INTRODUCTION Allergic Fungal Rhinosinusitis is a hypersensitivity against fungal antigens. Primary surgical management is complimented with medical management in preoperative and postoperative phases for better intraoperative field & to limit the recurrence. The effect of systemic steroids & itraconazole showed promising outcomes as a solo agent or in combination under preoperative status. Recent studies showed auspicious conclusions with steroid-based nasal douches. The current study aims to assess the effectiveness of medical management in combination with steroid-based nasal douches.
{"title":"RANDOMIZED CONTROL STUDY TO ANALYSE THE EFFICACY BUDESONIDE NASAL DOUCHING ON ALLERGIC FUNGAL RHINOSINUSITIS","authors":"Sowparnika TR, Ramaneeshwaran, Ashu Seith Bhalla, Karan Madan, Yashdeep Gupta, Rupesh K Srivastava, Ganesh Kumar Viswanathan, Gagandeep Singh, Alok Thakar, Rakesh Kumar, Kapil Sikka, Shuchita Singh Pachaury, Hitesh Verma","doi":"10.1101/2024.05.02.24306490","DOIUrl":"https://doi.org/10.1101/2024.05.02.24306490","url":null,"abstract":"<strong>INTRODUCTION</strong> Allergic Fungal Rhinosinusitis is a hypersensitivity against fungal antigens. Primary surgical management is complimented with medical management in preoperative and postoperative phases for better intraoperative field & to limit the recurrence. The effect of systemic steroids & itraconazole showed promising outcomes as a solo agent or in combination under preoperative status. Recent studies showed auspicious conclusions with steroid-based nasal douches. The current study aims to assess the effectiveness of medical management in combination with steroid-based nasal douches.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140888493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-30DOI: 10.1101/2024.04.28.24305905
Eleanor E. Harding, Etienne Gaudrain, Barbara Tillmann, Bert Maat, Robert L. Harris, Rolien H. Free, Deniz Başkent
This study aims to provide a comprehensive picture of auditory emotion perception in cochlear implant (CI) users by (1) investigating emotion categorization in both vocal (pseudo-speech) and musical domains and (2) how individual differences in residual acoustic hearing, sensitivity to voice cues (voice pitch, vocal tract length), and quality of life (QoL) might be associated with vocal emotion perception and, going a step further, also with musical emotion perception. In 28 adult CI users, with or without self-reported acoustic hearing, we showed that sensitivity (d’) scores for emotion categorization varied largely across the participants, in line with previous research. However, within participants, the d’ scores for vocal and musical emotion categorization were significantly correlated, indicating similar processing of auditory emotional cues across the pseudo-speech and music domains and robustness of the tests. Only for musical emotion perception, emotion d’ scores were higher in implant users with residual acoustic hearing compared to no acoustic hearing. The voice pitch perception did not significantly correlate with emotion categorization in either domain, while the vocal tract length significantly correlated in both domains. For QoL, only the subdomain of Speech production ability, but not the overall QoL scores, correlated with vocal emotion categorization, partially supporting previous findings. Taken together, results indicate that auditory emotion perception is challenging for some CI users, possibly a consequence of how available the emotion-related cues are via electric hearing. Improving these cues, either via rehabilitation or training, may also help auditory emotion perception in CI users.
本研究旨在通过以下方法全面了解人工耳蜗（CI）用户的听觉情感感知：（1）调查声乐（伪语音）和音乐领域的情感分类；（2）研究个体在残余听力、对声音线索（声调、声道长度）的敏感度以及生活质量（QoL）方面的差异如何与声乐情感感知以及音乐情感感知相关联。我们对 28 名成年 CI 使用者进行了研究，无论他们是否自称有听力障碍，研究结果表明，情感分类的敏感度（d'）得分在很大程度上因人而异，这与之前的研究结果一致。然而，在同一参与者中，声乐和音乐情绪分类的 d' 分数具有显著的相关性，这表明在伪语音和音乐领域中，听觉情绪线索的处理过程相似，而且测试具有稳健性。只有在音乐情感感知方面，有残余听力的植入者的情感 d'得分高于无残余听力的植入者。声调感知与情感分类在两个领域都没有明显的相关性，而声道长度在两个领域都有明显的相关性。在 QoL 方面，只有 "语音生成能力 "子域与发声情绪分类相关，而 QoL 总分与发声情绪分类无关，这在一定程度上支持了之前的研究结果。综上所述，研究结果表明，听觉情绪感知对一些人工耳蜗使用者来说具有挑战性，这可能是电听情绪相关线索可用性的结果。通过康复或训练来改善这些线索，也可能有助于 CI 用户的听觉情绪感知。
{"title":"Vocal and musical emotion perception, voice cue discrimination, and quality of life in cochlear implant users with and without acoustic hearing","authors":"Eleanor E. Harding, Etienne Gaudrain, Barbara Tillmann, Bert Maat, Robert L. Harris, Rolien H. Free, Deniz Başkent","doi":"10.1101/2024.04.28.24305905","DOIUrl":"https://doi.org/10.1101/2024.04.28.24305905","url":null,"abstract":"This study aims to provide a comprehensive picture of auditory emotion perception in cochlear implant (CI) users by (1) investigating emotion categorization in both vocal (pseudo-speech) and musical domains and (2) how individual differences in residual acoustic hearing, sensitivity to voice cues (voice pitch, vocal tract length), and quality of life (QoL) might be associated with vocal emotion perception and, going a step further, also with musical emotion perception. In 28 adult CI users, with or without self-reported acoustic hearing, we showed that sensitivity (d’) scores for emotion categorization varied largely across the participants, in line with previous research. However, within participants, the d’ scores for vocal and musical emotion categorization were significantly correlated, indicating similar processing of auditory emotional cues across the pseudo-speech and music domains and robustness of the tests. Only for musical emotion perception, emotion d’ scores were higher in implant users with residual acoustic hearing compared to no acoustic hearing. The voice pitch perception did not significantly correlate with emotion categorization in either domain, while the vocal tract length significantly correlated in both domains. For QoL, only the subdomain of Speech production ability, but not the overall QoL scores, correlated with vocal emotion categorization, partially supporting previous findings. Taken together, results indicate that auditory emotion perception is challenging for some CI users, possibly a consequence of how available the emotion-related cues are via electric hearing. Improving these cues, either via rehabilitation or training, may also help auditory emotion perception in CI users.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140838976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-09DOI: 10.1101/2024.03.08.24303910
Myrofora Goutaki, Yin Ting Lam, Andreas Anagiotos, Miguel Armengot, Andrea Burgess, Raewyn Campbell, Mathilde Carlier, Nathalie Caversaccio, Neil K Chadha, Berat Demir, Sinan Ahmed D. Dheyauldeen, Onder Gunaydin, Amanda Harris, Isolde Hayun, Deniz Inal-Ince, Eric Levi, Trini Lopez Fernandez, Jane S Lucas, Bernard Maitre, Anne-Lise ML Poirrier, Lynne Schofield, Kazuhiko Takeuchi, Christine van Gogh, Nikolaus E Wolter, Jean-Francois Papon
Background: Recurrent infections of the nose, sinuses, and ears are common problems for people with primary ciliary dyskinesia (PCD). While pulmonary exacerbations in PCD are defined, there is no definition for Ear-Nose-Throat (ENT) exacerbations, a potential outcome for research and clinical trials. Methods: We set up an expert panel of 24 ENT specialists, respiratory physicians, other healthcare professionals, and patients to develop consensus definitions of sinonasal and otologic exacerbations in children and adults with PCD for research settings. We reviewed the literature and used a modified Delphi approach with four electronic surveys. Results: Both definitions are based on a combination of major and minor criteria, requiring three major or two major and at least two minor criteria each. Major criteria for a sinonasal exacerbation are: 1) reported acute increase in nasal discharge or change in colour; 2) reported acute pain or sensitivity in the sinus regions; 3) mucopurulent discharge on examination. Minor criteria include: reported symptoms; examination signs; doctor s decision to treat; improvement after at least 14-days. Major criteria for the otologic exacerbation are: 1) reported acute ear pain or sensitivity, 2) reported acute ear discharge, 3) ear discharge on examination, 4) signs of otitis media in otoscopy. Minor criteria are: reported acute hearing problems; signs of acute complication; doctor s decision to treat. Conclusion: These definitions might offer a useful outcome measure for PCD research in different settings. They should be validated in future studies and trials together with other potential outcomes, to assess their usability.
{"title":"Definition of sinonasal and otologic exacerbation in patients with primary ciliary dyskinesia - an expert consensus","authors":"Myrofora Goutaki, Yin Ting Lam, Andreas Anagiotos, Miguel Armengot, Andrea Burgess, Raewyn Campbell, Mathilde Carlier, Nathalie Caversaccio, Neil K Chadha, Berat Demir, Sinan Ahmed D. Dheyauldeen, Onder Gunaydin, Amanda Harris, Isolde Hayun, Deniz Inal-Ince, Eric Levi, Trini Lopez Fernandez, Jane S Lucas, Bernard Maitre, Anne-Lise ML Poirrier, Lynne Schofield, Kazuhiko Takeuchi, Christine van Gogh, Nikolaus E Wolter, Jean-Francois Papon","doi":"10.1101/2024.03.08.24303910","DOIUrl":"https://doi.org/10.1101/2024.03.08.24303910","url":null,"abstract":"Background: Recurrent infections of the nose, sinuses, and ears are common problems for people with primary ciliary dyskinesia (PCD). While pulmonary exacerbations in PCD are defined, there is no definition for Ear-Nose-Throat (ENT) exacerbations, a potential outcome for research and clinical trials.\u0000Methods: We set up an expert panel of 24 ENT specialists, respiratory physicians, other healthcare professionals, and patients to develop consensus definitions of sinonasal and otologic exacerbations in children and adults with PCD for research settings. We reviewed the literature and used a modified Delphi approach with four electronic surveys. Results: Both definitions are based on a combination of major and minor criteria, requiring three major or two major and at least two minor criteria each. Major criteria for a sinonasal exacerbation are: 1) reported acute increase in nasal discharge or change in colour; 2) reported acute pain or sensitivity in the sinus regions; 3) mucopurulent discharge on examination. Minor criteria include: reported symptoms; examination signs; doctor s decision to treat; improvement after at least 14-days. Major criteria for the otologic exacerbation are: 1) reported acute ear pain or sensitivity, 2) reported acute ear discharge, 3) ear discharge on examination, 4) signs of otitis media in otoscopy. Minor criteria are: reported acute hearing problems; signs of acute complication; doctor s decision to treat. Conclusion: These definitions might offer a useful outcome measure for PCD research in different settings. They should be validated in future studies and trials together with other potential outcomes, to assess their usability.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140075695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-04DOI: 10.1101/2024.03.02.24303654
Zahra Ghasemahmad, Saeid Mahmoudian, Daniel Gavazzi, Shohreh Jalaei, Saeid Farahani
Objectives: This study aimed to investigate changes in auditory processing using auditory steady state response (ASSR) in patients with idiopathic tinnitus. Method: 19 tinnitus patients and 23 control subjects without tinnitus were examined with multiple ASSR. Three modulation frequencies of 20, 40, and 80HZ were tested and the steady state responses were compared between tinnitus and control group. Further, the thresholds in ipsi- and contralateral side to ear with tinnitus sensation were compared. Results: Our findings showed no significant difference in ASSR thresholds in ipsi- and contralateral side to ear with tinnitus. However, we observed enhanced ASSRs at 40 and 80Hz modulation in patients with Idiopathic tinnitus compared to no-tinnitus control subjects. Conclusions: The results of this study suggest possible sensory deficits along higher order auditory regions in patients with idiopathic tinnitus. Further, our data indicates a bilateral involvement of auditory pathway in these regions in patients with lateralized tinnitus.
{"title":"Enhanced 40 and 80 Hz Auditory Steady State Responses in Idiopathic Tinnitus","authors":"Zahra Ghasemahmad, Saeid Mahmoudian, Daniel Gavazzi, Shohreh Jalaei, Saeid Farahani","doi":"10.1101/2024.03.02.24303654","DOIUrl":"https://doi.org/10.1101/2024.03.02.24303654","url":null,"abstract":"Objectives: This study aimed to investigate changes in auditory processing using auditory\u0000steady state response (ASSR) in patients with idiopathic tinnitus.\u0000Method: 19 tinnitus patients and 23 control subjects without tinnitus were examined with multiple ASSR. Three modulation frequencies of 20, 40, and 80HZ were tested and the steady state responses were compared between tinnitus and control group. Further, the thresholds in ipsi- and\u0000contralateral side to ear with tinnitus sensation were compared.\u0000Results: Our findings showed no significant difference in ASSR thresholds in ipsi- and\u0000contralateral side to ear with tinnitus. However, we observed enhanced ASSRs at 40 and 80Hz modulation in patients with Idiopathic tinnitus compared to no-tinnitus control subjects. Conclusions: The results of this study suggest possible sensory deficits along higher order\u0000auditory regions in patients with idiopathic tinnitus. Further, our data indicates a bilateral\u0000involvement of auditory pathway in these regions in patients with lateralized tinnitus.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140033829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-27DOI: 10.1101/2024.02.25.24303341
Kiana Mahboubi, Steven Nakoneshny, Khara Sauro, Robert Hart, Thomas Wayne Matthews, Joseph Dort, Shamir Chandarana
Objective: To compare oncologic outcomes of South Asian (SA) patients treated at a regional cancer centre in Canada, for oral squamous cell carcinoma (OSCC), to the general population. Methods: Adult patients who underwent primary surgical resection of OSCC +/- adjuvant treatment between 2009 and 2022 (N=697) were included. SA patients were identified using a validated method and compared to non-SA patients. Baseline characteristics, including betel nut consumption, were compared, and disease-specific survival (DSS) and recurrence-free survival (RFS) were evaluated using Kaplan-Meier methods, with median follow-up time of 36.4 months [SD 31.02]. Cox proportional hazard regression models adjusted for potential confounders. A p-value < 0.05 was considered statistically significant. Results: SA patients (9% of cohort, n = 64) were significantly younger and had lower rates of smoking and alcohol consumption compared to non-SA patients. There were no differences in tumor characteristics or the use of adjuvant radiation. SA patients had a two-fold higher risk of recurrence and significantly worse disease-specific survival, even after adjusting for stage and high-risk features [RFS: HR 2.01(1.28 - 3.14), DSS: HR 1.79(1.12 - 2.88)]. The consumption of betel nut was not associated with outcomes. Conclusion: To our knowledge, this study is the first to compare the oncological outcomes of SA patients with OSCC to non-SA patients. SA patients had significantly worse outcomes, even after controlling for known predictors of recurrence and disease-specific survival. These findings can inform personalized treatment decisions and influence public health policies when managing patients with different ethnic backgrounds.
{"title":"The association of ethnicity and oncologic outcomes for oral cavity squamous cell carcinoma (OSCC)","authors":"Kiana Mahboubi, Steven Nakoneshny, Khara Sauro, Robert Hart, Thomas Wayne Matthews, Joseph Dort, Shamir Chandarana","doi":"10.1101/2024.02.25.24303341","DOIUrl":"https://doi.org/10.1101/2024.02.25.24303341","url":null,"abstract":"Objective: To compare oncologic outcomes of South Asian (SA) patients treated at a regional cancer centre in Canada, for oral squamous cell carcinoma (OSCC), to the general population. Methods: Adult patients who underwent primary surgical resection of OSCC +/- adjuvant treatment between 2009 and 2022 (N=697) were included. SA patients were identified using a validated method and compared to non-SA patients. Baseline characteristics, including betel nut consumption, were compared, and disease-specific survival (DSS) and recurrence-free survival (RFS) were evaluated using Kaplan-Meier methods, with median follow-up time of 36.4 months [SD 31.02]. Cox proportional hazard regression models adjusted for potential confounders. A p-value < 0.05 was considered statistically significant.\u0000Results: SA patients (9% of cohort, n = 64) were significantly younger and had lower rates of smoking and alcohol consumption compared to non-SA patients. There were no differences in tumor characteristics or the use of adjuvant radiation. SA patients had a two-fold higher risk of recurrence and significantly worse disease-specific survival, even after adjusting for stage and high-risk features [RFS: HR 2.01(1.28 - 3.14), DSS: HR 1.79(1.12 - 2.88)]. The consumption of betel nut was not associated with outcomes.\u0000Conclusion: To our knowledge, this study is the first to compare the oncological outcomes of SA patients with OSCC to non-SA patients. SA patients had significantly worse outcomes, even after controlling for known predictors of recurrence and disease-specific survival. These findings can inform personalized treatment decisions and influence public health policies when managing patients with different ethnic backgrounds.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139979062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-18DOI: 10.1101/2024.01.18.24301474
Nele De Poortere, Sarineh Keshishzadeh, Hannah Keppler, Ingeborg Dhooge, Sarah Verhulst
The pursuit of noninvasive early markers for sensorineural hearing loss (SNHL) has yielded diverse measures of interest. However, comprehensive studies evaluating the test-retest reliability of multiple measures and stimuli within a single study are scarce, and a standardized clinical protocol for robust SNHL-markers remains elusive. To address these gaps, this study covers the intra-subject variability of potential EEG-biomarkers for cochlear synaptopathy (CS) and other SNHL-markers to determine their clinical suitability. Fifteen normal-hearing young adults underwent repeated measures of (extended high-frequency) pure-tone audiometry, speech-in-noise intelligibility, distortion-product otoacoustic emissions (DPOAEs), and auditory evoked potentials; comprising envelope following responses (EFR) and auditory brainstem responses (ABR). Results show high reliability in pure-tone audiometry, whereas the matrix sentence-test showed a significant learning effect. DP-grams and input-output functions’ reliability varied across three evaluation methods with distinct SNR-based criteria for DPOAE-datapoints. EFRs demonstrated superior test-retest reliability compared to ABR-amplitudes. Our findings underscore careful interpretation of presumed noninvasive SNHL measures. While we confirm the robustness of tonal-audiometry, we found a confounding learning effect in longitudinal speech audiometry. DPOAE variability underscores the need for consistent ear probe replacement and meticulous measurement techniques and renders I/O-functions unsuitable for clinical application. As potential EEG-biomarkers of CS, EFRs are favored over ABR-amplitudes.
在寻找感音神经性听力损失（SNHL）的非侵入性早期标志物的过程中，人们发现了多种令人感兴趣的测量方法。然而，在一项研究中评估多种测量方法和刺激的测试-再测可靠性的综合研究并不多见，而针对可靠的感音神经性听力损失（SNHL）标志物的标准化临床方案仍未出台。为了填补这些空白，本研究涵盖了耳蜗突触病（CS）的潜在脑电图生物标记物和其他 SNHL 标记物的受试者内变异性，以确定其临床适用性。15 名听力正常的年轻成年人接受了（扩展高频）纯音测听、噪声中语言清晰度、失真产物耳声发射（DPOAEs）和听觉诱发电位的重复测量；包括包络跟随反应（EFR）和听性脑干反应（ABR）。结果显示，纯音测听的可靠性很高，而矩阵句子测试则显示出明显的学习效应。三种评估方法的 DP 图和输入输出函数的可靠性各不相同，DPOAE 数据点的信噪比标准也各不相同。与 ABR 振幅相比，EFR 的测试-再测可靠性更高。我们的研究结果强调要谨慎解释假定的无创 SNHL 测量。虽然我们证实了音调测听的稳健性，但在纵向言语测听中我们发现了学习效应的干扰。DPOAE 的变异性凸显了更换耳探头和采用细致测量技术的必要性，并使 I/O 功能不适合临床应用。作为 CS 的潜在脑电图生物标志物，EFR 比 ABR 振幅更受青睐。
{"title":"Intrasubject variability of early markers of sensorineural hearing damage","authors":"Nele De Poortere, Sarineh Keshishzadeh, Hannah Keppler, Ingeborg Dhooge, Sarah Verhulst","doi":"10.1101/2024.01.18.24301474","DOIUrl":"https://doi.org/10.1101/2024.01.18.24301474","url":null,"abstract":"The pursuit of noninvasive early markers for sensorineural hearing loss (SNHL) has yielded diverse measures of interest. However, comprehensive studies evaluating the test-retest reliability of multiple measures and stimuli within a single study are scarce, and a standardized clinical protocol for robust SNHL-markers remains elusive. To address these gaps, this study covers the intra-subject variability of potential EEG-biomarkers for cochlear synaptopathy (CS) and other SNHL-markers to determine their clinical suitability. Fifteen normal-hearing young adults underwent repeated measures of (extended high-frequency) pure-tone audiometry, speech-in-noise intelligibility, distortion-product otoacoustic emissions (DPOAEs), and auditory evoked potentials; comprising envelope following responses (EFR) and auditory brainstem responses (ABR). Results show high reliability in pure-tone audiometry, whereas the matrix sentence-test showed a significant learning effect. DP-grams and input-output functions’ reliability varied across three evaluation methods with distinct SNR-based criteria for DPOAE-datapoints. EFRs demonstrated superior test-retest reliability compared to ABR-amplitudes. Our findings underscore careful interpretation of presumed noninvasive SNHL measures. While we confirm the robustness of tonal-audiometry, we found a confounding learning effect in longitudinal speech audiometry. DPOAE variability underscores the need for consistent ear probe replacement and meticulous measurement techniques and renders I/O-functions unsuitable for clinical application. As potential EEG-biomarkers of CS, EFRs are favored over ABR-amplitudes.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.1101/2024.01.17.24301435
Jeffrey Skidmore, Yi Yuan, Shuman He
This report presents a new method for removing electrical artifact contamination from the electrically evoked compound action potential (eCAP) evoked by single cathodic-leading, biphasic-pulse stimulation. The development of the new method is motivated by results recorded in human cochlear implant (CI) users showing that the fundamental assumption of the classic forward masking artifact rejection technique is violated in up to 45% of cases tested at high stimulation levels when using default stimulation parameters. Subsequently, the new method developed based on the discovery that a hyperbola best characterizes the artifacts created during stimulation and recording is described. The eCAP waveforms obtained using the new method are compared to those recorded using the classic forward masking technique. The results show that eCAP waveforms obtained using both methods are comparable when the fundamental assumption of the classic forward masking technique is met. In contrast, eCAP amplitudes obtained using the two methods are significantly different when the fundamental assumption of the classic forward masking technique is violated, with greater differences in the eCAP amplitude for greater assumption violations. The new method also has excellent test-retest reliability (Intraclass correlation > 0.98). Overall, the new method is a viable alternative to the classic forward masking technique for obtaining artifact-free eCAPs evoked by single-pulse stimulation in CI users.
{"title":"A new method for removing artifacts from recordings of the electrically evoked compound action potential: Single-pulse stimulation","authors":"Jeffrey Skidmore, Yi Yuan, Shuman He","doi":"10.1101/2024.01.17.24301435","DOIUrl":"https://doi.org/10.1101/2024.01.17.24301435","url":null,"abstract":"This report presents a new method for removing electrical artifact contamination from the electrically evoked compound action potential (eCAP) evoked by single cathodic-leading, biphasic-pulse stimulation. The development of the new method is motivated by results recorded in human cochlear implant (CI) users showing that the fundamental assumption of the classic forward masking artifact rejection technique is violated in up to 45% of cases tested at high stimulation levels when using default stimulation parameters. Subsequently, the new method developed based on the discovery that a hyperbola best characterizes the artifacts created during stimulation and recording is described. The eCAP waveforms obtained using the new method are compared to those recorded using the classic forward masking technique. The results show that eCAP waveforms obtained using both methods are comparable when the fundamental assumption of the classic forward masking technique is met. In contrast, eCAP amplitudes obtained using the two methods are significantly different when the fundamental assumption of the classic forward masking technique is violated, with greater differences in the eCAP amplitude for greater assumption violations. The new method also has excellent test-retest reliability (Intraclass correlation > 0.98). Overall, the new method is a viable alternative to the classic forward masking technique for obtaining artifact-free eCAPs evoked by single-pulse stimulation in CI users.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139509866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-09DOI: 10.1101/2024.01.09.24300978
Stefan Schoisswohl, Laura Basso, Jorge Simoes, Milena Engelke, Berthold Langguth, Birgit Mazurek, Jose Antonio Lopez-Escamez, Dimitrios Kikidis, Rilana Cima, Alberto Bernal-Robledano, Benjamin Boecking, Jan Bulla, Christopher Cederroth, Sam Denys, Alba Escalera-Balsera, Alvaro Gallego-Martinez, Silvano Gallus, Leire Hidalgo-Lopez, Carlotta Jarach, Hafez Kader, Michael Koller, Alessandra Lugo, Steven Marcrum, Nikos Markatos, Juan Martin-Lagos, Marta Martinez-Martinez, Nicolas Muller-Locatelli, Patrick Neff, Uli Niemann, Patricia Perez-Carpena, Ruediger Pryss, Clara Puga, Paula Robles-Bolivar, Matthias Rose, Martin Schecklmann, Tabea Schiele, Miro Schleicher, Johannes Schobel, Myra Spiliopoulou, Sabine Stark, Susanne Staudinger, Alexandra Stege, Beat Toedtli, Ilias Trochidis, Vishnu Unnikrishnan, Evgenia Vassou, Nicolas Verhaert, Carsten Vogel, Zoi Zachou, Winfried Schlee
Background: Tinnitus is associated with a variety of etiologies, phenotypes, and underlying pathophysiological mechanisms, and available treatments have limited efficacy. A combination of treatments, addressing various aspects of tinnitus, might provide a viable and superior treatment strategy. Methods: In this multicenter, parallel-arm, randomized controlled clinical trial, patients with chronic subjective tinnitus were randomly assigned to single or combination treatment of 12 weeks each. Cognitive-behavioral therapy, hearing aids, structured counseling and sound therapy were administered either alone or as a combination of two treatments resulting in 10 treatment arms. The primary endpoint was the difference in the change from baseline to week 12 in the total score of the Tinnitus Handicap Inventory between single and combination treatments. Results: Out of 461 enrolled patients 230 were assigned to single and 231 to combination treatment. Least-squares mean changes from baseline to week 12 were -11.7 for single (95% confidence interval [CI], -14.4 to -9.0) and -14.9 for combination treatments (95% CI, -17.7 to -12.1), with a significant between-group difference (p=0.034). Sound therapy alone had the lowest effect size. In contrast, cognitive-behavioral therapy and hearing aids alone had large effect sizes, which could not be further increased by combination treatment. Conclusions: In this trial involving patients with chronic tinnitus, all treatment arms showed improvement in THI scores from baseline to week 12. No clear synergistic effect was observed when combining treatments, but rather a compensatory effect, where a more effective treatment offsets the clinical effects of a less effective treatment.
{"title":"Single versus Combination Treatment in Tinnitus: A Randomized, Multicenter Trial","authors":"Stefan Schoisswohl, Laura Basso, Jorge Simoes, Milena Engelke, Berthold Langguth, Birgit Mazurek, Jose Antonio Lopez-Escamez, Dimitrios Kikidis, Rilana Cima, Alberto Bernal-Robledano, Benjamin Boecking, Jan Bulla, Christopher Cederroth, Sam Denys, Alba Escalera-Balsera, Alvaro Gallego-Martinez, Silvano Gallus, Leire Hidalgo-Lopez, Carlotta Jarach, Hafez Kader, Michael Koller, Alessandra Lugo, Steven Marcrum, Nikos Markatos, Juan Martin-Lagos, Marta Martinez-Martinez, Nicolas Muller-Locatelli, Patrick Neff, Uli Niemann, Patricia Perez-Carpena, Ruediger Pryss, Clara Puga, Paula Robles-Bolivar, Matthias Rose, Martin Schecklmann, Tabea Schiele, Miro Schleicher, Johannes Schobel, Myra Spiliopoulou, Sabine Stark, Susanne Staudinger, Alexandra Stege, Beat Toedtli, Ilias Trochidis, Vishnu Unnikrishnan, Evgenia Vassou, Nicolas Verhaert, Carsten Vogel, Zoi Zachou, Winfried Schlee","doi":"10.1101/2024.01.09.24300978","DOIUrl":"https://doi.org/10.1101/2024.01.09.24300978","url":null,"abstract":"Background:\u0000Tinnitus is associated with a variety of etiologies, phenotypes, and underlying pathophysiological mechanisms, and available treatments have limited efficacy. A combination of treatments, addressing various aspects of tinnitus, might provide a viable and superior treatment strategy.\u0000Methods:\u0000In this multicenter, parallel-arm, randomized controlled clinical trial, patients with chronic subjective tinnitus were randomly assigned to single or combination treatment of 12 weeks each. Cognitive-behavioral therapy, hearing aids, structured counseling and sound therapy were administered either alone or as a combination of two treatments resulting in 10 treatment arms. The primary endpoint was the difference in the change from baseline to week 12 in the total score of the Tinnitus Handicap Inventory between single and combination treatments.\u0000Results:\u0000Out of 461 enrolled patients 230 were assigned to single and 231 to combination treatment. Least-squares mean changes from baseline to week 12 were -11.7 for single (95% confidence interval [CI], -14.4 to -9.0) and -14.9 for combination treatments (95% CI, -17.7 to -12.1), with a significant between-group difference (p=0.034). Sound therapy alone had the lowest effect size. In contrast, cognitive-behavioral therapy and hearing aids alone had large effect sizes, which could not be further increased by combination treatment.\u0000Conclusions:\u0000In this trial involving patients with chronic tinnitus, all treatment arms showed improvement in THI scores from baseline to week 12. No clear synergistic effect was observed when combining treatments, but rather a compensatory effect, where a more effective treatment offsets the clinical effects of a less effective treatment.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"109 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139408163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-19DOI: 10.1101/2023.12.19.23300189
W. Wiktor Jedrzejczak, Piotr H. Skarzynski, Danuta Raj-Koziak, Milaine Dominici Sanfins, Stavros Hatzopoulos, Krzysztof Kochanek
Background: ChatGPT - a conversational tool based on artificial intelligence - has recently been tested on a range of topics. However most of the testing has involved broad domains of knowledge. Here we test ChatGPT's knowledge of tinnitus, an important but specialized aspect of audiology and otolaryngology. Testing involved evaluating ChatGPT's answers to a defined set of 10 questions on tinnitus. Furthermore, given the technology is advancing quickly, we re-evaluated the responses to the same 10 questions 3 months later. Material and method: ChatGPT (free version 3.5) was asked 10 questions on tinnitus at two points of time - August 2023 and November 2023. The accuracy of the responses was rated by 6 experts using a Likert scale ranging from 1 to 5. The number of words in each response was also counted, and responses were specifically examined for whether references were provided or whether consultation with a specialist was suggested. Results: Most of ChatGPT's responses were rated as satisfactory or better. However, we did detect a few instances where the responses were not accurate and might be considered somewhat misleading. The responses from ChatGPT were quite long (averaging over 400 words) and they occasionally tended to stray off-topic. No solid references to sources of information were ever supplied, and when references were specifically asked for the sources were artificial. For most responses consultation with a specialist was suggested. It is worth noting that after 3 months the responses generally improved. Conclusions: ChatGPT provided surprisingly good responses, given that the questions were quite specific. Although no potentially harmful errors were identified, some mistakes could be seen as somewhat misleading. No solid references were ever supplied. ChatGPT shows great potential if further developed by experts in specific areas, but for now it is not yet ready for serious application.
{"title":"ChatGPT for tinnitus information and support: response accuracy and retest after three months","authors":"W. Wiktor Jedrzejczak, Piotr H. Skarzynski, Danuta Raj-Koziak, Milaine Dominici Sanfins, Stavros Hatzopoulos, Krzysztof Kochanek","doi":"10.1101/2023.12.19.23300189","DOIUrl":"https://doi.org/10.1101/2023.12.19.23300189","url":null,"abstract":"Background: ChatGPT - a conversational tool based on artificial intelligence - has recently been tested on a range of topics. However most of the testing has involved broad domains of knowledge. Here we test ChatGPT's knowledge of tinnitus, an important but specialized aspect of audiology and otolaryngology. Testing involved evaluating ChatGPT's answers to a defined set of 10 questions on tinnitus. Furthermore, given the technology is advancing quickly, we re-evaluated the responses to the same 10 questions 3 months later.\u0000Material and method: ChatGPT (free version 3.5) was asked 10 questions on tinnitus at two points of time - August 2023 and November 2023. The accuracy of the responses was rated by 6 experts using a Likert scale ranging from 1 to 5. The number of words in each response was also counted, and responses were specifically examined for whether references were provided or whether consultation with a specialist was suggested.\u0000Results: Most of ChatGPT's responses were rated as satisfactory or better. However, we did detect a few instances where the responses were not accurate and might be considered somewhat misleading. The responses from ChatGPT were quite long (averaging over 400 words) and they occasionally tended to stray off-topic. No solid references to sources of information were ever supplied, and when references were specifically asked for the sources were artificial. For most responses consultation with a specialist was suggested. It is worth noting that after 3 months the responses generally improved.\u0000Conclusions: ChatGPT provided surprisingly good responses, given that the questions were quite specific. Although no potentially harmful errors were identified, some mistakes could be seen as somewhat misleading. No solid references were ever supplied. ChatGPT shows great potential if further developed by experts in specific areas, but for now it is not yet ready for serious application.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138819397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-13DOI: 10.1101/2023.12.11.23299743
Michael R. Abidin, Oral Alpan, Matthew Plassmeyer, Lina Kozhaya, Denise Loizou, Mikail Dogan, Zachary Upchurch, Nathan P Manes, Aleksandra Nita-Lazar, Derya Unutmaz, Søren Ulrik Sønder
Objective: Chronic rhinosinusitis (CRS) impacts an estimated 5% to 15% of people worldwide, incurring significant economic healthcare burden. There is a urgent need for the discovery of predictive biomarkers to improve treatment strategies and outcomes for CRS patients.
{"title":"STAT4 Phosphorylation of T-helper Cells predicts surgical outcomes in Refractory Chronic Rhinosinusitis","authors":"Michael R. Abidin, Oral Alpan, Matthew Plassmeyer, Lina Kozhaya, Denise Loizou, Mikail Dogan, Zachary Upchurch, Nathan P Manes, Aleksandra Nita-Lazar, Derya Unutmaz, Søren Ulrik Sønder","doi":"10.1101/2023.12.11.23299743","DOIUrl":"https://doi.org/10.1101/2023.12.11.23299743","url":null,"abstract":"Objective: Chronic rhinosinusitis (CRS) impacts an estimated 5% to 15% of people worldwide, incurring significant economic healthcare burden. There is a urgent need for the discovery of predictive biomarkers to improve treatment strategies and outcomes for CRS patients.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138716607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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