Trends in Intraoperative Testing During Cochlear Implantation.

Objective: No consensus guidelines exist regarding intraoperative testing during cochlear implantation and wide variation in practice habits exists. The objective of this observational study was to survey otologists/neurotologists to understand practice habits and overall opinion of usefulness of intraoperative testing. Study Design: Cross-sectional survey. Setting: A web-based survey was sent to 194 practicing Otologists/Neurotologists. Main Outcome Measures: Questions included practice setting and experience, habits with respect to electrodes used, intraoperative testing modalities used, overall opinion of intraoperative testing, and practice habits in various scenarios. Results: Thirty-nine of 194 (20%) completed the survey. For routine patients, ECAPs and EIs were most commonly used together (38%) while 33% do not perform testing at all. Eighty-nine percent note that testing "rarely" or "never" changes management. Fifty-one percent marked the most important reason for testing is the reassurance provided to the family and/or the surgeon. Conclusion: Intraoperative testing habits and opinions regarding testing during cochlear implantation vary widely among otologic surgeons. The majority of surgeons use testing but many think there is minimal benefit and that surgical decision-making is rarely impacted. The importance of testing may change as electrodes continue to evolve. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Preservation of Cells of the Organ of Corti and Innervating Dendritic Processes Following Cochlear Implantation in the Human: an Immunohistochemical Study.

Hypothesis: This study evaluates the degree of preservation of hair cells, supporting cells, and innervating dendritic processes after cochlear implantation in the human using immunohistochemical methods. Background: Surgical insertion of a cochlear implant electrode induces various pathologic changes within the cochlea including insertional trauma, foreign body response, inflammation, fibrosis, and neo-osteogenesis. These changes may result in loss of residual acoustic hearing, adversely affecting the use of hybrid implants, and may result in loss of putative precursor cells, limiting the success of future regenerative protocols. Methods: Twenty-eight celloidin-embedded temporal bones from 14 patients with bilateral severe to profound sensorineural hearing loss and unilateral cochlear implants were studied. Two sections including the modiolus or basal turn from each temporal bone were stained using antineurofilament, antimyosin-VIIa, and antitubulin antibodies in both the implanted and unimplanted ears. Results: Inner and outer hair cells: Immunoreactivity was reduced throughout the implanted cochlea and in the unimplanted cochlea with the exception of the apical turn. Dendritic processes in the osseous spiral lamina: Immunoreactivity was significantly less along the electrode of the implanted cochlea than in the other segments. Inner and outer pillars, inner and outer spiral bundles, and Deiters' cells: Immunoreactivity was similar in the implanted and unimplanted cochleae. Conclusion: Insertion of a cochlear implant electrode may significantly affect the inner and outer hair cells both along and apical to the electrode, and dendritic processes in the osseous spiral lamina along the electrode. There was less effect on pillar cells, Deiters' cells, and spiral bundles. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Utility of Noncontrast Magnetic Resonance Imaging for Detection of Recurrent Vestibular Schwannoma.

Background: Gadolinium-enhanced T1-weighted magnetic resonance imaging (MRI) (T1WI) is the conventional imaging technique of choice to detect vestibular schwannoma (VS) recurrence or regrowth, despite suboptimal specificity secondary to enhancing postoperative changes. Furthermore, recent concerns regarding the accumulation of gadolinium in body tissues have led for a call to reduce the number of contrast-enhanced examinations. The objective of the current study is to evaluate the diagnostic accuracy of high-resolution noncontrast (three-dimensional [3D] T2) MRI relative to gadolinium-enhanced T1WI in the detection of VS recurrence after resection. Methods: Following Institutional Review Board approval, 13 consecutive postoperative patients with VS recurrence or regrowth were identified from a prospectively maintained clinical database in which recurrence was determined by progression on serial postoperative MRI examination. Three blinded neuroradiologists retrospectively evaluated a total of 41 postoperative MRI examinations from these patients using only gadolinium-enhanced T1WI and 3D T2 MRI for recurrence or regrowth. Interobserver agreement, differences in detection between the two sequences, and the sensitivity and specificity of 3D T2 MRI were assessed. Results: Fifteen of the 41 postoperative MRIs demonstrated progression, as determined by examiner consensus on the gadolinium-enhanced T1WI. Agreement, measured using Krippendorff's alpha, was 0.82 for the 3D T2 images and 0.83 for the contrast-enhanced T1WI. All the three examiners demonstrated no difference in the detection of progression between the two sequences (McNemar's test p values 0.69 for examiner 1, 0.63 for examiner 2, and 0.99 for examiner 3). The sensitivity of 3D T2 was 0.78 (CI 0.60-0.96), while the specificity was 0.94 (CI 0.86-1.00). Conclusion: Noncontrast high-resolution 3D T2 MRI seems sufficient to assess for recurrence or regrowth after VS resection. The results of this study have implications for reducing cost, time, and adverse events associated with gadolinium administration in this population requiring serial follow-up examinations. These promising, yet preliminary findings warrant confirmation with a larger prospective cohort of patients. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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An Optimal Partial Ossicular Prosthesis Should Connect Both to the Tympanic Membrane and Malleus: a Temporal Bone Study Using Laser Doppler Vibrometry.

Objective: To compare stapes vibrations in different partial ossicular replacement prosthesis (PORP) applications. Methods: Stapedial vibrations were measured on fresh frozen human temporal bones with laser Doppler vibrometry. Eight different types of common ossiculoplasty methods were compared regarding recovery of stapes vibrations in relation with the normal ossicular chain. The PORPs were divided into three groups: 1) PORPs with the lateral contact only with the tympanic membrane, 2) PORPs with lateral contact only to the malleus handle, and 3) PORPs with lateral contact with both the malleus handle and the tympanic membrane. Results: The PORPs with lateral contact only to the malleus handle performed better than the PORPs with lateral contact to the tympanic membrane only at 2 kHZ, but the best recovery was found in the group with contact both to the malleus handle and the tympanic membrane. Conclusion: The best sound transmission might be achieved by placing a PORP in contact with both the tympanic membrane and the handle of the malleus. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Unilateral Sensorineural Hearing Loss Presenting With Bilateral Temporal Bone Lesions.

No abstract available

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History of the Research Fund of the American Otological Society.

No abstract available

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Long-term Administration of Salicylate-induced Changes in BDNF Expression and CREB Phosphorylation in the Auditory Cortex of Rats.

Hypothesis: We investigated whether salicylate induces tinnitus through alteration of the expression levels of brain-derived neurotrophic factor (BDNF), proBDNF, tyrosine kinase receptor B (TrkB), cAMP-responsive element-binding protein (CREB), and phosphorylated CREB (p-CREB) in the auditory cortex (AC). Background: Salicylate medication is frequently used for long-term treatment in clinical settings, but it may cause reversible tinnitus. Salicylate-induced tinnitus is associated with changes related to central auditory neuroplasticity. Our previous studies revealed enhanced neural activity and ultrastructural synaptic changes in the central auditory system after long-term salicylate administration. However, the underlying mechanisms remained unclear. Methods: Salicylate-induced tinnitus-like behavior in rats was confirmed using gap prepulse inhibition of acoustic startle and prepulse inhibition testing, followed by comparison of the expression levels of BDNF, proBDNF, TrkB, CREB, and p-CREB. Synaptic ultrastructure was observed under a transmission electron microscope. Results: BDNF and p-CREB were upregulated along with ultrastructural changes at the synapses in the AC of rats treated chronically with salicylate (p 0.05). Conclusion: Long-term administration of salicylate increased BDNF expression and CREB activation, upregulated synaptic efficacy, and changed synaptic ultrastructure in the AC. There may be a relationship between these factors and the mechanism of tinnitus. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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The American Otological Society at its Sesquicentennial: Insights Into the Society's Formative Years.

Objective: To elucidate the sequence of events which led to the formation of the American Otological Society (AOS) in 1868 and to examine the lives and contributions of the nine founding members of the Society. Methods: Study of primary historical documents, biographical material, and previous histories of the AOS. Results: Earlier treatments of the history of the AOS minimally covered the events and personalities from the Society's formative period. The founders of the AOS were much influenced by recent advances in European Otology and the success of the nascent American Ophthalmological Society which had been founded in 1864. The AOS has long credited Elkanah Williams as its first president of the AOS, although he never actually served in this role and was not a contributor to otological literature. Documents suggest that 30 years old New York physician Daniel Bennett St John Roosa, recently returned from a grand tour of the leading European otological centers, was the principal advocate for the creation of the AOS. Conclusions: The 1860s were a pivotal period in the maturation of American Otology. Previously, most "aurists" were widely considered to be charlatans who practiced unscientifically and often unscrupulously. The AOS founder generation were a group of Ophthalmologists who strove to elevate otology from being a lesser appendage of the mother field to becoming a respected and scientifically based medical specialty in its own right. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Elevated Level of Myeloperoxidase-Deoxyribonucleic Acid Complex in the Middle Ear Fluid Obtained From Patients With Otitis Media Associated With Antineutrophil Cytoplasmic Antibody-associated Vasculitis.

Objective: The purpose was to explore the presence of myeloperoxidase (MPO)-deoxyribonucleic acid (DNA) complex as a surrogate marker of neutrophil extracellular traps (NETs) in the middle ear fluid, and to clarify the correlation between its quantifiable level and hearing outcome in patients with otitis media associated with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Study Design: Prospective study. Setting: Tertiary referral center. Patients: Nine AAV patients presenting with otitis media. Intervention: Collection of the fluid samples from middle ear. Main Outcome Measure: The quantifiable levels of MPO-DNA complex using an enzyme-linked immunosorbent assay. Results: The quantifiable levels of MPO-DNA complex in patients with AAV were significantly higher than those in controls (p

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Jugular Foramen Meningioma.

No abstract available

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Large Facial Nerve Schwannoma With Extensive Temporal Bone Destruction.

No abstract available

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Direction-fixed and Direction-changing Positional Nystagmus in Ramsay Hunt Syndrome.

Objectives: To investigate the incidence of positional nystagmus (PN) using a head-roll test in patients with Ramsay Hunt syndrome with vertigo (RHS_V) and discuss possible mechanisms. Study Design: Retrospective study. Setting: Tertiary referral academic medical center. Patients: Twenty-eight patients with RHS_V were enrolled. Main Outcome Measure: Eye movements were recorded at positions of head roll to the right or left, and PN was classified as direction-fixed or direction-changing. Vestibular function tests including caloric test were performed. Results: Direction-fixed nystagmus beating away from the affected side was the most common type of PN (61%), followed by direction-changing geotropic type (18%), direction-fixed nystagmus beating toward the affected side (14%), and direction-changing apogeotropic type (7%). The duration of nystagmus was longer than 60 seconds in all patients exhibiting direction-changing PN. Postcontrast T1-weighted internal auditory canal (IAC) magnetic resonance imaging showed enhancement of not only the facial and vestibulocochlear nerves, but also the inner ear structures or dura along the IAC, suggesting inflammatory changes within the labyrinthine membrane or IAC dura. Conclusion: Although direction-fixed PN was more commonly observed (75%), direction-changing PN was also observed in some RHS_V patients (25%). The mechanism of direction-changing PN may be, at least in part, explained by the alteration of specific gravity of the lateral semicircular canal cupula or endolymph due to inflammation in the inner ear membrane. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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External Ear Arteriovenous Malformation.

No abstract available

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The Impact of the Transcanal Endoscopic Approach and Mastoid Preservation on Recurrence of Primary Acquired Attic Cholesteatoma.

Objective: We aim to investigate the factors associated with recurrent disease following surgery for primary acquired attic cholesteatoma. We hypothesize that minimal invasive, mucosal sparing operation techniques have beneficial effects on the outcome in terms of recurrence. Study Design: Retrospective study. Setting: Tertiary referral center. Participants: A total of 110 patients presenting with primary acquired attic cholesteatoma were enrolled in the study. Patients undergoing revision surgery or a canal wall down procedure, as well as patients with residual disease were excluded from the study. Main Outcome Measures: During follow-up recurrence was assessed and classified into normal, self-cleaning retraction pockets, or recurrent cholesteatoma requiring revision surgery. Results: We observed during follow-up statistically significant decrease (p = 0.036) in the occurrence of retraction pockets and recurrence in patients operated by the transcanal endoscopic approach (n = 55, 11% re-retraction, 9% recurrence) compared with those who underwent a canal wall up procedure (n = 55, 16% re-retraction, 22% recurrence). However, the multivariate model did not demonstrate statistically significant predictors regarding the outcome. Moreover, the preservation or direct reconstruction of the ossicular chain had a beneficial effect on the outcome. We observed 11% re-retraction and 9% recurrence in cases with preserved or reconstructed ossicular chain versus 18% re-retraction and 24% recurrence (p = 0.011) in cases of nonpreserved or non-reconstructed ossicular chain. A score was established according to the intraoperative mucosal damage and correlated to the occurrence of recurrence (p = 0.02). The risk of recurrence increased by 23.6% (95% confidence interval: 3.22-48.1) with each additional mucosal damage site. Conclusion: Transcanal endoscopic approaches that preserve the mastoid may play an important role in preventing recurrence and underscores the importance of the mucosa and mastoid air cells on middle ear homeostasis. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Intraoperative Cochlear Implant Device Testing Utilizing an Automated Remote System: a Prospective Pilot Study.

Introduction: Intraoperative cochlear implant device testing provides valuable information regarding device integrity, electrode position, and may assist with determining initial stimulation settings. Manual intraoperative device testing during cochlear implantation requires the time and expertise of a trained audiologist. The purpose of the current study is to investigate the feasibility of using automated remote intraoperative cochlear implant reverse telemetry testing as an alternative to standard testing. Methods: Prospective pilot study evaluating intraoperative remote automated impedance and Automatic Neural Response Telemetry (AutoNRT) testing in 34 consecutive cochlear implant surgeries using the Intraoperative Remote Assistant (Cochlear Nucleus CR120). In all cases, remote intraoperative device testing was performed by trained operating room staff. A comparison was made to the "gold standard" of manual testing by an experienced cochlear implant audiologist. Electrode position and absence of tip fold-over was confirmed using plain film x-ray. Results: Automated remote reverse telemetry testing was successfully completed in all patients. Intraoperative x-ray demonstrated normal electrode position without tip fold-over. Average impedance values were significantly higher using standard testing versus CR120 remote testing (standard mean 10.7 k[OMEGA], SD 1.2 vs. CR120 mean 7.5 k[OMEGA], SD 0.7, p

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Systematic Review of Hearing Preservation After Radiotherapy for Vestibular Schwannoma.

Objective: To determine the long-term hearing preservation rate for spontaneous vestibular schwannoma treated by primary radiotherapy. Data Sources: The MEDLINE/PubMed, Web of Science, Cochrane Reviews, and EMBASE databases were searched using a comprehensive Boolean keyword search developed in conjunction with a scientific librarian. English language papers published from 2000 to 2016 were evaluated. Study Selection: Inclusion criteria: full articles, pretreatment and posttreatment audiograms or audiogram based scoring system, vestibular schwannoma only tumor type, reported time to follow-up, published after 1999, use of either Gamma Knife or linear accelerator radiotherapy. Exclusion criteria: case report or series with fewer than five cases, inadequate audiometric data, inadequate time to follow-up, neurofibromatosis type 2 exceeding 10% of study population, previous treatment exceeding 10% of study population, repeat datasets, use of proton beam therapy, and non-English language. Data Extraction: Two reviewers independently analyzed papers for inclusion. Class A/B, 1/2 hearing was defined as either pure tone average less than or equal to 50 db with speech discrimination score more than or equal to 50%, American Academy of Otolaryngology-Head & Neck Surgery (AAO-HNS) Hearing Class A or B, or Gardner-Robertson Grade I or II. Aggregate data were used when individual data were not specified. Data Synthesis: Means were compared with student t test. Conclusions: Forty seven articles containing a total of 2,195 patients with preserved Class A/B, 1/2 hearing were identified for analysis. The aggregate crude hearing preservation rate was 58% at an average reporting time of 46.6 months after radiotherapy treatment. Analysis of time-based reporting shows a clear trend of decreased hearing preservation extending to 10-year follow-up. This data encourages a future long-term controlled trial. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Does Hospital Volume Affect Outcomes in Patients Undergoing Vestibular Schwannoma Surgery?.

Objective: To determine the effect of hospital surgical case volume on the outcomes of vestibular schwannoma surgery. Study Design: Retrospective case review. Setting: University HealthSystem Consortium member hospitals (includes nearly every US academic medical center). Patients: Three thousand six hundred ninety-seven patients who underwent vestibular schwannoma resection over a 3-year timespan (2012-2015) grouped by race, age, comorbidities, payer, and sex. Intervention: Surgical resection of vestibular schwannoma. Main Outcome Measures: Morbidity and mortality following vestibular schwannoma excision are compared by hospital volume (low, medium, and high) including deciles. Results: There was significantly longer length of stay (p

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Preauricular Approach for Cholesteatoma Resection After Surgical Overclosure of the External Auditory Canal and Cochlear Implantation.

: Chronic suppurative otitis media can have long-term effects on hearing if not managed effectively. When combined with cholesteatoma the condition may require creation of an open mastoid cavity. Recurrence of cholesteatoma is a concern when cochlear implantation is performed with overclosure of the external auditory meatus. A 61-year-old female with recurrent cholesteatoma in this setting was treated using a preauricular approach to provide adequate visualization while preventing the need to remove the implant or risking injury to the internal components. This technique would be useful in similar patients to prevent morbidity from removal and reinsertion of a cochlear implant. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Gradual Symmetric Progression of DFNA34 Hearing Loss Caused by an NLRP3 Mutation and Cochlear Autoinflammation.

Objective: To characterize the audiometric phenotype of autosomal-dominant DFNA34 hearing loss (HL) caused by a missense substitution in the NLRP3 gene. NLRP3 encodes a critical component of the NLRP3 inflammasome that is activated in innate immune responses. Study Design: This study was conducted under protocol 01-DC-0229 approved by the NIH Combined Neurosciences IRB. We performed medical and developmental history interviews and physical and audiological examinations of affected individuals with DFNA34 HL caused by the p.Arg918Gln mutation of NLRP3. We retrospectively reviewed audiological reports, when available, from other health care centers. Setting: Federal biomedical research facility. Subjects: Eleven members of a North American family segregating p.Arg918Gln. Main Outcome Measures: Pure-tone thresholds, rates of pure-tone threshold progression, and speech discrimination scores. Results: Eight subjects had bilateral sensorineural HL with an onset in the late 2nd to 4th decade of life. Slowly progressive HL initially primarily affected high frequencies. Low and middle frequencies were affected with advancing age, resulting in moderate HL with a downsloping audiometric configuration. The average annual threshold deterioration was 0.9 to 1.5 dB/yr. Speech recognition scores ranging from 60 to 100% were consistent with cochlear, but not retrocochlear, etiology. Three subjects (16, 22, and 32 yr old) had normal hearing thresholds. Conclusion: DFNA34 HL has an onset during early adulthood and progresses approximately 1.2 dB/yr. Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Multicenter US Clinical Trial With an Electric-Acoustic Stimulation (EAS) System in Adults: Final Outcomes.

Objective: To demonstrate the safety and effectiveness of the MED-EL Electric-Acoustic Stimulation (EAS) System, for adults with residual low-frequency hearing and severe-to-profound hearing loss in the mid to high frequencies. Study Design: Prospective, repeated measures. Setting: Multicenter, hospital. Patients: Seventy-three subjects implanted with PULSAR or SONATA cochlear implants with FLEX24 electrode arrays. Intervention: Subjects were fit postoperatively with an audio processor, combining electric stimulation and acoustic amplification. Main Outcome Measures: Unaided thresholds were measured preoperatively and at 3, 6, and 12 months postactivation. Speech perception was assessed at these intervals using City University of New York sentences in noise and consonant-nucleus-consonant words in quiet. Subjective benefit was assessed at these intervals via the Abbreviated Profile of Hearing Aid Benefit and Hearing Device Satisfaction Scale questionnaires. Results: Sixty-seven of 73 subjects (92%) completed outcome measures for all study intervals. Of those 67 subjects, 79% experienced less than a 30 dB HL low-frequency pure-tone average (250-1000 Hz) shift, and 97% were able to use the acoustic unit at 12 months postactivation. In the EAS condition, 94% of subjects performed similarly to or better than their preoperative performance on City University of New York sentences in noise at 12 months postactivation, with 85% demonstrating improvement. Ninety-seven percent of subjects performed similarly or better on consonant-nucleus-consonant words in quiet, with 84% demonstrating improvement. Conclusion: The MED-EL EAS System is a safe and effective treatment option for adults with normal hearing to moderate sensorineural hearing loss in the low frequencies and severe-to-profound sensorineural hearing loss in the high frequencies who do not benefit from traditional amplification. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://ift.tt/OBJ4xP Copyright (C) 2018 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Bragi’s New Product Relieves Tinnitus and Enhances Hearing

​Bragi has unveiled a new personal sound amplification product (PSAP), called simply as Bragi Ears, created in collaboration with Mimi Technologies that incorporates personalized hearing enhancement and a solution for hearing issues like tinnitus at this year's CES. Making use of Bragi's in-ear computing technology and Mimi's audio processing technologies, the collaboration, which is called Project Ears, aims to create the world's first intelligent sound amplifier with an embedded pure tone threshold test and give users the best sound based on their hearing profile, or Earprint. Besides optimizing hearing and easing the ringing from tinnitus, Project Ears plans to provide an innovative and chic design as well as deliver a simple user experience through its products. Those interested can help provide feedback and advice to Bragi by signing up on Project Ears' website. A release date and pricing information have not been released yet. 

Published: 1/18/2018 12:34:00 PM

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Bragi’s New Product Relieves Tinnitus and Enhances Hearing

​Bragi has unveiled a new personal sound amplification product (PSAP), called simply as Bragi Ears, created in collaboration with Mimi Technologies that incorporates personalized hearing enhancement and a solution for hearing issues like tinnitus at this year's CES. Making use of Bragi's in-ear computing technology and Mimi's audio processing technologies, the collaboration, which is called Project Ears, aims to create the world's first intelligent sound amplifier with an embedded pure tone threshold test and give users the best sound based on their hearing profile, or Earprint. Besides optimizing hearing and easing the ringing from tinnitus, Project Ears plans to provide an innovative and chic design as well as deliver a simple user experience through its products. Those interested can help provide feedback and advice to Bragi by signing up on Project Ears' website. A release date and pricing information have not been released yet. 

Published: 1/18/2018 12:34:00 PM

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Convergent and Divergent Validity of the Grammaticality and Utterance Length Instrument

Purpose

This feasibility study examines the convergent and divergent validity of the Grammaticality and Utterance Length Instrument (GLi), a tool designed to assess the grammaticality and average utterance length of a child's prerecorded story retell.

Method

Three raters used the GLi to rate audio-recorded story retells from 100 English-speaking preschool children. To examine convergent validity, the results of the GLi were correlated with 2 language sample measures, mean length of utterance in words and percentage of grammatical utterances, and with the results of the Structured Photographic Expressive Language Test–Third Edition (Dawson, Stout, & Eyer, 2003). To examine divergent validity, the results of the GLi were correlated with the results of the Kaufman Brief Intelligence Test–Second Edition (Kaufman & Kaufman, 2004). Comparisons between task completion time for the GLi and Systematic Analysis of Language Transcripts (SALT; Miller & Iglesias, 2010) transcription and analysis were also conducted. Last, preliminary discriminant analysis was used to examine the diagnostic potential of the GLi.

Results

The results of this study provide evidence of convergent and divergent validity for the GLi. The task completion time for the GLi was considerably shorter than the SALT transcription and analysis. Preliminary analysis of diagnostic accuracy suggests that the GLi has the potential to be a good tool to identify children with language impairment.

Discussion

The GLi has good convergent and divergent validity and is a reliable instrument to assess utterance length and grammaticality of prerecorded language samples. However, SALT transcription and analysis provide a more detailed and comprehensive analysis of the language skills of a child.

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Convergent and Divergent Validity of the Grammaticality and Utterance Length Instrument

Purpose

This feasibility study examines the convergent and divergent validity of the Grammaticality and Utterance Length Instrument (GLi), a tool designed to assess the grammaticality and average utterance length of a child's prerecorded story retell.

Method

Three raters used the GLi to rate audio-recorded story retells from 100 English-speaking preschool children. To examine convergent validity, the results of the GLi were correlated with 2 language sample measures, mean length of utterance in words and percentage of grammatical utterances, and with the results of the Structured Photographic Expressive Language Test–Third Edition (Dawson, Stout, & Eyer, 2003). To examine divergent validity, the results of the GLi were correlated with the results of the Kaufman Brief Intelligence Test–Second Edition (Kaufman & Kaufman, 2004). Comparisons between task completion time for the GLi and Systematic Analysis of Language Transcripts (SALT; Miller & Iglesias, 2010) transcription and analysis were also conducted. Last, preliminary discriminant analysis was used to examine the diagnostic potential of the GLi.

Results

The results of this study provide evidence of convergent and divergent validity for the GLi. The task completion time for the GLi was considerably shorter than the SALT transcription and analysis. Preliminary analysis of diagnostic accuracy suggests that the GLi has the potential to be a good tool to identify children with language impairment.

Discussion

The GLi has good convergent and divergent validity and is a reliable instrument to assess utterance length and grammaticality of prerecorded language samples. However, SALT transcription and analysis provide a more detailed and comprehensive analysis of the language skills of a child.

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Convergent and Divergent Validity of the Grammaticality and Utterance Length Instrument

Purpose

This feasibility study examines the convergent and divergent validity of the Grammaticality and Utterance Length Instrument (GLi), a tool designed to assess the grammaticality and average utterance length of a child's prerecorded story retell.

Method

Three raters used the GLi to rate audio-recorded story retells from 100 English-speaking preschool children. To examine convergent validity, the results of the GLi were correlated with 2 language sample measures, mean length of utterance in words and percentage of grammatical utterances, and with the results of the Structured Photographic Expressive Language Test–Third Edition (Dawson, Stout, & Eyer, 2003). To examine divergent validity, the results of the GLi were correlated with the results of the Kaufman Brief Intelligence Test–Second Edition (Kaufman & Kaufman, 2004). Comparisons between task completion time for the GLi and Systematic Analysis of Language Transcripts (SALT; Miller & Iglesias, 2010) transcription and analysis were also conducted. Last, preliminary discriminant analysis was used to examine the diagnostic potential of the GLi.

Results

The results of this study provide evidence of convergent and divergent validity for the GLi. The task completion time for the GLi was considerably shorter than the SALT transcription and analysis. Preliminary analysis of diagnostic accuracy suggests that the GLi has the potential to be a good tool to identify children with language impairment.

Discussion

The GLi has good convergent and divergent validity and is a reliable instrument to assess utterance length and grammaticality of prerecorded language samples. However, SALT transcription and analysis provide a more detailed and comprehensive analysis of the language skills of a child.

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The Development of a Nano-based Approach to Alleviate Cisplatin-Induced Ototoxicity

Abstract

Cisplatin-induced hearing loss is experienced by a high percentage of patients with squamous cell carcinoma undergoing cisplatin chemotherapy. A novel nano-construct capable of sequestering extracellular cisplatin was developed to combat this problem. The nano-construct consisted of superparamagnetic iron oxide nanoparticles (SPIONs) entrapped within polymeric micelles, which were formed from a glutathione diethyl ester-conjugated amphiphilic diblock copolymer. The glutathione-micelles were analyzed at the cellular level and in an organotypic study for safety evaluation. All utilized methods indicated that the micelles do not cause cellular toxicity or organ damage. The micelles’ ability to reduce cisplatin-induced cytotoxicity was then probed in an in vitro model. Cisplatin was pre-treated with the novel nano-construct before being added to growing cells. When compared to cells that were exposed to untreated cisplatin, cells in the pre-treated cisplatin group showed a significant increase in cell viability. This clearly demonstrates that the construct is able to protect the cells from cisplatin cytotoxicity and makes it highly likely that the novel nano-construct will be able to play a role in the protection of the inner ear from cisplatin-induced ototoxicity.

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Hearing aid technology: model-based concepts and assessment.

Hearing aid technology: model-based concepts and assessment.

Int J Audiol. 2018 Jan 17;:1-2

Authors: Kollmeier B

PMID: 29338464 [PubMed - as supplied by publisher]

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Hearing aid technology: model-based concepts and assessment.

Hearing aid technology: model-based concepts and assessment.

Int J Audiol. 2018 Jan 17;:1-2

Authors: Kollmeier B

PMID: 29338464 [PubMed - as supplied by publisher]

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Health care professionals' neckties as a source of transmission of bacteria to patients: a systematic review.

Health care professionals' neckties as a source of transmission of bacteria to patients: a systematic review.

CMAJ Open. 2018 Jan 12;6(1):E26-E30

Authors: Pace-Asciak P, Bhimrao SK, Kozak FK, Westerberg BD

Abstract
BACKGROUND: There is growing concern that neckties worn by health care professionals may contribute to infections contracted in health care settings. We evaluated the evidence for health-care-associated infections resulting from neckties and whether the evidence is sufficient to warrant a tieless policy in Canada.
METHODS: We performed a systematic review to determine whether neckties worn by health care professionals colonize harmful pathogenic bacteria and whether they contribute to the spread of infection to patients in the inpatient or outpatient setting. We searched PubMed (1966 to 2017) and Embase (1974 to 2017). The level of evidence was appraised according to the Oxford Centre for Evidence-Based Medicine levels of evidence. We evaluated the quality of evidence and the risk of bias using the Jadad scale or the Newcastle-Ottawa Scale.
RESULTS: We screened 1675 citations, of which 6 were ultimately included in the systematic review. Only 1 study gave level 1b evidence (randomized controlled trial). Neckties were more likely than shirt pockets to colonize bacteria. There is limited evidence that neckties may be contaminated with pathogenic bacteria (e.g., methicillin-resistant Staphylococcus aureus) and very limited evidence that contaminated neckties may transmit bacteria (in a controlled experimental setting to a mannequin).
INTERPRETATION: There is no evidence of increased rates of health-care-associated infections related to the wearing of neckties by health care professionals. There is weak evidence that neckties are contaminated with pathogenic (and nonpathogenic) bacteria. The level of evidence was weak and the studies were heterogeneous. Evidence to support the need for a tieless dress code policy is lacking.

PMID: 29339405 [PubMed]

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Association of Chronic Subjective Tinnitus with Neuro- Cognitive Performance.

Related Articles

Association of Chronic Subjective Tinnitus with Neuro- Cognitive Performance.

Int Tinnitus J. 2017 Dec 01;21(2):90-97

Authors: Gudwani S, Munjal SK, Panda NK, Kohli A

Abstract
INTRODUCTION: Chronic subjective tinnitus is associated with cognitive disruptions affecting perception, thinking, language, reasoning, problem solving, memory, visual tasks (reading) and attention.
OBJECTIVE: To evaluate existence of any association between tinnitus parameters and neuropsychological performance to explain cognitive processing.
MATERIALS AND METHODS: Study design was prospective, consisting 25 patients with idiopathic chronic subjective tinnitus and gave informed consent before planning their treatment. Neuropsychological profile included (i) performance on verbal information, comprehension, arithmetic and digit span; (ii) non-verbal performance for visual pattern completion analogies; (iii) memory performance for long-term, recent, delayed-recall, immediate-recall, verbal-retention, visualretention, visual recognition; (iv) reception, interpretation and execution for visual motor gestalt. Correlation between tinnitus onset duration/ loudness perception with neuropsychological profile was assessed by calculating Spearman's coefficient.
RESULTS: Findings suggest that tinnitus may interfere with cognitive processing especially performance on digit span, verbal comprehension, mental balance, attention & concentration, immediate recall, visual recognition and visual-motor gestalt subtests. Negative correlation between neurocognitive tasks with tinnitus loudness and onset duration indicated their association. Positive correlation between tinnitus and visual-motor gestalt performance indicated the brain dysfunction.
CONCLUSION: Tinnitus association with non-auditory processing of verbal, visual and visuo-spatial information suggested neuroplastic changes that need to be targeted in cognitive rehabilitation.

PMID: 29336125 [PubMed - in process]

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Balance Assessment in Deaf Children and Teenagers Prior to and Post Capoeira Practice through the Berg Balance Scale.

Related Articles

Balance Assessment in Deaf Children and Teenagers Prior to and Post Capoeira Practice through the Berg Balance Scale.

Int Tinnitus J. 2017 Dec 01;21(2):77-822

Authors: Lima R

Abstract
INTRODUCTION: Hearing loss changes the functionality and body structure a disability that limits activity and restricts the participation of the individual in situations of daily life. It is believed that capoeira can help people with visual disabilities to minimize these deficits. BSE is a low specificity scale that evaluates objectively and functionally aspects of balance and risk of falls in the elderly and children, including the effect of environment on balance function.
OBJECTIVE: The objective of the research is to analyze deaf children and adolescents prior to and post-practice of capoeira using the Berg Balance Scale (BBS).
METHODS: Quantitative, clinical and observational studies. Twenty five deaf children between 10 and 16 years old of both genders were assessed. BBS was applied in two stages: before starting capoeira and after 6 months of training. The one-hour classes were held once a week for quantitative evaluation purposes. The subjects were divided and evaluated in two groups (10-13 years old and 14-16 years old).
RESULTS: There was a significant statistical difference in BBS scores. The general group and the group of 10-13 years old (p = 0.0251) showed an increase in scores after practicing capoeira (p = 0.0039). There were no statistically significant differences in the group from 14 to 16 years of age (p = 0.0504).
CONCLUSION: Using the Berg Balance Scale, it was possible to observe an improvement in the balance of the group of children and adolescents who practiced capoeira, and consequently, a decrease in the risk of falling.

PMID: 29336123 [PubMed - in process]

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Effect of Elevated Intracranial Pressure on Amplitudes and Frequency Tuning of Ocular Vestibular Evoked Myogenic Potentials Elicited by Bone-Conducted Vibration.

Related Articles

Effect of Elevated Intracranial Pressure on Amplitudes and Frequency Tuning of Ocular Vestibular Evoked Myogenic Potentials Elicited by Bone-Conducted Vibration.

Ear Hear. 2016 Nov/Dec;37(6):e409-e413

Authors: Gürkov R, Speierer G, Wittwer L, Kalla R

Abstract
OBJECTIVE: Recently, it could be demonstrated that an increased intracranial pressure causes a modulation of the air conducted sound evoked ocular vestibular evoked myogenic potential (oVEMP). The mechanism for this modulation is not resolved and may depend on a change of either receptor excitability or sound energy transmission.
DESIGN: oVEMPs were elicited in 18 healthy subjects with a minishaker delivering 500 and 1000 Hz tone bursts, in supine and tilted positions.
RESULTS: The study could confirm the frequency tuning of oVEMP. However, at neither stimulus frequency could a modulating effect of increased intracranial pressure be observed.
CONCLUSION: These data suggest that the observed modulation of the oVEMP response by an increased intracranial pressure is primarily due to the effect of an increased intralabyrinthine pressure onto the stiffness of the inner ear contents and the middle ear-inner ear junction. Future studies on the effect of intracranial pressure on oVEMP should use air-conducted sound and not bone-conducted vibration.

PMID: 27467406 [PubMed - indexed for MEDLINE]

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Health care professionals' neckties as a source of transmission of bacteria to patients: a systematic review.

Health care professionals' neckties as a source of transmission of bacteria to patients: a systematic review.

CMAJ Open. 2018 Jan 12;6(1):E26-E30

Authors: Pace-Asciak P, Bhimrao SK, Kozak FK, Westerberg BD

Abstract
BACKGROUND: There is growing concern that neckties worn by health care professionals may contribute to infections contracted in health care settings. We evaluated the evidence for health-care-associated infections resulting from neckties and whether the evidence is sufficient to warrant a tieless policy in Canada.
METHODS: We performed a systematic review to determine whether neckties worn by health care professionals colonize harmful pathogenic bacteria and whether they contribute to the spread of infection to patients in the inpatient or outpatient setting. We searched PubMed (1966 to 2017) and Embase (1974 to 2017). The level of evidence was appraised according to the Oxford Centre for Evidence-Based Medicine levels of evidence. We evaluated the quality of evidence and the risk of bias using the Jadad scale or the Newcastle-Ottawa Scale.
RESULTS: We screened 1675 citations, of which 6 were ultimately included in the systematic review. Only 1 study gave level 1b evidence (randomized controlled trial). Neckties were more likely than shirt pockets to colonize bacteria. There is limited evidence that neckties may be contaminated with pathogenic bacteria (e.g., methicillin-resistant Staphylococcus aureus) and very limited evidence that contaminated neckties may transmit bacteria (in a controlled experimental setting to a mannequin).
INTERPRETATION: There is no evidence of increased rates of health-care-associated infections related to the wearing of neckties by health care professionals. There is weak evidence that neckties are contaminated with pathogenic (and nonpathogenic) bacteria. The level of evidence was weak and the studies were heterogeneous. Evidence to support the need for a tieless dress code policy is lacking.

PMID: 29339405 [PubMed]

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Association of Chronic Subjective Tinnitus with Neuro- Cognitive Performance.

Related Articles

Association of Chronic Subjective Tinnitus with Neuro- Cognitive Performance.

Int Tinnitus J. 2017 Dec 01;21(2):90-97

Authors: Gudwani S, Munjal SK, Panda NK, Kohli A

Abstract
INTRODUCTION: Chronic subjective tinnitus is associated with cognitive disruptions affecting perception, thinking, language, reasoning, problem solving, memory, visual tasks (reading) and attention.
OBJECTIVE: To evaluate existence of any association between tinnitus parameters and neuropsychological performance to explain cognitive processing.
MATERIALS AND METHODS: Study design was prospective, consisting 25 patients with idiopathic chronic subjective tinnitus and gave informed consent before planning their treatment. Neuropsychological profile included (i) performance on verbal information, comprehension, arithmetic and digit span; (ii) non-verbal performance for visual pattern completion analogies; (iii) memory performance for long-term, recent, delayed-recall, immediate-recall, verbal-retention, visualretention, visual recognition; (iv) reception, interpretation and execution for visual motor gestalt. Correlation between tinnitus onset duration/ loudness perception with neuropsychological profile was assessed by calculating Spearman's coefficient.
RESULTS: Findings suggest that tinnitus may interfere with cognitive processing especially performance on digit span, verbal comprehension, mental balance, attention & concentration, immediate recall, visual recognition and visual-motor gestalt subtests. Negative correlation between neurocognitive tasks with tinnitus loudness and onset duration indicated their association. Positive correlation between tinnitus and visual-motor gestalt performance indicated the brain dysfunction.
CONCLUSION: Tinnitus association with non-auditory processing of verbal, visual and visuo-spatial information suggested neuroplastic changes that need to be targeted in cognitive rehabilitation.

PMID: 29336125 [PubMed - in process]

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Balance Assessment in Deaf Children and Teenagers Prior to and Post Capoeira Practice through the Berg Balance Scale.

Related Articles

Balance Assessment in Deaf Children and Teenagers Prior to and Post Capoeira Practice through the Berg Balance Scale.

Int Tinnitus J. 2017 Dec 01;21(2):77-822

Authors: Lima R

Abstract
INTRODUCTION: Hearing loss changes the functionality and body structure a disability that limits activity and restricts the participation of the individual in situations of daily life. It is believed that capoeira can help people with visual disabilities to minimize these deficits. BSE is a low specificity scale that evaluates objectively and functionally aspects of balance and risk of falls in the elderly and children, including the effect of environment on balance function.
OBJECTIVE: The objective of the research is to analyze deaf children and adolescents prior to and post-practice of capoeira using the Berg Balance Scale (BBS).
METHODS: Quantitative, clinical and observational studies. Twenty five deaf children between 10 and 16 years old of both genders were assessed. BBS was applied in two stages: before starting capoeira and after 6 months of training. The one-hour classes were held once a week for quantitative evaluation purposes. The subjects were divided and evaluated in two groups (10-13 years old and 14-16 years old).
RESULTS: There was a significant statistical difference in BBS scores. The general group and the group of 10-13 years old (p = 0.0251) showed an increase in scores after practicing capoeira (p = 0.0039). There were no statistically significant differences in the group from 14 to 16 years of age (p = 0.0504).
CONCLUSION: Using the Berg Balance Scale, it was possible to observe an improvement in the balance of the group of children and adolescents who practiced capoeira, and consequently, a decrease in the risk of falling.

PMID: 29336123 [PubMed - in process]

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Effect of Elevated Intracranial Pressure on Amplitudes and Frequency Tuning of Ocular Vestibular Evoked Myogenic Potentials Elicited by Bone-Conducted Vibration.

Related Articles

Effect of Elevated Intracranial Pressure on Amplitudes and Frequency Tuning of Ocular Vestibular Evoked Myogenic Potentials Elicited by Bone-Conducted Vibration.

Ear Hear. 2016 Nov/Dec;37(6):e409-e413

Authors: Gürkov R, Speierer G, Wittwer L, Kalla R

Abstract
OBJECTIVE: Recently, it could be demonstrated that an increased intracranial pressure causes a modulation of the air conducted sound evoked ocular vestibular evoked myogenic potential (oVEMP). The mechanism for this modulation is not resolved and may depend on a change of either receptor excitability or sound energy transmission.
DESIGN: oVEMPs were elicited in 18 healthy subjects with a minishaker delivering 500 and 1000 Hz tone bursts, in supine and tilted positions.
RESULTS: The study could confirm the frequency tuning of oVEMP. However, at neither stimulus frequency could a modulating effect of increased intracranial pressure be observed.
CONCLUSION: These data suggest that the observed modulation of the oVEMP response by an increased intracranial pressure is primarily due to the effect of an increased intralabyrinthine pressure onto the stiffness of the inner ear contents and the middle ear-inner ear junction. Future studies on the effect of intracranial pressure on oVEMP should use air-conducted sound and not bone-conducted vibration.

PMID: 27467406 [PubMed - indexed for MEDLINE]

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Long-term Average Spectra Analysis of Voice in Children With Cleft Palate

Publication date: Available online 12 January 2018
Source:Journal of Voice
Author(s): Zengjie Yang, Jincai Fan, Jia Tian, Liqiang Liu, Cheng Gan, Tiran Zhang, Zheng Liu, Bing Han
ObjectivesThe purpose of this study was to survey the spectral characteristics and to compare, using an acoustic analyzer, the objective data obtained from patients with cleft palates with the objective data of normal children using long-term average spectra (LTAS) analysis.MethodsParticipants were divided into a clinical group and a control group. All participants were asked to practice reading a sentence to become fluent. The duration of each recording was about 60 seconds. All samples were subjected to acoustic analysis using Praat software. All recordings were analyzed acoustically using LTAS.ResultsIn this study, there was no significant difference between the control group and the clinical group in the low-frequency region (boys: 0–2720 Hz; girls: 0–2240 Hz). LTAS measurements showed a great difference between the control group and the clinical group in the middle-frequency region (boys: 2720–4000 Hz; girls: 2240–4000 Hz). We also found that the energy distributed in the clinical group was lower than that of the control group in the high-frequency region (4000 Hz–8000 Hz) in both boys and girls.ConclusionsThe results reveal a lack of flat region in the middle-frequency range in the clinical group (both boys and girls) in comparison with the control group. The results also reveal that there is no significant difference across the control group and the clinical group in the low-frequency region.



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Reliability and Validity of the Turkish Version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)

Publication date: Available online 11 January 2018
Source:Journal of Voice
Author(s): Esra Özcebe, Fatma Esen Aydinli, Tuğçe Karahan Tiğrak, Önal İncebay, Taner Yilmaz
ObjectivesThe main purpose of this study was to culturally adapt the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) to Turkish and to evaluate its internal consistency, validity, and reliability.Materials and MethodsThe Turkish version of CAPE-V was developed, and with the use of a prospective case-control design, the voice recordings of 130 participants were collected according to CAPE-V protocol. Auditory-perceptual evaluation was conducted according to CAPE-V and Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale by two ear, nose, and throat specialists and two speech and language therapists. The different types of voice disorders, classified as organic and functional disorders, were compared in terms of their CAPE-V scores.ResultsThe overall severity parameter had the highest intrarater and inter-reliability values for all the participants. For all four raters, the differences in the six CAPE-V parameters between the study and the control groups were found to be statistically significant. Among the correlations for the comparable parameters of the CAPE-V and the GRBAS scales, the highest correlation was found between the overall severity-grade parameters. There was no difference found between the organic and functional voice disorders in terms of the CAPE-V scores.ConclusionsThe Turkish version of CAPE-V has been proven to be a reliable and valid instrument to use in the auditory-perceptual evaluation of voice. For the future application of this study, it would be important to investigate whether cepstral measures correlate with the auditory-perceptual judgments of dysphonia severity collected by a Turkish version of the CAPE-V.



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Trends in Singing Voice Research: An Innovative Approach

Publication date: Available online 11 January 2018
Source:Journal of Voice
Author(s): Pedro Melo Pestana, Vaz Freitas Susana, Maria Conceição Manso
ObjectivesThe objectives of this study were to trace and describe research patterns in singing voice, to compare the amount of published research over time, to identify journals that published most papers on “singing voice,” and to establish the most frequent research topics.Materials and MethodsThe study uses qualitative and quantitative approaches through descriptive statistics, text mining, and clustering. The authors conducted a search to identify scientific papers. The titles and abstracts were analyzed regarding word frequency and relations between them, through hierarchical cluster analysis and co-occurrence networks. The frequency of journals was calculated, as well as the amount of papers across time.ResultsSince 1949, 754 papers were published and an increase was noticed. Even though 162 journals were identified by the authors, the Journal of Voice holds the majority of papers, in every analyzed period. An evolution of studied topics is described. Up to 2010, the main theme was professional singers, especially classical and opera interpreters. Since then, voice quality and the effects of training gathered more attention.ConclusionsThe growing interest in singing has been conspicuous since the first indexed paper. However, it has been slightly slowing down. Until 2010, great importance was given to the voice quality of singers and their occupational demands. Acoustic analysis was widely used to study the effects of training. Since 2010, the concern with functionality is increasing, rather than the organic voice structures. Musical perception studies have been a trend, as well as the use of electroglottography.



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Effect of Auditory-Perceptual Training With Natural Voice Anchors on Vocal Quality Evaluation

Publication date: Available online 10 January 2018
Source:Journal of Voice
Author(s): Priscila Campos Martins dos Santos, Maurílio Nunes Vieira, João Pedro Hallack Sansão, Ana Cristina Côrtes Gama
PurposeTo analyze the effects of auditory-perceptual training with anchor stimuli of natural voices on inter-rater agreement during the assessment of vocal quality.Study designThis is a quantitative nature study.MethodsAn auditory-perceptual training site was developed consisting of Programming Interface A, an auditory training activity, and Programming Interface B, a control activity. Each interface had three stages: pre-training/pre-interval evaluation, training/interval, and post-training/post-interval evaluation. Two experienced evaluators classified 381 voices according to the GRBASI scale (G-grade, R-roughness, B-breathiness, A-asthenia, S-strain, I-instability). Voices were selected that received the same evaluation by both evaluators: 57 voices for evaluation and 56 for training were selected, with varying degrees of deviation across parameters. Fifteen inexperienced evaluators were then selected. In the pre-, post-training, pre-, and postinterval stages, evaluators listened to the voices and classified them via the GRBASI scale. In the stage interval evaluators read a text. In the stage training each parameter was trained separately. Evaluators analyzed the degrees of deviation of the GRBASI parameters based on anchor stimuli, and could only advance after correctly classifying the voices. To quantify inter-rater agreement and provide statistical analyses, the AC1 coefficient, confidence intervals, and percentage variation of agreement were employed.ResultsExcept for the asthenia parameter, decreased agreement was observed in the control condition. Improved agreement was observed with auditory training, but this improvement did not achieve statistical significance.ConclusionTraining with natural voice anchors suggest an increased inter-rater agreement during perceptual voice analysis, potentially indicating that new internal references were established.



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Evaluation of a Shorter Follow-up Time to Capture Benefit of a Trial Vocal Fold Augmentation

Publication date: Available online 17 January 2018
Source:Journal of Voice
Author(s): Thomas L. Carroll, Elizabeth Faudoa, Maxine Van Doren
ObjectiveTrial vocal fold injection (TVFI) is employed diagnostically for patients with subtle glottic insufficiency to explore potential for improvement. Clinical experience demonstrates the time to and length of peak benefit of the TVFI is variable. Previous studies collected data 4 weeks or more after TVFI. The aim of this study was to compare subjectively successful and unsuccessful TVFI patient groups. It is hypothesized that patients with subjectively reported success will also have significant improvements in Voice Handicap Index-10 (VHI-10), phase closure percentage, and aerodynamic measures 2 weeks after trial augmentation.Methods/DesignSubjects with glottic insufficiency were included in this retrospective review if they underwent office-based, per-oral vocal fold injection augmentation specifically for trial purposes. Patients were divided into “successful” and “unsuccessful” groups based on their subjective experience during the 2-week post-TVFI period. VHI-10, subjective report, phase closure evaluation using frame-by-frame analysis, and aerodynamic data were collected pre- and 2 weeks post-TVFI.ResultsOf the subjects, 15 of 23 (65%) reported a successful subjective improvement of their symptom, whereas 8 (35%) were unsuccessful (only partial improvement or no improvement). The number of subjects with an improvement in VHI-10 by 5 or more points was not significantly different between groups. The number of subjects that demonstrated complete, long phase closure was significantly higher in the successful group (P = 0.021).ConclusionsThe understanding of how to more precisely determine the success of TVFI remains incomplete. Subjective improvement of successful TVFI was captured with basic clinical questioning, yet the VHI-10 was unable to confidently demonstrate this reported success 2 weeks after TVFI.



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Hearing aid technology: model-based concepts and assessment.

Hearing aid technology: model-based concepts and assessment.

Int J Audiol. 2018 Jan 17;:1-2

Authors: Kollmeier B

PMID: 29338464 [PubMed - as supplied by publisher]

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Hearing aid technology: model-based concepts and assessment.

Hearing aid technology: model-based concepts and assessment.

Int J Audiol. 2018 Jan 17;:1-2

Authors: Kollmeier B

PMID: 29338464 [PubMed - as supplied by publisher]

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Gradual Symmetric Progression of DFNA34 Hearing Loss Caused by an NLRP3 Mutation and Cochlear Autoinflammation.

Gradual Symmetric Progression of DFNA34 Hearing Loss Caused by an NLRP3 Mutation and Cochlear Autoinflammation.

Otol Neurotol. 2018 Jan 16;:

Authors: Nakanishi H, Kawashima Y, Kurima K, Muskett JA, Kim HJ, Brewer CC, Griffith AJ

Abstract
OBJECTIVE: To characterize the audiometric phenotype of autosomal-dominant DFNA34 hearing loss (HL) caused by a missense substitution in the NLRP3 gene. NLRP3 encodes a critical component of the NLRP3 inflammasome that is activated in innate immune responses.
STUDY DESIGN: This study was conducted under protocol 01-DC-0229 approved by the NIH Combined Neurosciences IRB. We performed medical and developmental history interviews and physical and audiological examinations of affected individuals with DFNA34 HL caused by the p.Arg918Gln mutation of NLRP3. We retrospectively reviewed audiological reports, when available, from other health care centers.
SETTING: Federal biomedical research facility.
SUBJECTS: Eleven members of a North American family segregating p.Arg918Gln.
MAIN OUTCOME MEASURES: Pure-tone thresholds, rates of pure-tone threshold progression, and speech discrimination scores.
RESULTS: Eight subjects had bilateral sensorineural HL with an onset in the late 2nd to 4th decade of life. Slowly progressive HL initially primarily affected high frequencies. Low and middle frequencies were affected with advancing age, resulting in moderate HL with a downsloping audiometric configuration. The average annual threshold deterioration was 0.9 to 1.5 dB/yr. Speech recognition scores ranging from 60 to 100% were consistent with cochlear, but not retrocochlear, etiology. Three subjects (16, 22, and 32 yr old) had normal hearing thresholds.
CONCLUSION: DFNA34 HL has an onset during early adulthood and progresses approximately 1.2 dB/yr.

PMID: 29342053 [PubMed - as supplied by publisher]

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Long-term treatment with aldosterone slows the progression of age-related hearing loss.

Related Articles

Long-term treatment with aldosterone slows the progression of age-related hearing loss.

Hear Res. 2016 Jun;336:63-71

Authors: Halonen J, Hinton AS, Frisina RD, Ding B, Zhu X, Walton JP

Abstract
Age-related hearing loss (ARHL), clinically referred to as presbycusis, is one of the three most prevalent chronic medical conditions of our elderly, with the majority of persons over the age of 60 suffering from some degree of ARHL. The progressive loss of auditory sensitivity and perceptual capability results in significant declines in workplace productivity, quality of life, cognition and abilities to communicate effectively. Aldosterone is a mineralocorticoid hormone produced in the adrenal glands and plays a role in the maintenance of key ion pumps, including the Na-K(+)-Cl co-transporter 1 or NKCC1, which is involved in homeostatic maintenance of the endocochlear potential. Previously we reported that aldosterone (1 μM) increases NKCC1 protein expression in vitro and that this up-regulation of NKCC1 was not dose-dependent (dosing range from 1 nM to 100 μM). In the current study we measured behavioral and electrophysiological hearing function in middle-aged mice following long-term systemic treatment with aldosterone. We also confirmed that blood pressure remained stable during treatment and that NKCC1 protein expression was upregulated. Pre-pulse inhibition of the acoustic startle response was used as a functional measure of hearing, and the auditory brainstem response was used as an objective measure of peripheral sensitivity. Long-term treatment with aldosterone improved both behavioral and physiological measures of hearing (ABR thresholds). These results are the first to demonstrate a protective effect of aldosterone on age-related hearing loss and pave the way for translational drug development, using aldosterone as a key component to prevent or slow down the progression of ARHL.

PMID: 27157488 [PubMed - indexed for MEDLINE]

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