Drug-induced Defibrinogenation as New Treatment Approach of Acute Hearing Loss in an Animal Model for Inner Ear Vascular Impairment.

Objective: Disturbance of cochlear microcirculation is considered to be the final common pathway of various inner ear diseases. Hyperfibrinogenemia causing increased plasma viscosity is a known risk factor for sudden sensorineural hearing loss and may lead to a critical reduction of cochlear blood flow. The aim of this study was to evaluate the effect of a substantial reduction of plasma fibrinogen levels by drug-induced defibrinogenation for the treatment of acute hearing loss in vivo. Methods: Acute hearing loss was induced by hyperfibrinogenemia (i.v. injection of 330 mg/kg BW fibrinogen), using a guinea pig animal model. Parameters of cochlear microcirculation and hearing thresholds were quantified by intravital microscopy and evoked response audiometry. After obtaining baseline values, the course of hearing loss and disturbances of microcirculation were investigated under influence of intravenous defibrinogenation therapy (ancrod), corticosteroid, or placebo treatment, using 5 animals/group. Results: Acute hyperfibrinogenemia caused hearing loss from 10 +/- 7 to 26 +/- 10 dB SPL at baseline. Drug-induced reduction of fibrinogen levels showed a significant increase of cochlear microcirculation (1.6-fold) and recovered hearing threshold (11 +/- 6 dB SPL). Placebo or corticosteroid treatment had no effect on hearing loss (35 +/- 7 dB SPL and 32 +/- 18 dB SPL, respectively). Conclusion: Acute hyperfibrinogenemia resulted in hearing loss. Drug-induced reduction of elevated fibrinogen levels caused an increase in cochlear blood flow and a decrease in hearing thresholds. Placebo or corticosteroid treatment had no effect. Reduction of plasma fibrinogen levels could serve as a clinical treatment option for acute hearing loss. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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MRI Showing Bilateral Facial Nerve Enhancement: A Diagnostic Enigma.

No abstract available

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Can You Hear What I Think? Theory of Mind in Young Children With Moderate Hearing Loss.

Objectives: The first aim of this study was to examine various aspects of Theory of Mind (ToM) development in young children with moderate hearing loss (MHL) compared with hearing peers. The second aim was to examine the relation between language abilities and ToM in both groups. The third aim was to compare the sequence of ToM development between children with MHL and hearing peers. Design: Forty-four children between 3 and 5 years old with MHL (35 to 70 dB HL) who preferred to use spoken language were identified from a nationwide study on hearing loss in young children. These children were compared with 101 hearing peers. Children were observed during several tasks to measure intention understanding, the acknowledgement of the other's desires, and belief understanding. Parents completed two scales of the child development inventory to assess expressive language and language comprehension in all participants. Objective language test scores were available from the medical files of children with MHL. Results: Children with MHL showed comparable levels of intention understanding but lower levels of both desire and belief understanding than hearing peers. Parents reported lower language abilities in children with MHL compared with hearing peers. Yet, the language levels of children with MHL were within the average range compared with test normative samples. A stronger relation between language and ToM was found in the hearing children than in children with MHL. The expected developmental sequence of ToM skills was divergent in approximately one-fourth of children with MHL, when compared with hearing children. Conclusion: Children with MHL have more difficulty in their ToM reasoning than hearing peers, despite the fact that their language abilities lie within the average range compared with test normative samples. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Can You Hear What I Think? Theory of Mind in Young Children With Moderate Hearing Loss.

Objectives: The first aim of this study was to examine various aspects of Theory of Mind (ToM) development in young children with moderate hearing loss (MHL) compared with hearing peers. The second aim was to examine the relation between language abilities and ToM in both groups. The third aim was to compare the sequence of ToM development between children with MHL and hearing peers. Design: Forty-four children between 3 and 5 years old with MHL (35 to 70 dB HL) who preferred to use spoken language were identified from a nationwide study on hearing loss in young children. These children were compared with 101 hearing peers. Children were observed during several tasks to measure intention understanding, the acknowledgement of the other's desires, and belief understanding. Parents completed two scales of the child development inventory to assess expressive language and language comprehension in all participants. Objective language test scores were available from the medical files of children with MHL. Results: Children with MHL showed comparable levels of intention understanding but lower levels of both desire and belief understanding than hearing peers. Parents reported lower language abilities in children with MHL compared with hearing peers. Yet, the language levels of children with MHL were within the average range compared with test normative samples. A stronger relation between language and ToM was found in the hearing children than in children with MHL. The expected developmental sequence of ToM skills was divergent in approximately one-fourth of children with MHL, when compared with hearing children. Conclusion: Children with MHL have more difficulty in their ToM reasoning than hearing peers, despite the fact that their language abilities lie within the average range compared with test normative samples. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Long-Term Outcomes, Education, and Occupational Level in Cochlear Implant Recipients Who Were Implanted in Childhood.

Objectives: To document the long-term outcomes of auditory performance, educational status, vocational training, and occupational situation in users of cochlear implants (CIs) who were implanted in childhood. Design: This retrospective cross-sectional study of 933 recipients of CIs examined auditory performance, education and vocational training, and occupational outcomes. All participants received their first CI during their childhood between 1986 and 2000. Speech comprehension results were categorized using the categories of auditory performance (CAP) arranged in order of increasing difficulty ranging from 0 to 8. 174 of the 933 pediatric recipients of CIs completed a self-assessment questionnaire regarding their education and occupational outcomes. To measure and compare school education, qualifications were converted into International Standard Classification of Education levels (ISCED-97). Occupations were converted into International Standard Classification of Occupation-88 skill levels. Data from the German General Social Survey (Allgemeine Bevolkerungsumfrage der Sozialwissenschaften/ALLBUS) for 2012 were used as a basis for comparing some of the collected data with the general population in Germany. Results: The results showed that 86.8% of the 174 participants who completed the survey used their devices more than 11 hr per day. Only 2% of the surveyed individuals were nonusers. Median CAP was 4.00 (0 to 8). Age at implantation was significantly correlated with CAP level (r = -0.472; p

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Long-Term Outcomes, Education, and Occupational Level in Cochlear Implant Recipients Who Were Implanted in Childhood.

Objectives: To document the long-term outcomes of auditory performance, educational status, vocational training, and occupational situation in users of cochlear implants (CIs) who were implanted in childhood. Design: This retrospective cross-sectional study of 933 recipients of CIs examined auditory performance, education and vocational training, and occupational outcomes. All participants received their first CI during their childhood between 1986 and 2000. Speech comprehension results were categorized using the categories of auditory performance (CAP) arranged in order of increasing difficulty ranging from 0 to 8. 174 of the 933 pediatric recipients of CIs completed a self-assessment questionnaire regarding their education and occupational outcomes. To measure and compare school education, qualifications were converted into International Standard Classification of Education levels (ISCED-97). Occupations were converted into International Standard Classification of Occupation-88 skill levels. Data from the German General Social Survey (Allgemeine Bevolkerungsumfrage der Sozialwissenschaften/ALLBUS) for 2012 were used as a basis for comparing some of the collected data with the general population in Germany. Results: The results showed that 86.8% of the 174 participants who completed the survey used their devices more than 11 hr per day. Only 2% of the surveyed individuals were nonusers. Median CAP was 4.00 (0 to 8). Age at implantation was significantly correlated with CAP level (r = -0.472; p

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Can You Hear What I Think? Theory of Mind in Young Children With Moderate Hearing Loss.

Objectives: The first aim of this study was to examine various aspects of Theory of Mind (ToM) development in young children with moderate hearing loss (MHL) compared with hearing peers. The second aim was to examine the relation between language abilities and ToM in both groups. The third aim was to compare the sequence of ToM development between children with MHL and hearing peers. Design: Forty-four children between 3 and 5 years old with MHL (35 to 70 dB HL) who preferred to use spoken language were identified from a nationwide study on hearing loss in young children. These children were compared with 101 hearing peers. Children were observed during several tasks to measure intention understanding, the acknowledgement of the other's desires, and belief understanding. Parents completed two scales of the child development inventory to assess expressive language and language comprehension in all participants. Objective language test scores were available from the medical files of children with MHL. Results: Children with MHL showed comparable levels of intention understanding but lower levels of both desire and belief understanding than hearing peers. Parents reported lower language abilities in children with MHL compared with hearing peers. Yet, the language levels of children with MHL were within the average range compared with test normative samples. A stronger relation between language and ToM was found in the hearing children than in children with MHL. The expected developmental sequence of ToM skills was divergent in approximately one-fourth of children with MHL, when compared with hearing children. Conclusion: Children with MHL have more difficulty in their ToM reasoning than hearing peers, despite the fact that their language abilities lie within the average range compared with test normative samples. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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