White Noise Machine Tinnitus – What It Is and How Does It Help

For people who suffer from tinnitus, each day can be difficult to say the least. While most people can carry on normal lives, some have problems with what are known as “phantom” sounds, which in some cases can lead to bouts of severe depression and insomnia. To combat this, many people turn to machines that produce white noise. Similar to the sound produced when televisions or radios are not tuned in to a station, it allows for much better sleep and concentration. Fortunately, there is now a white noise machine tinnitus sufferers can purchase and use to help alleviate their suffering.

How It Works
Producing 10 different tones of white noise, a white noise machine tinnitus patients can use has been clinically proven to help improve sleep as well as block out other unwanted sounds. Compatible with iPhones, iPods, and personal computers, the machines can be programmed to play whatever tone of white noise a person prefers. Along with this, the noise can be fine-tuned to allow patients to get maximum relief from their symptoms.

Compact Designs
When considering a white noise machine tinnitus patients may believe the machine is big and cumbersome. However, it’s actually very small and compact, resembling a small stereo speaker. Because of this, it fits in very easily to most rooms and decors, and can be easily transported from one place to another during vacations or business trips. And with apps that can be downloaded to a person’s smartphone or tablet, the white noise machine tinnitus patients use can be as convenient as possible.

Machine Features
To make these machines as beneficial as possible to patients, they come with a variety of features. Some of the most common include:
–Automatic timers from 30-90 minutes, plus continuous play
–Fine-tuned volume controls
–Replay buttons, allowing for previous selections to be played
–Headphone jacks
–Energy-efficient, using only one percent of energy of previous machines
With technology making advances every day in the development of these machines, those suffering from tinnitus can have many more options to help manage their condition.

Worth the Investment
With many white noise machines costing between $50-$100, they are easily affordable for most tinnitus patients. Proven to be very helpful in managing this complicated condition, most patients who use these machines consider them to be well worth the investment. By purchasing one as soon as possible, patients can be one step closer to getting a much better night’s sleep.

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Randomized Controlled Trial of a Novel Device for Tinnitus Sound Therapy During Sleep

Purpose

The aim of this study was to determine if a customized stimulus from the Otoharmonics Levo System reduces tinnitus perceptions and reactions for people with bothersome tinnitus.

Method

Sixty participants were randomized to 1 of 3 groups that used sound therapy devices during sleep that differed in their acoustic stimulus: (a) tinnitus-matched (TM), (b) noise stimulus (NS), and (c) bedside sound generator (BSG). Outcome measures were the Tinnitus Functional Index (TFI), numeric rating scale of tinnitus loudness, and tinnitus loudness match. A Bayesian hierarchical model was fit to estimate the differences in treatment efficacy among groups.

Results

Average tinnitus reactions and perceptions improved across treatment groups. We are at least 87% certain that treatment with TM or NS reduces mean TFI compared to treatment with BSG, with an estimated relative efficacy of 4.5–5 points greater reduction. We are at least 95% certain that treatment with TM results in greater reduction in mean numeric rating scale (NRS) of tinnitus loudness compared to the other groups, with an estimated relative efficacy of about 0.75 points greater reduction.

Conclusions

This study offers some support for greater average improvement in reactions to tinnitus with TM or NS devices compared to the BSG device. The TM group, compared to the BSG and NS groups, showed a greater reduction in ratings of tinnitus loudness on the NRS on average.

Supplemental Material

http://ift.tt/2h0o2h3

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A Benign Paroxysmal Positional Vertigo Triage Clinic

Purpose

The purpose of this study was to evaluate the effectiveness of triaging patients with motion-provoked dizziness into a benign paroxysmal positional vertigo (BPPV) clinic.

Method

A retrospective chart review was performed of veterans who were tested and treated for BPPV in a triaged BPPV clinic and veterans who were tested and treated for BPPV in a traditional vestibular clinic.

Results

The BPPV triage clinic had a hit rate of 39%. On average, the triaged BPPV clinic reduced patient wait times by 23 days relative to the wait times for the traditional vestibular clinic while also reducing patient costs.

Conclusion

Triaging patients with BPPV is one method to improve access to evaluation and treatment and a mechanism for the effective use of clinic time and resources.

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The First Step to Early Intervention Following Diagnosis: Communication in Pediatric Hearing Aid Orientation Sessions

Purpose

This preliminary study aimed to explore communication processes and information exchange in pediatric hearing aid orientation (HAO) sessions. Effective information exchange in such sessions is crucial to support appropriate hearing aid use.

Method

Using a qualitative sociolinguistic framework, we recorded and analyzed 5 HAO sessions between 2 audiologists and 5 caregivers of children who had just been fitted with hearing aids. We also conducted semistructured interviews with the audiologists and caregivers and analyzed these using content analysis.

Results

By necessity, audiologists provide a significant amount of information about hearing aids to caregivers in HAO sessions. Although caregivers in our study recalled and understood certain points such as the importance of not getting the hearing aids wet, crucial information about insertion and cleaning was often not recalled. Some caregivers misunderstood how the hearing aids would assist their child.

Conclusions

Caregivers need time to practice and absorb the information given, particularly given the emotional aspects associated with the diagnosis and “switch-on.” There is a need to revisit approaches to information giving, which align with the ongoing early intervention process. We offer some suggestions for improving HAO sessions and information giving about hearing aids.

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Estimating Nonorganic Hearing Thresholds Using Binaural Auditory Stimuli

Purpose

Minimum contralateral interference levels (MCILs) are used to estimate true hearing thresholds in individuals with unilateral nonorganic hearing loss. In this study, we determined MCILs and examined the correspondence of MCILs to true hearing thresholds to quantify the accuracy of this procedure.

Method

Sixteen adults with normal hearing participated. Subjects were asked to feign a unilateral hearing loss at 1.0, 2.0, and 4.0 kHz. MCILs were determined. Subjects also made lateralization judgments for simultaneously presented tones with varying interaural intensity differences.

Results

The 90% confidence intervals, calculated for the distributions, indicate that the MCIL in 90% of cases would be expected to be very close to threshold to approximately 17–19 dB poorer than the true hearing threshold. How close the MCIL is to true threshold appears to be based on the individual's response criterion.

Conclusions

Response bias influences the MCIL and how close an MCIL is to true hearing threshold. The clinician can never know a client's response bias and therefore should use a 90% confidence interval to predict the range for the expected true threshold. On the basis of this approach, a clinician may assume that true threshold is at or as much as 19 dB better than MCIL.

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Factors Associated With Depression in Patients With Tinnitus and Hyperacusis

Purpose

The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.

Method

Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.

Results

One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.

Conclusion

Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.

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Internet-Based Self-Help for Ménière's Disease: Details and Outcome of a Single-Group Open Trial

Purpose

In this article, we present the details and the pilot outcome of an Internet-based self-help program for Ménière's disease (MD).

Method

The Norton–Kaplan model is applied to construct a strategic, person-focused approach in the enablement process. The program assesses the disorder profile and diagnosis. In the therapeutic component of the program, the participant defines vision and time frame, inspects confounding factors, determines goals, establishes a strategy, and starts to work on the important problems caused by the disorder. The program works interactively, utilizes collaboration with significant others, and enhances positive thinking. Participants took part in an Internet-based self-help program. Data were collected interactively using open-ended and structured questionnaires on various disease-specific and general health aspects. The pilot outcome of 41 patients with MD was evaluated.

Results

The analysis of the pilot data showed statistically significant improvement in their general health-related quality of life (p < .001). Also, the outcome of the Posttraumatic Growth Inventory (Cann et al., 2010) showed small to moderate change as a result of the intervention.

Conclusions

The Internet-based self-help program can be helpful in the rehabilitation of patients with MD to supplement medical therapy.

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Characteristics and Treatment Outcomes of Benign Paroxysmal Positional Vertigo in a Cohort of Veterans

Background

The Mountain Home Veterans Affairs (VA) Medical Center has been diagnosing and treating veterans with benign paroxysmal positional vertigo (BPPV) for almost 2 decades. The clinic protocol includes a 2-week follow-up visit to determine the treatment outcome of the canalith repositioning treatment (CRT). To date, the characteristics of BPPV and treatment efficacy have not been reported in a cohort of veterans with BPPV.

Purpose

To determine the prevalence and characteristics of veterans diagnosed with BPPV in a Veterans Affairs Medical Center Audiology Clinic and to examine treatment outcomes.

Research Design

Retrospective chart review.

Study Sample

A total of 102 veterans who tested positive for BPPV in the Vestibular Clinic at the Mountain Home VA Medical Center from March 2010 to August 2011.

Results

In 102 veterans who were diagnosed with BPPV, the posterior semicircular canal was most often involved (75%), motion-provoked vertigo was the most common symptom (84%), and the majority (43%) were diagnosed with BPPV in their sixth decade. The prevalence of BPPV in the Audiology Vestibular Clinic was 15.6%. Forty-one percent of veterans reported a symptom onset within 12 months of treatment for BPPV; however, 36% reported their symptoms began > 36 months prior to treatment. CRT was effective (negative Dix–Hallpike/roll test) in most veterans (86%) following 1 treatment appointment (M = 1.6), but more than half reported incomplete symptom resolution (residual dizziness) at the follow-up appointment. Eighteen percent of veterans experienced a recurrence (M = 1.8 years; SD = 1.7 years).

Conclusions

The characteristics and treatment outcomes of BPPV in our veteran cohort was similar to what has been reported in the general population. Future work should focus on improving the timeliness of evaluation and treatment of BPPV and examining the time course and management of residual dizziness.

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Validating a Rapid, Automated Test of Spatial Release From Masking

Purpose

To evaluate the test–retest reliability of a headphone-based spatial release from a masking task with two maskers (referred to here as the SR2) and to describe its relationship to the same test done over loudspeakers in an anechoic chamber (the SR2A). We explore what thresholds tell us about certain populations (such as older individuals or individuals with hearing impairment) and discuss how the SR2 might be useful in the clinic.

Method

Fifty-four participants completed speech intelligibility tests in which a target phrase and two masking phrases from the Coordinate Response Measure corpus (Bolia, Nelson, Ericson, & Simpson, 2000) were presented either via earphones using a virtual spatial array or via loudspeakers in an anechoic chamber. For the SR2, the target sentence was always at 0° azimuth angle, and the maskers were either colocated at 0° or positioned at ± 45°. For the SR2A, the target was located at 0°, and the maskers were colocated or located at ± 15°, ± 30°, ± 45°, ± 90°, or ± 135°. Spatial release from masking was determined as the difference between thresholds in the colocated condition and each spatially separated condition. All participants completed the SR2 at least twice, and 29 of the individuals who completed the SR2 at least twice also participated in the SR2A. In a second experiment, 40 participants completed the SR2 8 times, and the changes in performance were evaluated as a function of test repetition.

Results

Mean thresholds were slightly better on the SR2 after the first repetition but were consistent across 8 subsequent testing sessions. Performance was consistent for the SR2A, regardless of the number of times testing was repeated. The SR2, which simulates 45° separations of target and maskers, produced spatially separated thresholds that were similar to thresholds obtained with 30° of separation in the anechoic chamber. Over headphones and in the anechoic chamber, pure-tone average was a strong predictor of spatial release, whereas age only reached significance for colocated conditions.

Conclusions

The SR2 is a reliable and effective method of testing spatial release from masking, suitable for screening abnormal listening abilities and for tracking rehabilitation over time. Future work should focus on developing and validating rapid, automated testing to identify the ability of listeners to benefit from high-frequency amplification, smaller spatial separations, and larger spectral differences among talkers.

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Enhanced Identification of Long Versus Short Voice Onset Time Consonant–Vowel Syllables in a Dichotic Listening Task

Purpose

This study investigated the influence of voice onset time (VOT) on the perception of consonant–vowel (CV) signals during a dichotic listening (DL) task.

Method

Sixty-two young adults with normal hearing were tested with the English language version of the Hugdahl Dichotic CV (DCV) Test. They were asked to identify 1 CV syllable during 3 DL conditions: free recall (report the syllable heard most clearly), forced right (report the syllable in the right ear), and forced left (report the syllable in the left ear). Averages for number and percent correct syllables were recorded under each condition and across the entire test.

Results

All subjects demonstrated an overall right-ear advantage (REA) when scores from all 3 listening conditions were averaged. The REA occurred for all VOT pairings except when the long VOT was presented to the left ear, whereas the short VOT was presented to the right ear when subjects produced an average left-ear advantage. The left-ear advantage overcame the structural advantage of the right ear even when subjects were directed to attend to the right ear. This result was consistent with findings of earlier studies done with Norwegian and Australian subjects.

Conclusions

Listeners' REA may be overcome by interaural temporal differences that favor processing in the listener's nondominant ear during the DCV test. Balanced VOT conditions across the DCV test prevent this effect from producing an overall bias toward the left ear, but clinical DL tests with consonant–vowel–consonant words should be examined for effects of the long VOT on laterality of performance.

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Combined Effects of Noise and Reverberation on Sound Localization for Listeners With Normal Hearing and Bilateral Cochlear Implants

Purpose

This study examined the individual and combined effects of noise and reverberation on the ability of listeners with normal hearing (NH) and with bilateral cochlear implants (BCIs) to localize speech.

Method

Six adults with BCIs and 10 with NH participated. All subjects completed a virtual localization test in quiet and at 0-, −4-, and −8-dB signal-to-noise ratios (SNRs) in simulated anechoic and reverberant (0.2-, 0.6-, and 0.9-s RT₆₀) environments. BCI users were also tested at +8- and +4-dB SNR. A 3-word phrase was presented at 70 dB SPL from 9 simulated locations in the frontal horizontal plane (±90°), with the noise source at 0°.

Results

BCIs users had significantly poorer localization than listeners with NH in all conditions. BCI users' performance started to decrease at a higher SNR (+4 dB) and shorter RT₆₀ (0.2 s) than listeners with NH (−4 dB and 0.6 s). The combination of noise and reverberation began to degrade localization of BCI users at a higher SNR and a shorter RT₆₀ than listeners with NH.

Conclusion

The clear effect of noise and reverberation on the performance of BCI users provides information that should be useful for refining cochlear implant processing strategies and developing cochlear implant rehabilitation plans to optimize binaural benefit for BCI users in everyday listening situations.

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Promoting Hearing Health Collaboration Through an Interprofessional Education Experience

Purpose

To enhance audiology and physician assistant (PA) student appreciation for collaboration/team-based care through an interprofessional educational activity focused on hearing assessments.

Method

A total of 18 students from Louisiana State University Health–New Orleans's audiology and PA programs participated in an optional interprofessional education learning opportunity, which included a demonstration of hearing assessments. To assess student perspectives regarding interprofessional learning, the students completed pre- and post-surveys.

Results

Eighteen students completed a survey, including 5 questions using a Likert scale and 1 open-ended question. Both audiology and PA students demonstrated significant statistical improvement in 2 interprofessional competencies: roles/responsibilities and interprofessional communication. Students also reported increased awareness and knowledge in the skills of the opposite professions as related to hearing assessments.

Conclusion

Integrating interprofessional education experiences within an audiology program promotes collaborative practice patterns and supports new educational accreditation standards.

Supplemental Material

http://ift.tt/2gKjpay

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The Effect of Adaptive Nonlinear Frequency Compression on Phoneme Perception

Purpose

This study implemented a fitting method, developed for use with frequency lowering hearing aids, across multiple testing sites, participants, and hearing aid conditions to evaluate speech perception with a novel type of frequency lowering.

Method

A total of 8 participants, including children and young adults, participated in real-world hearing aid trials. A blinded crossover design, including posttrial withdrawal testing, was used to assess aided phoneme perception. The hearing aid conditions included adaptive nonlinear frequency compression (NFC), static NFC, and conventional processing.

Results

Enabling either adaptive NFC or static NFC improved group-level detection and recognition results for some high-frequency phonemes, when compared with conventional processing. Mean results for the distinction component of the Phoneme Perception Test (Schmitt, Winkler, Boretzki, & Holube, 2016) were similar to those obtained with conventional processing.

Conclusions

Findings suggest that both types of NFC tested in this study provided a similar amount of speech perception benefit, when compared with group-level performance with conventional hearing aid technology. Individual-level results are presented with discussion around patterns of results that differ from the group average.

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Masthead

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Randomized Controlled Trial of a Novel Device for Tinnitus Sound Therapy During Sleep

Purpose

The aim of this study was to determine if a customized stimulus from the Otoharmonics Levo System reduces tinnitus perceptions and reactions for people with bothersome tinnitus.

Method

Sixty participants were randomized to 1 of 3 groups that used sound therapy devices during sleep that differed in their acoustic stimulus: (a) tinnitus-matched (TM), (b) noise stimulus (NS), and (c) bedside sound generator (BSG). Outcome measures were the Tinnitus Functional Index (TFI), numeric rating scale of tinnitus loudness, and tinnitus loudness match. A Bayesian hierarchical model was fit to estimate the differences in treatment efficacy among groups.

Results

Average tinnitus reactions and perceptions improved across treatment groups. We are at least 87% certain that treatment with TM or NS reduces mean TFI compared to treatment with BSG, with an estimated relative efficacy of 4.5–5 points greater reduction. We are at least 95% certain that treatment with TM results in greater reduction in mean numeric rating scale (NRS) of tinnitus loudness compared to the other groups, with an estimated relative efficacy of about 0.75 points greater reduction.

Conclusions

This study offers some support for greater average improvement in reactions to tinnitus with TM or NS devices compared to the BSG device. The TM group, compared to the BSG and NS groups, showed a greater reduction in ratings of tinnitus loudness on the NRS on average.

Supplemental Material

http://ift.tt/2h0o2h3

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A Benign Paroxysmal Positional Vertigo Triage Clinic

Purpose

The purpose of this study was to evaluate the effectiveness of triaging patients with motion-provoked dizziness into a benign paroxysmal positional vertigo (BPPV) clinic.

Method

A retrospective chart review was performed of veterans who were tested and treated for BPPV in a triaged BPPV clinic and veterans who were tested and treated for BPPV in a traditional vestibular clinic.

Results

The BPPV triage clinic had a hit rate of 39%. On average, the triaged BPPV clinic reduced patient wait times by 23 days relative to the wait times for the traditional vestibular clinic while also reducing patient costs.

Conclusion

Triaging patients with BPPV is one method to improve access to evaluation and treatment and a mechanism for the effective use of clinic time and resources.

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The First Step to Early Intervention Following Diagnosis: Communication in Pediatric Hearing Aid Orientation Sessions

Purpose

This preliminary study aimed to explore communication processes and information exchange in pediatric hearing aid orientation (HAO) sessions. Effective information exchange in such sessions is crucial to support appropriate hearing aid use.

Method

Using a qualitative sociolinguistic framework, we recorded and analyzed 5 HAO sessions between 2 audiologists and 5 caregivers of children who had just been fitted with hearing aids. We also conducted semistructured interviews with the audiologists and caregivers and analyzed these using content analysis.

Results

By necessity, audiologists provide a significant amount of information about hearing aids to caregivers in HAO sessions. Although caregivers in our study recalled and understood certain points such as the importance of not getting the hearing aids wet, crucial information about insertion and cleaning was often not recalled. Some caregivers misunderstood how the hearing aids would assist their child.

Conclusions

Caregivers need time to practice and absorb the information given, particularly given the emotional aspects associated with the diagnosis and “switch-on.” There is a need to revisit approaches to information giving, which align with the ongoing early intervention process. We offer some suggestions for improving HAO sessions and information giving about hearing aids.

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Estimating Nonorganic Hearing Thresholds Using Binaural Auditory Stimuli

Purpose

Minimum contralateral interference levels (MCILs) are used to estimate true hearing thresholds in individuals with unilateral nonorganic hearing loss. In this study, we determined MCILs and examined the correspondence of MCILs to true hearing thresholds to quantify the accuracy of this procedure.

Method

Sixteen adults with normal hearing participated. Subjects were asked to feign a unilateral hearing loss at 1.0, 2.0, and 4.0 kHz. MCILs were determined. Subjects also made lateralization judgments for simultaneously presented tones with varying interaural intensity differences.

Results

The 90% confidence intervals, calculated for the distributions, indicate that the MCIL in 90% of cases would be expected to be very close to threshold to approximately 17–19 dB poorer than the true hearing threshold. How close the MCIL is to true threshold appears to be based on the individual's response criterion.

Conclusions

Response bias influences the MCIL and how close an MCIL is to true hearing threshold. The clinician can never know a client's response bias and therefore should use a 90% confidence interval to predict the range for the expected true threshold. On the basis of this approach, a clinician may assume that true threshold is at or as much as 19 dB better than MCIL.

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Factors Associated With Depression in Patients With Tinnitus and Hyperacusis

Purpose

The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.

Method

Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.

Results

One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.

Conclusion

Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.

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Internet-Based Self-Help for Ménière's Disease: Details and Outcome of a Single-Group Open Trial

Purpose

In this article, we present the details and the pilot outcome of an Internet-based self-help program for Ménière's disease (MD).

Method

The Norton–Kaplan model is applied to construct a strategic, person-focused approach in the enablement process. The program assesses the disorder profile and diagnosis. In the therapeutic component of the program, the participant defines vision and time frame, inspects confounding factors, determines goals, establishes a strategy, and starts to work on the important problems caused by the disorder. The program works interactively, utilizes collaboration with significant others, and enhances positive thinking. Participants took part in an Internet-based self-help program. Data were collected interactively using open-ended and structured questionnaires on various disease-specific and general health aspects. The pilot outcome of 41 patients with MD was evaluated.

Results

The analysis of the pilot data showed statistically significant improvement in their general health-related quality of life (p < .001). Also, the outcome of the Posttraumatic Growth Inventory (Cann et al., 2010) showed small to moderate change as a result of the intervention.

Conclusions

The Internet-based self-help program can be helpful in the rehabilitation of patients with MD to supplement medical therapy.

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Characteristics and Treatment Outcomes of Benign Paroxysmal Positional Vertigo in a Cohort of Veterans

Background

The Mountain Home Veterans Affairs (VA) Medical Center has been diagnosing and treating veterans with benign paroxysmal positional vertigo (BPPV) for almost 2 decades. The clinic protocol includes a 2-week follow-up visit to determine the treatment outcome of the canalith repositioning treatment (CRT). To date, the characteristics of BPPV and treatment efficacy have not been reported in a cohort of veterans with BPPV.

Purpose

To determine the prevalence and characteristics of veterans diagnosed with BPPV in a Veterans Affairs Medical Center Audiology Clinic and to examine treatment outcomes.

Research Design

Retrospective chart review.

Study Sample

A total of 102 veterans who tested positive for BPPV in the Vestibular Clinic at the Mountain Home VA Medical Center from March 2010 to August 2011.

Results

In 102 veterans who were diagnosed with BPPV, the posterior semicircular canal was most often involved (75%), motion-provoked vertigo was the most common symptom (84%), and the majority (43%) were diagnosed with BPPV in their sixth decade. The prevalence of BPPV in the Audiology Vestibular Clinic was 15.6%. Forty-one percent of veterans reported a symptom onset within 12 months of treatment for BPPV; however, 36% reported their symptoms began > 36 months prior to treatment. CRT was effective (negative Dix–Hallpike/roll test) in most veterans (86%) following 1 treatment appointment (M = 1.6), but more than half reported incomplete symptom resolution (residual dizziness) at the follow-up appointment. Eighteen percent of veterans experienced a recurrence (M = 1.8 years; SD = 1.7 years).

Conclusions

The characteristics and treatment outcomes of BPPV in our veteran cohort was similar to what has been reported in the general population. Future work should focus on improving the timeliness of evaluation and treatment of BPPV and examining the time course and management of residual dizziness.

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Validating a Rapid, Automated Test of Spatial Release From Masking

Purpose

To evaluate the test–retest reliability of a headphone-based spatial release from a masking task with two maskers (referred to here as the SR2) and to describe its relationship to the same test done over loudspeakers in an anechoic chamber (the SR2A). We explore what thresholds tell us about certain populations (such as older individuals or individuals with hearing impairment) and discuss how the SR2 might be useful in the clinic.

Method

Fifty-four participants completed speech intelligibility tests in which a target phrase and two masking phrases from the Coordinate Response Measure corpus (Bolia, Nelson, Ericson, & Simpson, 2000) were presented either via earphones using a virtual spatial array or via loudspeakers in an anechoic chamber. For the SR2, the target sentence was always at 0° azimuth angle, and the maskers were either colocated at 0° or positioned at ± 45°. For the SR2A, the target was located at 0°, and the maskers were colocated or located at ± 15°, ± 30°, ± 45°, ± 90°, or ± 135°. Spatial release from masking was determined as the difference between thresholds in the colocated condition and each spatially separated condition. All participants completed the SR2 at least twice, and 29 of the individuals who completed the SR2 at least twice also participated in the SR2A. In a second experiment, 40 participants completed the SR2 8 times, and the changes in performance were evaluated as a function of test repetition.

Results

Mean thresholds were slightly better on the SR2 after the first repetition but were consistent across 8 subsequent testing sessions. Performance was consistent for the SR2A, regardless of the number of times testing was repeated. The SR2, which simulates 45° separations of target and maskers, produced spatially separated thresholds that were similar to thresholds obtained with 30° of separation in the anechoic chamber. Over headphones and in the anechoic chamber, pure-tone average was a strong predictor of spatial release, whereas age only reached significance for colocated conditions.

Conclusions

The SR2 is a reliable and effective method of testing spatial release from masking, suitable for screening abnormal listening abilities and for tracking rehabilitation over time. Future work should focus on developing and validating rapid, automated testing to identify the ability of listeners to benefit from high-frequency amplification, smaller spatial separations, and larger spectral differences among talkers.

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Enhanced Identification of Long Versus Short Voice Onset Time Consonant–Vowel Syllables in a Dichotic Listening Task

Purpose

This study investigated the influence of voice onset time (VOT) on the perception of consonant–vowel (CV) signals during a dichotic listening (DL) task.

Method

Sixty-two young adults with normal hearing were tested with the English language version of the Hugdahl Dichotic CV (DCV) Test. They were asked to identify 1 CV syllable during 3 DL conditions: free recall (report the syllable heard most clearly), forced right (report the syllable in the right ear), and forced left (report the syllable in the left ear). Averages for number and percent correct syllables were recorded under each condition and across the entire test.

Results

All subjects demonstrated an overall right-ear advantage (REA) when scores from all 3 listening conditions were averaged. The REA occurred for all VOT pairings except when the long VOT was presented to the left ear, whereas the short VOT was presented to the right ear when subjects produced an average left-ear advantage. The left-ear advantage overcame the structural advantage of the right ear even when subjects were directed to attend to the right ear. This result was consistent with findings of earlier studies done with Norwegian and Australian subjects.

Conclusions

Listeners' REA may be overcome by interaural temporal differences that favor processing in the listener's nondominant ear during the DCV test. Balanced VOT conditions across the DCV test prevent this effect from producing an overall bias toward the left ear, but clinical DL tests with consonant–vowel–consonant words should be examined for effects of the long VOT on laterality of performance.

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Combined Effects of Noise and Reverberation on Sound Localization for Listeners With Normal Hearing and Bilateral Cochlear Implants

Purpose

This study examined the individual and combined effects of noise and reverberation on the ability of listeners with normal hearing (NH) and with bilateral cochlear implants (BCIs) to localize speech.

Method

Six adults with BCIs and 10 with NH participated. All subjects completed a virtual localization test in quiet and at 0-, −4-, and −8-dB signal-to-noise ratios (SNRs) in simulated anechoic and reverberant (0.2-, 0.6-, and 0.9-s RT₆₀) environments. BCI users were also tested at +8- and +4-dB SNR. A 3-word phrase was presented at 70 dB SPL from 9 simulated locations in the frontal horizontal plane (±90°), with the noise source at 0°.

Results

BCIs users had significantly poorer localization than listeners with NH in all conditions. BCI users' performance started to decrease at a higher SNR (+4 dB) and shorter RT₆₀ (0.2 s) than listeners with NH (−4 dB and 0.6 s). The combination of noise and reverberation began to degrade localization of BCI users at a higher SNR and a shorter RT₆₀ than listeners with NH.

Conclusion

The clear effect of noise and reverberation on the performance of BCI users provides information that should be useful for refining cochlear implant processing strategies and developing cochlear implant rehabilitation plans to optimize binaural benefit for BCI users in everyday listening situations.

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Promoting Hearing Health Collaboration Through an Interprofessional Education Experience

Purpose

To enhance audiology and physician assistant (PA) student appreciation for collaboration/team-based care through an interprofessional educational activity focused on hearing assessments.

Method

A total of 18 students from Louisiana State University Health–New Orleans's audiology and PA programs participated in an optional interprofessional education learning opportunity, which included a demonstration of hearing assessments. To assess student perspectives regarding interprofessional learning, the students completed pre- and post-surveys.

Results

Eighteen students completed a survey, including 5 questions using a Likert scale and 1 open-ended question. Both audiology and PA students demonstrated significant statistical improvement in 2 interprofessional competencies: roles/responsibilities and interprofessional communication. Students also reported increased awareness and knowledge in the skills of the opposite professions as related to hearing assessments.

Conclusion

Integrating interprofessional education experiences within an audiology program promotes collaborative practice patterns and supports new educational accreditation standards.

Supplemental Material

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The Effect of Adaptive Nonlinear Frequency Compression on Phoneme Perception

Purpose

This study implemented a fitting method, developed for use with frequency lowering hearing aids, across multiple testing sites, participants, and hearing aid conditions to evaluate speech perception with a novel type of frequency lowering.

Method

A total of 8 participants, including children and young adults, participated in real-world hearing aid trials. A blinded crossover design, including posttrial withdrawal testing, was used to assess aided phoneme perception. The hearing aid conditions included adaptive nonlinear frequency compression (NFC), static NFC, and conventional processing.

Results

Enabling either adaptive NFC or static NFC improved group-level detection and recognition results for some high-frequency phonemes, when compared with conventional processing. Mean results for the distinction component of the Phoneme Perception Test (Schmitt, Winkler, Boretzki, & Holube, 2016) were similar to those obtained with conventional processing.

Conclusions

Findings suggest that both types of NFC tested in this study provided a similar amount of speech perception benefit, when compared with group-level performance with conventional hearing aid technology. Individual-level results are presented with discussion around patterns of results that differ from the group average.

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Masthead

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Randomized Controlled Trial of a Novel Device for Tinnitus Sound Therapy During Sleep

Purpose

The aim of this study was to determine if a customized stimulus from the Otoharmonics Levo System reduces tinnitus perceptions and reactions for people with bothersome tinnitus.

Method

Sixty participants were randomized to 1 of 3 groups that used sound therapy devices during sleep that differed in their acoustic stimulus: (a) tinnitus-matched (TM), (b) noise stimulus (NS), and (c) bedside sound generator (BSG). Outcome measures were the Tinnitus Functional Index (TFI), numeric rating scale of tinnitus loudness, and tinnitus loudness match. A Bayesian hierarchical model was fit to estimate the differences in treatment efficacy among groups.

Results

Average tinnitus reactions and perceptions improved across treatment groups. We are at least 87% certain that treatment with TM or NS reduces mean TFI compared to treatment with BSG, with an estimated relative efficacy of 4.5–5 points greater reduction. We are at least 95% certain that treatment with TM results in greater reduction in mean numeric rating scale (NRS) of tinnitus loudness compared to the other groups, with an estimated relative efficacy of about 0.75 points greater reduction.

Conclusions

This study offers some support for greater average improvement in reactions to tinnitus with TM or NS devices compared to the BSG device. The TM group, compared to the BSG and NS groups, showed a greater reduction in ratings of tinnitus loudness on the NRS on average.

Supplemental Material

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A Benign Paroxysmal Positional Vertigo Triage Clinic

Purpose

The purpose of this study was to evaluate the effectiveness of triaging patients with motion-provoked dizziness into a benign paroxysmal positional vertigo (BPPV) clinic.

Method

A retrospective chart review was performed of veterans who were tested and treated for BPPV in a triaged BPPV clinic and veterans who were tested and treated for BPPV in a traditional vestibular clinic.

Results

The BPPV triage clinic had a hit rate of 39%. On average, the triaged BPPV clinic reduced patient wait times by 23 days relative to the wait times for the traditional vestibular clinic while also reducing patient costs.

Conclusion

Triaging patients with BPPV is one method to improve access to evaluation and treatment and a mechanism for the effective use of clinic time and resources.

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The First Step to Early Intervention Following Diagnosis: Communication in Pediatric Hearing Aid Orientation Sessions

Purpose

This preliminary study aimed to explore communication processes and information exchange in pediatric hearing aid orientation (HAO) sessions. Effective information exchange in such sessions is crucial to support appropriate hearing aid use.

Method

Using a qualitative sociolinguistic framework, we recorded and analyzed 5 HAO sessions between 2 audiologists and 5 caregivers of children who had just been fitted with hearing aids. We also conducted semistructured interviews with the audiologists and caregivers and analyzed these using content analysis.

Results

By necessity, audiologists provide a significant amount of information about hearing aids to caregivers in HAO sessions. Although caregivers in our study recalled and understood certain points such as the importance of not getting the hearing aids wet, crucial information about insertion and cleaning was often not recalled. Some caregivers misunderstood how the hearing aids would assist their child.

Conclusions

Caregivers need time to practice and absorb the information given, particularly given the emotional aspects associated with the diagnosis and “switch-on.” There is a need to revisit approaches to information giving, which align with the ongoing early intervention process. We offer some suggestions for improving HAO sessions and information giving about hearing aids.

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Estimating Nonorganic Hearing Thresholds Using Binaural Auditory Stimuli

Purpose

Minimum contralateral interference levels (MCILs) are used to estimate true hearing thresholds in individuals with unilateral nonorganic hearing loss. In this study, we determined MCILs and examined the correspondence of MCILs to true hearing thresholds to quantify the accuracy of this procedure.

Method

Sixteen adults with normal hearing participated. Subjects were asked to feign a unilateral hearing loss at 1.0, 2.0, and 4.0 kHz. MCILs were determined. Subjects also made lateralization judgments for simultaneously presented tones with varying interaural intensity differences.

Results

The 90% confidence intervals, calculated for the distributions, indicate that the MCIL in 90% of cases would be expected to be very close to threshold to approximately 17–19 dB poorer than the true hearing threshold. How close the MCIL is to true threshold appears to be based on the individual's response criterion.

Conclusions

Response bias influences the MCIL and how close an MCIL is to true hearing threshold. The clinician can never know a client's response bias and therefore should use a 90% confidence interval to predict the range for the expected true threshold. On the basis of this approach, a clinician may assume that true threshold is at or as much as 19 dB better than MCIL.

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Factors Associated With Depression in Patients With Tinnitus and Hyperacusis

Purpose

The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis.

Method

Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom.

Results

One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety.

Conclusion

Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.

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Internet-Based Self-Help for Ménière's Disease: Details and Outcome of a Single-Group Open Trial

Purpose

In this article, we present the details and the pilot outcome of an Internet-based self-help program for Ménière's disease (MD).

Method

The Norton–Kaplan model is applied to construct a strategic, person-focused approach in the enablement process. The program assesses the disorder profile and diagnosis. In the therapeutic component of the program, the participant defines vision and time frame, inspects confounding factors, determines goals, establishes a strategy, and starts to work on the important problems caused by the disorder. The program works interactively, utilizes collaboration with significant others, and enhances positive thinking. Participants took part in an Internet-based self-help program. Data were collected interactively using open-ended and structured questionnaires on various disease-specific and general health aspects. The pilot outcome of 41 patients with MD was evaluated.

Results

The analysis of the pilot data showed statistically significant improvement in their general health-related quality of life (p < .001). Also, the outcome of the Posttraumatic Growth Inventory (Cann et al., 2010) showed small to moderate change as a result of the intervention.

Conclusions

The Internet-based self-help program can be helpful in the rehabilitation of patients with MD to supplement medical therapy.

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Characteristics and Treatment Outcomes of Benign Paroxysmal Positional Vertigo in a Cohort of Veterans

Background

The Mountain Home Veterans Affairs (VA) Medical Center has been diagnosing and treating veterans with benign paroxysmal positional vertigo (BPPV) for almost 2 decades. The clinic protocol includes a 2-week follow-up visit to determine the treatment outcome of the canalith repositioning treatment (CRT). To date, the characteristics of BPPV and treatment efficacy have not been reported in a cohort of veterans with BPPV.

Purpose

To determine the prevalence and characteristics of veterans diagnosed with BPPV in a Veterans Affairs Medical Center Audiology Clinic and to examine treatment outcomes.

Research Design

Retrospective chart review.

Study Sample

A total of 102 veterans who tested positive for BPPV in the Vestibular Clinic at the Mountain Home VA Medical Center from March 2010 to August 2011.

Results

In 102 veterans who were diagnosed with BPPV, the posterior semicircular canal was most often involved (75%), motion-provoked vertigo was the most common symptom (84%), and the majority (43%) were diagnosed with BPPV in their sixth decade. The prevalence of BPPV in the Audiology Vestibular Clinic was 15.6%. Forty-one percent of veterans reported a symptom onset within 12 months of treatment for BPPV; however, 36% reported their symptoms began > 36 months prior to treatment. CRT was effective (negative Dix–Hallpike/roll test) in most veterans (86%) following 1 treatment appointment (M = 1.6), but more than half reported incomplete symptom resolution (residual dizziness) at the follow-up appointment. Eighteen percent of veterans experienced a recurrence (M = 1.8 years; SD = 1.7 years).

Conclusions

The characteristics and treatment outcomes of BPPV in our veteran cohort was similar to what has been reported in the general population. Future work should focus on improving the timeliness of evaluation and treatment of BPPV and examining the time course and management of residual dizziness.

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Validating a Rapid, Automated Test of Spatial Release From Masking

Purpose

To evaluate the test–retest reliability of a headphone-based spatial release from a masking task with two maskers (referred to here as the SR2) and to describe its relationship to the same test done over loudspeakers in an anechoic chamber (the SR2A). We explore what thresholds tell us about certain populations (such as older individuals or individuals with hearing impairment) and discuss how the SR2 might be useful in the clinic.

Method

Fifty-four participants completed speech intelligibility tests in which a target phrase and two masking phrases from the Coordinate Response Measure corpus (Bolia, Nelson, Ericson, & Simpson, 2000) were presented either via earphones using a virtual spatial array or via loudspeakers in an anechoic chamber. For the SR2, the target sentence was always at 0° azimuth angle, and the maskers were either colocated at 0° or positioned at ± 45°. For the SR2A, the target was located at 0°, and the maskers were colocated or located at ± 15°, ± 30°, ± 45°, ± 90°, or ± 135°. Spatial release from masking was determined as the difference between thresholds in the colocated condition and each spatially separated condition. All participants completed the SR2 at least twice, and 29 of the individuals who completed the SR2 at least twice also participated in the SR2A. In a second experiment, 40 participants completed the SR2 8 times, and the changes in performance were evaluated as a function of test repetition.

Results

Mean thresholds were slightly better on the SR2 after the first repetition but were consistent across 8 subsequent testing sessions. Performance was consistent for the SR2A, regardless of the number of times testing was repeated. The SR2, which simulates 45° separations of target and maskers, produced spatially separated thresholds that were similar to thresholds obtained with 30° of separation in the anechoic chamber. Over headphones and in the anechoic chamber, pure-tone average was a strong predictor of spatial release, whereas age only reached significance for colocated conditions.

Conclusions

The SR2 is a reliable and effective method of testing spatial release from masking, suitable for screening abnormal listening abilities and for tracking rehabilitation over time. Future work should focus on developing and validating rapid, automated testing to identify the ability of listeners to benefit from high-frequency amplification, smaller spatial separations, and larger spectral differences among talkers.

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Enhanced Identification of Long Versus Short Voice Onset Time Consonant–Vowel Syllables in a Dichotic Listening Task

Purpose

This study investigated the influence of voice onset time (VOT) on the perception of consonant–vowel (CV) signals during a dichotic listening (DL) task.

Method

Sixty-two young adults with normal hearing were tested with the English language version of the Hugdahl Dichotic CV (DCV) Test. They were asked to identify 1 CV syllable during 3 DL conditions: free recall (report the syllable heard most clearly), forced right (report the syllable in the right ear), and forced left (report the syllable in the left ear). Averages for number and percent correct syllables were recorded under each condition and across the entire test.

Results

All subjects demonstrated an overall right-ear advantage (REA) when scores from all 3 listening conditions were averaged. The REA occurred for all VOT pairings except when the long VOT was presented to the left ear, whereas the short VOT was presented to the right ear when subjects produced an average left-ear advantage. The left-ear advantage overcame the structural advantage of the right ear even when subjects were directed to attend to the right ear. This result was consistent with findings of earlier studies done with Norwegian and Australian subjects.

Conclusions

Listeners' REA may be overcome by interaural temporal differences that favor processing in the listener's nondominant ear during the DCV test. Balanced VOT conditions across the DCV test prevent this effect from producing an overall bias toward the left ear, but clinical DL tests with consonant–vowel–consonant words should be examined for effects of the long VOT on laterality of performance.

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Combined Effects of Noise and Reverberation on Sound Localization for Listeners With Normal Hearing and Bilateral Cochlear Implants

Purpose

This study examined the individual and combined effects of noise and reverberation on the ability of listeners with normal hearing (NH) and with bilateral cochlear implants (BCIs) to localize speech.

Method

Six adults with BCIs and 10 with NH participated. All subjects completed a virtual localization test in quiet and at 0-, −4-, and −8-dB signal-to-noise ratios (SNRs) in simulated anechoic and reverberant (0.2-, 0.6-, and 0.9-s RT₆₀) environments. BCI users were also tested at +8- and +4-dB SNR. A 3-word phrase was presented at 70 dB SPL from 9 simulated locations in the frontal horizontal plane (±90°), with the noise source at 0°.

Results

BCIs users had significantly poorer localization than listeners with NH in all conditions. BCI users' performance started to decrease at a higher SNR (+4 dB) and shorter RT₆₀ (0.2 s) than listeners with NH (−4 dB and 0.6 s). The combination of noise and reverberation began to degrade localization of BCI users at a higher SNR and a shorter RT₆₀ than listeners with NH.

Conclusion

The clear effect of noise and reverberation on the performance of BCI users provides information that should be useful for refining cochlear implant processing strategies and developing cochlear implant rehabilitation plans to optimize binaural benefit for BCI users in everyday listening situations.

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Promoting Hearing Health Collaboration Through an Interprofessional Education Experience

Purpose

To enhance audiology and physician assistant (PA) student appreciation for collaboration/team-based care through an interprofessional educational activity focused on hearing assessments.

Method

A total of 18 students from Louisiana State University Health–New Orleans's audiology and PA programs participated in an optional interprofessional education learning opportunity, which included a demonstration of hearing assessments. To assess student perspectives regarding interprofessional learning, the students completed pre- and post-surveys.

Results

Eighteen students completed a survey, including 5 questions using a Likert scale and 1 open-ended question. Both audiology and PA students demonstrated significant statistical improvement in 2 interprofessional competencies: roles/responsibilities and interprofessional communication. Students also reported increased awareness and knowledge in the skills of the opposite professions as related to hearing assessments.

Conclusion

Integrating interprofessional education experiences within an audiology program promotes collaborative practice patterns and supports new educational accreditation standards.

Supplemental Material

http://ift.tt/2gKjpay

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The Effect of Adaptive Nonlinear Frequency Compression on Phoneme Perception

Purpose

This study implemented a fitting method, developed for use with frequency lowering hearing aids, across multiple testing sites, participants, and hearing aid conditions to evaluate speech perception with a novel type of frequency lowering.

Method

A total of 8 participants, including children and young adults, participated in real-world hearing aid trials. A blinded crossover design, including posttrial withdrawal testing, was used to assess aided phoneme perception. The hearing aid conditions included adaptive nonlinear frequency compression (NFC), static NFC, and conventional processing.

Results

Enabling either adaptive NFC or static NFC improved group-level detection and recognition results for some high-frequency phonemes, when compared with conventional processing. Mean results for the distinction component of the Phoneme Perception Test (Schmitt, Winkler, Boretzki, & Holube, 2016) were similar to those obtained with conventional processing.

Conclusions

Findings suggest that both types of NFC tested in this study provided a similar amount of speech perception benefit, when compared with group-level performance with conventional hearing aid technology. Individual-level results are presented with discussion around patterns of results that differ from the group average.

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Masthead

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Newborn Screening of Genetic Mutations in Common Deafness Genes With Bloodspot-Based Gene Chip Array

Purpose

This study screens for deafness gene mutations in newborns in the Northwest China population.

Method

The 9 sites of 4 common deafness genes (GJB2, GJB3, SLC26A 4, and mt 12S rRNA) were detected by bloodspot-based gene chip array in 2,500 newborns.

Results

We detected mutations of the 4 genes in 101 (4.04%) newborns; particularly, 0.20% detected the double mutations. In the Hui population, 4.58% of the newborns tested positive for mutations, whereas 4.01% of Han newborns tested positive for mutations. The detective rates are as follows: 1.44% for GJB2 235delC, 1.08% for SLC26A4 IVS7-2A>G, 0.48% for GJB2 299_300delAT, 0.28% for SLC26A4 2168A>G, 0.2% for mt 12S rRNA 1555A>G, and 0.16% for GJB3 538C>T. The 31.25% (5/16) of infants with GJB2 235delC, 50% (3/6) with GJB2 299_300delAT, and 25% (3/12) with SLC26A4 IVS7-2A>G showed abnormal hearing when tested; only 1 double mutation case received the hearing test, and this infant showed abnormality in both ears on the hearing test.

Conclusions

High mutation rates in the common deafness genes were detected in newborns in Northwest China. Our study is helpful in understanding the deafness genomic epidemiology and also provides evidence for prenatal and postnatal care as well as policy making on population health in the region.

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Newborn Screening of Genetic Mutations in Common Deafness Genes With Bloodspot-Based Gene Chip Array

Purpose

This study screens for deafness gene mutations in newborns in the Northwest China population.

Method

The 9 sites of 4 common deafness genes (GJB2, GJB3, SLC26A 4, and mt 12S rRNA) were detected by bloodspot-based gene chip array in 2,500 newborns.

Results

We detected mutations of the 4 genes in 101 (4.04%) newborns; particularly, 0.20% detected the double mutations. In the Hui population, 4.58% of the newborns tested positive for mutations, whereas 4.01% of Han newborns tested positive for mutations. The detective rates are as follows: 1.44% for GJB2 235delC, 1.08% for SLC26A4 IVS7-2A>G, 0.48% for GJB2 299_300delAT, 0.28% for SLC26A4 2168A>G, 0.2% for mt 12S rRNA 1555A>G, and 0.16% for GJB3 538C>T. The 31.25% (5/16) of infants with GJB2 235delC, 50% (3/6) with GJB2 299_300delAT, and 25% (3/12) with SLC26A4 IVS7-2A>G showed abnormal hearing when tested; only 1 double mutation case received the hearing test, and this infant showed abnormality in both ears on the hearing test.

Conclusions

High mutation rates in the common deafness genes were detected in newborns in Northwest China. Our study is helpful in understanding the deafness genomic epidemiology and also provides evidence for prenatal and postnatal care as well as policy making on population health in the region.

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Newborn Screening of Genetic Mutations in Common Deafness Genes With Bloodspot-Based Gene Chip Array

Purpose

This study screens for deafness gene mutations in newborns in the Northwest China population.

Method

The 9 sites of 4 common deafness genes (GJB2, GJB3, SLC26A 4, and mt 12S rRNA) were detected by bloodspot-based gene chip array in 2,500 newborns.

Results

We detected mutations of the 4 genes in 101 (4.04%) newborns; particularly, 0.20% detected the double mutations. In the Hui population, 4.58% of the newborns tested positive for mutations, whereas 4.01% of Han newborns tested positive for mutations. The detective rates are as follows: 1.44% for GJB2 235delC, 1.08% for SLC26A4 IVS7-2A>G, 0.48% for GJB2 299_300delAT, 0.28% for SLC26A4 2168A>G, 0.2% for mt 12S rRNA 1555A>G, and 0.16% for GJB3 538C>T. The 31.25% (5/16) of infants with GJB2 235delC, 50% (3/6) with GJB2 299_300delAT, and 25% (3/12) with SLC26A4 IVS7-2A>G showed abnormal hearing when tested; only 1 double mutation case received the hearing test, and this infant showed abnormality in both ears on the hearing test.

Conclusions

High mutation rates in the common deafness genes were detected in newborns in Northwest China. Our study is helpful in understanding the deafness genomic epidemiology and also provides evidence for prenatal and postnatal care as well as policy making on population health in the region.

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'We all hear voices in our heads,' but why? Study investigates

New research suggests that the brain regards talking inside of our heads as equivalent to talking out loud, with the same degree of dampened response.

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'We all hear voices in our heads,' but why? Study investigates

New research suggests that the brain regards talking inside of our heads as equivalent to talking out loud, with the same degree of dampened response.

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'We all hear voices in our heads,' but why? Study investigates

New research suggests that the brain regards talking inside of our heads as equivalent to talking out loud, with the same degree of dampened response.

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A Multicenter Clinical Evaluation of Data Logging in Cochlear Implant Recipients Using Automated Scene Classification Technologies

Currently, there are no studies assessing everyday use of cochlear implant (CI) processors by recipients by means of objective tools. The Nucleus 6 sound processor features a data logging system capable of real-time recording of CI use in different acoustic environments and under various categories of loudness levels. In this study, we report data logged for the different scenes and different loudness levels of 1,366 CI patients, as recorded by SCAN. Monitoring device use in cochlear implant recipients of all ages provides important information about the listening conditions encountered in recipients' daily lives that may support counseling and assist in the further management of their device settings. The findings for this large cohort of active CI users confirm differences between age groups concerning device use and exposure to various noise environments, especially between the youngest and oldest age groups, while similar levels of loudness were observed.
Audiol Neurotol 2017;22:226-235

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Early Outcomes With a Slim, Modiolar Cochlear Implant Electrode Array.

Early Outcomes With a Slim, Modiolar Cochlear Implant Electrode Array.

Otol Neurotol. 2018 Jan;39(1):e28-e33

Authors: McJunkin JL, Durakovic N, Herzog J, Buchman CA

Abstract
OBJECTIVE: To describe outcomes from cochlear implantation with a new, slim modiolar electrode array.
STUDY DESIGN: Retrospective cohort study.
SETTING: Tertiary referral centers.
PATIENTS: Adult cochlear implant candidates.
INTERVENTIONS: Cochlear implantation with CI532 (Cochlear Corp).
MAIN OUTCOME MEASURES: Pre- and postoperative speech perception scores, operative details, and postoperative computed tomography (CT) reconstructions of array location.
RESULTS: One hundred seventeen patients are implanted to date. There were eight tip rollovers identified with intraoperative x-ray and resolved with reinsertion. An additional rollover was identified on postoperative CT. CT reconstructions in 17 of 23 patients showed complete scala tympani placement with a wrap factor of 58% (range 53-64%) and a mean insertion angle of 406 degrees (range 360-452 degrees). Three implants demonstrated array translocation with electrodes in the scala vestibuli. Consonant-nucleus-consonant word scores improved from 10% preoperatively to 48% at 3 months postoperatively. Pure-tone thresholds were preserved postoperatively in 37 to 52% of patients across frequencies from 250 to 4000 Hz. Functional pure-tone thresholds (≤80 dB) were recorded in 9 to 25% of patients.
CONCLUSION: CI532 array insertion results in consistent scala tympani location and provides expected audiologic performance. Initial hearing preservation results are not consistent with current electro-acoustic arrays.

PMID: 29227449 [PubMed - in process]

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Spontaneous intramural duodenal hematoma as the manifestation of Noonan syndrome.

Spontaneous intramural duodenal hematoma as the manifestation of Noonan syndrome.

Am J Med Genet A. 2017 Dec 11;:

Authors: Yamazawa K, Yamada Y, Kuroda T, Mutai H, Matsunaga T, Komiyama O, Takahashi T

PMID: 29226542 [PubMed - as supplied by publisher]

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Early Outcomes With a Slim, Modiolar Cochlear Implant Electrode Array.

Early Outcomes With a Slim, Modiolar Cochlear Implant Electrode Array.

Otol Neurotol. 2018 Jan;39(1):e28-e33

Authors: McJunkin JL, Durakovic N, Herzog J, Buchman CA

Abstract
OBJECTIVE: To describe outcomes from cochlear implantation with a new, slim modiolar electrode array.
STUDY DESIGN: Retrospective cohort study.
SETTING: Tertiary referral centers.
PATIENTS: Adult cochlear implant candidates.
INTERVENTIONS: Cochlear implantation with CI532 (Cochlear Corp).
MAIN OUTCOME MEASURES: Pre- and postoperative speech perception scores, operative details, and postoperative computed tomography (CT) reconstructions of array location.
RESULTS: One hundred seventeen patients are implanted to date. There were eight tip rollovers identified with intraoperative x-ray and resolved with reinsertion. An additional rollover was identified on postoperative CT. CT reconstructions in 17 of 23 patients showed complete scala tympani placement with a wrap factor of 58% (range 53-64%) and a mean insertion angle of 406 degrees (range 360-452 degrees). Three implants demonstrated array translocation with electrodes in the scala vestibuli. Consonant-nucleus-consonant word scores improved from 10% preoperatively to 48% at 3 months postoperatively. Pure-tone thresholds were preserved postoperatively in 37 to 52% of patients across frequencies from 250 to 4000 Hz. Functional pure-tone thresholds (≤80 dB) were recorded in 9 to 25% of patients.
CONCLUSION: CI532 array insertion results in consistent scala tympani location and provides expected audiologic performance. Initial hearing preservation results are not consistent with current electro-acoustic arrays.

PMID: 29227449 [PubMed - in process]

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Spontaneous intramural duodenal hematoma as the manifestation of Noonan syndrome.

Spontaneous intramural duodenal hematoma as the manifestation of Noonan syndrome.

Am J Med Genet A. 2017 Dec 11;:

Authors: Yamazawa K, Yamada Y, Kuroda T, Mutai H, Matsunaga T, Komiyama O, Takahashi T

PMID: 29226542 [PubMed - as supplied by publisher]

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Heat Shock Proteins in Human Perilymph: Implications for Cochlear Implantation.

Heat Shock Proteins in Human Perilymph: Implications for Cochlear Implantation.

Otol Neurotol. 2018 Jan;39(1):37-44

Authors: Schmitt H, Roemer A, Zeilinger C, Salcher R, Durisin M, Staecker H, Lenarz T, Warnecke A

Abstract
OBJECTIVE: Biomarkers reflecting the etiology and pathophysiology of inner ear diseases are limited. Evaluation of proteins in the perilymph may improve our understanding of inner ear disease. Heat shock proteins (HSP) belong to a superfamily of stress proteins and promote refolding of denatured proteins. The aim of the study was to analyze HSP in human perilymph and to identify possible correlation with audiological and etiologic data.
METHODS: Sampling of the perilymph was performed during cochlear implantation and vestibular schwannoma removal. Individual proteins were identified by a shot-gun proteomics approach by orbitrap mass spectrometry. Expression of HSP genes was determined in human cochlear tissue that was obtained during transcochlear surgeries.
RESULTS: Ten subgroups of HSP were identified in human perilymph samples. Increased levels of HSP were detected in a higher percentage in the perilymph of patients with residual hearing when compared with patients with no residual hearing in cochlear implantation. In patients with complete preservation of residual hearing, HSP 90 is identified in a lower percentage whereas HSP 70 1A/1B and 6 was identified in all the samples. Constitutive expression of HSP family members was verified in normal cochlear tissue.
CONCLUSION: The 10 HSP variants are not identified in all the perilymph samples, but in a higher proportion in patients with residual hearing compared with patients with no residual hearing. In-depth proteome analysis of perilymph samples in correlation to patients' audiogram data shows an increased concentration of HSP in patients with residual hearing. An increase in specific HSP in patients with loss of residual hearing after cochlear implantation was not observed.

PMID: 29227447 [PubMed - in process]

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Parental knowledge and attitudes to childhood hearing loss and hearing services in the Solomon Islands.

Parental knowledge and attitudes to childhood hearing loss and hearing services in the Solomon Islands.

Int J Pediatr Otorhinolaryngol. 2017 Dec;103:87-92

Authors: Kaspar A, Newton O, Kei J, Driscoll C, Swanepoel W, Goulios H

Abstract
OBJECTIVE: An understanding of parental knowledge and attitudes towards childhood hearing loss is essential to the successful implementation of audiology services. The present study aimed to investigate parental knowledge and attitudes among parents in the Solomon Islands.
METHODS AND MATERIALS: A total of 100 mothers and 50 fathers were administered a questionnaire via semi-structured interviews.
RESULTS: Highest parental awareness of aetiology of childhood hearing loss was noted for otitis media (94%), noise exposure (87.3%), and family history (72.7%). The highest parental awareness concerning public health initiatives to reduce/prevent otitis media was noted for routine childhood immunizations (84%) and breast-feeding (76%). Higher rates of knowledge in fathers than in mothers included otitis media (p = 0.038), noise exposure (p = 0.007), and breast-feeding (p = 0.031). Approximately half of parents (56%) agreed that curses may cause hearing loss. Overall parental responses showed positive support for infant hearing screening programs (96%) and school-based ear and hearing health examinations (99.3%).
CONCLUSIONS: High levels of parental readiness and support for childhood hearing services in the Solomon Islands was evident. Knowledge of aetiology of childhood hearing loss was highest for otitis media, noise exposure, and family history. Knowledge and attitudes of fathers to childhood hearing loss and hearing services was either the same or better than that of mothers.

PMID: 29224773 [PubMed - in process]

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Next-generation sequencing identifies three novel missense variants in ILDR1 and MYO6 genes in an Iranian family with hearing loss with review of the literature.

Next-generation sequencing identifies three novel missense variants in ILDR1 and MYO6 genes in an Iranian family with hearing loss with review of the literature.

Int J Pediatr Otorhinolaryngol. 2017 Dec;103:103-108

Authors: Talebi F, Mardasi FG, Asl JM, Sayahi M

Abstract
OBJECTIVES: Hearing impairment is the most common sensorineural disorder and is genetically heterogeneous. Identification of the pathogenic mutations underlying hearing impairment is difficult, since causative mutations in 127 different genes have so far been reported.
METHODS: In this study, we performed Next-generation sequencing (NGS) in 2 individuals from a consanguineous family with hearing loss.
RESULTS: Three novel mutations in known deafness genes were identified in the family; MYO6-p.R928C and -p.D1223N in heterozygous state and ILDR1-p.Y143C in homozygous state. Sanger sequencing confirmed co-segregation of the three mutations with deafness in the family. The identified mutation in ILDR1 gene is located in the immunoglobulin-type domain of the ILDR1 protein and the detected mutations in MY06 are located in the tail domain of the MYO6 protein. The mutations are predicted to be pathogenic by SIFT, PolyPhen and Mutation Taster.
CONCLUSIONS: Our results suggest that either the homozygous ILDR1-p.Y143C mutation might be the pathogenic variant for ARNSHL or heterozygous MYO6- p.R928C, -p.D1223N might be involved in these patient's disorder due to compound heterozygousity. To our knowledge, this is the first ILDR1 and MYO6 mutations recognized in the southwest Iran. Our data expands the spectrum of mutations in ILDR1 and MYO6 genes.

PMID: 29224747 [PubMed - in process]

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Deaf New Zealand Sign Language users' access to healthcare.

Related Articles

Deaf New Zealand Sign Language users' access to healthcare.

N Z Med J. 2017 Dec 01;130(1466):53-61

Authors: Witko J, Boyles P, Smiler K, McKee R

Abstract
AIMS: The research described was undertaken as part of a Sub-Regional Disability Strategy 2017-2022 across the Wairarapa, Hutt Valley and Capital and Coast District Health Boards (DHBs). The aim was to investigate deaf New Zealand Sign Language (NZSL) users' quality of access to health services. Findings have formed the basis for developing a 'NZSL plan' for DHBs in the Wellington sub-region.
METHODS: Qualitative data was collected from 56 deaf participants and family members about their experiences of healthcare services via focus group, individual interviews and online survey, which were thematically analysed. Contextual perspective was gained from 57 healthcare professionals at five meetings. Two professionals were interviewed, and 65 staff responded to an online survey. A deaf steering group co-designed the framework and methods, and validated findings.
RESULTS: Key issues reported across the health system include: inconsistent interpreter provision; lack of informed consent for treatment via communication in NZSL; limited access to general health information in NZSL and the reduced ability of deaf patients to understand and comply with treatment options. This problematic communication with NZSL users echoes international evidence and other documented local evidence for patients with limited English proficiency.
CONCLUSION: Deaf NZSL users face multiple barriers to equitable healthcare, stemming from linguistic and educational factors and inaccessible service delivery. These need to be addressed through policy and training for healthcare personnel that enable effective systemic responses to NZSL users. Deaf participants emphasise that recognition of their identity as members of a language community is central to improving their healthcare experiences.

PMID: 29197901 [PubMed - indexed for MEDLINE]

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Deletion of the γ-secretase subunits Aph1B/C impairs memory and worsens the deficits of knock-in mice modeling the Alzheimer-like familial Danish dementia.

Related Articles

Deletion of the γ-secretase subunits Aph1B/C impairs memory and worsens the deficits of knock-in mice modeling the Alzheimer-like familial Danish dementia.

Oncotarget. 2016 Mar 15;7(11):11923-44

Authors: Biundo F, Ishiwari K, Del Prete D, D'Adamio L

Abstract
Mutations in BRI2/ITM2b genes cause Familial British and Danish Dementias (FBD and FDD), which are pathogenically similar to Familial Alzheimer Disease (FAD). BRI2 inhibits processing of Amyloid precursor protein (APP), a protein involved in FAD pathogenesis. Accumulation of a carboxyl-terminal APP metabolite -ß-CTF- causes memory deficits in a knock-in mouse model of FDD, called FDDKI.We have investigated further the pathogenic function of ß-CTF studying the effect of Aph1B/C deletion on FDDKI mice. This strategy is based on the evidence that deletion of Aph1B/C proteins, which are components of the γ-secretase that cleaves ß-CTF, results in stabilization of ß-CTF and a reduction of Aβ. We found that both the FDD mutation and the Aph1B/C deficiency mildly interfered with spatial long term memory, spatial working/short-term memory and long-term contextual fear memory. In addition, the Aph1BC deficiency induced deficits in long-term cued fear memory. Moreover, the two mutations have additive adverse effects as they compromise the accuracy of spatial long-term memory and induce spatial memory retention deficits in young mice. Overall, the data are consistent with a role for β-CTF in the genesis of memory deficits.

PMID: 26942869 [PubMed - indexed for MEDLINE]

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High Resolution Three-Dimensional Delayed Contrast MRI Detects Endolymphatic Hydrops in Patients With Vertigo and Vestibular Schwannoma.

High Resolution Three-Dimensional Delayed Contrast MRI Detects Endolymphatic Hydrops in Patients With Vertigo and Vestibular Schwannoma.

Otol Neurotol. 2018 Jan;39(1):e39-e44

Authors: Moayer R, Ishiyama GP, Karnezis S, Sepahdari AR, Ishiyama A

Abstract
OBJECTIVE: Advances in high resolution magnetic resonance imaging (MRI) have enabled the detection of endolymphatic hydrops (EH), a pathological ballooning of the endolymphatic fluid system, known to be associated with Menière's disease. When a patient has a known diagnosis of vestibular schwannoma and develops recurrent episodic vertigo spells, many surgeons recommend surgical intervention, attributing the vestibular symptoms to the vestibular schwannoma. The aim of this study is to evaluate the clinical outcome in patients with vestibular schwannoma and EH, treated medically, for recurrent spells of vertigo.
PATIENTS: Two patients with EH and vestibular schwannoma who presented with recurrent spells of vertigo are included. Both had characteristic low frequency hearing loss ipsilateral to the schwannoma.
INTERVENTION: MRI sequences with 3T scanner (Skyra, Siemens Healthcare, Erlangen, Germany) using high resolution three-dimensional delayed postcontrast protocol included "cisternographic" T2 and delayed intravenous-enhanced three-dimensional fluid-attenuation inversion recovery (DIVE-3D-FLAIR) sequences, performed with 2350 ms (bright perilymph) and 2050 ms (bright endolymph) inversion times and with subtracted images.
MAIN OUTCOME MEASURE: MRI FLAIR evaluation of EH and presence or absence of vestibular symptoms.
RESULTS: Both patients had resolution of the disabling vertigo spells with a diuretic, and Patient 1 had unchanged EH, while Patient 2 had partial resolution of the EH and the FLAIR hyperintensity.
CONCLUSION: When EH coexists with vestibular schwannoma in a patient presenting with recurrent vertigo spells, medical treatments for EH may alleviate the vestibular symptoms. We recommend that patients with small vestibular schwannomas who present with vertigo spells undergo high resolution MRI to evaluate for EH and undergo a trial of medical treatment with diuretics.

PMID: 29227452 [PubMed - in process]

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