Journal of Otology最新文献

The binaural masking level difference (BMLD) is a psychoacoustic method to determine binaural interaction and central auditory processes. The BMLD is the difference in hearing thresholds in homophasic and antiphasic conditions. The duration, phase and frequency of the stimuli can affect the BMLD. The main aim of the study is to evaluate the BMLD for stimuli of different durations and frequencies which could also be used in future electrophysiological studies. To this end we developed a GUI to present different frequency signals of variable duration and determine the BMLD. Three different durations and five different frequencies are explored. The results of the study confirm that the hearing threshold for the antiphasic condition is lower than the hearing threshold for the homophasic condition and that differences are significant for signals of 18ms and 48ms duration. Future objective binaural processing studies will be based on 18ms and 48ms stimuli with the same frequencies as used in the current study.

Purpose

Our study aims to compare speech understanding in noise and spectral- temporal resolution skills with regard to the degree of hearing loss, age, hearing aid use experience and gender of hearing aid users.

Methods

Our study included sixty-eight hearing aid users aged between 40-70 years, with bilateral mild and moderate symmetrical sensorineural hearing loss. Random gap detection test, Turkish matrix test and spectral-temporally modulated ripple test were implemented on the participants with bilateral hearing aids. The test results acquired were compared statistically according to different variables and the correlations were examined.

Results

No statistically significant differences were observed for speech-in-noise recognition, spectral-temporal resolution among older and younger adults in hearing aid users (p>0.05). There wasn’t found a statistically significant difference among test outcomes as regards different hearing loss degrees (p>0.05). Higher performances were obtained in terms of temporal resolution in male participants and participants with more hearing aid use experience (p<0.05). Significant correlations were obtained between the results of speech-in-noise recognition, temporal resolution and spectral resolution tests performed with hearing aids (p<0.05).

Conclusion

Our study findings emphasized the importance of regular hearing aid use and it showed that some auditory skills can be improved with hearing aids. Observation of correlations among the speech-in-noise recognition, temporal resolution and spectral resolution tests have revealed that these skills should be evaluated as a whole to maximize the patient's communication abilities.

Objective

To determine whether cervical ultrasonography, magnetic resonance imaging (MRI), and magnetic resonance angiography (MRA) are useful in the differential diagnosis of etiology and understanding the pathophysiology in cases of apogeotropic direction-changing positional nystagmus (DCPN).

Methods

Thirty patients with apogeotropic DCPN were classified into 11 cases of central disease, seven cases of mixed central and peripheral disease, and 12 cases of peripheral disease by differential diagnosis based on various balance function, neuro-otological, and imaging tests.

Cervical ultrasonography using the cervical rotation method and MRI and MRA of the head and neck were performed in most patients with apogeotropic DCPN. We reviewed the presence of abnormal imaging findings according to the disease etiology.

Results

Of the 30 patients with apogeotropic DCPN, 23 showed vascular abnormalities or central lesions on imaging. Vascular lesions were found in six of the 12 patients with peripheral disease. Cervical ultrasonography with cervical rotation detected blood flow disturbance in the vertebral artery in eight patients in whom the disturbance could not be detected by MRI or MRA of the head and neck.

Discussion

We hypothesize that the causative disease of apogeotropic DCPN may be strongly associated with circulatory insufficiency of the vertebrobasilar and carotid arteries, and that impaired blood flow in these vessels may affect peripheral vestibular and central function. In patients with apogeotropic DCPN, examinations of vestibular function, central nervous system symptoms, and brain hemodynamics are valuable for differential diagnosis.

Purpose

Meniere's disease (MD), first introduced by Prosper Meniere, is characterized mainly by vertigo, tinnitus, aural fullness and sensorineural hearing loss. Though the exact pathophysiology of MD is unknown, immunologic and inflammatory interactions are possible underlying mechanisms involved in MD. This study is aimed to investigate the immunomodulatory and anti-inflammatory effect of Nigella sativa on MD as a therapeutic agent.

Methods

We divided 40 patients with definite MD into two groups of 20 cases. The study group received 1 g of Nigella sativa oil daily for three months and the control group received a placebo. Changes in hearing, tinnitus and vertigo were estimated by pure tone audiometry, tinnitus handicap inventory questionnaire and dizziness handicap inventory questionnaire, respectively.

Results

At the end of the study we did not observe any significant improvement in study's group hearing threshold, tinnitus and vertigo compared to the control group.

Conclusions

In this study, statistical analysis showed that Nigella sativa failed to improve signs and symptoms of MD. However, further investigations with a larger study population are needed to ascertain the current conclusion.

Background

The assessment and management of misophonia need a team approach, and audiologists are essential team members. However, the role of an audiologist in this condition is not well understood, and there is a lack of awareness even among professionals about their role in the assessment and management of misophonia.

Purpose

The main aim of our study is to document the present level of awareness and knowledge about misophonia assessment and management among audiologists in India.

Methods

A descriptive cross-sectional study was carried out among audiologists from all over India. Descriptive statistical procedures were measured based on the type of questions being addressed, and a non-parametric chi-square test was done to see the association among variables.

Results

The results show a lack of knowledge about misophonia even among audiologists, as only 15.3% of the audiologist reported being confident in handling cases with misophonia.

Conclusion

Although the exact assessment and management of misophonia is still the topic of debate, it is clear that audiologists are the team's key members. However, the results clearly show a lack of confidence in handling cases of misophonia among audiologists in India. This result shows the future need for Research in misophonia from an audiological perspective.

Intralabyrinthine schwannomas (ILS) are rare benign tumors, often responsible for hearing loss. MRI is important in establishing the diagnosis. We present the example of a 48-year-old lady who reported a 3-years history of right-sided sensorineural deafness. MRI demonstrated a loss of the normal hypersignal of the second turn of the right cochlea compatible with intracochlear schwannoma.

Background

Subjective measures of auditory development are equally important as objective measures to obtain a realistic image of the hearing status in infants and toddlers.

Objectives

The objectives of the current study were to translate and validate the LittleEARS questionnaire into the Hindi language, to calculate its psychometric properties and establish a regression curve of the scores obtained as a function of age, to calculate the inter-test and test retest reliability of the same. The secondary objectives were to compare the scores obtained by the normal hearing children and those with hearing impairment and to plot a regression curve of total scores obtained by the hearing-impaired children as a function of the duration of auditory training attended since their first fit of the device.

Materials and methods

The procedures involved conventional translation, reverse translation, and content validation before administering the questionnaire. The translated version was administered to parents of 59 children with normal hearing and 41 children with hearing impairment.

Results

The finalized version had good reliability and efficient internal consistency with a Cronbach alpha value of 0.96. The mean scores obtained by the normal hearing children showed a progressive pattern as a function of age.

Conclusion

The LittleEARS questionnaire has been successfully translated and validated into the Hindi language with excellent validity and reliability and can be used for screening and early identification of hearing impairment and in evaluating the outcome of audiological treatment approaches.

Background

Saccades are often observed on video head impulse tests (vHIT) in patients with Meniere's Disease (MD) and Vestibular Migraine (VM). However, their saccadic features are not fully described.

Objective

This study aims to identify the saccades characteristics of MD and VM.

Methods

75 VM patients and 103 definite unilateral MD patients were enrolled in this study. First raw saccades were exported and analyzed. The VM patients were divided into left and right based on their ears, while the MD patients were separated into affected and unaffected subgroups based on their audiograms and symptoms.

Results

The MD patients have more saccades on the affected side (85% vs. 69%), and saccade velocity is more consistent than the contralateral side (shown by the coefficient of variation). The saccades occurrence rates on both sides are similar in VM (77% vs. 76%), as are other saccadic parameters. The MD patients have more significant inter-aural differences than the VM patients, manifested in higher velocity (p-value 0.000), earlier arriving (p-value 0.010), and more time-domain gathered (p-value 0.003) on the affected side.

Conclusions

Bilateral saccades are commonly observed in MD and VM. In contrast to MD, saccades on VM are subtle, scattered, and late-arrived. Furthermore, the MD patients showed inconsistent saccadic distribution with more velocity-uniform saccades on the affected side.

Objective

We describe the first-year implementation experience of an Instrumented Sensory Integration Therapy Program in Audiological & Balance Center patients.

Design

This is a retrospective descriptive study. Participants included Seventy-three adults with diagnoses of acute, episodic, or chronic vestibular syndromes. They were classified into the following two groups: group 1 included 46 individuals treated with ISIT plus VRT, and group 2 included 27 individuals treated only with ISIT.

Results

The Sensory Organization Test (SOT) for both groups showed a statistical significance for all three sensory inputs; visual systems (G1: p = 0.0003; G2: p = 0.0337), vestibular system (G1: p < 0.0001; G2: p = 0.0003), and balance as demonstrated by compound balance score (G1: p < 0.0001; G2: p = 0.0035), and balance percentage deficit (G1: p < 0.0001; G2: p = 0.0078).

Conclusions

The severity and complexity of functional neurological disorders in the context of vestibular syndromes seem to require between 10 and 20 therapy sessions, and combined ISIT plus VRT appears to be more effective than ISIT as a monotherapy.