João Simões, S. Vlaminck, R. Seiça, F. Acke, A. Miguéis
Background: Previous studies found a relationship between audiometric patterns and the risk of developing vascular disease and considered the strial and low-sloping hearing loss of interest in predicting vascular disease. Objective: The aim of this study was to assess whether low-frequency audiometric patterns can be associated with the presence of vascular risk in a group of age-related hearing loss (ARHL) patients. Methods: A retrospective case series of 156 patients diagnosed with ARHL between July 2021 and July 2022 was assessed for a possible correlation between vascular risk factors (e.g., high blood pressure [HBP], diabetes mellitus [DM], and dyslipidemia [DLP]) and audiometric patterns. Results: One hundred fifty-six patients (79 women and 77 men) with a mean age of 73.2 ± 10.9 years who were diagnosed with ARHL were studied. A low-frequency audiometric notch at 250 Hz or 500 Hz verified in 36 patients was significantly associated with the presence of HBP, DM, or DLP (adjusted odds ratio [OR] 3.54, 95% confidence interval [CI]: 1.48–8.46, p < 0.001). A positive association between low-frequency hearing loss and the presence of at least 1 cardiovascular risk factor (adjusted OR 2.16, 95% CI: 1.01–4.62, p = 0.046) was verified. No other association was observed between audiometric patterns and vascular risk factors. Conclusion: Low-frequency audiometric notches might be related to vascular risk in ARHL patients and merit future attention in larger population studies.
背景:先前的研究发现听力学模式与发生血管疾病的风险之间存在关系，并认为试验和低倾斜听力损失对预测血管疾病很有意义。目的:本研究的目的是评估低频听力模式是否与一组年龄相关性听力损失(ARHL)患者血管风险的存在相关。方法:对2021年7月至2022年7月期间诊断为ARHL的156例患者的回顾性病例系列进行评估，以确定血管危险因素(如高血压[HBP]、糖尿病[DM]和血脂异常[DLP])与听力模式之间可能存在的相关性。结果:156例确诊为ARHL的患者(女性79例，男性77例)平均年龄73.2±10.9岁。在36例患者中，250 Hz或500 Hz的低频听力缺口与HBP、DM或DLP的存在显著相关(校正优势比[or] 3.54, 95%可信区间[CI]: 1.48-8.46, p < 0.001)。低频听力损失与至少1种心血管危险因素之间存在正相关(校正OR 2.16, 95% CI: 1.01-4.62, p = 0.046)。在听力模式和血管危险因素之间没有观察到其他关联。结论:低频听力学缺口可能与ARHL患者的血管风险有关，值得未来在更大规模的人群研究中予以关注。
{"title":"Low-Frequency Audiometric Notch and Vascular Risk in Age-Related Hearing Loss","authors":"João Simões, S. Vlaminck, R. Seiça, F. Acke, A. Miguéis","doi":"10.1159/000531937","DOIUrl":"https://doi.org/10.1159/000531937","url":null,"abstract":"Background: Previous studies found a relationship between audiometric patterns and the risk of developing vascular disease and considered the strial and low-sloping hearing loss of interest in predicting vascular disease. Objective: The aim of this study was to assess whether low-frequency audiometric patterns can be associated with the presence of vascular risk in a group of age-related hearing loss (ARHL) patients. Methods: A retrospective case series of 156 patients diagnosed with ARHL between July 2021 and July 2022 was assessed for a possible correlation between vascular risk factors (e.g., high blood pressure [HBP], diabetes mellitus [DM], and dyslipidemia [DLP]) and audiometric patterns. Results: One hundred fifty-six patients (79 women and 77 men) with a mean age of 73.2 ± 10.9 years who were diagnosed with ARHL were studied. A low-frequency audiometric notch at 250 Hz or 500 Hz verified in 36 patients was significantly associated with the presence of HBP, DM, or DLP (adjusted odds ratio [OR] 3.54, 95% confidence interval [CI]: 1.48–8.46, p < 0.001). A positive association between low-frequency hearing loss and the presence of at least 1 cardiovascular risk factor (adjusted OR 2.16, 95% CI: 1.01–4.62, p = 0.046) was verified. No other association was observed between audiometric patterns and vascular risk factors. Conclusion: Low-frequency audiometric notches might be related to vascular risk in ARHL patients and merit future attention in larger population studies.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84474938","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}
Objective: The aim of this study was to assess hearing, language, and school performance in children with cleft lip/palate waiting for alveolar and hard palate reconstruction at the age of mixed dentition, compared to age-matched children with no birth anomalies. Methods: Forty-four children aged 8–12 years participated in the study (22 with/22 without cleft). After tympanometry and audiometry, a short in-house questionnaire was administered to their guardians to record data on school performance. Then, assessments were performed on velopharyngeal competency, intelligibility, language, and reading/writing skills. Bivariate and multivariate analyses were performed with p value set at 0.05. Results: Middle ear function, language, and school performance of children with cleft lip/palate were worse than that of children without cleft, particularly on spelling and phoneme-grapheme correspondence. Among children with cleft lip/palate, about half of the variability on the average school notes was related to their results on phonemic synthesis and spelling tests (ANCoVA, R2 = 0.52, p = 0.003), while the spelling results were related to the hearing thresholds (ANCoVA, R2 = 0.39, p = 0.01), regardless if the cleft was unilateral or bilateral. Conclusion: In children with cleft lip/palate, late alveolar and hard palate reconstruction may have an impact on hearing, language development, and performance at school.
目的:本研究的目的是评估在混合牙列年龄等待牙槽和硬腭重建的唇腭裂儿童的听力，语言和学业表现，并与年龄匹配的无出生异常儿童进行比较。方法:44例8 ~ 12岁儿童(22例有唇裂/22例无唇裂)参与研究。在鼓室测量和听力测量之后，对他们的监护人进行了一份简短的内部问卷调查，以记录学校表现的数据。然后，对腭咽能力、可理解性、语言和阅读/写作技能进行评估。进行双变量和多变量分析，p值设为0.05。结果:唇腭裂患儿的中耳功能、语言和学业表现均较正常患儿差，尤其是在拼写和音素-字素对应方面。在唇腭裂儿童中，无论唇腭裂是单侧还是双侧，平均学校笔记的变异性约有一半与音位综合和拼写测试结果有关(ANCoVA, R2 = 0.52, p = 0.003)，而拼写结果与听力阈值有关(ANCoVA, R2 = 0.39, p = 0.01)。结论:唇腭裂儿童牙槽和硬腭晚期重建可能对听力、语言发育和学业表现有影响。
{"title":"Hearing, Language, and General School Performance in Children with Cleft Lip/Palate Waiting for Alveolar and Hard Palate Reconstruction at the Age of Mixed Dentition","authors":"Blanca Isabel Pérez Hernández, Hilda González Olivares, Aline Berenice Herrera Rangel, Belma Jessica Lamas González, Kathrine Jáuregui-Renaud","doi":"10.1159/000531394","DOIUrl":"https://doi.org/10.1159/000531394","url":null,"abstract":"Objective: The aim of this study was to assess hearing, language, and school performance in children with cleft lip/palate waiting for alveolar and hard palate reconstruction at the age of mixed dentition, compared to age-matched children with no birth anomalies. Methods: Forty-four children aged 8–12 years participated in the study (22 with/22 without cleft). After tympanometry and audiometry, a short in-house questionnaire was administered to their guardians to record data on school performance. Then, assessments were performed on velopharyngeal competency, intelligibility, language, and reading/writing skills. Bivariate and multivariate analyses were performed with p value set at 0.05. Results: Middle ear function, language, and school performance of children with cleft lip/palate were worse than that of children without cleft, particularly on spelling and phoneme-grapheme correspondence. Among children with cleft lip/palate, about half of the variability on the average school notes was related to their results on phonemic synthesis and spelling tests (ANCoVA, R2 = 0.52, p = 0.003), while the spelling results were related to the hearing thresholds (ANCoVA, R2 = 0.39, p = 0.01), regardless if the cleft was unilateral or bilateral. Conclusion: In children with cleft lip/palate, late alveolar and hard palate reconstruction may have an impact on hearing, language development, and performance at school.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79255002","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}
Molly Smeal, Hillary A. Snapp, S. Ausili, Meredith A. Holcomb, S. Prentiss
Purpose: This study investigated the objective and subjective benefit of a second cochlear implant (CI) on binaural listening tasks of speech understanding in noise and localization in younger and older adults. We aimed to determine if the aging population can utilize binaural cues and obtain comparable benefits from bilateral CI (BIL_CI) when compared to the younger population. Methods: Twenty-nine adults with severe to profound bilateral sensorineural hearing loss were included. Participants were evaluated in two conditions, better CI (BE_CI) alone and BIL_CI using AzBio and Bamford-Kowal-Bench (BKB) sentence in noise tests. Localization tasks were completed in the BIL_CI condition using a broadband stimulus, low-frequency stimuli, and high-frequency stimuli. A subjective questionnaire was administered to assess satisfaction with CI. Results: Older age was significantly associated with poorer performance on AzBio +5 dB signal-to-noise ratio (SNR) and BKB-speech in noise (SIN); however, improvements from BE_CI to BIL_CI were observed across all ages. In the AzBio +5 condition, nearly half of all participants achieved a significant improvement from BE_CI to BIL_CI with the majority of those occurring in patients younger than 65 years of age. Conversely, the majority of participants who achieved a significant improvement in BKB-SIN were adults >65 years of age. Years of BIL_CI experience and time between implants were not associated with performance. For localization, mean absolute error increased with age for low and high narrowband noise, but not for the broadband noise. Response gain was negatively correlated with age for all localization stimuli. Neither BIL_CI listening experience nor time between implants significantly impacted localization ability. Subjectively, participants report reduction in disability with the addition of the second CI. There is no observed relationship between age or speech recognition score and satisfaction with BIL_CI. Conclusion: Overall performance on binaural listening tasks was poorer in older adults than in younger adults. However, older adults were able to achieve significant benefit from the addition of a second CI, and performance on binaural tasks was not correlated with overall device satisfaction. The significance of the improvement was task and stimulus dependent but suggested a critical limit may exist for optimal performance on SIN tasks for CI users. Specifically, older adults require at least a +8 dB SNR to understand 50% of speech postoperatively; therefore, solely utilizing a fixed +5 dB SNR preoperatively to qualify CI candidates is not recommended as this test condition may introduce limitations in demonstrating CI benefit.
{"title":"Effects of Bilateral Cochlear Implantation on Binaural Listening Tasks for Younger and Older Adults","authors":"Molly Smeal, Hillary A. Snapp, S. Ausili, Meredith A. Holcomb, S. Prentiss","doi":"10.1159/000523914","DOIUrl":"https://doi.org/10.1159/000523914","url":null,"abstract":"Purpose: This study investigated the objective and subjective benefit of a second cochlear implant (CI) on binaural listening tasks of speech understanding in noise and localization in younger and older adults. We aimed to determine if the aging population can utilize binaural cues and obtain comparable benefits from bilateral CI (BIL_CI) when compared to the younger population. Methods: Twenty-nine adults with severe to profound bilateral sensorineural hearing loss were included. Participants were evaluated in two conditions, better CI (BE_CI) alone and BIL_CI using AzBio and Bamford-Kowal-Bench (BKB) sentence in noise tests. Localization tasks were completed in the BIL_CI condition using a broadband stimulus, low-frequency stimuli, and high-frequency stimuli. A subjective questionnaire was administered to assess satisfaction with CI. Results: Older age was significantly associated with poorer performance on AzBio +5 dB signal-to-noise ratio (SNR) and BKB-speech in noise (SIN); however, improvements from BE_CI to BIL_CI were observed across all ages. In the AzBio +5 condition, nearly half of all participants achieved a significant improvement from BE_CI to BIL_CI with the majority of those occurring in patients younger than 65 years of age. Conversely, the majority of participants who achieved a significant improvement in BKB-SIN were adults >65 years of age. Years of BIL_CI experience and time between implants were not associated with performance. For localization, mean absolute error increased with age for low and high narrowband noise, but not for the broadband noise. Response gain was negatively correlated with age for all localization stimuli. Neither BIL_CI listening experience nor time between implants significantly impacted localization ability. Subjectively, participants report reduction in disability with the addition of the second CI. There is no observed relationship between age or speech recognition score and satisfaction with BIL_CI. Conclusion: Overall performance on binaural listening tasks was poorer in older adults than in younger adults. However, older adults were able to achieve significant benefit from the addition of a second CI, and performance on binaural tasks was not correlated with overall device satisfaction. The significance of the improvement was task and stimulus dependent but suggested a critical limit may exist for optimal performance on SIN tasks for CI users. Specifically, older adults require at least a +8 dB SNR to understand 50% of speech postoperatively; therefore, solely utilizing a fixed +5 dB SNR preoperatively to qualify CI candidates is not recommended as this test condition may introduce limitations in demonstrating CI benefit.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90052751","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}
L. C. Vicente, M. Polonenko, K. Gordon, Leandra Tabanez do Nascimento Silva, O. A. Costa, K. F. Alvarenga
Introduction: Benefits of bilateral cochlear implants (CI) may be compromised by delays to implantation of either ear. This study aimed to evaluate the effects of sequential bilateral CI use in children who received their first CI at young ages, using a clinical set-up. Methods: One-channel cortical auditory evoked potentials and speech perception in quiet and noise were evoked at repeated times (0, 3, 6, 12 months of bilateral CI use) by unilateral and bilateral stimulation in 28 children with early-onset deafness. These children were unilaterally implanted before 3.69 years of age (mean ± SD of 1.98 ± 0.73 years) and received a second CI after 5.13 ± 2.37 years of unilateral CI use. Comparisons between unilaterally evoked responses were used to measure asymmetric function between the ears and comparisons between bilateral responses and each unilateral response were used to measure the bilateral benefit. Results: Chronic bilateral CI promoted changes in cortical auditory responses and speech perception performance; however, large asymmetries were present between the two unilateral responses despite ongoing bilateral CI use. Persistent cortical differences between the two sides at 1 year of bilateral stimulation were predicted by increasing age at the first surgery and inter-implant delay. Larger asymmetries in speech perception occurred with longer inter-implant delays. Bilateral responses were more similar to the unilateral responses from the first rather than the second CI. Conclusion: These findings are consistent with the development of the aural preference syndrome and reinforce the importance of providing bilateral CIs simultaneously or sequentially with very short delays.
{"title":"Effects of Sequential Bilateral Cochlear Implantation in Children: Evidence from Speech-Evoked Cortical Potentials and Tests of Speech Perception","authors":"L. C. Vicente, M. Polonenko, K. Gordon, Leandra Tabanez do Nascimento Silva, O. A. Costa, K. F. Alvarenga","doi":"10.1159/000521600","DOIUrl":"https://doi.org/10.1159/000521600","url":null,"abstract":"Introduction: Benefits of bilateral cochlear implants (CI) may be compromised by delays to implantation of either ear. This study aimed to evaluate the effects of sequential bilateral CI use in children who received their first CI at young ages, using a clinical set-up. Methods: One-channel cortical auditory evoked potentials and speech perception in quiet and noise were evoked at repeated times (0, 3, 6, 12 months of bilateral CI use) by unilateral and bilateral stimulation in 28 children with early-onset deafness. These children were unilaterally implanted before 3.69 years of age (mean ± SD of 1.98 ± 0.73 years) and received a second CI after 5.13 ± 2.37 years of unilateral CI use. Comparisons between unilaterally evoked responses were used to measure asymmetric function between the ears and comparisons between bilateral responses and each unilateral response were used to measure the bilateral benefit. Results: Chronic bilateral CI promoted changes in cortical auditory responses and speech perception performance; however, large asymmetries were present between the two unilateral responses despite ongoing bilateral CI use. Persistent cortical differences between the two sides at 1 year of bilateral stimulation were predicted by increasing age at the first surgery and inter-implant delay. Larger asymmetries in speech perception occurred with longer inter-implant delays. Bilateral responses were more similar to the unilateral responses from the first rather than the second CI. Conclusion: These findings are consistent with the development of the aural preference syndrome and reinforce the importance of providing bilateral CIs simultaneously or sequentially with very short delays.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84305437","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}
C. Völter, K. Oberländer, Imme Haubitz, Rebecca Carroll, S. Dazert, J. Thomas
Introduction: Several factors are known to influence speech perception in cochlear implant (CI) users. To date, the underlying mechanisms have not yet been fully clarified. Although many CI users achieve a high level of speech perception, a small percentage of patients does not or only slightly benefit from the CI (poor performer, PP). In a previous study, PP showed significantly poorer results on nonauditory-based cognitive and linguistic tests than CI users with a very high level of speech understanding (star performer, SP). We now investigate if PP also differs from the CI user with an average performance (average performer, AP) in cognitive and linguistic performance. Methods: Seventeen adult postlingually deafened CI users with speech perception scores in quiet of 55 (9.32) % (AP) on the German Freiburg monosyllabic speech test at 65 dB underwent neurocognitive (attention, working memory, short- and long-term memory, verbal fluency, inhibition) and linguistic testing (word retrieval, lexical decision, phonological input lexicon). The results were compared to the performance of 15 PP (speech perception score of 15 [11.80] %) and 19 SP (speech perception score of 80 [4.85] %). For statistical analysis, U-Test and discrimination analysis have been done. Results: Significant differences between PP and AP were observed on linguistic tests, in Rapid Automatized Naming (RAN: p = 0.0026), lexical decision (LexDec: p = 0.026), phonological input lexicon (LEMO: p = 0.0085), and understanding of incomplete words (TRT: p = 0.0024). AP also had significantly better neurocognitive results than PP in the domains of attention (M3: p = 0.009) and working memory (OSPAN: p = 0.041; RST: p = 0.015) but not in delayed recall (delayed recall: p = 0.22), verbal fluency (verbal fluency: p = 0.084), and inhibition (Flanker: p = 0.35). In contrast, no differences were found hereby between AP and SP. Based on the TRT and the RAN, AP and PP could be separated in 100%. Discussion: The results indicate that PP constitute a distinct entity of CI users that differs even in nonauditory abilities from CI users with an average speech perception, especially with regard to rapid word retrieval either due to reduced phonological abilities or limited storage. Further studies should investigate if improved word retrieval by increased phonological and semantic training results in better speech perception in these CI users.
引言:有几个因素已知会影响人工耳蜗(CI)使用者的语言感知。迄今为止，潜在的机制尚未得到充分澄清。尽管许多CI使用者实现了高水平的语音感知，但一小部分患者没有或仅从CI中略微受益(表现不佳，PP)。在之前的一项研究中，PP在非听觉认知和语言测试中表现出明显低于言语理解水平非常高的CI用户(star performer, SP)。我们现在研究PP在认知和语言表现上是否也不同于具有平均表现的CI用户(平均执行者，AP)。方法:17例在德语Freiburg单音节语音测试(65 dB)中言语感知得分为55 (9.32)% (AP)的成年语后聋CI使用者进行了神经认知(注意、工作记忆、短期和长期记忆、言语流畅性、抑制)和语言测试(词语检索、词汇决策、语音输入词汇)。将结果与15名PP(语音感知得分15[11.80]%)和19名SP(语音感知得分80[4.85]%)的表现进行比较。在统计分析方面，进行了u检验和判别分析。结果:在快速自动命名(RAN: p = 0.0026)、词汇决策(LexDec: p = 0.026)、语音输入词汇(LEMO: p = 0.0085)和对不完整单词的理解(TRT: p = 0.0024)等语言测试中，PP和AP存在显著差异。在注意(M3: p = 0.009)和工作记忆(osan: p = 0.041;RST: p = 0.015)，但在延迟回忆(延迟回忆:p = 0.22)、言语流畅性(言语流畅性:p = 0.084)和抑制(Flanker: p = 0.35)方面没有影响。相比之下，AP和SP在这方面没有差异。基于TRT和RAN, AP和PP可以100%分离。讨论:结果表明，PP构成了CI用户的一个独特实体，即使在非听觉能力上也不同于具有平均语音感知的CI用户，特别是由于语音能力降低或存储有限而导致的快速单词检索。进一步的研究应该调查通过增加语音和语义训练来提高单词检索是否能提高这些CI用户的语音感知能力。
{"title":"Poor Performer: A Distinct Entity in Cochlear Implant Users?","authors":"C. Völter, K. Oberländer, Imme Haubitz, Rebecca Carroll, S. Dazert, J. Thomas","doi":"10.1159/000524107","DOIUrl":"https://doi.org/10.1159/000524107","url":null,"abstract":"Introduction: Several factors are known to influence speech perception in cochlear implant (CI) users. To date, the underlying mechanisms have not yet been fully clarified. Although many CI users achieve a high level of speech perception, a small percentage of patients does not or only slightly benefit from the CI (poor performer, PP). In a previous study, PP showed significantly poorer results on nonauditory-based cognitive and linguistic tests than CI users with a very high level of speech understanding (star performer, SP). We now investigate if PP also differs from the CI user with an average performance (average performer, AP) in cognitive and linguistic performance. Methods: Seventeen adult postlingually deafened CI users with speech perception scores in quiet of 55 (9.32) % (AP) on the German Freiburg monosyllabic speech test at 65 dB underwent neurocognitive (attention, working memory, short- and long-term memory, verbal fluency, inhibition) and linguistic testing (word retrieval, lexical decision, phonological input lexicon). The results were compared to the performance of 15 PP (speech perception score of 15 [11.80] %) and 19 SP (speech perception score of 80 [4.85] %). For statistical analysis, U-Test and discrimination analysis have been done. Results: Significant differences between PP and AP were observed on linguistic tests, in Rapid Automatized Naming (RAN: p = 0.0026), lexical decision (LexDec: p = 0.026), phonological input lexicon (LEMO: p = 0.0085), and understanding of incomplete words (TRT: p = 0.0024). AP also had significantly better neurocognitive results than PP in the domains of attention (M3: p = 0.009) and working memory (OSPAN: p = 0.041; RST: p = 0.015) but not in delayed recall (delayed recall: p = 0.22), verbal fluency (verbal fluency: p = 0.084), and inhibition (Flanker: p = 0.35). In contrast, no differences were found hereby between AP and SP. Based on the TRT and the RAN, AP and PP could be separated in 100%. Discussion: The results indicate that PP constitute a distinct entity of CI users that differs even in nonauditory abilities from CI users with an average speech perception, especially with regard to rapid word retrieval either due to reduced phonological abilities or limited storage. Further studies should investigate if improved word retrieval by increased phonological and semantic training results in better speech perception in these CI users.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91468732","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}
Kengo Yamamoto, T. Kurioka, M. Ohki, K. Ohashi, Y. Harada, Yukiko Asako, H. Sano, T. Yamashita
Introduction: The prognosis of Bell’s palsy, idiopathic facial nerve palsy (FNP), is usually predicted by electroneuronography in subacute phase. However, it would be ideal to establish a reliable and objective examination applicable in acute phase to predict the prognosis of FNP. Immune-nutritional status (INS) calculated from peripheral blood examination is recently reported as the prognostic factor in various disease. However, the validity of INS as the prognostic factor in Bell’s palsy is not well known. Thus, we conducted a retrospective study to investigate the usefulness of INS as prognostic predictors of Bell’s palsy. Methods: We reviewed the medical records of 79 patients with Bell’s palsy and divided into two groups as “complete recovery” and “incomplete recovery” groups. Clinical features such as severity of FNP and INS, including neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), prognostic nutritional index (PNI), and controlling nutrition status (CONUT) score, were assessed. Results: In univariate analysis, statistically significant differences were observed in clinical score of facial movement, NLR, LMR, PNI, and CONUT score at the initial examination between the two groups (p < 0.05). Furthermore, in multivariate analysis, statistically significant differences were also observed in facial movement score and PNI at the initial examination (p < 0.05). Conclusion: Immune and nutritional condition play important roles in the pathogenesis of Bell’s palsy, suggesting that INS would be one of the useful prognostic factors in Bell’s palsy.
{"title":"Immune-Nutritional Status as a Novel Prognostic Predictor of Bell’s Palsy","authors":"Kengo Yamamoto, T. Kurioka, M. Ohki, K. Ohashi, Y. Harada, Yukiko Asako, H. Sano, T. Yamashita","doi":"10.1159/000524355","DOIUrl":"https://doi.org/10.1159/000524355","url":null,"abstract":"Introduction: The prognosis of Bell’s palsy, idiopathic facial nerve palsy (FNP), is usually predicted by electroneuronography in subacute phase. However, it would be ideal to establish a reliable and objective examination applicable in acute phase to predict the prognosis of FNP. Immune-nutritional status (INS) calculated from peripheral blood examination is recently reported as the prognostic factor in various disease. However, the validity of INS as the prognostic factor in Bell’s palsy is not well known. Thus, we conducted a retrospective study to investigate the usefulness of INS as prognostic predictors of Bell’s palsy. Methods: We reviewed the medical records of 79 patients with Bell’s palsy and divided into two groups as “complete recovery” and “incomplete recovery” groups. Clinical features such as severity of FNP and INS, including neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), prognostic nutritional index (PNI), and controlling nutrition status (CONUT) score, were assessed. Results: In univariate analysis, statistically significant differences were observed in clinical score of facial movement, NLR, LMR, PNI, and CONUT score at the initial examination between the two groups (p < 0.05). Furthermore, in multivariate analysis, statistically significant differences were also observed in facial movement score and PNI at the initial examination (p < 0.05). Conclusion: Immune and nutritional condition play important roles in the pathogenesis of Bell’s palsy, suggesting that INS would be one of the useful prognostic factors in Bell’s palsy.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72552895","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}
R. Greisiger, M. G. Heldahl, M. Myhrum, T. M. Sørensen, J. J. Dammerud, K. Rasmussen, Hilde Korslund, M. Bunne, G. Jablonski
Background: The first surgeries with CI532 showed an effect of the proximity of the electrode to the modiolus on the Evoked Compound Action Potentials (ECAPs). Objectives: Objectives of the study were to investigate the effect of the “pullback” procedure on intraoperative ECAP responses in three different electrode array positions and additionally to compare behavioral thresholds with the thresholds obtained in a group of patients using the standard insertion. The hypothesis of this study is that pullback will cause lower ECAPs and behavioral thresholds. Patients: The study included 40 patients, 20 in the pullback insertion group and 20 in the standard insertion group (without pullback). Method: During insertion of the CI532 electrode array, ECAP was performed in three different positions for the pullback group: at initial insertion, at over-insertion, and after pullback. Insertion was monitored by fluoroscopy. In the standard group, ECAP was performed at the initial position, which is also the final position. ECAP thresholds (T-ECAPs) were compared within subjects at the initial and the final position in the pullback group and between groups in the final positions of the pullback and standard groups. Programming levels (C- and T-levels) were compared between the two groups 1 year after switch-on. Results: Intraoperative measurements pullback shows lower average T-ECAPs after pullback compared to thresholds in initial position. Comparison of intraoperative T-ECAPs at the final positions showed no statistically significant difference between the pullback group and the standard insertion group. Furthermore, 1 year after switch-on there was no statistically significant difference in C- and T-levels between the two groups. Conclusion: The pullback maneuver of the CI532 electrode array after an over-insertion gave significantly lower T-ECAPs compared to the thresholds at the initial position. However, the between-groups analysis of pullback and standard insertion showed neither significantly different T-ECAPs nor different programming levels. Because T-ECAPs and programming levels vary considerably between subjects, large groups are required to detect differences between groups. Additionally, the effect pullback technique to preserving the residual hearing is not known yet.
{"title":"Effect of Proximity to the Modiolus for the Cochlear CI532 Slim Modiolar Electrode Array on Evoked Compound Action Potentials and Programming Levels","authors":"R. Greisiger, M. G. Heldahl, M. Myhrum, T. M. Sørensen, J. J. Dammerud, K. Rasmussen, Hilde Korslund, M. Bunne, G. Jablonski","doi":"10.1159/000524256","DOIUrl":"https://doi.org/10.1159/000524256","url":null,"abstract":"Background: The first surgeries with CI532 showed an effect of the proximity of the electrode to the modiolus on the Evoked Compound Action Potentials (ECAPs). Objectives: Objectives of the study were to investigate the effect of the “pullback” procedure on intraoperative ECAP responses in three different electrode array positions and additionally to compare behavioral thresholds with the thresholds obtained in a group of patients using the standard insertion. The hypothesis of this study is that pullback will cause lower ECAPs and behavioral thresholds. Patients: The study included 40 patients, 20 in the pullback insertion group and 20 in the standard insertion group (without pullback). Method: During insertion of the CI532 electrode array, ECAP was performed in three different positions for the pullback group: at initial insertion, at over-insertion, and after pullback. Insertion was monitored by fluoroscopy. In the standard group, ECAP was performed at the initial position, which is also the final position. ECAP thresholds (T-ECAPs) were compared within subjects at the initial and the final position in the pullback group and between groups in the final positions of the pullback and standard groups. Programming levels (C- and T-levels) were compared between the two groups 1 year after switch-on. Results: Intraoperative measurements pullback shows lower average T-ECAPs after pullback compared to thresholds in initial position. Comparison of intraoperative T-ECAPs at the final positions showed no statistically significant difference between the pullback group and the standard insertion group. Furthermore, 1 year after switch-on there was no statistically significant difference in C- and T-levels between the two groups. Conclusion: The pullback maneuver of the CI532 electrode array after an over-insertion gave significantly lower T-ECAPs compared to the thresholds at the initial position. However, the between-groups analysis of pullback and standard insertion showed neither significantly different T-ECAPs nor different programming levels. Because T-ECAPs and programming levels vary considerably between subjects, large groups are required to detect differences between groups. Additionally, the effect pullback technique to preserving the residual hearing is not known yet.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88814349","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}
Introduction: This retrospective cohort study of myringoplasty performed at Tauranga Hospital, Bay of Plenty, New Zealand from 2010 to 2020 sought to identify predictive factors for successful myringoplasty with particular consideration given to the known high prevalence of middle ear conditions in New Zealand Māori. Methods: Outcomes were surgical success (perforation closure at 1 month) and hearing improvement, which were correlated against demographic, pathological, and surgical variables. Results: 174 patients underwent 221 procedures (139 in children under 18 years old), with 66.1% of patients being New Zealand Māori and 24.7% New Zealand European ethnicity. Normalized by population demographics, New Zealand Māori were 2.3 times overrepresented, whereas New Zealand Europeans were underrepresented by 0.34 times (a 6.8 times relative treatment differential). The rate of surgical success was 84.6%, independent of patient age, gender, and ethnicity. A postauricular approach and the use of temporalis fascia grafts were both correlated with optimal success rates, whereas early postoperative infection (<1 month) was correlated with ∼3 times increased failure. Myringoplasty improved hearing in 83.1% of patients (average air-bone gap reduction of 10.7 dB). New Zealand Māori patients had ∼4 times greater preoperative conductive hearing loss compared to New Zealand Europeans, but benefited the most from myringoplasty. Discussion/Conclusion: New Zealand Māori and pediatric populations required greater access to myringoplasty, achieving good surgical and audiological outcomes. Myringoplasty is highly effective and significantly improves hearing, particularly for New Zealand Māori. Pediatric success rates were equivalent to adults, supporting timely myringoplasty to minimize morbidity from untreated perforations.
{"title":"Audiological and Surgical Correlates of Myringoplasty Associated with Ethnography in the Bay of Plenty, New Zealand","authors":"D. Housley, D. Irani, G. Housley, W. T. ten Cate","doi":"10.1159/000524312","DOIUrl":"https://doi.org/10.1159/000524312","url":null,"abstract":"Introduction: This retrospective cohort study of myringoplasty performed at Tauranga Hospital, Bay of Plenty, New Zealand from 2010 to 2020 sought to identify predictive factors for successful myringoplasty with particular consideration given to the known high prevalence of middle ear conditions in New Zealand Māori. Methods: Outcomes were surgical success (perforation closure at 1 month) and hearing improvement, which were correlated against demographic, pathological, and surgical variables. Results: 174 patients underwent 221 procedures (139 in children under 18 years old), with 66.1% of patients being New Zealand Māori and 24.7% New Zealand European ethnicity. Normalized by population demographics, New Zealand Māori were 2.3 times overrepresented, whereas New Zealand Europeans were underrepresented by 0.34 times (a 6.8 times relative treatment differential). The rate of surgical success was 84.6%, independent of patient age, gender, and ethnicity. A postauricular approach and the use of temporalis fascia grafts were both correlated with optimal success rates, whereas early postoperative infection (<1 month) was correlated with ∼3 times increased failure. Myringoplasty improved hearing in 83.1% of patients (average air-bone gap reduction of 10.7 dB). New Zealand Māori patients had ∼4 times greater preoperative conductive hearing loss compared to New Zealand Europeans, but benefited the most from myringoplasty. Discussion/Conclusion: New Zealand Māori and pediatric populations required greater access to myringoplasty, achieving good surgical and audiological outcomes. Myringoplasty is highly effective and significantly improves hearing, particularly for New Zealand Māori. Pediatric success rates were equivalent to adults, supporting timely myringoplasty to minimize morbidity from untreated perforations.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73981058","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}
Introduction: The objective of this study was to evaluate the effectiveness of a new auditory training (AT) program on the speech recognition in the noise and on the auditory event-related potentials in elderly hearing aid users. Methods: Thirty-three elderly individuals using hearing aids aged from 60 to 80 years participated. A new AT program was developed for the study. AT program lasts for 8 weeks and includes sound discrimination exercises and cognitive exercises. Seventeen individuals (mean age 72.17 ± 6.94) received AT and 16 individuals (mean age 71.75 ± 6.81) did not receive AT. The mismatch negativity (MMN) test and matrix test were used to evaluate the effectiveness of AT. Tests were conducted for the study group before and after the AT. The tests were carried out for the control group at the same times with the study group and the results were compared. Results: In comparison with the first evaluation, the last evaluation of the study group demonstrated a significant difference regarding the decrease of mean latency in the MMN wave (p = 0.038), and regarding the improving score of matrix test (p = 0.004), there was no difference in the control group. Conclusion: The AT program prepared for the study was effective in improving speech recognition in noise in the elderly, and the efficiency of AT could be demonstrated with MMN and matrix test.
{"title":"Evaluating the Effectiveness of a New Auditory Training Program on the Speech Recognition Skills and Auditory Event-Related Potentials in Elderly Hearing Aid Users","authors":"Aysenur Kucuk Ceyhan, H. H. Dere, B. Mujdeci","doi":"10.1159/000523807","DOIUrl":"https://doi.org/10.1159/000523807","url":null,"abstract":"Introduction: The objective of this study was to evaluate the effectiveness of a new auditory training (AT) program on the speech recognition in the noise and on the auditory event-related potentials in elderly hearing aid users. Methods: Thirty-three elderly individuals using hearing aids aged from 60 to 80 years participated. A new AT program was developed for the study. AT program lasts for 8 weeks and includes sound discrimination exercises and cognitive exercises. Seventeen individuals (mean age 72.17 ± 6.94) received AT and 16 individuals (mean age 71.75 ± 6.81) did not receive AT. The mismatch negativity (MMN) test and matrix test were used to evaluate the effectiveness of AT. Tests were conducted for the study group before and after the AT. The tests were carried out for the control group at the same times with the study group and the results were compared. Results: In comparison with the first evaluation, the last evaluation of the study group demonstrated a significant difference regarding the decrease of mean latency in the MMN wave (p = 0.038), and regarding the improving score of matrix test (p = 0.004), there was no difference in the control group. Conclusion: The AT program prepared for the study was effective in improving speech recognition in noise in the elderly, and the efficiency of AT could be demonstrated with MMN and matrix test.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86491017","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}
Scott B. Shapiro, Nathan Kemper, Austin Jameson, N. Lipschitz, Mike Hazenfield, M. Zuccarello, R. Samy
Objective: The aim of this study was to determine the incidence of cochlear fibrosis after vestibular schwannoma (VS) resection via middle cranial fossa (MCF) approach. Design: A retrospective case review was conducted. Setting: The review was conducted in a tertiary care academic medical center. Participants: Patients who (1) underwent resection of VS via MCF approach between 2013 and 2018, (2) had complete pre- and post-audiometric testing, and (3) had clinical follow-up with magnetic resonance imaging (MRI) for at least 1 year after surgery were included. Main Outcome Measure(s): The main outcome of this study was cochlear fibrosis as assessed by MRI 1 year after surgery. Results: Fifty-one patients underwent VS resection via MCF technique during the study period. Of 31 patients with AAO-HNS class A or B preoperative hearing ability, 18 (58.0%) maintained class A, B, or C hearing postoperatively. Of 16 patients who lost hearing and had MRI 1 year after surgery, 11 (61.1%) had MRI evidence of fibrosis in at least some portion of the labyrinth and 4 (22.2%) showed evidence of cochlear fibrosis. Of 16 patients with preserved hearing and MRI 1 year after surgery, 4 (25%) had fibrosis in some portion of the labyrinth, with no fibrosis in the cochlea. Conclusions: In patients who lose hearing during VS resection with the MCF approach, there is usually MRI evidence of fibrosis in the labyrinth 1 year after surgery. However, there is also, but less commonly, fibrosis involving the cochlea. It is unclear if this will affect the ability to insert a cochlear implant electrode array.
{"title":"Cochlear Fibrosis after Vestibular Schwannoma Resection via the Middle Cranial Fossa Approach","authors":"Scott B. Shapiro, Nathan Kemper, Austin Jameson, N. Lipschitz, Mike Hazenfield, M. Zuccarello, R. Samy","doi":"10.1159/000520782","DOIUrl":"https://doi.org/10.1159/000520782","url":null,"abstract":"Objective: The aim of this study was to determine the incidence of cochlear fibrosis after vestibular schwannoma (VS) resection via middle cranial fossa (MCF) approach. Design: A retrospective case review was conducted. Setting: The review was conducted in a tertiary care academic medical center. Participants: Patients who (1) underwent resection of VS via MCF approach between 2013 and 2018, (2) had complete pre- and post-audiometric testing, and (3) had clinical follow-up with magnetic resonance imaging (MRI) for at least 1 year after surgery were included. Main Outcome Measure(s): The main outcome of this study was cochlear fibrosis as assessed by MRI 1 year after surgery. Results: Fifty-one patients underwent VS resection via MCF technique during the study period. Of 31 patients with AAO-HNS class A or B preoperative hearing ability, 18 (58.0%) maintained class A, B, or C hearing postoperatively. Of 16 patients who lost hearing and had MRI 1 year after surgery, 11 (61.1%) had MRI evidence of fibrosis in at least some portion of the labyrinth and 4 (22.2%) showed evidence of cochlear fibrosis. Of 16 patients with preserved hearing and MRI 1 year after surgery, 4 (25%) had fibrosis in some portion of the labyrinth, with no fibrosis in the cochlea. Conclusions: In patients who lose hearing during VS resection with the MCF approach, there is usually MRI evidence of fibrosis in the labyrinth 1 year after surgery. However, there is also, but less commonly, fibrosis involving the cochlea. It is unclear if this will affect the ability to insert a cochlear implant electrode array.","PeriodicalId":8624,"journal":{"name":"Audiology and Neurotology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82224802","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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