test times are reduced and more infants can be screened every day. Distortion Product Otoacoustic Emissions (DPOAE) and Transient Otoacoustic Emissions (TEOAE) protocols add the flexibility required for efficiency in newborn screening.

HearSIM data management software compliments the GSI Novus and offers everything required to manage your newborn screening program. Load patient names into the Novus or quickly determine which patients need additional testing with the intuitive database view. In addition to viewing, storing, and printing test results, it is possible to export data to XML or Hi-Track. Device settings such as screener names, security, and risk factors may be configured from HearSIM.

Published: 1/16/2018 8:35:00 AM

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A Potential Cure for Genetic Deafness

​Researchers from the Howard Hughes Medical Institute have successfully prevented genetic hearing loss in mice through the genome editing technology CRISPR-Cas9 in a recent study. (Nature 2017. doi: 10.1038/nature25164. [Epub ahead of print].) They injected a single treatment of a genome editing cocktail, which acted as molecular scissors and disrupted the mutation in the gene Tmc1, into the inner ears of infant mice with that mutation. The hair cells in treated ears resembled those in healthy animals after eight weeks, and treated ears could hear sounds about 15 dB lower than untreated ears. 

                                                       

Scientists can gauge mouse hearing by measuring how much noise (dB SPL) it takes to trigger an auditory brainstem response (ABR). Sounds starting at roughly 30 decibels can spark brain activity in normal mice (green/bottom line). Mice with the Tmc1 mutation lose their ability to hear and eventually become deaf. But injecting their inner ears with a genome editing agent made them more sensitive to sound (blue/middle line) than ears without an injection (red/top line). Credit: X. Gao, et al./Nature 2017 (http://bit.ly/2CZXbdR). ​

A single spelling error in Tmc1causes the loss of the inner ear's hair cells over time, and just one copy of a mutated Tmc1 gene causes progressive hearing loss leading to profound deafness in both humans and mice. Scientists at Howard Hughes snipped both strands of the DNA double helix with Cas9 to disable the gene. The challenge of the study lied in directing Cas9 to only the bad copy of Tmc1 and not the good one because the two copies differ by just one DNA letter. Researchers in this study packaged Cas9 and the guiding RNA into a greasy bundle that slips inside cells but doesn't stick around, allowing Cas9 to hit the bad gene copy and fade away before it could harm the good one. 

       

In the genome editing technology known as CRISPR-Cas9, RNA (blue) guides the protein Cas9 (large bumpy structure) to a target site in DNA (red). Cas9 unwinds the DNA double helix and acts as molecular scissors, snipping both strands of DNA. This animation is a preview of an interactive web feature that HHMI BioInteractive will debut in March of 2018. Credit: Howard Hughes Medical Institute (http://bit.ly/2CZXbdR).

​David Liu, PhD, a professor of chemistry and chemical biology at Harvard University and an investigator in the study, said the work is among the first to apply a genome editing approach to deafness in animals, and the positive change they observed in the mice could make a major difference in the quality of life for patients with hearing loss. "We hope that the work will one day inform the development of a cure for certain forms of genetic deafness in people," he said. 

Published: 1/14/2018 2:13:00 PM

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New Tool Enables Superior 3D Visualization of the Middle Ear

Imaging the middle-ear structure is problematic but researchers at the Canadian Light Source (CLS), Canada's national synchrotron light source facility, have made it possible to take complete, high-resolution 3D images.

In a recently published article, Western University biomedical engineering professor Hanif Ladak and his team detailed the methodology and findings of their comparison of commonly used imaging techniques, particularly micro-computed tomography (CT) and optical microscopy, with synchrotron radiation phase-contrast imaging (SR-PCI) in the visualization of structural details and soft-tissue contrast of the middle ear. The goal of their research was to study the biomechanical function of the middle ear, which is possible through finite-element (FE) modeling using high-resolution images.

Ladak explained that comprehensive unified three-dimensional images of both the bones and the soft tissue are necessary for designing prostheses or implants.

What makes generating three-dimensional images that capture of all the parts together problematic? The complexity and size of the organ. The middle ear has very small and complicated structure. It is made up of three microscopic bones, which measure only a few millimeters across, and even more microscopic soft tissues that connect these tiny bones. While there are facilities that can take 3D images of the middle ear's bones, they fail to capture the soft tissues. Ladak said that the biomedical imaging facility at CLS allowed his team to successfully image both.

Another advantage of SR-PCI is that unlike the widely used computed tomography (CT) and optical microscopy that require tedious sample preparation to achieve sufficient soft-tissue contrast, SR-PCI delivers superior images without the need for staining or decalcification.

The researchers concluded that SR-PCI provides superior visualization of microstructures over conventional micro-CT and that it is an exceptional device for simultaneously imagining both middle-ear bones and soft tissue. The article highlighted that SR-PCI's improved visualization, modeling accuracy, and simple sample preparation, make it a promising high-performance device for generating reliable FE models of the middle-ear structures.

​ 

Published: 1/9/2018 2:28:00 PM

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InnerScope to Distribute Universal Remote Hearing Aid Programming Software

​InnerScope Hearing Technologies (http://www.innd.com/) has entered into a letter of intent (LOI) for an exclusive worldwide licensing and distribution for the FlexiHub Software as it relates to remote programming of hearing aids. The FlexiHub Software, created by Eltima Software GmbH, is a USB-over-Ethernet technology that allows total secure access and connection remotely via the internet for sharing of USB port devices to any remote computers around the world or using an Android smartphone. Hearing care providers can use the FlexiHub to remotely program and adjust their patients' hearing aids remotely, reducing the number of clinic visits for fine-tuning adjustments of hearing aids. InnerScope plans to make the FlexiHub available through a monthly or yearly subscription for hearing professionals and hearing aid users. Under the LOI, the company will also be able to white label the software and sublicense the use for other teleaudiology software platforms to global retailers and manufactures of hearing aid devices and other hearing augmented technologies.​

Published: 1/5/2018 10:45:00 AM

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MED-EL Announces Winners of Its Ideas4Ears Competition

​MED-EL (http://ift.tt/1pfpn1t) has announced the winners of its global Ideas4Ears children's invention contest. Parker Welsh from Ozawkie, KS, won the grand prize with his entry involving inserting regenerative cells from salamanders, which are responsible for tissue repair and regeneration, into human macrophages. Welsh won a $1,000 college scholarship and a trip for two to MED-EL's international headquarters in Innsbruck, Austria. The Ideas4Ears competition challenged children to create a piece of artwork showcasing their invention to improve the quality of life for people living with hearing loss. More than 240 entries were received from around the world, and winners were selected from seven countries, including the United States, Austria, Brazil, Germany, Italy, New Zealand and the United Kingdom. Avery Bennett from Chicago, IL, was awarded the finalist prize.​

Published: 12/30/2017 5:23:00 PM

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Eosera Now Offers Earwax MD to Long-Term Care Facilities

​Eosera (https://earcaremd.com/), the maker of the topical cerumen dissolving drop Earwax MD, has established a partnership with nursing home and long-term care hospital health care product supplier VitalMedix to extend the availability of Earwax MD to long-term care facilities. Under this partnership, nursing homes and long-term care facilities in the United States will be able to purchase Earwax MD, which is already available in CVS nationwide, directly from VitalMedix to use in their offices starting this month. Elyse Dickerson, co-founder and CEO of Eosera, said hearing loss is common in the elderly, but it's largely avoidable. "Often, it is a direct result of severe earwax impaction, resulting from failure to keep the ears clean," Dickerson said. "In our ongoing conversations with health care professionals, we have identified this population as one that truly and urgently needs an effective solution to alleviate the discomfort related to earwax impaction, and they need it on premises." The dual-action Earwax MD solubilizes lipids and wax while simultaneously disrupting the sheets of keratinocytes that are continually shed from the ear canal. The product has won the company the 2017 Tech Fort Worth IMPACT Awards.​

Published: 12/22/2017 8:14:00 AM

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Hearing Loss May Be a Risk Factor for Dementia and Cognitive Decline

​Researchers found that hearing loss is significantly associated with dementia and other forms of cognitive decline in the first systematic review and meta-analysis of age-related hearing loss (ARHL) and cognitive decline using only pure-tone thresholds as the audiometric criteria ( JAMA Otolaryngol Head Neck Surg 2017. doi: 10.1001/jamaoto.2017.2513). Thirty-six unique studies found in PubMed, the Cochrane Library, EMBASE, and SCOPUS with about 20,264 participants were included in this study. The authors found a significant association between ARHL and dementia, and a small but statistically significant association between ARHL and all 10 cognitive domains that were investigated in this analyze, including global cognition, executive functions (attention, fluency, reasoning, and working memory), episodic memory (delayed and immediate recall), processing speed, semantic memory, and visuospatial ability. ARHL was also found to have a statistically significant association with cognitive impairment.

The authors said the causal mechanisms between ARHL and cognitive decline remain unclear, but one hypothesis is a common etiology like decline in the vascular system or a broader physiological decline. ARHL has been linked with multiple indicators of functional decline and is a biomarker for frailty syndrome, which has been causally linked to dementia. The authors also noted other hypotheses suggesting that ARHL may be causing cognitive decline through impaired speech perception. They recommended more randomized clinical trials exploring the cognitive benefit of hearing loss treatment and more research on whether treatment, alone or as part of a wider approach to risk factors, modifies dementia outcomes. 

Published: 12/15/2017 12:15:00 PM

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PSAPs and Hearing Products Now Available on InnerScope Hearing Technologies’ Online Store

​InnerScope Hearing Technologies (http://www.innd.com/) has added personal sound amplification products (PSAPs) and hearable or wearable hearing products to the offerings on its direct-to-consumer (DTC) online store. The store offers two ear-level PSAP products with the company's universal fitting earpiece. It also offers two hearable or wearable PSAP products that can be used to understand conversations better in a variety of situations and difficult listening environments. The hearable and wearable products are equipped with Bluetooth functionality: They can be adjusted by the user for more advanced hearing features using a smartphone with the Android app, and they have streaming capabilities via audio input for music or movies.

​Matthew Moore, president of InnerScope Hearing Technologies, said their new online store aims at combating the sticker shock of traditional hearing aids that dissuades people from seeking help. "We have built our e-commerce platform specifically for those individuals who are not receiving the help they need and deserve," Moore said. "The PSAPs and hearables/wearables technology products that we are offering through our DTC e-commerce store are fast becoming an alternative hearing solution over the high cost and inconvenience of hearing aids."

Published: 12/8/2017 10:25:00 AM

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Earwax MD Now Available in Canada

Eosera (https://earcaremd.com/) has made Earwax MD available in Canada through Amazon.ca, the first foreign market the company has brought its product to. On Amazon.ca, the product is available in a kit that includes a 15 mL bottle and rinsing bulb. Amazon Prime members can get Earwax MD with free shipping on Amazon.ca. The topical cerumen-dissolving drop has been stocked in CVS stores across the United States since August, and has been part of the U.S. Amazon Exclusives program since April 2017.

Elyse Dickerson, co-founder and CEO of Eosera, said they founded Eosera to develop solutions for unmet healthcare needs that would have a global impact, and since launching Earwax MD on Amazon.com in April, they have received considerable interest from Canadian consumers, audiologists, ENTs and other health care professionals. "We are thrilled to enter Canada on Amazon.ca, so that from the start, we are available to all Canadians," Dickerson said. "We are working towards a larger distribution channel in Canada, and anticipate availability in retail stores and additional distributors in the future."

Published: 11/30/2017 3:52:00 PM

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2018 World Congress of Audiology – A Historic Occasion

​By De Wet Swanepoel, PhD

The International Society of Audiology has been the global home of audiology since the very early beginnings of the profession, now almost 70 years ago. The society supports and advances audiology around the globe, and its biennial World Congress of Audiology (previously called the International Congress of Audiology) provides a unique platform to showcase audiological research from around the world.
 
A Historic Event
The World Congress of Audiology, held biennially since 1952 will be hosted in Cape Town, South Africa in October 2018. Held on every continent of the world, except for Africa, the 2018 meeting promises to be a truly historic occasion. Not only because of the iconic destination but as a platform showcasing clinical audiology science from around the world.
Having the 2018 World Congress of Audiology hosted on African soil for the first time creates a unique opportunity to advocate and promote audiology and hearing health across the continent. Close to 40 million people are living with a permanent disabling hearing loss in sub-Saharan Africa. Most of these persons have no access to hearing health care due to challenges that include a lack of human resources - with less than one audiologist to every million persons - and due to unavailable hearing health infrastructure. The 2018 World Congress of Audiology will, therefore, prioritise and use this historic event to stimulate awareness and growth in audiology across Africa.
 
A Diverse Global Program
The rich and varied heritage of the International Society of Audiology's (ISA) biennial congress is characteristic of its continued success, drawing leading researchers, academics and clinicians. ISA’s network of affiliate societies, representing audiological societies in more than 30 countries and on every continent (except Antarctica!), is central to the success of its World Congress of Audiology.
The scientific programme already covers a wide-range of areas including adult and pediatric hearing aids, diagnostic audiology, e-Health, electrophysiology, special populations and a focus on the future priorities for the profession and science of audiology. Leading experts from the USA, Europe, Australia, UK and other world regions will ensure a programme that will cover cutting-edge translational and clinical research.

Considering the ISA’s role as an official partner and financial supporter of the World Health Organization (WHO) and its initiatives in hearing healthcare the World Congress will  showcase global priorities in hearing care with a keynote session by Dr Shelly Chadha, WHO technical officer for prevention of deafness and hearing loss
 
A “Singularly Beautiful” Location
The 2018 World Congress of Audiology will be hosted in the “singularly beautiful city” of Cape Town at the tip of the African continent (Lonely Planet, 2017). Cape Town has been chosen as one of the Top 10 cities in the world for travellers in 2017 (Lonely Planet, 2017) – the latest in a series of accolades that have helped to cement the city’s reputation as a global giant among destinations. Cape Town features second on the list of top cities for 2017 after Bordeaux in France.
The Cape Town International Convention Centre regularly hosts world-class conferences and events and has become  the top convention centre in Africa and one of the leading convention centres in the southern hemisphere. Excellent accommodation, ranging from 5- to 2-star options, is available right at the convention centre to ensure everyone can be accommodated. The convention centre is walking distance from the famous waterfront area with a view of Table Mountain and the Atlantic Ocean. 
Tourist attractions are everywhere with Table Mountain, Robben Island and the Waterfront right on your doorstep. There is something for everyone, from the Winelands to shopping, nature reserves, hiking, and exquisite beaches. World Congress of Audiology 2018 delegates and their families can be sure that this promises to be an unforgettable experience.
 
Go Ahead #SaveTheDate
Make sure you save the dates of 28 – 31 October 2018 for this historic audiology event. Individual membership of the International Society of Audiology (http://ift.tt/2DhRo4c) includes discounted registration fees to the World Congress of Audiology, access to the International Journal of Audiology and to the society’s international community and networks. Abstract submissions are open until 16 April 2018. For more information please visit www.wca2018.co.za.

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Published: 11/24/2017 9:02:00 AM

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FDA Approves the First Telehealth Option to Program Cochlear Implants Remotely

The U.S. Food and Drug Administration has approved a remote feature for follow-up programming of Cochlear's Nucleus Implant System through a telemedicine platform. The FDA evaluated data supporting this feature's effectiveness, including those from a clinical study of 39 patients aged 12 or older, each of whom had a cochlear implant for at least one year. Each patient had one in-person programming session and two remote programming sessions, and speech perception tests showed no significant difference between in-person and remote programing. The FDA also evaluated data from patients' self-assessment of their ability to hear speech in the presence of other sounds and sense the direction, distance, and motion of sound. Cybersecurity measures for the remote interaction were also assessed.

​This feature is designed for patients who have had six months of experience with their cochlear implant sound processor and are comfortable with the programming process. "Being able to have a qualified audiologist program the device via telemedicine from a remote location can greatly reduce the burden to patients and their families, especially those who must travel great distances or need frequent adjustments," said Malvina Eydelman, MD, director of the Division of Ophthalmic and Ear, Nose and Throat Devices in the FDA's Center for Devices and Radiological Health.

Published: 11/20/2017 2:26:00 PM

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Stem Cells Can Restore Hearing but May Pose Cancer Risk

A new study found that injecting stem cells into the inner ear can restore hearing, but the process could lead to cancer. (Stem Cell Reports 2017;9[5]:1516.) Researchers at Rutgers University-New Brunswick overexpressed the gene NEUROG1, which plays a role in spiral ganglion neuron and hair cell development, to turn inner ear stem cells into auditory neurons, which could reverse deafness. This, however, could can also make those cells divide too quickly, posing a cancer risk. To control this process, researchers used chromatin, DNA studded with histone proteins, to influence how NEUROG1 functions. Researchers discovered that chromatin may help reduce unwanted stem cell proliferation, and it can be achieved by adding drugs to experimental cultures in Petri dishes.

​Kelvin Kwan, PhD, a senior author of the study and an assistant professor in the department of cell biology and neuroscience at Rutgers University, said this is a cautionary tale. "People say, 'we'll just put stem cells in and we're going to replace lost neurons,'" Kwan said. "We're saying that 'yes, we can make neurons,' but you have other side effects that are unanticipated, such as increased proliferation of stem cells. So this will guide us toward a better strategy for cell replacement therapies."

Published: 11/17/2017 9:50:00 AM

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Oticon’s HearingFitness App Wins CES Innovation Award

Oticon's (https://www.oticon.com/) HearingFitness app, a tracker that monitors the impact of hearing on its wearer's overall health, won a Consumer Electronics Show Innovation Award. Used in conjunction with Oticon's internet-connected hearing aids, Oticon Opn, the HearingFitness app tracks hearing aid use, listening environments, and other data. It then collates those data with measurements of heart rate, sleep patterns, and other health markers from other wearable devices to give hearing aid users advice and encouragement on ways to hear better, protect their hearing, and stay healthy.

​Dom Schum, PhD, vice president of audiology at Oticon, said the HearingFitness app empowers users to learn about their hearing and take charge of their long-term health and well-being through their hearing habits. "They gain a sense of belonging to a new generation that's on top of their hearing and health, instead of being defined by it," Schum said. "But most importantly, HearingFitness encourages users to wear their hearing aids more and helps generate data that will lead to better hearing care and, ultimately, better and more rewarding lives." Oticon will demo the HearingFitness app and Oticon Opn on Jan. 9-12 at CES 2018 in Las Vegas.

Published: 11/10/2017 1:19:00 PM

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Spider Web Holds the Secret to Superior Microphones in Hearing Aids

A new study found that spider silk has the potential to enhance hearing aid microphones' sensitivity and ability to process low-frequency sounds. (Proc Natl Acad Sci U S A. 2017. doi: 10.1073/pnas.1710559114.) Spiders hear by using their hairs to detect the velocity of air. To see if they could harness these capabilities to improve the quality of microphones, researchers from Binghamton University coated spider silk with gold to add electrical conductivity to the fiber, and incorporated it into a microphone. They discovered that nanodimensional spider silk captures fluctuating airflow with maximum physical efficiency from 1 Hz to 50 kHz.

​Ron Miles, a mechanical engineer at Binghamton University who created the microphone, said the resulting microphone consists of super-thin fibers that move with the air in a sound field. "The fibers are driven by viscous forces in air, like those that cause tiny dust particles to float around in a slight breeze," he said. The researchers said adding spider silk to microphones is a miniature, directional, broadband, passive, low-cost approach to detecting airflow over a frequency bandwidth that spans the full range of human hearing.

Published: 11/3/2017 1:21:00 PM

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Hearing Aid Startup to Receive $45 Million Funding

​Eargo (https://eargo.com/), a direct-to-consumer hearing technology company, has announced the closing of the first tranche of an aggregate $45 million Series C investment round, which the company said will be used to accelerate their product innovation. The new investment was led by Nan Fung Life Sciences. New Enterprise Associates, Charles and Helen Schwab, and Maveron have also provided investments. Eargo is designed for consumers with on-the-go lifestyles and the desire for simplicity. Christian Gormsen, the CEO of Eargo, said, "We believe people shouldn't feel that they need a hearing aid.  They should feel that they want one.  Eargo was created with this in mind and we're just getting started."​

Published: 10/27/2017 2:07:00 PM

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Researchers Discover New Genes Critical for Understanding Hearing Loss

A study has identified new genes linked to hearing loss in mice, which will provide insights into the causes of hearing loss in humans (Nat Commun. 2017;8[1]:886). Scientists from Medical Research Council Hartwell who led the research found 67 genes that were associated with hearing loss, of which 52 had not been previously connected to hearing loss, by testing 3,006 strains of mice for signs of hearing loss. They assessed the hearing thresholds of these mice with rising volumes of sounds at different frequencies. Mice were considered hearing impaired if they could not hear the quieter sounds for two or more frequencies. The genes identified varied in how they affect hearing, with effects ranging from mild to severe hearing loss or hearing difficulties at lower or higher frequencies.

​​Steve Brown, PhD, senior author of this paper, said the results of the study increased the knowledge of the many genes and molecular mechanisms required for hearing and provide a short list of new genes to investigate to discover the genetic basis of many human hearing loss syndrome. "Further investigation of these hearing loss mouse models will increase understanding of how the auditory system develops, is maintained, and the pathological processes involved with its decline," Brown said. "In particular, we need to establish whether the genes impact on known hearing loss pathways or if they implicate new processes in the auditory system. A longer term benefit that could arise from studying these models might be the identification of critical cellular functions, which can then be targets for therapies."

 

 

Published: 10/20/2017 9:44:00 AM

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SonicCloud Builds Functionality of Hearing Aids Into iPhones

​The startup SonicCloud (https://soniccloud.com/) has launched an iOS app that allows those with moderate to severe hearing loss hear phone calls clearly by calibrating every mobile phone call for their unique hearing needs. The SonicCloud App users will be able to determine custom levels for their right and left ears by taking a quick hearing assessment on the app. Each user gets his or her own personal Hearing Fingerprint, which is driven by an algorithm in the cloud that adjusts to an individual's hearing needs. Incoming and outgoing calls are then processed through SonicCloud's "mixing board in the cloud," which optimizes voices and noisy environments. The SonicCloud App is the company's first step towards making hearing technology truly accessible to hearing-impaired individuals. SonicCloud was featured in Apple's 2017 Worldwide Developers Conference. 

               

Published: 10/13/2017 12:04:00 PM

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Therapies for Inner Ear Disorders Are One Step Closer to Reality

Spiral Therapeutics (http://ift.tt/2xooDek), a pre-clinical stage company developing first-in-class therapies targeting inner ear disorders, has received positive feedback from the U.S. Drug and Food Administration (FDA) regarding its first Pre-Investigational New Drug (Pre-IND) package submission.  The FDA answered Spiral's product development questions related to manufacturing and non-clinical testing, and concurred with the company's clinical development plans for its LPT99 program for preventing chemotherapy-induced hearing loss in pediatric patients. Pre-IND is a program through which the FDA's Office of Antimicrobial Products could provide advice on drug development before it begins. Spiral plans to raise additional funds for an initial Phase 1 trial, the development of new preclinical data, and the company's operations for the next 18 months.​

Published: 10/6/2017 1:51:00 PM

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iotaMotion Receives NIH Grant to Develop Robotics for Cochlear Implant Surgery

​The medical device startup iotaMotion (http://iotamotion.com/) has been awarded a $1.4 million grant from the National Institutes of Health (NIH) to develop its next-generation implantable robotic technology IOTA-Progress. The company will use this funding from the NIH's Small Business Innovation Research program to hone a robotic-assisted cochlear implant insertion system that will provide precise and controlled electrode advancement during hybrid cochlear implant surgeries. Marlan Hansen, MD, one of the founders of iotaMotion, said providing a more controlled, fine electrode insertion of the electrode should significantly enhance professionals' ability to preserve hearing. "Then we have what this grant is helping to fund for our company, which is the development of an implantable system allowing for electrode adjustments within the cochlea after the original surgery, without surgical intervention," Hansen said. "The goal here is optimal positioning within the cochlea to best match that patient's hearing, which often changes over time."

Published: 9/29/2017 9:16:00 AM

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New Experimental Device Promises Tinnitus Relief

Millions of Americans suffer from tinnitus, which is defined by researchers at the Kresge Hearing Research Institute of the Department of Otolaryngology at the University of Michigan as the phantom perception of sound in the absence of external stimuli. About 2 million are incapacitated by the negative impacts of tinnitus. People with tinnitus experience varying severity of discomfort—some individuals are minimally disturbed while others sufferer sleep disturbances, poor concentration, depression, and anxiety. Fortunately, a recently published study entitled "Auditory-somatosensory bimodal stimulation desynchronizes brain circuitry to reduce tinnitus in guinea pigs and humans" reported that there is a promising technology that may help sufferers reduce their tinnitus.

Here's a technical explanation in the study: Tinnitus is believed to result from the impairment of physiological regulatory mechanism of neural synchrony from the dorsal cochlear nucleus (DNC) to the neural ensembles along the auditory pathway. The DNC is where the initial multisensory integration of neural inputs from the auditory nerve, auditory midbrain, auditory cortex, trigeminal and cervical ganglia, spinal trigeminal nucleus, and dorsal column nuclei happens. Research in animals reveals that increased instinctive cross-neural activity of DCN's output neurons, the fusiform cells, results in behavioral evidence of tinnitus.

University of Michigan Medical School professor Susan Shore, PhD, the lead researcher of the study, has a less technical answer. In an article, Shore said that the specific the region of the brainstem, the DNC, is the root of tinnitus. "When the main neurons in this region, called fusiform cells, become hyperactive and synchronize with one another, the phantom signal is transmitted into other centers where perception occurs," she explained.

"If we can stop these signals, we can stop tinnitus," said Shore. "That is what our approach attempts to do, and we're encouraged by these initial parallel results in animals and humans."

The research, which studied fusiform cells and their role in tinnitus perception, used a dual-stimulus approach called targeted bimodal auditory-somatosensory stimulation to incite long-term depression (LTD) in the cochlear nucleus and to beneficially reset the activity of the fusiform cells. The experimental approach was delivered to guinea pigs for 25 days. The same bimodal treatment was administered to 20 human subjects for 28 days. The results are encouraging. The study concludes that bimodal auditory-somatosensory stimulation may suppress chronic tinnitus in patients.

​While the tinnitus treatment offered by this research is promising, it remains to be experimental and commercially unavailable. The human test subjects were limited to those sufferers capable of temporarily altering their symptoms through clenching of jaws, sticking out of tongues, or turning/flexing of necks. There will be another clinical trial this year.

Published: 1/16/2018 3:16:00 PM

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