bluuebunny/crossref_metadata_2025 huggingface dataset:
CONNEXIN 43 EXPRESSION IN THE HUMAN COCHLEA:
AN IMMUNOHISTOCHEMISTRY STUDY
Authors: Liu Wei , Bostrom Marja , Kinnefors Anders , Edin Fredrik , Rask-Andersen Helge
Published: May 2021

Background

Mutations in the gene GJA1 which encodes gap junction protein connexin 43 (Cx43) have been linked to nonsyndromic prelingual deafness in humans. The protein forms gap junction channels (GJChs), creating intercellular pathways
for ions and small molecules – such as second messengers (IP3, cAMP, cGMP, and others), diverse metabolites (e.g. glucose,
amino acids, glutathione, ATP) and neuroprotectant (e.g. adenosine) – to reach neighboring cells. Cx43 in glial cells of the
central nervous system (CNS) and in satellite glial cells of the peripheral nociceptive sensory ganglia has been studied for its
structure as well as function in signal transduction and neuron protection. Distribution of Cx43 in the human cochlea is an
important unresolved issue.

Material and Methods

For the first time we analysed, using immunofluorescence and confocal immunofluorescence, the expression and distribution of Cx43 in 5 normal fresh human cochleae obtained at surgery for removal of giant posterior cranial fossa meningioma.

Results

In the lateral wall of the cochlea, Cx43 was expressed mainly in the basal cell layer of the stria vascularis and the fibrocytes of the spiral ligament. In the organ of Corti, Cx43 antibody strongly stained both inner and outer pillar cells, the
covering layer cells of the basilar membrane and the supporting cells underneath outer hair cells. In the spiral ganglion, Cx43
expression was located in the satellite glial cells (SGCs) surrounding type I neurons.

Conclusions

Cx43 expression was found in human cochleae including the lateral wall, organ of Corti and spiral ganglion
satellite cells. Potential roles played by GJChs built up by Cx43 in maintaining homeostasis of the cochlea and protection of
neurons are speculated.
COMPUTERISED TURKISH VERSIONS OF TESTS FOR
CENTRAL AUDITORY PROCESSING DISORDER
Authors: Turkyilmaz Meral , Yilmaz Suna , Yagcioglu Suha , Yarali Mehmet , Celik Nagihan
Published: May 2021

Background

To detect central auditory processing disorder (CAPD), a test battery is needed that probes the integrity of the
central auditory nervous system and describes its response parameters. The audiologist needs to select a well-designed test
battery that examines a variety of auditory performance areas. Computer-controlled adaptive tests are recommended because
they maximise test efficiency and minimise floor and ceiling effects as well as minimising memory load. In order to increase
test efficiency and minimise difficulties and training, we adapted computerised versions of the Frequency Pattern test and the
Duration Pattern test.

Material and Methods

The present study was conducted at Hacettepe University, Turkey, in the Faculty of Medicine’s Otorhinolarnygology Department, Audiology and Speech Pathology Unit. In total, 80 children (43 girls, 37 boys) aged between 7 years
0 months and 11 years 11 months were recruited. Each participant completed an informed consent form and a biographical
survey prior to the tests. All tests were administered according to instructions at a comfortable listening level on a calibrated
laptop computer which delivered a ‘Frequency Pattern’ test and a ‘Duration Pattern’ test.

Results

Normative test results are presented. Scores obtained by both tests were evaluated as percent scores for clinical study.

Conclusions

We adapted the computerised versions of the Frequency Pattern and Duration Pattern tests. Norm percent scores
were obtained. We are continuing development of a computerised test battery that will include “gaps in noise” and “dichotic
digits” tests using touch-screen protocols.
LEVELS OF MONOCYTE CHEMOATTRACTANT PROTEIN-1
DIFFER FROM THE NORM IN PATIENTS WITH SUDDEN
SENSORINEURAL HEARING LOSS
Authors: Haubner Frank , Martin Ludwig , Steffens Thomas , Rohrmeier Christian , Strutz Juergen , Kleinjung Tobias
Published: May 2021

Background

The aim of this study was to evaluate the role of cytokines and soluble adhesion molecules in patients with sudden sensorineural hearing loss (SSNHL) with respect to their pure-tone audiometry values.

Material and Methods

This study analyses blood samples of 51 patients with SSNHL. Serum levels of ICAM-1, VCAM-1,
E-selectin, IL-6, IL-8, and MCP-1 were evaluated by ELISA. Pure-tone audiometry data were compared before and after a systemic steroid treatment regimen. The subjects with SSNHL were compared to a control group of 44 patients with normal hearing and matching age and gender. The data complete our previous data collection.

Results

There is trend toward suppressed levels of MCP-1 in sera of SSNHL patients. There were no statistically significant
differences concerning ICAM-1, VCAM-1, E-selectin, IL-6, IL-8, and MCP-1 between SSNHL patients and controls. Puretone audiometry of the SSNHL group showed a significant improvement in hearing after systemic steroid therapy and a median follow-up of 4 months.

Conclusions

Further prospective studies are necessary to prove the role of MCP-1 and other cytokines in SSNHL in order
to develop adequate treatment regimens.
SINGLE TO MULTI-CHANNEL COCHLEAR REIMPLANTATION
AFTER 21 YEARS: CASE REPORT
Authors: Schnabl Johannes , Wolf-Magele Astrid , Koci Viktor , Schartinger Volker , Markl Andreas , Sprinzl Georg
Published: May 2021

Background

In the literature cochlear reimplantation is described as a possible surgical procedure and the change from a single to a multichannel device is associated with audiological improvement.

Material and Methods

A 47 year old male caucasian patient presented after cochlear implantation 21 years ago. Lacking any
benefit from the old single-channel implant over the last few years, the patient no longer used the device. The old cochlear
implant was changed for a modern multichannel unit.

Results

The patient showed a great improvement in hearing threshold and his quality of life with the new device.

Conclusions

This case justifies the reimplantation of patients who have been implanted more than 20 years ago.
PREPROCESSING STRATEGIES AND SPEECH PERCEPTION
IN COCHLEAR IMPLANT USERS
Authors: Yathiraj Asha , Rao Ashwini
Published: May 2021

Background

The aim of the study was to investigate whether noise reduction algorithms are beneficial for speech perception
in the presence of noise in children using cochlear implants. Further, the study also aimed to determine whether any difference in speech perception existed between different pre-processing strategies such as Adaptive Dynamic Range Optimization
(ADRO), Autosensitivity Control (ASC), and the two-stage adaptive beam-forming algorithm (Beam) in different signal-tonoise ratios (SNRs).

Material and Method

Speech identification scores of the participants were tested in quiet with the ‘Everyday’ default setting
activated. They were also tested using speech in noise at +5 dB and +10 dB SNR with ADRO, ASC, and Beam activated. Exactly 17 children using Nucleus cochlear implants for at least 1 year were tested.

Results

A significant difference was found between performance in quiet (in the ‘Everyday’ default setting) and in the presence of noise (with ADRO, ASC, and Beam). No significant difference was found between the 3 pre-processing strategies at
both SNRs and between the 2 SNRs for all 3 strategies.

Conclusions

In conditions where the signal and noise emerge from in front of the listener, no influence of the pre-processing strategies was seen.
SPEECH PERCEPTION ABILITIES IN INDIVIDUALS
WITH AUDITORY NEUROPATHY SPECTRUM DISORDER
WITH PRESERVED TEMPORAL SYNCHRONY
Authors: Chandan H. , Prabhu P.
Published: May 2021

Background

The auditory brainstem response (ABR) is usually abnormal in individuals with auditory neuropathy spectrum
disorder (ANSD). However, in some such individuals the ABR is preserved at low repetition rates. This study attempts to understand the speech perception abilities of ANSD individuals who have preserved temporal synchronicity.

Material and Methods

There were 149 individuals with ANSD in the study. They were classified into two groups based on
preserved or absent ABR. Speech identification scores (SISs) in these individuals in quiet and in the presence of noise were
compared.

Results

At low repetition rates some 12.5% of subjects had preserved ABR with low amplitude wave V. Of these, 81% had an
SIS of more than 50% in quiet. However, in patients with absent ABR, only 27% of individuals had an SIS of more than 50%.
For subjects who had preserved ABR the mean SIS was 73.1% in quiet and 36.5% in noise compared to 35.9% in quiet and
20.2% in noise for individuals who had absent ABR.

Conclusions

One in eight of the patients with ANSD had preserved ABR. Speech understanding was also better in quiet and
in the presence of noise in individuals with preserved ABR. We conclude that speech reception abilities depend upon neural
synchronicity at the level of the auditory nerve.
Cervical and ocular vestibular evoked myogenic
potentials in individuals with severe to profound
hearing loss
Authors: Bansal Shalini , Sahni Shruti , Sinha Sujeet
Published: May 2021

Background

Vestibular evoked myogenic potential (VEMP) is a test to assess the functioning of otolith organs of the inner
ear. Cervical VEMPs (cVEMPs) assess the saccule and the inferior vestibular nerve, whereas ocular VEMPs (oVEMPs) assess the utricle and superior vestibular nerve. In individuals with sensorineural hearing loss, disturbances of cochlear function could accompany vestibular impairment since both these parts of the inner ear are anatomically related. The aim of the
present study was to find out the prevalence of cVEMPs and oVEMPs in individuals with congenital severe to profound sensorineural hearing loss.

Material and Methods

There were 46 participants in the present study: 23 with normal hearing and 23 with bilateral severe
to profound hearing loss, and cVEMPs and oVEMPs were recorded from all of them.

Results

cVEMPs were present in 100% of subjects, both in the control and experimental groups; oVEMPs were present in
100% of the control and 66% of the experimental group. In hearing impaired individuals no correlation was found between
cVEMPs and oVEMPs, although a Mann-Whitney test revealed that the amplitude of cVEMPs and oVEMPs were significantly smaller in the hearing impaired group compared to normals.

Conclusions

The results indicate impairment of both utricular and saccular function in individuals with severe to profound
hearing loss. Also oVEMPs were absent in more individuals compared to cVEMPs, which suggests that utricular function is
more linked with the cochlea compared to that of the saccule.
Diagnostic Accuracy of High-Frequency DistortionProduct Otoacoustic Emission Screening of
Schoolchildren with Down Syndrome
Authors: Driscoll Carlie , Kei Joseph , Hearn Kate , Walsh Trina , Swann Sarah
Published: May 2021

Background

It has been suggested that children with Down syndrome (DS) may display high frequency hearing loss much
earlier than those in the general population. The purpose of this study was to investigate the diagnostic accuracy of high-frequency distortion-product otoacoustic emissions (HFDPOAEs) as a screening technique for schoolchildren with DS.

Material and Methods

Exactly 25 children with DS (15 males, 10 females, mean age =9.7 years, SD=2.6) were sampled from
six special education schools. HFDPOAE results were compared to the reference test results – high-frequency pure tone audiometry (HFPTA) at 8 and 10 kHz.

Results

Test performance was found to reach adequate levels (≥0.7) of accuracy for HFDPOAE SNR at 8 kHz and 10 kHz.
The hit rate at 8 kHz was average, but moderately high at 10 kHz. True negative rates and positive posterior probabilities for
the HFDPOAE test were high, and false alarm rates were acceptably low. However, the false negative rate was average at 8 kHz
and negative posterior probabilities were moderately high at both frequencies. Efficiency index values were high indicating
that a large proportion of HFDPOAE results were correct when compared with HFPTA results.

Conclusions

Initial findings support the potential future use of HFDPOAE for screening children with DS for high-frequency hearing loss.
ATROPHY OF THE LONG CRUS OF INCUS OF UNCLEAR
ETIOLOGY: CASE REPORT
Authors: Skarzynski Henryk , Plichta Lukasz
Published: May 2021

Background

Study presents the case of a 27-year-old man admitted to our clinic with unilateral stable hearing loss in the
right ear which had been present for about 10 years. Patient’s medical history did not suggest inflammatory or trauma-related etiology of hearing loss.

Material and Methods

Pure tone audiometry tests showed conductive hearing loss of 40 dB in right ear and normal hearing
in left ear. Exploratory tympanotomy revealed atrophy of the distal 2/3 of the long process of the incus, with an extant thin
strand of connective tissue joining the remnant of the long process of the incus with the stapes head. During reconstruction, the
missing part of the incus was rebuilt using glass ionomer cement, with this strand serving as a core of the reconstructed part.

Results

The missing part of the incus was successfully restored preserving the mobility of the ossicular chain. Pure tone audiometry performed at 1 and 12 months after surgery showed improved hearing in operated ear and closure of the air-bone gap.

Conclusions

There are rare cases presenting with ossicular damage without history of otitis media or head trauma in which
etiology is not possible to ascertain. Alloplastic reconstruction of atrophied elements using a glass ionomer cement is an effective treatment method producing lasting hearing improvement.
RELATION BETWEEN TWO SCORING PROCEDURES TO
ASSESS AUDITORY MEMORY AND SEQUENCING ABILITIES
Authors: Vaidyanath Ramya , Yathiraj Asha
Published: May 2021

Background

Tests to assess auditory memory are scored differently, but there is scanty information regarding the effect of
the scoring procedure.

Material and Method

The current retrospective study compared two scoring procedures for evaluating auditory memory in
189 children aged 5 to 11 years. One scoring procedure was the original memory technique used by Yathiraj and Vijayalakshmi. The other was a modification calculated using the same data obtained by Yathiraj and Vijayalakshmi. The original auditory memory and sequencing scoring procedure required the administration of the entire test, while the alternate scoring procedure, that calculated auditory memory and sequencing span, did not.

Results

A Pearson’s correlation coefficient between the two scoring procedure was calculated. Both scoring procedures showed
gradual improvement with age. A significant high correlation was found between the two scoring procedures when the age
groups were combined.

Conclusions

Since the two scoring procedures provide similar information, it is recommended that, for individuals with relatively poor auditory memory and sequencing abilities, the span should be the choice of scoring. This would avoid a sense
of failure when individuals are tested on the more difficult longer word-sequences. Additionally, it would make the test more
time efficient. However, if subtle changes in performance across ages are to be determined, the original scoring procedure is
recommended.
AIR- AND BONE-CONDUCTION VESTIBULAR EVOKED
MYOGENIC POTENTIALS IN CHRONIC SUPPURATIVE
OTITIS MEDIA, PRE- AND POST-OPERATIVELY
Authors: Shabana Mohamed , Dabbous Abeir , Khalifa Badawy , Humaid Asma
Published: May 2021

Background

Vestibular evoked myogenic potentials (VEMPs) are reflex myogenic potentials of the neck muscles elicited by
stimulating the vestibular system with a click or tone burst sound stimulus. VEMP responses depend on good energy transfer
of sound from the middle ear to the inner ear and are presumed absent in the presence of a conductive hearing loss (CHL) of
more than 20 dB air-bone gap (ABG). The aim of this study was to evaluate VEMPs in patients with chronic suppurative otitis media (CSOM) before and after surgery.

Material and Methods

T﻿he study was conducted on 20 patients with CSOM preoperatively and postoperatively and on 20
controls. Their ages ranged from 20 to 50 years. Each subject underwent history taking, otologic examination, basic audiological evaluation, and air- and bone-conducted VEMP testing.

Results

All perforated ears showed a lost air conduction VEMP response pre-operatively without any post-operative improvement. This can be attributed to the absence of any statistically significant differences between the pre-operative and post-operative ABGs at all tested frequencies. Bone conduction VEMP was preserved in all CSOM cases pre-operatively and post-operatively. There were no statistically significant differences between the air conduction and bone conduction VEMP parameters
in the controls except for a significantly smaller P13–N23 amplitude of bone conduction VEMP compared to air conduction
VEMP. There was no statistically significant differences between the pre-operative perforated ears of CSOM cases and their
controls regarding bone conduction P13, N23 latencies, or P13–N23 amplitude. There was a significantly delayed P13 latency and greater P13–N23 amplitude of bone conduction VEMP post-operatively compared to pre-operatively. But there was
no statistically significant difference between pre-operative and post-operative bone conduction N23 VEMP latency or interaural amplitude difference. Bone conduction VEMP results were pre-operatively affected by the ABG and bone conduction,
but not post-operatively.

Conclusions

Air conduction VEMP in patients with CSOM showed a zero-percent response rate pre-operatively that did not
change post-operatively, whereas bone conduction VEMP showed a 100% response rate pre- and post-operatively. We therefore recommend using bone rather than air conduction VEMP for assessment of the sacculo-collic reflex in patients with
CSOM who complain of balance problems.
MATURATION OF TEMPORAL PROCESSING IN CHILDREN:
MEASUREMENTS USING SPEECH AND NON-SPEECH
STIMULI
Authors: Jain Saransh , Vasudevamurthy Bhavana , Raghavendra Ashwini
Published: May 2021

Background

Auditory temporal processing is the ability of the nervous system to detect small variations in the duration of
an acoustic stimuli. A substantial body of research is available on the development of various temporal skills, but temporal
resolution abilities have not been well investigated in terms of speech and non-speech stimuli. The present study investigates
the development of temporal resolution abilities in children.

Material and Methods

A normative cross-sectional research design was adopted by administering a set of psychoacoustic
tests involving both speech and non-speech stimuli. Six groups of 20 children each, aged 6–12 years, with a 1-year interval between each age group, were tested and the results were compared with those of 20 adults.

Results

The results revealed generally poorer performance of children on the entire test battery. Temporal modulation transfer
function test scores, word recognition scores, and categorical perception of stop consonants matured by about 10–11 years of
age. Gap detection test and time compressed speech test results showed maturation at around 8–9 years of age, whereas temporal change detection continued to mature even for the second decade of life.

Conclusions

Overall, maturation of temporal processing skills is reached by 10–11 years of age. This information is relevant
when evaluating children with various processing disorders, and should also be considered when developing various assessment and rehabilitation protocols for children with special abilities.
SPEECH-EVOKED CORTICAL POTENTIALS IN NORMALHEARING CHILDREN AND ADULTS USING THREE PHONEMES
Authors: Kumar Prawin , Sanju Himanshu , Bohra Vaishnavi , Khanna Astha
Published: May 2021

Background

The neural representation of different speech stimuli (phonemes) can be measured at the cortex using electrophysiological techniques, a procedure called speech-evoked cortical potentials. Each phoneme produces cortical potentials
with different temporal and spectral properties. Latency and amplitude measures reflect changes in the way different phonemes are neurally represented, so these measures are expected to change with maturation of the system, that is with age. The
aim of the present study to investigate whether there were differences in latency and amplitude between children and adults
in response to the three phonemes /m/, /g/, and /t/.

Material and Methods

Exactly 10 normal-hearing children of age 5–7 years and 10 normal-hearing adults of age 17–24 years
were recruited. Speech-evoked cortical potential were recorded using the HEARLab (v.1.0) auditory evoked potential system.
Non-parametric statistics were used to compare both groups.

Results

Mann-Whitney U-tests shows statistically significant differences between children and adults for both the latency and
amplitude of wave P1 and N1 at the 0.05 level. At the same time, there were no significant differences between /m/, /g/, and
/t/ for children and adults at the same level when a Kruskal-Wallis test was applied.

Conclusions

The present study shows there are differences between children and adults in terms of the latency and amplitude
of their cortical potential responses, but the particular phoneme used does not appear to make a difference.
A REVIEW OF THE PERFORMANCE OF WIRELESS
SYNCHRONIZED HEARING AIDS
Authors: Geetha Chinnaraj , Rajan Ravindran , Tanniru Kishore
Published: May 2021

Some paired digital hearing aids use wireless technology to communicate with each other and generate improved binaural information. Coordination between the two ears makes it easier for the brain to identify sound sources and understand speech
even in complex environments. How well does this technology work. This article gives an evidence-based review.
NOVEL TRENDS IN THE MOLECULAR GENETICS OF HEARING
LOSS
Authors: Lechowicz Urszula , Pollak Agnieszka , Oldak Monika
Published: May 2021

Genetically determined hearing loss is a highly heterogeneous disorder, and to date the analysis of its causes has been conducted selectively, covering only individual genes. Breakthroughs associated with current technological advances have contributed to a rapid development in the molecular genetics of hearing loss. Here we review a number of novel and important
achievements in the field: application of next-generation sequencing, novel genes, and trends in molecular therapies for hearing loss. Current achievements in the molecular genetics of hearing loss are discussed in the context of previously published
results and data from our own studies.
CORRELATING TWO QUESTIONNAIRES: VESTIBULAR
ACTIVITIES AND PARTICIPATION (VAP) AND DIZZINESS
HANDICAP INVENTORY (DHI)
Authors: Sarda Sharda , Vanaja C.
Published: May 2021

Background

Dizziness is known to affect the quality of life, irrespective of its underlying pathology. The Dizziness Handicap
Inventory (DHI) is a commonly used questionnaire to assess self-perceived handicap among individuals with dizziness. However, the International Classification of Functioning, Disability and Health (ICF), emphasises the assessment of activity limitations and participation restrictions. A recently developed questionnaire, the Vestibular Activities and Participation (VAP),
is based on the ICF model and has been found to be a valid and reliable tool. The present study was undertaken to explore
which items of DHI relate to vestibular activity limitations and participation restrictions by investigating the correlations between items of DHI and VAP.

Material and Methods

This was a prospective study involving 56 individuals whose primary complaint was dizziness due to
vestibular pathology. All had undergone detailed audio-vestibular tests prior to administration of a Marathi translation of the
DHI and VAP questionnaires.

Results

12 of the 25 questions on the DHI showed strong and moderate correlations with the total VAP score (r=0.48–0.68,
p<0.05), while 8 questions showed significant but weak correlation (r=0.34–0.44, p<0.05), and 5 questions showed no correlation (r=0.27–0.29, p>0.05). The results indicate that less than half the 25 questions covering the physical, functional, or emotional domains of DHI reflect activity limitations or participation restriction in day-to-day life.

Conclusions

The results indicate that responses to only some of the items of DHI are important when studying activity limitations and participation restrictions of people with dizziness. These particular items may be a better indicator of the effect of dizziness on the quality of life, and hence could be most relevant when reporting post-therapeutic improvement in quality of life.
STAPEDOTOMY TO TREAT MIXED HEARING LOSS
IN OSTEOGENESIS IMPERFECTA: A CASE STUDY
Authors: Skarzynski Henryk , Osinska Kamila , Dziendziel Beata , Skarzynski Piotr
Published: May 2021

Background

Osteogenesis imperfecta is a congenital disorder underlain by an inherited deficiency of a connective tissue component. Different clinical symptoms related to various collagen mutations make it possible to distinguish several types of osteogenesis imperfecta. The most common four symptoms are defects of the osteoarticular system, sclera, skin, and hearing loss.

Case report

We report the case of a 60 year-old patient who was referred to the Institute of Physiology and Pathology of Hearing with bilateral progressive hearing loss, which she had first noted about 35 years ago. Based on clinical findings, the patient
was diagnosed with osteogenesis imperfecta. She had a history of multiple bone fractures, short stature, and minor teeth malformations. No genetic test results were available for this patient. Based on results of an examination and the character of the
hearing loss, the patient was referred for surgical treatment: explorative tympanotomy with bilateral reconstruction in stages. Both surgeries revealed fixation of the stapes and a thickened stapes footplate. Stapedotomies were performed in each ear.
Follow-up after surgeries included pure tone audiometries.

Results

Surgical intervention resulted in closure or reduction of the air-bone gap on both sides, demonstrating effectiveness
of the treatment.

Conclusions

In osteogenesis imperfecta hearing loss is a common comorbidity of anomalies in the osteoarticular system. A
thickened and fixated stapes footplate can contribute to conductive component of hearing loss. Exploratory tympanotomy with
stapedotomy is the method of choice in such cases. It allows the air-bone gap to be reduced and a subjective improvement of
hearing, to reach, as this report demonstrates.
RISK FACTORS AFFECTING HEARING IN NEONATAL
INTENSIVE CARE UNIT NEONATES
Authors: Nisotakis Emmanouil , Chalkiadakis Vasilios , Marangoudakis Pavlos , Tzagkaroulakis Antonios , Nikolopoulos Thomas
Published: May 2021

Background

Neonatal intensive care unit graduates are considered to be of higher risk for hearing impairment, either auditory neuropathy or hearing loss. In this study we examine the presence of risk factors and try to identify their effect on the
hearing of high-risk neonates.

Material and Methods

In this prospective cohort study we used automated auditory brainstem responses (a-ABRs) and
otoacoustic emissions (OAEs) to screen 453 neonatal intensive care unit neonates who had at least one risk factor for hearing impairment.

Results

In the initial examination, 382 (84.3%) infants passed and 71 (15.7%) failed a-ABRs. Out of those who failed, 39 newborns (55%) passed the transiently evoked otoacoustic emission (TEOAE) test, while 32 (45%) failed that test too. Re-examination was performed before their first month of age, eventually resulting in 8 newborns being diagnosed with possible hearing loss and 8 with possible auditory neuropathy. The overall dropout rate was 4.9%. Low birth-weight (p=0.016), as well as
craniofacial abnormalities (p=0.03) and TORCH (toxoplasmosis, rubella, cytomegalovirus, herpes) infections proved to have
a statistically significant correlation (p=0.05) with hearing impairment.

Conclusions

Because a significant number of children may have auditory neuropathy, ABRs and OAEs (both transiently evoked
and distortion product OAEs) remain the cornerstones of any universal hearing screening program in neonatal intensive care
units. An efficient tracking system is needed to reduce the number of neonates lost to follow-up. Low birth-weight, craniofacial
deformities, and congenital infections appear to be the most significant factors predisposing an infant to hearing impairment.
A REVIEW OF HEARING AID TELECONSULTATION
IN BRAZIL
Authors: Ferrari Deborah , Lopez Esteban
Published: May 2021

Since 1993, Brazil’s public Unified Health System (SUS) has been enhancing the provision of hearing healthcare services, ranging from prevention to intervention. The provision of quality services is challenged by the country’s large size, socio-economic contrasts, poorly distributed infrastructure, and the concentration of qualified audiology professionals in metropolitan areas. It is estimated that 14 million Brazilians have a disabling hearing impairment – a number already beyond service capacity. Increased life expectancy enlarges the prevalence of
hearing impairment, further saturating the system. Ongoing societal changes call for alternative approaches to healthcare – one of them being telehealth. This paper describes the milestones in the development of hearing healthcare public policies in Brazil and discusses the main
concepts behind the provision of services via telehealth and the implementation of the Brazilian Telehealth Networks Program. Furthermore,
the results and implications of research on remote hearing aid fitting, conducted at Bauru Dental School, are presented. This review indicates
that issues such as shortage of audiologists, lack of the use of real ear measures, and patient absenteeism could be mitigated by incorporating remote hearing aid fitting routinely in public hearing healthcare clinics. But in order to implement this approach, more constructive interactions among different stakeholders is required. Overall, telehealth has the potential to help healthcare providers meet the demands of a
technologically increasing society.
USE OF A COCHLEAR IMPLANT IN A PATIENT
WITH COGAN’S SYNDROME AND PROFOUND
SENSORINEURAL HEARING LOSS: A CASE STUDY
Authors: Pastuszak Andrzej , Skarzynski Henryk , Pastuszak Dorota , Oldak Monika , Skarzynski Piotr
Published: May 2021

Background

Cogan’s syndrome is a very rare autoimmune disease characterized by the coexistence of inflammatory lesions in the eyeball and
inner ear dysfunction. The symptoms of Cogan’s syndrome within the inner ear appear suddenly and resemble Meniere’s disease symptoms:
severe vertigo, nausea, vomiting, and usually bilateral, fluctuating sensorineural hearing loss with concomitant tinnitus.

Case report

A 59-year-old woman was admitted to the Otolaryngology Head and Neck Surgery Clinic to undergo cochlear implantation. At
57 years of age, the patient had been diagnosed with scleritis. About a year later, vertigo and nausea arose, followed by rapidly progressing
hearing loss – at first in the left ear and subsequently in the right, accompanied by tinnitus. At the time of implantation, the patient’s speech
discrimination score was 0% for both ears. Taking into consideration the audiometric tests results and imaging scans, promontorial cochleostomy was carried out during the cochlear implantation procedure. In the postoperative period, no complications were observed. After 24
months of using the speech processor, the subjective assessment of speech intelligibility given by the patient on a 0–10 scale was 8.5 in quiet and 5.0 in a noisy environment. The patient could identify 95% of monosyllabic words in silence and 35% in noise (in conditions of SNR
+10 dB, speech level at 70 dB HL, and noise level at 60 dB HL). The benefits obtained were confirmed by results of an Abbreviated Profile of
Hearing Aid Benefit (APHAB) questionnaire. The patient is presently eligible for cochlear implantation in the other ear.

Conclusions

Cochlear implantation was effective in improving hearing in a patient with Cogan’s syndrome.
OTOTOXICITY OF DRUGS USED IN THE TREATMENT OF COVID-19
Authors: Skarzynska Magdalena , Krol Bartłomiej , Czajka Natalia , Czajka Łukasz
Published: May 2021

Background

Actual level of knowledge of treatment of COVID-19 disease caused by a type of coronavirus is that the disease cannot at present be cured by targeted therapy. Worldwide research is aiming to find a specific treatment, such as a vaccine or drug, for this type of coronavirus; this may help improve the situation, but it is highly expensive and time-consuming. The purpose of this paper is to review drug therapies approved in different parts of the world to treat COVID-19 and draw attention to ototoxicity as one of the adverse side-effects.

Material and Methods

eview of current literature was done in the scientific databases PubMed, ResearchGate, GoogleScholar, and Science-Direct. Studies were reviewed with reference to the inclusion criteria, then graded to assess the internal and external validity, leaving 50 studies for review.

Results

According to scientific reports, possible antiviral pharmacological agents to treat COVID-19 consist of chloroquine, hydroxychloro-quine, azitromycine, oseltamivir, and tocilizumab. In some cases, certain combinations may lead to additive ototoxicity as an adverse effect. Ototoxicity may be manifested by sensory and nervous hearing loss, tinnitus, imbalance, and cochlear-mandibular symptoms, which are sometimes temporary but sometimes permanent.

Conclusions

Drug ototoxicity is well known as a cause of cochlear hearing loss, and so the use of new pharmacotherapy methods and drug combinations in the fight against the new coronavirus may have harmful effects. Ototoxicity needs to be taken into account.
DIFFICULTIES WITH MAGNETIC RESONANCE IMAGING IN PATIENTS WITH COCHLEAR IMPLANTS: A REVIEW
Authors: Włodarczyk Kinga , Skarżyński Piotr
Published: May 2021

Background

There are many patients with cochlear implants (CIs) who need to undergo an MRI examination. Due to recent develop-ments in science and medicine a CI is no longer a contraindication for an MRI.

Material and Methods

The review is based on scientific publications found in Google Scholar and PubMed databases.

Results

The problems with carrying out an MRI examination on a patient with a CI are the low quality of the image and possible head pain when the MRI machine is operating. Demagnetization or displacement of the CI magnet can also occur. Normally, special procedures are required, including removing all external parts of the implant system before the MRI, and bandaging of the head before the procedure. Implants compatible with new generation magnets exist and they allow an MRI to be performed without removing magnetic materials from the CI.

Conclusions

There are still many limitations in performing an MRI with CI patients; however the risk of implant damage can be significantly decreased. Patient comfort during the examination can also be increased.
OTOTOXICITY AS A SIDE-EFFECT OF DRUGS: LITERATURE REVIEW
Authors: Skarzynska Magdalena , Król Bartłomiej , Czajka Lukasz
Published: May 2021

Background

The first reports of drug ototoxicity were documented in the 1940s. Epidemiological data indicate that changes in audiometric image may affect several percent of patients taking ototoxic drugs. Ototoxicity is manifested by hearing loss and/or changes in the vestibular system. Knowledge of mechanisms responsible for ototoxic effects, as well as important physiological parameters of the human body, may be used as a basis for developing guidelines for the pharmacotherapy. The aim of this paper is to draw attention to the scale and nature of adverse effects of ototoxic drugs.

Material and Methods

The review of current literature included the databases PubMed, ResearchGate, GoogleScholar, and ScienceDirect. The studies were reviewed in relation to the inclusion criteria and subsequently evaluated for internal and external validity.

Results

According to the literature, pharmacotherapy using drugs with documented ototoxic potential may cause hearing loss and changes in the vestibular system. Depending on the drugs used, changes may be reversible or irreversible. Pathological changes involve hair cells in Corti's organ, stria vascularis, and cochlear potentials. The effect of drugs may cause dysfunction in psychophysical and psychosocial development, especially important for the pediatric population.

Conclusions

The ototoxicity of drugs is well known as a cause of cochlear hearing loss. Due to the nature of these substances and their use, more extensive monitoring of adverse reactions should be introduced, including in clinical trial protocols.
TEST-RETEST RELIABILITY OF VARIOUS PSYCHOACOUSTIC MEASURES USING THE MAXIMUM LIKELIHOOD PROCEDURE
Authors: Jain Chandni , Joshi Kirti
Published: May 2021

Objective

Psychoacoustic abilities include the perception of frequency, intensity, and the temporal parameters of sound, which are necessary for speech perception. These abilities can be measured using adaptive and non-adaptive procedures. The maximum likelihood procedure (MLP) is an adaptive psychophysical procedure that is usually utilized in psychoacoustic tasks. The present study aimed to assess the testretest reliability of various psychoacoustic measures assessed using the MLP toolbox implemented in Matlab.

Material and methods

A total of 20 participants with normal hearing sensitivity were selected for the study. The test–retest reliability of psychoacoustic measures was studied in terms of frequency difference limen, intensity difference limen, duration discrimination thresholds, gap detection thresholds, and modulation detection thresholds (4 Hz and 128 Hz). To check test–retest reliability all measures were assessed twice within a span of one day.

Results

The results showed no significant difference in the various psychoacoustic measures obtained across the two sessions. The reliability of each measure was tested using the intraclass correlation coefficient (ICC).The results indicated that the test-retest reliability of various psychoacoustic measures assessed using the MLP toolbox was fair to good.

Conclusions

It can be concluded that MLP is a reliable tool to assess various psychoacoustic abilities.
Quality of life after septoplasty
Authors: Dąbrowska-Bień Justyna , Skarżyński Piotr
Published: May 2021

Z uwagi na rosnącą świadomość społeczeństwa i większe wymagania odnośnie opieki zdrowotnej i zdrowia subiektywna ocena
jakości życia (ang. quality of life, QoL) stała się istotnym aspektem oceny wyników leczenia. Pacjenci są lepiej wyedukowani na
temat negatywnych konsekwencji chorób i często decydują się na dany zabieg chirurgiczny, kierując się chęcią poprawy jakości
życia. Zwiększa się zatem zapotrzebowanie na narzędzia, które pozwolą badać jakość życia i oceniać wyniki leczenia w sposób wystandaryzowany, cechujące się rzetelnością, trafnością i czułością. Artykuł ma na celu przegląd piśmiennictwa dotyczącego oceny
jakości życia po operacjach nosa. Operacje przegrody nosa to jedne z najczęściej wykonywanych procedur chirurgicznych przez
otorynolaryngologów na całym świecie. Od wielu lat publikowane były subiektywne oceny efektów tych operacji. W ostatniej dekadzie coraz częściej zaczęły pojawiać się w literaturze prace dotyczące jakości życia po operacjach nosa, w których do oceny tej
jakości posłużono się zwalidowanymi kwestionariuszami. Wcześniej oceny satysfakcji pacjenta dokonywano na podstawie badań
retrospektywnych z użyciem skali wizualno-analogowej. Do chwili obecnej brakuje badań prospektywnych, w których użyte zostałyby specyficzne dla danego schorzenia, zwalidowane kwestionariusze. Większość pacjentów po septoplastyce jest zadowolona z efektu operacji, jednakże istnieje także istotna grupa pacjentów, którzy są nieusatysfakcjonowani. Kwestionariusze oceniające
jakość życia dają możliwość wykrycia potencjalnych czynników wpływających na zadowolenie pacjenta i efekt końcowy leczenia
oraz identyfikacji podgrupy pacjentów, którzy nie będą mieli efektu z leczenia chirurgicznego.
The Implantable Bone Conduction Devices
– operating principles and indications
Authors: Ratuszniak Anna , Mrówka Maciej , Skarżyński Piotr , Skarżyński Henryk
Published: May 2021

Zdolność ludzkiego układu słuchowego do odbioru sygnałów akustycznych na drodze przewodnictwa kostnego nabiera specyficznego znaczenia w przypadku wad wrodzonych i nabytych ucha zewnętrznego i środkowego. W obecnym wówczas niedosłuchu typu
przewodzeniowego lub mieszanego postępowaniem mogą być różne postaci klasycznej rekonstrukcji układu przewodzącego ucha na
drodze chirurgicznej. Kiedy jednak możliwości te zostają wyczerpane lub nie przynoszą zadowalającego efektu słuchowego jedynym
sposobem na kompensowanie niedosłuchu pozostaje protezowanie na drodze przewodnictwa powietrznego lub kostnego. W przypadku braku możliwości lub przeciwwskazań do protezownia klasycznego na drodze przewodnictwa powietrznego do rozważenia
pozostaje zastosowanie urządzenia wykorzystującego kostne przewodnictwo dźwięków. Niniejsza praca opisuje kostną drogę odbioru dźwięków, wskazania i kryteria kwalifikacji do wszczepienia urządzeń na przewodnictwo kostne oraz przybliża budowę i zasadę
działania dostępnych rozwiązań.
Review of questionnaires used to assess quality
of life in deaf (hard of hearing) adults using
a cochlear implant
Authors: Rostkowska Joanna , Skarżyński Piotr
Published: May 2021

Celem artykułu jest przybliżenie zagadnienia jakości życia w naukach medycznych, przede wszystkim przegląd najczęściej stosowanych kwestionariuszy ogólnych i specyficznych przeznaczonych do badania jakości życia u osób dorosłych głuchych (niedosłyszących) korzystających z implantu ślimakowego (CI). Odzyskanie możliwości słyszenia ma pozytywny wpływ nie tylko na identyfikację dźwięków z otoczenia oraz rozumienie mowy, lecz także na zdrowie psychiczne oraz funkcjonowanie społeczne. Dlatego oprócz
metod audiologicznego pomiaru percepcji słuchowej konieczne jest stosowanie kwestionariuszy, dzięki którym można ocenić jakość
życia. Dopiero pomiar jakości życia związanej ze zdrowiem jest traktowany jako wskaźnik efektywności leczenia. Dodatkowo umożliwia określenie potrzeb pacjentów, a także ułatwia konstruowanie kompleksowych programów medyczno-terapeutycznych.
Vibrant Soundbridge system application
in the bilateral congenital malformation
of the middle and external ear in the child
Authors: Skarżyński Henryk , Osińska Kamila , Kwasiuk Marcin , Skarżyński Piotr
Published: May 2021

Wprowadzenie

Implant ucha środkowego Vibrant Soundbridge stosowany jest u pacjentów z różnymi rodzajami niedosłuchów –
z niedosłuchami odbiorczymi w stopniu od łagodnych do umiarkowanych, a także z niedosłuchami mieszanymi i przewodzeniowymi. System ten stosuje się w przypadku wad wrodzonych ucha zewnętrznego i środkowego, kiedy to brak bądź zarośnięcie przewodu
słuchowego zewnętrznego oraz zmienione warunki anatomiczne ucha środkowego stanowią duże ograniczenie w wyborze metody
leczenia niedosłuchu. Rozwiązaniem proponowanym w takich przypadkach może być system Vibrant Soundbridge, którego przetwornik FMT (ang. Floating Mass Transducer) może być przytwierdzony do różnych struktur ucha środkowego. Od niedawna jest
dostępny nowy typ łącznika – coupler typu SP, który pozwala na zastosowanie bezklipsowego FMT przymocowanego do konglomeratu kosteczek słuchowych.

Materiał i metody

Opis przypadku dotyczy 11-letniej pacjentki z obustronnym niedosłuchem przewodzeniowym, z obustronną mikrocją i atrezją przewodów słuchowych zewnętrznych. Pacjentka w przeszłości została wielokrotnie poddana operacjom rekonstrukcyjnym przewodów słuchowych zewnętrznych. Efekty tych zabiegów były krótkotrwałe. W związku z brakiem skuteczności dotychczasowego leczenia zdecydowano o wszczepieniu implantów typu Vibrant Soundbridge. Podczas implantacji wykorzystano różne punkty
zaczepu przetwornika FMT. W czasie pierwszej operacji – w uchu prawym – przytwierdzono przetwornik do odnogi przedniej strzemiączka. Z kolei w trakcie drugiego zabiegu – w uchu lewym – zastosowano zaczep typu SP – na odnogę krótką kowadełka. Jako ewaluację zastosowanej metody leczenia wykonano audiometrię tonalną przed implantacjami i po nich, audiometrię progową i słowną
w wolnym polu z urządzeniami i bez nich oraz przeprowadzono ankietę APHAB, oceniając korzyści słuchowe pacjenta z implantów.

Wyniki

Stwierdzona u pacjentki poprawa rozumienia mowy oraz subiektywna poprawa funkcjonowania na co dzień dzięki użytkowaniu systemu wskazują na prawidłowość wykonania zróżnicowanych mocowań przetworników FMT oraz korzyści słuchowe z użytkowania systemu VSB.

Wnioski

Niniejszy opis przypadku wskazuje na podobną skuteczność mocowania systemu Vibrant Soundbridge za pomocą zaczepu
na odnogę krótką kowadełka, zostosowanego w leczeniu niedosłuchu spowodowanego wadą wrodzoną ucha środkowego, jak wcześniej stosowane metody. Nowe mocowanie przetwornika pozwala na jeszcze większą elastyczność chirurgiczną w przypadku zmienionych warunków anatomicznych ucha środkowego.
Cochlear implantation as a treatment of hearing
loss in MELAS syndrome
Authors: Skarżyński Henryk , Osińska Kamila , Skarżyński Piotr
Published: May 2021

Zespół MELAS to genetycznie uwarunkowany defekt w obrębie mitochondrialnego DNA. Objawy chorobowe dotyczą narządów
o znacznym zapotrzebowaniu tlenowym – m.in. mózgowia, narządów wydzielania wewnętrznego, mięśni oraz narządów zmysłów,
w tym narządu słuchu. Niniejszy opis przypadku dotyczy 29-letniej pacjentki z postępującym, obustronnym niedosłuchem i miopatią
w wywiadzie. U pacjentki stwierdzono obustronny głęboki niedosłuch odbiorczy i zakwalifikowano do wszczepienia implantu ślimakowego. Pacjentce wszczepiono implant do ucha prawego, a po kilku latach również do ucha lewego. W ramach ewaluacji zastosowanej metody przeanalizowano wyniki audiometrii słownej w wolnym polu. Znaczna poprawa rozumienia mowy zarówno w ciszy, jak
i w szumie wskazuje na skuteczność zastosowanej metody kompensowania niedosłuchu u pacjenta z zespołem MELAS i obustronnym głębokim niedosłuchem odbiorczym.