Audiology and Neuro-Otology最新文献

Introduction The aim of this study is to measure the effectiveness of hearing aid fitting in improving understanding in quiet and in noise, and to investigate the factors that significantly influence these results. This study will be carried out through a retrospective analysis of the results obtained from patients fitted with hearing aids at hearing-aid centers between 2018 and 2021. This study explores and classifies the predictive factors of patient outcomes, looking at the impact of the choice of hearing aid technology (category level), the personalized adjustments made by the hearing care professional (amplification level, binaural loudness balancing) and the patient follow-up and daily use (data logging). Methods Hearing impaired people were fitted in hearing-aid centers from 2018 to 2021. This included 77,661 patients. In the first part of the study, the data are statistically analyzed, and various correlations are studied. Then, machine learning and feature explanatory algorithms are used for prediction, in particular, a neural network based on PyTorch and the eXtreme Gradient Boosting (XGBoost). For explanatory power, the SHapley Additive exPlanation (SHAP) method was used to evaluate the individual contribution of each variable. Results Using predictive models (SHAP value and XGBoost), the effect of technology level on Speech Perception In Noise (SPIN) and Speech Perception In Quiet (SPIQ) scores is significant, and binaural loudness compensation is significant for improving test results by the same amount. Finally, linear relationships were found between the initial Speech Noise Ratio (SNR) and the adjusted SNR, as well as for the Speech Recognition Threshold (SRT). Finally, the effect of wearing hearing aids for more than 9 hours per day was analyzed and resulted in better recovery. This is a retrospective study. This bias is compensated by the large amount of data. Conclusion Big data analysis is a new method to evaluate predictive factors for hearing aid outcomes.

The primary concern among adults with regard to their hearing is the difficulty in comprehending speech, particularly in noisy environments. The constant need to listen attentively leads to heightened frustration, fatigue and decreased concentration. According to research, high-frequency hearing loss could have negative implications on speech perception and make it even harder to communicate. In this study, the focus is on patients with DFNA9 as it is one of the most common forms of non-syndromic high-frequency hearing loss. These patients carry the p.Pro51Ser variant in the COCH gene, which leads to progressive decline of hearing and vestibular function. Despite various cross-sectional studies on the natural progression of hearing levels, speech perception in silence and noisy surroundings is largely unexplored in this group of patients. Method. For the longitudinal analysis of speech perception, 101 heterozygous carriers were enrolled. In addition, a control group composed of individuals with normal hearing, who matched the patients with DFNA9 in terms of age and sex, was recruited. All patients underwent pure-tone audiometry, speech perception in quiet (SPIQ), and in noise (SPIN).The SPIQ outcomes reveal a mean SRT of 28.18 dB SPL for male carriers and 29.29 dB SPL for female carriers in the youngest age group (18-29 years). With increasing age, a steep decrease was noticed, and no speech discrimination ability in quiet remained for carriers in their seventh decade. Differences between carriers and control participants seem evident in the third decade of life and become more pronounced in the decades that follow. The SPIN displayed a similar trend, varying from -5 dB SNR in the youngest age group, to no speech-in-noise thresholds in patients above the age of 60 years. In contrast, the matched group exhibited a SRT range from -5.5 to -3.25 dB SNR for males, and from -6.23 to -4.58 dB SNR for females from the second/third to the seventh decade. This stands in contrast to the DFNA9 population, where male carriers reach values of -5.18 dB SNR and female carriers reach -3.12 dB SNR as early as in the fourth decade. This study indicates poor performance on speech understanding in quiet and noise in DFNA9 patients in comparison with the group with normal hearing, even at a young age. Therefore, future research should not only investigate pure-tone audiometry, but also speech perception. Moreover, reimbursing hearing aids based on speech-in-noise testing could prove to be more advantageous than based on pure-tone audiometry.

Introduction: Neurotrophic factors are widely known for their protective effect on spiral ganglion neurons (SGN) and the protection of these neurons is of great importance to optimize Cochlear Implants, which directly stimulate SGN in deaf patients. Previous studies have identified Cometin - also known as Meteroin-like - to be neuroprotective and beneficial for metabolic disorders. The aim of our study was to investigate the effects of different concentrations of recombinant human Cometin (hCometin) on SGN in regard to neuroprotection and neurite outgrowth and to evaluate its neurite guidance potential using a neurite outgrowth chamber.

Methods: Human Cometin was initially tested in two separate dosing experiments: 5, 10, and 15 µg/ml (medium dose group) and 10, 25, and 50 µg/ml (high dose group). The hCometin was added to dissociated neonatal murine SGN. The number, morphology, and neurite length of SGN treated with hCometin were compared to untreated (negative control, NC) and brain-derived neurotrophic factor treated (50 ng/ml) (positive control, PC) cells. Subsequently, to investigate a potential effect on neurite guidance, 10 µg/ml hCometin was delivered via osmotic pumps to neonatal murine spiral ganglion explants (SGE) cultured in a neurite outgrowth chamber to experimentally mimic the scala tympani and the Rosenthal's canal. The amount of pump-released hCometin was measured by Enzyme-linked Immunosorbent Assay and neurite growth was quantified and compared to a Cometin-free NC.

Results: All medium dose group concentrations of hCometin resulted in significant neuronal protection, whereas high dose group concentrations (25 and 50 µg/ml) were neurotoxic. The medium doses significantly increased the number of monopolar neurons compared to NC, and 10 and 15 µg/ml hCometin increased the number of neurons with a physiological bipolar morphology to an even greater extent than BDNF. For neurite length, 5 and 10 µg/ml hCometin had the greatest effect, which was comparable with the BDNF-PC. The osmotic-pump based delivery of 10 µg/ml hCometin to SGE had no or an adverse effect on the number, extent, or orientation of outgrowing neurites in the culture set up used.

Conclusion: A concentration of 10 µg/ml hCometin significantly protects dissociated SGN from degeneration and significantly increases the outgrowth of neurites, which is favourable in view of induced neurite outgrowth towards cochlear electrode arrays for future optimisation of the nerve-electrode-interface. The study failed to detect a guided neurite outgrowth by pump-based drug release, which may be due to the experimental set up, which could be improved in future studies.

Introduction: Despite improved hearing, children who receive cochlear implants (CIs) at a later age encounter difficulties in adapting to society, exposing them to psychological and social risks. This study contributes to the conceptualisation of preventive interventions in schools to address potential issues so that these children can play a more active role in society.

Methods: A total of 52 children (aged 3-12 years) who received CIs at 30 months of age were assessed using the Asahide-Shiki Social Adaptive skills test, which evaluates children's social skills on four domains: (A) language, (B) everyday life, (C) social life, (D) communication.

Results: Overall, the average score of children who receive CIs at a later age was lower than that of their hearing peers. Pre-school children obtained statistically lower scores in all skills. While this general lag in skill development was no longer observed in the lower grades of elementary school, the upper-grade school children presented lower scores than their hearing peers, although only those pertaining to everyday and social life skills were statistically significant. Accordingly, the average scores were distributed in an inverted V shape among age groups.

Conclusion: These results suggest that children who receive CIs at a later age develop their social skills later than their peers with normal hearing in preschool, catch up to their peers in the 1st to 3rd grades, and then lag in the 4th to 6th grades. Accordingly, acquiring age-appropriate social skills in the upper grades remains a challenge for children who obtained CIs at the age of approximately 3, suggesting the need for intervention programs for school-age children even when they do not show significant language acquisition delays.

Introduction The Epley maneuver is the recommended treatment for benign paroxysmal positional vertigo of the posterior semicircular canal (PC-BPPV). Traditionally, the angle of the patient's head in each position during the Epley maneuver is not monitored and subjectively estimated by physicians. As a result, deviations of head angles from the standard may affect the treatment result. This study aimed to compare the outcome of the Epley maneuver between the group of exact head angles and the group of subjectively estimated angles (traditional Epley maneuver). Methods A single-blind randomized controlled trial was conducted at the Department of Otolaryngology, Chiang Mai University Hospital. PC-BPPV patients were attached with the head angle measuring device and randomized into 2 groups: Group I - the exact angle group, physicians performed the Epley maneuver with accurate head angle in each step; and Group II - the estimated angle group, physicians performed the Epley maneuver by estimating the head angle (traditional Epley maneuver). The treatment outcomes were measured at 1 week in the aspects of negative Dix Hallpike results and severity of dizziness. Results Thirty-one PC-BPPV patients were recruited and randomized into Group I (15 participants) and Group II (16 participants). Both groups showed clinical improvement. Although significant deviations of head angles were observed in group II, there was no significant difference in outcomes between the two groups in terms of negative Dix Hallpike and severity of dizziness at the 1-week follow-up. Conclusion Although significant variations of head angles were observed during the traditional Epley maneuver by experienced physicians, these deviations were slight (less than 15°) and did not significantly affect the successful treatment outcome at 1 week, in terms of negative Dix Hallpike and severity of dizziness, when compared to the group with accurate head angle during the Epley maneuver.

Introduction: This study aims to investigate the impact of auditory input on postural control in young adult cochlear implant users with profound sensorineural hearing loss. The research explores the relationship between auditory cues and static postural stability in individuals with hearing impairment.

Methods: 34 young adult cochlear implant users, consisting of 15 males and 19 females aged 18-35 years, underwent various balance tests, including the modified Clinical Tests of Sensory Interaction on Balance (mCTSIB) and the Unilateral Stance Test (UST), under different auditory conditions: (1) White noise stimulus present with the sound processor activated, (2) Ambient noise present with the sound processor activated, and (3) Sound processor deactivated. Statistical analysis was performed to evaluate the participants' postural control performance in relation to auditory stimuli.

Results: Statistical analysis revealed that participants exhibited better postural control in the presence of white noise stimuli compared to when the sound processor was turned off in the UST (p = .001) and Fukuda Stepping Test [in terms of displacement (p = .004)]. The composite mCTSIB scores showed no significant difference between sound processors off, sound processors on with ambient noise, and sound processors on with broadband white noise conditions.

Conclusion: The findings suggest that access to auditory cues through cochlear implants plays a crucial role in preserving static postural control in young adults with hearing impairment. This study highlights the positive effect of auditory information on balance performance in individuals with cochlear implants and profound hearing loss. Future research is recommended to further explore the impact of auditory stimuli on dynamic postural abilities and to include preoperative balance assessments in individuals undergoing cochlear implantation (CI).

Objective To develop an algorithm, based on the voltage matrix, for detecting regular cochlear implant (CI) electrode position during the implantation procedure, tip fold-over or basal kinking for lateral-wall electrodes. The availability of an algorithm would be valuable in clinical routine, as incorrect positioning of the electrode array can potentially be recognized intraoperatively. Design In this retrospective study intraoperative voltage matrix and postoperative digital volume tomography of 525 CI recipients were analyzed. On the basis of these data an algorithm was developed for detecting various kinds of electrode misplacements. Results Seven incorrect electrode positions, three tip fold (0.57%) and four basal kinking (0.76%) were detected. For detecting correct positioning, a sensitivity of 99.6%, a specificity of 83.3% and a positive predictive value (PPV) of 99.8% were found. For detecting tip fold-over a sensitivity of 100%, a specificity of 99.8% and a PPV of 75% were found. For detecting basal kinking, a sensitivity of 66%, a specificity of 99.8% and a PPV of 66% were determined. Conclusion The algorithm was found to be an effective screening tool for detecting tip fold-over or basal kinking.

Introduction: To date, no study has reported the various otologic conditions associated with coronavirus disease 2019 (COVID-19) using population-based design. The aim of this study was to investigate the incidence and risk of audio-vestibular disorders (benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere's disease, vestibular neuritis, and tinnitus) increasing after COVID-19 infection.

Methods: This retrospective population-based study was conducted using the National Health Insurance Service (NHIS)-COVID-19 cohort database of South Korea. We identified participants in the COVID-19 group using real-time reverse transcription-polymerase chain reaction tests. A matched cohort without COVID-19 was randomly selected in a 1:1 ratio. Benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere's disease, vestibular neuritis, and tinnitus were defined using diagnostic, medication, and procedure codes. The incidence and risk of these disorders were assessed in both groups using univariate and multivariate Cox proportional hazard analyses.

Results: In total, 4,976,589 COVID-19 patients and an equivalent number of matched non-infected controls were analyzed. COVID-19 patients faced an increased risk of developing benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus compared to controls in univariate and multivariate Cox hazard analyses. COVID patients were at an increased risk of Meniere's disease in the univariate analysis; however, the risk of Meniere's disease after COVID-19 did not reach statistical significance in the multivariate analysis.

Conclusion: COVID-19 infection may increase the risk of benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus.

Introduction: Research suggests deaf children who receive cochlear implants (CIs) at an early age can achieve age-appropriate language. Recent studies suggest age at full-time CI use is a better predictor of language outcomes than age at implant. The aim of this study was to investigate whether there are correlations between age at implantation, establishing consistent device use, and language outcomes in a cohort of young children in Aotearoa New Zealand.

Methods: A retrospective analysis was conducted. The study included 46 participants, implanted by the Southern Cochlear Implant Programme by age 18 months. The median age at implant was 8 months. Device use was measured via data logging. Consistent device use was defined as ≥8 h per day. Language outcomes were measured at 2- and 3-year post-implantation using PLS-5.

Results: Consistent use was established by 78.3% by 3 years. Language results were at least one SD higher for children who achieved consistent use within 2 years of implant. Language scores for Maori children were more than one SD lower than non-Maori, a finding not entirely explained by less usage. There was no correlation between age of implantation and length of time to consistent device use. The presence of additional disabilities affected consistent device use.

Conclusion: Simply offering CIs earlier is not sufficient to improve language outcomes in the congenitally deaf population. Earlier consistent use was associated with better language outcomes for those implanted before 18 months of age, and language scores were higher for children who achieved consistent use within 2 years of implantation. There is a need to understand why children with pre-lingual deafness may not be achieving consistent device use, and by doing so, we would be a step closer to being able to tailor culturally appropriate supports and services that could help more children achieve better outcomes.

Objective: We investigated the accuracy of imaging modalities in diagnosis and outcome of otitis media with effusion by correlating the imaging findings with the preoperative otomicroscopic examinations, tympanometric results, and intraoperative findings in patients who underwent cochlear implant surgery.

Methods: The results of the preoperative physical examination and intraoperative findings of patients younger than 18 years who underwent cochlear implant surgery at a single tertiary institution were recorded from their medical charts. Tympanometries, which were performed in maximum 1 week prior to imaging modalities, were analyzed. The high resolution computed tomography of temporal bone and magnetic resonance imaging of internal acoustic meati findings were reviewed. The mastoid cavity and middle ears were evaluated separately.

Results: The data comprising of 280 ears were evaluated. The correlation between imaging findings and both physical examination and tympanometries were statistically significant (p = 0.000). The intraoperative findings supported this correlation.

Conclusions: Our study showed that imaging modalities might detect the middle ear and mastoid cavity effusions. The severity of these changes may differ according to the severity of disease.