bluuebunny/crossref_metadata_2025 huggingface dataset:
AUDITORY BRAINSTEM IMPLANTATION AS AN OPTION TO IMPROVE HEARING AND REDUCE TINNITUS: A RETROSPECTIVE STUDY OF FOUR CASES
Authors: Pinkas Wojciech , Rajchel Joanna , Dziendziel Beata , Lorens Artur , Skarzynski Piotr , Skarzynski Henryk
Published: May 2021

Background

Auditory brainstem implantation (ABI) is a modern method of treating hearing impairment, directed especially to patients with neurofibromatosis type 2 (NF2). One of the co-occurring symptoms in these patients is tinnitus; however, little is known about its prevalence and severity. This study evaluated the self-reported hearing ability, hearing-related quality of life, and tinnitus severity in 4 adult ABI users.

Material and Methods

The study was a retrospective design. A series of 6 patients who underwent ABI in a single tertiary referral center were asked to fill in two sets of questionnaires referring to their pre- and postoperative experiences. The Abbreviated Profile of Hearing Aid Benefit (APHAB) was used to evaluate self-perceived hearing ability and Nijmegen Cochlear Implant Questionnaire (NCIQ) to assess

Results

Of the 6 patients who initially agreed to participate, 4 returned questionnaires. Based on the self-reported results, it was found that each patient noticed an improvement in hearing ability (mean improvement in APHAB score of M = 25; SD = 27), which was greatest in background noise conditions. A considerable improvement was also noted in the patients’ hearing-related quality of life (mean improvement in NCIQ score of M = 38; SD = 13), which was most pronounced for basic and advanced sound perception. Tinnitus disappeared completely in two patients and was reduced in one patient (mean improvement in THI score for these patients of M = 25; SD = 21). An increase in tinnitus severity from 26 to 84 points in THI was observed in the remaining patient, who had the greatest intensity of NF2 symptoms in the postoperative period and reported the smallest benefits with ABI.

Conclusions

Brainstem implantation has the potential to improve self-reported hearing ability, hearing-related quality of life, and reduce tinnitus in NF2 patients. However, more prospective studies are needed to confirm and further explore this potential.
CONDUCTIVE HEARING LOSS WITHIN
UNIVERSAL NEWBORN HEARING SCREENING
PROGRAMS: A SYSTEMATIC REVIEW
Authors: Collins Alison , Beswick Rachael , Driscoll Carlie , Kei Joseph
Published: May 2021

Background

Universal Newborn Hearing Screening (UNHS) attempts to identify children with a permanent, bilateral, moderate or greater hearing loss at birth. However, children who are referred from UNHS programs may have conductive hearing loss (CHL), sensorineural, or mixed hearing loss. The aim of this review was to investigate the prevalence, sub-classifications, audiological diagnosis, and medical
management of CHL within UNHS programs.

Material and Methods

A systematic literature search was completed in the scientific databases PubMed, CINAHL, and Embase. Studies
were reviewed with reference to the inclusion criteria, then graded to assess the internal and external validity, leaving 25 studies for review.

Results

The prevalence of conductive hearing loss ranged from 0.4% to 64.5%. ‘Genetic’ and ‘Permanent’ were the only two sub-classifications of CHL identified, with no uniform terminology evident. Given CHL is not a target condition of UNHS, audiological assessment was
consistent with the diagnosis of Permanent Childhood Hearing Loss (PCHL). There was little evidence of audiological review, onward referrals, or medical management for CHL within UNHS programs. Of the evidence obtained, no alternative pathway was found for children
identified with CHL through UNHS.

Conclusions

In view of the limited evidence for CHL within UNHS, further investigation into the prevalence, sub-classification, and appropriate
management of CHL within a UNHS program is recommended to better guide evidence-based assessment and management of these children.
HOW DO MIDDLE EAR MUSCLES PROTECT THE COCHLEA? RECONSIDERATION OF THE INTRALABYRINTHINE PRESSURE THEORY
Authors: Bell Andrew
Published: May 2021

The middle ear muscles are part of a control system for regulating the acoustic input to a supersensitive detector, the cochlea, preventing overload and damage. Yet there is a long-standing paradox. When Békésy measured sound transmission through the middle ear of cadavers, he found that acoustic transmission was not affected when the annular ligament was stretched by pressure. Similarly, reflex activation experiments often show only a few decibels of attenuation, assumed to be due to stiffening of middle ear joints and ligaments. In contrast, psychophysical experiments reveal attenuations of 30 dB or more when the middle ear muscles are voluntarily contracted. How can the difference be explained? This synthesis paper shows how the paradox can be resolved by reconsidering a theory put forward by Gellé in the 19th century. According to Gellé’s intralabyrinthine pressure theory, which has long been dismissed, the purpose of the middle ear muscles is to press the stapes inwards and raise the hydraulic pressure in the labyrinthine fluids, thereby regulating cochlear sensitivity. The focus of this review is to revisit the theory and show how it can explain a range of audiological findings. The theory is updated and the hypothesis made that static pressure in the cochlear fluids is sensed by the outer hair cells, which are in continuous hydraulic connection with the stapes. It is this factor which reduces the gain of the cochlear amplifier and provides rapid and effective overload protection. The case is made that the intralabyrinthine pressure theory deserves renewed attention.
FACTORS INFLUENCING THE SUCCESS OF
CHOLESTEATOMA SURGERY: A POSTOPERATIVE REVIEW
Authors: Stankovic Milan , Stankovic Petar
Published: May 2021

Objective

To review the audiological results of patients surgically treated for cholesteatoma.

Patients and Methods

A retrospective study of patients operated for acquired middle ear cholesteatoma during the period
1990–2002 was performed. A total of 758 patients were followed in the short term and 611 patients in the long term. Localization of cholesteatoma was classified as attic, sinus, or tensa. Closed tympanoplasty was performed as the single procedure
of choice on all the children, and reoperation or conversion to open tympanoplasty was made later if needed. Adult patients
were treated with single classical canal wall up (CWU), or wall down (CWD), according to the propagation of disease and condition of the middle ear. Preoperative and postoperative air-bone gap (ABG), and pure tone average (PTA), were compared.

Results

Considering all the patients, hearing improvement (reduction of ABG) amounted to 20 dB in the short term and 18
dB over the long term. Preoperative hearing level was significantly worse for the CWD than for the intact canal wall (ICW)
technique. The ABG closure was much better in the group with attic cholesteatoma. Revision operations and bilateral cholesteatoma gave worse total postoperative hearing. Damage of auditory ossicles correlated well with total preoperative and postoperative results.

Conclusions

The audiological results of cholesteatoma surgery are preserved during long-term follow-up. Poorer preoperative hearing level, CWD tympanoplasty, bilateral cholesteatoma, and ossicular damage, as well as revision surgery, were associated with reduced gains in hearing with surgical management.
ACUTE RHINOSINUSITIS DURING THE SWIMMING SEASON
– ETIOPATHOGENESIS, DIAGNOSTIC APPROACHES AND
TREATMENT
Authors: Pukhlik Sergiy , Melnicov Oleg , Shchelkunov Anatoly , Titarenko Olga
Published: May 2021

Background

A significant increase of acute rhinosinusitis, mainly maxilloethmoiditis, occurs during the summer season in
Ukrainian resort areas, particularly in Odessa.

Material and Methods

106 patients with acute “bathing” rhinosinusitis (ABRS) were examined in terms of microbiology, immunology, and allergy during 3 summers (2008–2010). The control group consisted of 51 patients who developed acute purulent rhinosinusitis during the “nonbathing” season.

Results

In the case of ABRS, fungi and mycotoxins were found to damage the mucous membranes of the nose and paranasal
sinuses, making ABRS aggressive and fast. It occurred against a background of lowered immunity and sensitization.

Conclusions

Traditional therapy for ABRS can quickly eliminate inflammation, but sensitization to mold remains high, leaving the possibility of re-development of inflammation. Incorporation of interferon inducers and anti-allergy agents substantially improves clinical and immunological indices of treatment efficacy
NEW SOLUTIONS FOR HIGH-FREQUENCY HEARING
IMPAIRMENT
Authors: McDermott Hugh
Published: May 2021

The common observation that hearing impairment tends to affect sound perception at high frequencies more than at lower
ones has led recently to the development and evaluation of a number of innovative signal-processing techniques. These include frequency-lowering schemes that aim to provide improved audibility and discriminability of sound components by shifting them into a frequency range where the listener has less impairment. For people who have usable low-frequency hearing,
but insufficient high-frequency hearing for effective use of a frequency-lowering hearing instrument, cochlear implantation is
rapidly becoming a well-accepted option. The use of a cochlear implant, in combination with an acoustic hearing aid either in
the implanted ear or the opposite ear, can provide large perceptual benefits, especially for understanding speech in noise and
for listening to music. Selecting and fitting the most appropriate configuration of hearing devices is critical in maximising the
perceptual benefits for both children and adults with severe high-frequency hearing impairment.
EFFECT OF SENSORINEURAL HEARING LOSS ON
THE TIME-COMPRESSED SPEECH TEST
Authors: Castro Franz , Carballo Gonzalez Ana , del Carmen Rodriguez Jimenez Maria , Lascarro Maria , Cosials Silvia , Barajas de Prat Jose
Published: May 2021

Background

The comprehension of spoken language is based on the analysis of complex acoustic signals by the central auditory system. Cognitive declines and deficits in speech understanding are seen in aged individuals and also in the
hearing impaired. The Time-Compressed Speech Test is a low redundancy central auditory processing test that evaluates
the closure ability to recognise degraded acoustic speech, words, or sentences.

Material and Methods

In this work, we evaluated the difficulties in understanding compressed speech. Volunteer patients, both with normal hearing and with hearing loss, took part in the experiments. Also a group of hearing aid users
were included. The stimuli consisted of speech words that were either unmodified in duration or time-compressed and
presented at the most comfortable level.

Results

An inverse relationship was seen between the compression ratio and the capacity to identify correctly the words
presented. Compressed words were worse perceived by hearing-aid users than by patients with flat audiograms and with
a high-frequency hearing loss.

Conclusions

In patients with a flat audiogram, a deficit in the mechanism of temporal resolution exists. Furthermore, hearing aids facilitate the audibility of sound even though they do not act efficiently with speech at high ratios of presentation.
PERSISTENT UPPER RESPIRATORY DISEASES IN CHILDREN:
ROLE OF GASTROESOPHAGEAL REFLUX STUDIED USING
INTRALUMINAL IMPEDANCE AND PH
Authors: Cudejko Renata , Dziekiewicz Marcin , Banaszkiewicz Aleksandra , Skarzynski Henryk , Radzikowski Andrzej
Published: May 2021

Background

A variety of signs and symptoms of otolaryngological complaints have been attributed to gastroesophageal reflux disease (GERD). However, proof of such an association is spare. Recent studies suggest that in some cases GERD may be
connected with upper respiratory diseases in children, and this paper explores the connection. The aim of the study was to
estimate the incidence of GERD among children with persistent upper respiratory disease by inserting an electrode into the
esophagus. Reflux can be detected as changes in intraluminal resistance brought on by liquid inside the esophagus, and pH
measurements can be used to classify the reflux as acidic or nonacidic.

Material and Methods

This was a multicenter, prospective study of children (4–11.5 years old) with persistent upper respiratory disease. Chronic diseases such as allergy, asthma, cystic fibrosis, or congenital anomalies were excluded. The diagnosis
of chronic upper tract disease was made by a single laryngologist. All children underwent a 24-hour multichannel intraluminal impedance and pH (MII–pH) study. The diagnosis of GERD was made with BioVIEW analysis software after manual review by a single investigator.

Results

Exactly 31 consecutive patients (17 boys, 14 girls, mean age 6.8 years) were enrolled in the study. A diagnosis of GERD
was made in 11/31 (35%) patients. A total of 1172 reflux episodes were detected by MII–pH, and 759 (65%) of them were acid,
413 (35%) were nonacid. The most common symptoms were mouth breathing (28/31), snoring (22/31), fetor ex ore (13/31),
hawking (4/11), and apnea (2/11). None of the patients declared gastroenterological symptoms of GERD.

Conclusions

The incidence of GERD in children with persistent upper respiratory diseases was high (35%) in our group, but
not as high as has been previously assessed. More than 1/3 of reflux episodes were non-acid. Reflux should be taken into consideration as a probable etiology of persistent upper respiratory diseases in children. 24-h pH and impedance monitoring is a
more precise way of diagnosing GERD than classic pH-metry
SURGICAL TECHNIQUES IN PARTIAL DEAFNESS TREATMENT
Authors: Skarzynski Henryk , Matusiak Monika , Piotrowska Anna , Skarzynski Piotr
Published: May 2021

Background

To maximise the success of cochlear implantation, optimal placement of the electrodes inside the cochlea is required. Hearing preservation also means that intracochlear spaces must be approached in a way that avoids traumatising inner ear structures.

Material and Methods

In order to examine this issue a literature search was performed targeting articles on surgical techniques
used in partial deafness cochlear implantation. The aim was to evaluate the advantages and shortcomings of each technique.

Results

In cochlear implantation two main approaches to the middle ear have been described: mastoidectomy/posterior tympanostomy and suprameatal. Two approaches to the inner ear are in use: cochleostomy and round window.

Conclusions

From temporal bone studies and clinical work some general conclusion can be drawn: straight arrays should use
round window insertion, and precurved arrays should use cochleostomy
BILATERAL OTITIS MEDIA AND UNILATERAL
SENSORINEURAL HEARING LOSS AS THE FIRST SIGNS OF
WEGENER’S GRANULOMATOSIS
Authors: Korres George , Maragkoudakis Pavlos , Kousoulis Panagiotis , Nikolopoulos Thomas
Published: May 2021

Background

Wegener’s granulomatosis (WG) is a rare disease characterised by blood vessel inflammation. Due to its endorgan damage it is life threatening, primarily affecting the upper and lower respiratory tract (nose, sinuses, trachea, lungs)
and the kidneys.

Materials, Methods, Results

In this paper we describe the case of a 46-year-old woman who within one year developed bilateral otitis media and unilateral sensorineural hearing loss as the first clinical manifestations of Wegener’s granulomatosis.

Conclusions

Even though bilateral otitis media is not a rare condition, in some cases it can be associated with a systemic disease. Suspicion of such a diagnosis should be reinforced when sensorineural hearing loss is present and the history of chronic
otitis media is short. In the absence of other typical findings, the role of the otorhinolaryngologist is very important and any
case with such symptoms should be thoroughly investigated.
TEST OF MODIFIED ULTRA-HIGH MOLECULAR WEIGHT
POLYETHYLENE FOR PROSTHETIC REPAIR OF THE
OSSICULAR CHAIN
Authors: Khorov Oleg , Struk Vasily , Novasialetski Uladzimir
Published: May 2021

Background

Our aim was to evaluate the effect of implantation of a surface-modified ultra-high molecular weight polyethylene (UHMWPE) of high density into a rabbit ear’s bulla in terms of biochemical and immunological blood parameters and
middle ear tissue morphology.

Material and Methods

Exactly 35 rabbits were used, divided into 3 groups. In the 1st group the ears were implanted with a
piece of UHMWPE 6 mm long and 1 mm in diameter the surface of which had been modified with a laser. In the 2nd group
similar titanium implants were used. The 3rd group was a control (5 rabbits). The 1st and 2nd groups comprised 15 animals
which were euthanased 15, 60, and 90 days after implantation (5 animals each).

Results

Comparison of the two experimental groups with the control group revealed no significant differences in biochemical and immunological blood parameters or tissue morphology in the middle ear at different times after surgery

Conclusions

UHMWPE of high density can be regarded as a material suitable for developing prostheses for the ossicular chain.
CLINICAL STUDY OF AIDED CORTICAL AUDITORY EVOKED
POTENTIALS IN PEDIATRIC AUDITORY BRAINSTEM
IMPLANTEES
Authors: Sampathkumar Raghunandhan , Kameswaran Mohan , Sharma Prashant , Rajeswaran Ranjith , Reddy Chandrashekar
Published: May 2021

Background

Cortical auditory evoked potentials (CAEPs) reflect the function of the auditory thalamo-cortical pathways and
the auditory cortex, and so are a window to the ‘auditory brain’. They are a valuable prognosticator for predicting long-term
outcomes in cochlear implantees. This preliminary study evaluated its use in pediatric auditory brainstem implant (ABI) who
had bilateral Michel’s deformity with cochlear nerve hypoplasia.

Objectives

To profile the aided CAEPs in children with ABI and to assess its efficacy as a tool for evaluating ABI outcomes.

Method

This prospective clinical study was performed in 3 pre-lingually deaf, non-syndromic children (aged 3–5 yrs) who
had congenital bilateral hypoplastic cochlear nerves with Michel’s cochlear deformity who underwent ABI at our institute.
All implantees underwent CAEP testing at 6 months and 1 year post-implantation and their results were compared. To compare responses between the various electrodes in contact with the brainstem the 12 ABI electrodes were divided into 4 groups
(G1–G4). These groups were sequentially activated and the CAEPs recorded; the responses were compared to the overall CAEP
response obtained by stimulating the entire electrode array. Testing comprised /m/, /g/, and /t/ acoustic stimuli and responses to them were recorded from each group of electrodes. Latency of P1, amplitude of P1 complex, and morphology of the responses were analyzed.

Conclusions

Results from our preliminary study showed that CAEP can be successfully recorded in ABI, and CAEP profiling can be an objective method of analyzing the optimal placement and function of the ABI electrodes on the brainstem.
Thus CAEP is an efficient adjunct to electrically evoked auditory brainstem response (EABR) for testing ABIs. When stimulated via the ABI, CAEP may reflect re-organization of higher auditory centers and hence may be a good prognosticator for
long-term assessment of ABI performance.
SIZE DISCRIMINATION OF TRANSIENT SOUNDS:
PERCEPTION AND MODELLING
Authors: O’Meara Niamh , Bleeck Stefan
Published: May 2021

Humans are able to get an impression of the size of an object by hearing it resonate. While this ability is well described for periodic speech sounds we investigate here the ability to discriminate the size of non-periodic transient impact sounds. Three
experiments were performed on normal listeners (n=19) to investigate the importance of the spectral cue in different frequency regions. Recordings from pulse resonance sounds made by a metal ball hitting polystyrene spheres of 5 different sizes were used in the experiments. Recordings were manipulated in order to show that the same cues used in speaker size discrimination are used for transient signals. Results show that the most prominent resonances are the most important cue, but
frequencies above 8 kHz also contribute. The results are explained by physiologically inspired model of size discrimination
that is based on the Auditory Image Model, and its key part is the Mellin transform. The model can predict which of two objects is bigger. We conclude that similar cues that are used for speaker size discrimination are important for transient sounds.
CENTRAL AUDITORY PROCESSES PREDICT READING
ABILITIES OF CHILDREN WITH DEVELOPMENTAL DYSLEXIA
Authors: Lewandowska Monika , Ganc Malgorzata , Wlodarczyk Elzbieta , Senderski Andrzej , McPherson David , Bednarek Dorota , Skarzynski Henryk
Published: May 2021

Background

In this paper we showed predictive relationships between central auditory processes, phonological abilities, and
reading abilities in children diagnosed with developmental dyslexia (DD). Both empirical data and theoretical approaches indicate that central auditory processing deficits may contribute to developmental dyslexia; however, associations between reading and phonological skills and central auditory processes remain unclear.

Material and Methods

Exactly 57 children with dyslexia and 40 age- and gender-matched normal reading children performed
reading, phonological, and auditory information processing tests, i.e. the Frequency Pattern Test (FPT), Dichotic Digit Test
(DDT), and Gap Detection Test (GDT).

Results

Dyslexic children showed parallel reading, phonological, and auditory information processing deficits. Principal component analysis, performed in dyslexic and normal reading children to reduce the data set before exploring the predictors
of language skills, revealed three factors: 1) ‘Auditory processing’, which received high loadings from phonological, FPT, and
DDT for the right ear; 2) ‘Age and Cognition’, including chronological age as well as measures of fluid intelligence and auditory working memory span; and 3) ‘Dichotic listening’ for the left ear. All three factors together best predicted reading regular words in children diagnosed with DD, while ‘Auditory processing’ and ‘Age and cognition’ together explained most of the
variance while predicting pseudo-word reading.

Conclusions

The present study indicates that frequency pattern recognition, dichotic listening for the right year, and phonological awareness are strongly interrelated and constitute the most significant predictor of reading abilities in children diagnosed with dyslexia. The results may have important implications for diagnosis and therapy of language disorders.
BEHAVIORAL ASSESSMENT OF CHILDREN AT RISK OF
CENTRAL AUDITORY PROCESSING DISORDER WITHOUT
READING DEFICITS
Authors: Kumar Prawin , Singh Niraj , Ghosh Vipin
Published: May 2021

Background

Auditory processing abilities in children with dyslexia and reading disabilities have been widely studied using
various behavioral and electrophysiological measures. However explorations in children with (C)APD without reading disability are lacking, and the present study was designed to fill that gap.

Material and Methods

The study comprised an experimental group and a control group, the former having 15 children at risk
of (C)APD without reading difficulties and the latter 15 typically developing children. Behavioral tests for (C)APD were administered to participants in both groups, and included the gap detection test (GDT), pitch pattern test (PPT), dichotic consonant vowel test (DCV), speech perception in noise (SPIN), and masking level difference (MLD) test.

Results

Children who were at risk of (C)APD without reading deficit displayed higher thresholds in GDT and gained poorer scores on PPT as well as SPIN when compared to the group of typically developing children. However, the performance on
MLD and DCV were comparable between the groups.

Conclusions

The present study suggests a combination of GDT, PPT, and SPIN as a possible sensitive tool in clinics for indicating central auditory deficits in children at risk of (C)APD without reading deficits. DCV and MLD were not sensitive.
Perception of the size and shape of resonant
objects
Authors: Bleeck Stefan , O’Meara Niamh
Published: May 2021

Background

We investigated the ability of naïve, untrained listeners to identify the physical parameters of 3D polystyrene objects from listening to single impulse sounds generated by an impact collision. We were specifically interested in the perception of object shape and object size and their interaction.

Material and Methods

Twenty polystyrene objects of various shapes (spheres, hearts, cubes, eggs, rings, and cones) and sizes (between 64 cm3
and 2278 cm3
) were used in three experiments investigating size and shape perception. In the first experiment, the task was to identify the ‘odd one out’ of three sounds originating from objects of different shape or size. In the second experiment the task was to identify the shape and size of an object just by listening to it. In the third experiment the task
was to rate how similar two sounds were.

Results

Results show that listeners were able, to a degree, to identify the size and shape of objects without reference and in
relation to each other. Multidimensional scaling suggests that shape (most salient) and size (second most salient) are the predominant perceptual dimensions.

Conclusions

We conclude that humans, to some degree and without training and without prior experience, have the ability
to infer the physical properties of object size and shape by listening to single impulse sounds. Size and shape seem to be independent and are the most salient parameters.
AUDITORY BRAINSTEM RESPONSES IN HIGH-RISK
NEONATES: 3 YEARS’ EXPERIENCE AT AN ITALIAN HOSPITAL
Authors: Giordano Pietro , Ortore R. , D’Ecclesia A. , Cavalluzzo F. , Loria E. , Vigliaroli C. , Cocchi R.
Published: May 2021

Background

The World Health Organization (WHO) reported in 2013 that approximately 360 million people have disabling
hearing loss, of which 32 million are children. A major consequence of hearing loss is a disability in communication: development of spoken language is often delayed in children with hearing loss, or absent in total deafness. Such children can benefit
from a range of interventions such as hearing aids, cochlear implants, and educational and social support. Hearing screening
can prevent the most severe consequences of hearing loss, but it is preferable first to consider populations with a high probability of developing hearing impairment. The present study assessed the incidence of hearing impairment through ABR in infants at high risk at Casa Sollievo della Sofferenza Hospital in southern Italy.

Material and Methods

The paper reports the results of auditory brain stem response (ABR) testing over a period of 3 years on
infants born with a history of infantile respiratory distress syndrome (IRDS), otoacoustic emission failure at hearing screening, low birth-weight (<1800 g), family history of deafness, hyperbiluribinemia, premature birth, congenital infection (cytomegalovirus), or craniofacial anomalies.

Results

Of 549 infants tested, 469 (85.4%) showed normal hearing, 51 (9.3%) suffered mild hearing impairment, 6 (1.1%)
had moderate hearing impairment, 8 (1.5%) had severe hearing loss, and 15 (2.7%) failed to show any response at maximum
intensity levels in both ears. For the hearing loss categories, the most important risk factors were found to be (in order of importance): craniofacial malformation, CMV infection, and familial factors.

Conclusions

ABR is an important clinical tool in the identification and quantification of hearing impairment. In neonatal
screening it is preferable first to consider populations with a high probability of developing hearing losses.
OUTCOMES FOR PATIENTS WITH SLOPING HEARING LOSS
GIVEN STANDARD COCHLEAR IMPLANTS
Authors: Moran Michelle , Dowell Richard , Umansky Arielle , Briggs Robert , Corbett Susannah
Published: May 2021

Background

This study examined the speech perception outcomes for postlingually deafened adults using cochlear implants
who preoperatively had steeply sloping hearing loss and in whom there was no attempt at electroacoustic stimulation. The
aims were firstly to determine whether patients with sloping loss (SL) who received a standard-length cochlear implant electrode would show significant benefit; and secondly to compare the degree of benefit to a matched group of cochlear implant
users with preoperative profound hearing loss.

Material and Methods

A retrospective analysis of pre- and post-implant speech perception scores of 27 adults with sloping
hearing loss and a matched group of 27 adults with profound hearing loss was conducted. Matching was based on age at implant and duration of loss. All were implanted with a Nucleus Freedom (CA) or a Nucleus 5 implant.

Results

Postoperative open-set speech perception testing demonstrated significant improvement compared to pre-implant for
both groups. Speech perception outcomes were better in the SL group; however, there was no significant difference between
the groups in the degree of improvement pre- to post-operatively under either the condition of implant alone or binaurally.

Conclusions

This study demonstrates that postlingually deafened adults with sloping hearing loss have the potential to gain
significant benefit from cochlear implants, and achieve equivalent improvement in speech perception to implant recipients
with profound loss. The results achieved in this group, without any attempt at hearing preservation, support the use of newer
standard-length electrodes for both hearing preservation and optimal electric stimulation in patients with sloping hearing loss.
COCHLEAR IMPLANTATION IN CONGENITALLY DEAF
CHILDREN WITH ISOLATED LARGE VESTIBULAR AQUEDUCT:
A SURGEON’S PERSPECTIVE
Authors: Pradhananga Rabindra , Thomas John , Natarajan Kiran , Sampathkumar Raghunandhan , Kameswaran Mohan
Published: May 2021

Background

The vestibular aqueduct is a bony canal containing the endolymphatic duct. Its average diameter is 0.6 to 1.5 mm
at its midpoint between the crus communes and its opening at the posterior cranial fossa. If the radiographic diameter at this
point is more than 1.5 mm, it is considered a case of large vestibular aqueduct (LVA). It is the most common radiographically detectable inner ear anomaly in congenital hearing loss. LVA with hearing loss is described as LVA syndrome (LVAS). In
children with LVA, cochlear implantation has been proven to be effective in increasing both auditory perception and speech
and language development.

Material and Methods

The study was carried out from March 2009 to March 2014 on 9 isolated LVAS cases among 406 congenitally deaf children who had been implanted at the Madras ENT Research Foundation (MERF), Chennai, India. This observational study is focused on pre-operative assessment, surgical issues, and postoperative follow-up.

Results

Five males and four females less than six years old were detected with LVAS. There was a pulsatile stapes in five cases and a CSF gusher in eight cases. CSF gushers were well controlled during surgery by tightly sealing the insertion site with
soft tissue. An intraoperative mannitol drip was used in six patients and fibrin glue in three. Postoperative oral acetazolamide was used routinely in cases of CSF gusher. No early postoperative complications were seen. Intraoperative impedance
and neural telemetry were all satisfactory.

Conclusions

Cochlear implantation in LVAS is feasible and effective. However, CSF gushers are common and require appropriate management and follow-up.
CORTICAL AUDITORY EVOKED POTENTIALS
IN TWO PRELINGUALLY DEAFENED ADULTS
Authors: Abraham Aju , Prakash Hari , Rajashekhar Bellur , Yerraguntla Krishna
Published: May 2021

Background

It has been reported that in prelingually deafened adults there is maturation of the late latency response (LLR)
after rehabilitation using cochlear implants. Other evidence suggests that the auditory system, like any other sensory system,
receives multimodal stimulation, a factor which could help the auditory system mature even in the absence of any auditory input. The current study was done on two prelingually deaf adults who had not received rehabilitation, and their latencies were
within the normal mature range, suggesting their auditory cortex responses were maturely developed prior to rehabilitation.

Material and Methods

Two male participants took part in the study: one was 21 years old and the other was 36, and both
had congenital profound hearing loss. Using pure tone thresholds obtained earlier, a strong class hearing aid (Siemens Infiniti
Pro SP) was programmed using NOAH software and fitted to the right ear using the NALNL-1 fitting formula. As an objective measure of verification of hearing aid effect, auditory P1, N1, P2, and N2 were recorded using the free-field facility available in the IHS SmartEP system: a 1000 Hz pure tone was presented at 70 dB SPL (30 dB SL) and 50 dB SPL (10 dB SL) from
a loudspeaker at a distance of 1 m and 45° angle.

Results

The latencies of P1, N1, P2, and N2 for both participants were recorded for 70 and 90 dB HL; all latencies were well
within normal limits.

Conclusions

The results indicate that, with adequate amplification, a mature response from the auditory cortex can be obtained even in adults who have profound hearing loss and who have been deprived of auditory stimuli since a prelingual age
RESULTS OF COCHLEAR IMPLANTATION IN CHILDREN WITH
CONGENITAL CYTOMEGALOVIRUS INFECTION VERSUS GJB2
MUTATION
Authors: Ferreira Raquel , Martins Jorge , Alves Marisa , Oliveira Jose , Silva Luis , Ribeiro Carlos , Paiva Antonio
Published: May 2021

Background

Children with congenital cytomegalovirus (CMV) infection face a bigger risk of neurological deficits and developmental delays associated with sensorineural hearing loss (SNHL). Their rehabilitation with a cochlear implant (CI) may
therefore be inferior to the paediatric population in general. This study describes post-implant outcomes in children with
CMV-related deafness and compares them to children with genetic deafness caused by GJB2 mutation (connexin 26) rehabilitated at the Centro Hospitalar e Universitário de Coimbra, Portugal.

Material and Methods

We conducted a revision of 11 children with profound hearing loss caused by congenital CMV infection rehabilitated with a CI in our institution. The children were divided into 3 groups according to age of implantation
(<2 years, 2–3 years, >3 years) and their performance was compared to a group of children with genetic hearing loss caused
by GJB2 mutation. To compare performance the following tests were applied: SIR, CAP, vocal characteristics evaluation grid
(VCEG), MAIS, and MUSS.

Results

We found no differences between the two groups in terms of hearing thresholds obtained with a CI. In spite of a wider spread of results in the CMV group, there were no significant statistical differences in the SIR and VCEG tests or in the
MAIS and MUSS questionnaires. There was a significant difference in the CAP test (p=0.049) where the GJB2 group had superior results.

Conclusions

The present study has shown that the CMV group had poorer results for the CAP test and a wider spread of results in the other tests. However, the CMV group attained results comparable to children with profound hearing loss and no
other deficit, and benefited from rehabilitation with a cochlear implant.
COCHLEAR IMPLANTS AND TELEPHONE USE:
PERFORMANCE ASSESSMENT IN ADULT PATIENTS
Authors: Martins Jorge , Alves Marisa , Ramos Daniela , Alves Helena , Quadros Jorge , Ribeiro Carlos , Paiva António
Published: May 2021

Background

Using the telephone for everyday communication and social interaction allows the profoundly deaf patient who
uses a cochlear implant to increase their independence and self-esteem. Being able to use the telephone presupposes the ability to perceive speech without the aid of lipreading or any other visual cue.

Objective

This paper aims to evaluate speech perception performance through the telephone in adult users of cochlear implants

Study sample

200 adult patients who had used a cochlear implant for a minimum of 1 year were evaluated with speech perception tests (words and sentences) in free-field and through the telephone. They were divided into two groups: group I, composed of individuals who used the telephone in everyday life, and group II, individuals who did not use it.

Results

The results showed statistically significant differences in free-field tonal and vocal thresholds between both groups,
with better performance from group I. When the speech perception test results in free-field and through the telephone were
compared, for both groups the performance was better in free-field.

Conclusions

The results showed a statistically significant difference between the two groups, with better performance from
group I in all tests.
VARIABILITY OF DISTORTION PRODUCT OTOACOUSTIC
EMISSIONS AT 10, 12, AND 16 KHZ: A PRELIMINARY
STUDY
Authors: Piłka Edyta , Jędrzejczak W. , Trzaskowski Bartosz , Skarżyński Henryk
Published: May 2021

Background

Distortion product otoacoustic emissions (DPOAEs) are usually measured up to 8 kHz. However some systems
can measure DPOAEs up to 16 kHz. Therefore the aim of the study was to verify reliability of DPOAEs at 10, 12, and 16 kHz.
The single- and multiple-fit options were compared.

Material and Methods

DPOAEs were measured in subjects with normal hearing who had hearing thresholds better or equal
to 25 dB HL for frequencies from 0.25 to 16 kHz. DPOAEs were measured at frequencies of 1, 2, 4, 6, 8, 10, 12, and 16 kHz.
The main focus was on the 10–16 kHz range, while 1–8 kHz served as a comparison. Each recording session consisted of three
measurements. The first two were made consecutively without taking out the probe – single-fit mode. The third measurement
was made after taking out and refitting the probe – multiple-fit mode.

Results

Results indicated that the inter-measurement variability was higher for frequencies in the 8–16 kHz range than in the
1–6 kHz range. Additionally, the variability was higher when multiple-fit was used compared to single-fit.

Conclusions

Measurement of DPOAEs at frequencies higher than 8 kHz seems reliable; however, DPOAEs at these frequencies have greater variability than those at lower frequencies.
COMPUTER-AIDED VOICE PITCH THERAPY IN AURALLY
IMPAIRED STUDENTS
Authors: Plutecka Katarzyna , Zielinska Jolanta
Published: May 2021

Background

The aim was to measure, evaluate, and improve voice pitch characteristics (measured on the basis of the average fundamental frequency, Fx), in students aged 10–12 who had substantial or severe hearing loss and were fitted with hearing aids. Two core questions were asked: (i) Is therapy using the PCLX Laryngograph Processor effective? (ii) Which factors
affect the outcome of therapy?

Material and Methods

Therapy based on a multimedia computer workstation using the PCLX Laryngograph Processor is
proposed, a system capable of visualizing voiced speech using electroglotography. The study is constructed as a pedagogical
experiment, using parallel groups and Mill’s method of difference.

Results

Pretest results show that, prior to therapy sessions, both groups (experimental and control) were largely equivalent
with respect to voice pitch characteristics. In total, 49 students exhibited anomalous voice pitch characteristics while 14 cases could be described as unstable (with pitch sometimes correct, but not consistently so). Correlations between concomitant
variables and the effectiveness of the therapeutic process were found. In particular, intelligence and visual-motor coordination
played a significant role. Variables such as learning speed, working memory capacity, forgetfulness, time since onset of hearing loss, and degree of aural impairment seem to be less important. Improvements appeared to depend on the subject’s family environment and were largely independent of age and degree of hearing loss.

Conclusions

The research has shown that in most aurally impaired subjects voice pitch is too high and needs to be corrected. The proposed therapy is shown to be highly effective, producing persistent long-term improvements, especially in the case
of younger students.
COCHLEAR IMPLANTATION IN PATIENTS WITH RENAL
DYSFUNCTION
Authors: Goyal Sunil , Arumugam Senthil , Kalra Suven , Thirugnanam Sarankumar , Nair Geetha , Kameswaran Mohan
Published: May 2021

Background

Cochlear implantation is a safe surgery for restoration of hearing in severe to profound cochlear hearing loss
candidates. Patients with congenital cochlear hearing loss may at times have renal anomalies. Renal dysfunction can contribute to sensorineural hearing loss, and it can affect cochlear implantation in a variety of ways, from minor intraoperative issues to major life-threatening complications.
Our study aimed to determine the prevalence of renal association encountered in cochlear implantees over a period of 15 years
(Jan 2000–Dec 2014) at our centre; secondly to classify these renal associations, as this has an effect on management; and finally to suggest a protocol for perioperative management of cochlear implantees with renal comorbidity.

Material and Methods

This is a retrospective study of 1000 consecutive patients who underwent cochlear implantation at the
Madras ENT Research Foundation (Chennai) over the period Jan 2000–Dec 2014. All cochlear implantees with bilateral severe to profound cochlear hearing loss and associated renal associations were included. The data for our study were collected
from nephrologist referral forms and medical records. The paper gives a nephrologist’s perspective on perioperative care to
be given during cochlear implantation. Relevant literature is reviewed.

Results

Overall prevalence of renal disease was 6 out of 1000 implantees (0.6%) in our series. We classify the associated renal
associations in cochlear implant candidates into 4 categories, and appropriate management for them is described.

Conclusions

A protocol for evaluating renal associations as they affect cochlear implantation has been designed, and the optimal management of these issues has been discussed.
OBJECTIVE ASSESSMENT OF INFANT HEARING:
ESSENTIAL FOR EARLY INTERVENTION
Authors: Hall III James
Published: May 2021

Substantial evidence supports the benefits of early intervention in infant hearing loss. Intervention can lead to the acquisition of effective communication skills and psychosocial development. Accurate diagnosis of infant hearing loss is not possible with conventional behavioral audiometry techniques. Objective auditory procedures are invaluable in the assessment of
infant hearing because they do not rely on behavioral responses to sound and are unaffected by listener variables such as cognition, motivation, and language impairment.
Objective hearing procedures include aural immittance measures (tympanometry and acoustic reflexes), otoacoustic emissions (OAEs), electrocochleography (ECochG), auditory brainstem response (ABR), and the auditory steady state response
(ASSR). Exclusive reliance on only one or two objective auditory measures often results in equivocal outcomes. Careful analysis of findings from a comprehensive objective auditory test battery can almost always yield a precise description of auditory status; it can often lead to accurate diagnosis of auditory dysfunction within weeks of birth. The key to meaningful analysis of findings from a test battery is the recognition of patterns associated with major auditory disorders. This is not a novel
concept; it is simply the modern day version of the 40-year-old cross-check principle.
ANATOMICAL LOCUS OF THE ANGULAR GYRUS:
PRELIMINARY FINDINGS
Authors: Everett Alyssa , George Barrett , Denny Nicole , Musiek Frank
Published: May 2021

Background

The angular gyrus (AG) is an association area of the human cerebral cortex that plays a role in several processes, including auditory function. However, the precise anatomical location of the AG is not entirely clear. There are two common approaches for locating the AG based on gyral and sulcal landmarks: the ‘parallel’ and ‘count-back’ methods (as termed
by the present authors). These two techniques do not always point to the same location on the cortex, thus making the macroanatomical locus of the AG rather ambiguous.

Material

Twenty high-resolution brain MRIs of normal, right-handed human subjects chosen from an online database (OASIS).

Methods

MRIs were sequentially chosen from OASIS and analyzed in MRIcron using two different visualization techniques:
1) skull-stripped surface renderings, and 2) serial sagittal slices. The AG was demarcated in the left and right hemisphere of
each brain, as defined by the parallel and count-back methods. The reliability of each method for locating the AG was systematically assessed using both descriptive and inferential statistics, based on measures of hemispheric laterality

Results and discussion

Examination of both methods for locating the AG showed poorer reliability in the left hemisphere
compared to the right for both surface and more medial sites. Several anatomical factors were identified that compromised
the reliability of the two methods.

Conclusions

Our finding of poor reliability between the parallel and count-back methods suggests that the AG is sometimes
difficult to identify, particularly in the left hemisphere. This places the traditional gross anatomical methods for locating the
AG in question. Development of new techniques to define this area of human neuroanatomy is needed.
SUDDEN SENSORINEURAL HEARING LOSS IN CHILDREN: A LITERATURE REVIEW
Authors: Skarzynski Piotr , Rajchel Joanna , Skarzynski Henryk
Published: May 2021

Many issues concerning sudden sensorineural hearing loss (SSNHL) remain unresolved. An especially troublesome and uncharted field is SSNHL in children. The aim of the present literature review was to recognize, critically evaluate, and synthesize knowledge on pediatric SSNHL derived from available studies. Articles published between 2000 and 2016 in the English and Polish languages were investigated. Included in the analysis were studies examining children and adolescents ≤18 years or, in the case of comparative studies of children and adults, reports which treated the younger age group as a separate entity. An increase in the attention given to pediatric SSNHL could be observed over the last 16 years. Due to substantial differences in approach found in the analyzed articles, it was impossible to conduct a meta-analysis and provide descriptive statistics. The average age of the investigated children was 12 years. There was no difference in SSNHL prevalence between either gender. Unilateral cases were much more common than bilateral, and no preponderance for left or right ear was noted. The most common factors accompanying SNSHL were tinnitus and vertigo; the most common proposed etiologies were idiopathic and viral infections. There were two main treatment types: steroids (oral, intratympanic, intravenous) and hyperbaric oxygen therapy. Depending on the treatment protocol, the rate of complete recovery ranged from 9 to 57%. The most common positive prognostic factors were mild degrees of hearing loss, occurrence of tinnitus, and early treatment onset, whereas bilateral hearing loss and vertigo were found to be negative prognostic factors.