Enhanced Auditory Sensitivity to Body Vibrations in Superior Canal Dehiscence Syndrome

A key feature of superior canal dehiscence (SCD) syndrome is supranormal hearing of body sounds. The aim of the present study was to quantify this phenomenon and to ascertain whether auditory sensitivity to body vibrations can distinguish SCD patients. Hearing thresholds in response to vibration at the vertex, at the spinous process of the 7th cervical vertebra, and at the medial malleolus were tested in 10 SCD patients and 10 controls. Both patients and controls had insert earphones in both ears. The insert in the test ear was blocked while masking was presented to the other ear. Vibration in the frequency range of 125-1,000 Hz was presented to each of the 3 stimulation sites. The SCD patients were found to have significantly lower hearing thresholds compared with controls. The two study groups reacted differently with respect to frequency. The SCD patients showed an enhanced sensitivity for the lower stimulus frequencies. The difference was, however, rather independent of stimulus presentation site. The findings suggest that hearing thresholds in response to low-frequency body vibration at sites distant from the ears can distinguish SCD patients. The present findings may also support the idea that auditory sensation to body vibrations is a response related to soft tissue conduction.
Audiol Neurotol 2016;21:365-371

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Sound Localization in Patients With Congential Unilateral Conductive Hearing Loss With a Transcutaneous Bone Conduction Implant.

Objective: There is no consensus regarding the benefit of implantable hearing aids in congenital unilateral conductive hearing loss (UCHL). This study aimed to measure sound source localization performance in patients with congenital UCHL and contralateral normal hearing who received a new bone conduction implant. Study Design: Evaluation of within-subject performance differences for sound source localization in a horizontal plane. Setting: Tertiary referral center. Patients: Five patients with atresia of the external auditory canal and contralateral normal hearing implanted with transcutaneous bone conduction implant at the Medical University of Vienna were tested. Intervention: Activated/deactivated implant. Main Outcome Measure: Sound source localization test; localization performance quantified using the root mean square (RMS) error. Results: Sound source localization ability was highly variable among individual subjects, with RMS errors ranging from 21 to 40 degrees. Horizontal plane localization performance in aided conditions showed statistically significant improvement compared with the unaided conditions, with RMS errors ranging from 17 to 27 degrees. The mean RMS error decreased by a factor of 0.71 (p

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Influence of Behavior on Complications of Osseointegrated Bone Conduction Devices in Children.

Objective: Compare incidences of complications following implantation of osseointegrated bone conduction devices (OBCD) between children with and without behavioral disorders. Study Design: Case series with chart review. Setting: Tertiary referral center otology and neurotology practice. Patients: Pediatric patients who underwent implantation of OBCD between May 2009 and July 2014 at Arkansas Children's Hospital. Interventions: Implantation with Cochlear BAHA 200 series, Cochlear BAHA BI300, or Oticon OBCD. Main Outcome Measures: Osseointegration failure (OIF) with resulting loss of flange-fixture and/or skin and soft tissue reactions. Results: The total rate of complications was 66.2%, with the majority being minor complications (39.4%). There was no difference in the total rate of complication (p = 0.461), minor complications (p = 0.443), major complications (p = 0.777), and minor and major complications (p = 0.762) between the control group and children with behavioral disorders. Conclusion: Behavior was not observed to influence the incidence of OIF or skin/soft tissue reactions after implantation of OBCD in pediatric patients. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Middle-Ear Sound Transmission Under Normal, Damaged, Repaired, and Reconstructed Conditions.

Hypothesis: We hypothesize that current clinical treatment strategies for the disarticulated or eroded incus have the effect of combining the incus and stapes of the human middle ear (ME) into one rigid structure, which, while capable of adequately transmitting lower-frequency sounds, fails for higher frequencies. Background: ME damage causes conductive hearing loss (CHL) and while great progress has been made in repairing or reconstructing damaged MEs, the outcomes are often far from ideal. Methods: Temporal bones (TBs) from human cadavers, a laser Doppler vibrometer (LDV), and a fiber-optic based micro-pressure sensor were used to characterize ME transmission under various ME conditions: normal; with a disarticulated incus; repaired using medical glue; or reconstructed using a partial ossicular replacement prosthesis (PORP). Results: Repairing the disarticulated incus using medical glue, or replacing the incus using a commercial PORP, provided similar restoration of ME function including almost perfect function at frequencies below 4 kHz, but with more than a 20-dB loss at higher frequencies. Associated phase responses under these conditions sometimes varied and seemed dependent on the degree of coupling of the PORP to the remaining ME structure. A new ME-prosthesis design may be required to allow the stapes to move in three-dimensional (3-D) space to correct this deficiency at higher frequencies. Conclusions: Fixation of the incus to the stapes or ossicular reconstruction using a PORP limited the efficiency of sound transmission at high frequencies. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Internal Jugular Vein Compression: A Novel Approach to Mitigate Blast Induced Hearing Injury.

Hypothesis: Internal jugular vein (IJV) compression before blast injury will lead to reduced risk of traumatic hearing injury following exposure to a blast injury. Background: IJV compression and its effects on not only intracranial, but also intracochlear pressure may potentiate blast induced hearing injury, therefore, precluding its use as a prophylactic therapy for blast induced traumatic brain injury. Methods: Twenty Sprague Dawley rats were exposed to a 17.9 +/- 0.4 PSI (195.8 dB SPL) right sided shock wave in which 10 had application of a custom IJV compression collar before injury. All rodents received baseline and post blast injury otoacoustic emission (OAE) and auditory brainstem response (ABR) testing followed by cochlear histology. Results: IJV compression was shown to significantly reduce ABR and OAE threshold shifts in comparison to the non-intervention group by: 14.9 +/- 4.8 dB (right ear ABR 0.5 kHz Day 1 post blast, p = 0.01), 13.1 +/- 4.9 dB (right ear ABR 4 kHz Day 1 post blast, p = 0.04), 16.5 +/- 4.5 dB (right ear ABR click Day 1 post blast, p = 0.003), 12.1 +/- 4.6 dB (right ear ABR click Day 6 post blast, p = 0.04), and 14.0 +/- 3.2 dB (both ears OAE 3.2-10 kHz, p

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Cadaveric Testing of Robot-Assisted Access to the Internal Auditory Canal for Vestibular Schwannoma Removal.

Hypothesis: An image-guided robotic system can safely perform the bulk removal of bone during the translabyrinthine approach to vestibular schwannoma (VS). Background: The translabyrinthine approach to VS removal involves extensive manual milling in the temporal bone to gain access to the internal auditory canal (IAC) for tumor resection. This bone removal is time consuming and challenging due to the presence of vital anatomy (e.g., facial nerve) embedded within the temporal bone. A robotic system can use preoperative imaging and segmentations to guide a surgical drill to remove a prescribed volume of bone, thereby preserving the surgeon for the more delicate work of opening the IAC and resecting the tumor. Methods: Fresh human cadaver heads were used in the experiments. For each trial, the desired bone resection volume was planned on a preoperative computed tomography (CT) image, the steps in the proposed clinical workflow were undertaken, and the robot was programmed to mill the specified volume. A postoperative CT scan was acquired for evaluation of the accuracy of the milled cavity and examination of vital anatomy. Results: In all experimental trials, the facial nerve and chorda tympani were preserved. The root mean squared surface accuracy of the milled cavities ranged from 0.23 to 0.65 mm and the milling time ranged from 32.7 to 57.0 minute. Conclusion: This work shows feasibility of using a robot-assisted approach for VS removal surgery. Further testing and system improvements are necessary to enable clinical translation of this technology. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Voice Emotion Perception and Production in Cochlear Implant Users

Publication date: Available online 11 January 2017
Source:Hearing Research
Author(s): N.T. Jiam, M. Caldwell, M.L. Deroche, M. Chatterjee, C.J. Limb
Voice emotion is a fundamental component of human social interaction and social development. Unfortunately, cochlear implant users are often forced to interface with highly degraded prosodic cues as a result of device constraints in extraction, processing, and transmission. As such, individuals with cochlear implants frequently demonstrate significant difficulty in recognizing voice emotions in comparison to their normal hearing counterparts. Cochlear implant-mediated perception and production of voice emotion is an important but relatively understudied area of research. However, a rich understanding of the voice emotion auditory processing offers opportunities to improve upon CI biomedical design and to develop training programs benefiting CI performance. In this review, we will address the issues, current literature, and future directions for improved voice emotion processing in cochlear implant users.



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