99 results on '"AUDIOMETRY"'
Search Results
2. Examining the Combined Estimated Effects of Hearing Loss and Depressive Symptoms on Risk of Cognitive Decline and Incident Dementia
- Author
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Powell, Danielle S, Brenowitz, Willa D, Yaffe, Kristine, Armstrong, Nicole M, Reed, Nicholas S, Lin, Frank R, Gross, Alden L, and Deal, Jennifer A
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Acquired Cognitive Impairment ,Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD) ,Neurodegenerative ,Behavioral and Social Science ,Bioengineering ,Aging ,Rehabilitation ,Assistive Technology ,Mental Health ,Prevention ,Brain Disorders ,Depression ,Clinical Research ,Alzheimer's Disease ,Neurosciences ,Dementia ,2.1 Biological and endogenous factors ,Aetiology ,Ear ,Neurological ,Mental health ,Good Health and Well Being ,Aged ,Audiometry ,Cognitive Dysfunction ,Deafness ,Hearing Loss ,Humans ,Risk Factors ,Cognition ,Hearing loss ,Clinical Sciences ,Sociology ,Psychology ,Gerontology - Abstract
ObjectivesLate-life depression is a comorbidity that may co-occur in older adults with hearing loss-each has prevalent and independent modifiable risk factors for dementia.MethodsUsing data from 1,820 Health, Aging and Body Composition study participants (74 ± 2.8 years, 38% Black race), we compared the hearing loss-dementia/cognitive decline relationship between those with normal hearing/mild hearing loss and those with moderate or greater hearing loss. Using linear mixed-effects and Cox proportional hazard models, we investigated if the associations between hearing loss and cognitive decline or dementia (Modified Mini-Mental State [3MS] Examination and Digit Symbol Substitution Test [DSST]) differed by the presence or absence of depressive symptoms. Depressive symptoms were defined as Center for Epidemiologic Study-Depression scale 10 ≥10 at one or more visits from Years 1-5. Algorithmic incident dementia was defined using medication use, hospitalizations, and cognitive test scores. Audiometric hearing loss was measured at Year 5 and categorized as normal/mild versus moderate or greater hearing loss.ResultsHaving both hearing loss and depressive symptoms (vs. having neither) was associated with faster rates of decline in 3MS Examination (β = -0.30; 95% confidence interval [CI]: -0.78, -0.19) and DSST (β = -0.35; 95% CI: -0.67, -0.03) over 10 years of follow-up. Having both hearing loss and depressive symptoms (vs. neither) was associated with increased risk (hazard ratio [HR]: 2.91; 95% CI: 1.59, 5.33 vs. HR: 1.54; 95% CI: 1.10, 2.15 hearing loss only and HR: 2.35; 95% CI: 1.56, 3.53 depressive symptoms only) of incident dementia in multivariable-adjusted Cox proportional hazards models.DiscussionComorbid conditions among hearing-impaired older adults should be considered and may aid in dementia prevention and management strategies.
- Published
- 2022
3. Case 4-2022: A 55-Year-Old Man with Bilateral Hearing Loss and Eye Redness
- Author
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Harris, Jeffrey P, Ciaranello, Andrea L, and Tabb, Elisabeth S
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Biomedical and Clinical Sciences ,Allied Health and Rehabilitation Science ,Clinical Sciences ,Health Sciences ,Ophthalmology and Optometry ,Ear ,Audiometry ,Cogan Syndrome ,Diagnosis ,Differential ,Eye Diseases ,Glucocorticoids ,Hearing Loss ,Bilateral ,Hearing Loss ,Sensorineural ,Humans ,Lyme Disease ,Male ,Middle Aged ,Neurosyphilis ,Treponema pallidum ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Published
- 2022
4. Parallel and distributed encoding of speech across human auditory cortex
- Author
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Hamilton, Liberty S, Oganian, Yulia, Hall, Jeffery, and Chang, Edward F
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Biomedical and Clinical Sciences ,Clinical Sciences ,Neurosciences ,Neurological ,Audiometry ,Pure-Tone ,Auditory Cortex ,Electrodes ,Electronic Data Processing ,Humans ,Phonetics ,Pitch Perception ,Reaction Time ,Speech ,Temporal Lobe ,Heschl's gyrus ,auditory cortex ,cortical stimulation ,electrocorticography ,intracranial recordings ,speech ,superior temporal gyrus ,Biological Sciences ,Medical and Health Sciences ,Developmental Biology ,Biological sciences ,Biomedical and clinical sciences - Abstract
Speech perception is thought to rely on a cortical feedforward serial transformation of acoustic into linguistic representations. Using intracranial recordings across the entire human auditory cortex, electrocortical stimulation, and surgical ablation, we show that cortical processing across areas is not consistent with a serial hierarchical organization. Instead, response latency and receptive field analyses demonstrate parallel and distinct information processing in the primary and nonprimary auditory cortices. This functional dissociation was also observed where stimulation of the primary auditory cortex evokes auditory hallucination but does not distort or interfere with speech perception. Opposite effects were observed during stimulation of nonprimary cortex in superior temporal gyrus. Ablation of the primary auditory cortex does not affect speech perception. These results establish a distributed functional organization of parallel information processing throughout the human auditory cortex and demonstrate an essential independent role for nonprimary auditory cortex in speech processing.
- Published
- 2021
5. Treatment of Long-term Sudden Sensorineural Hearing Loss as an Otologic Migraine Phenomenon
- Author
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Goshtasbi, Khodayar, Chua, Janice T, Risbud, Adwight, Sarna, Brooke, Jamshidi, Shahrnaz, Abouzari, Mehdi, and Djalilian, Hamid R
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Neurosciences ,Headaches ,Migraines ,Pain Research ,Brain Disorders ,Aged ,Audiometry ,Pure-Tone ,Dexamethasone ,Female ,Glucocorticoids ,Hearing Loss ,Sensorineural ,Hearing Loss ,Sudden ,Humans ,Male ,Middle Aged ,Migraine Disorders ,Retrospective Studies ,Treatment Outcome ,Chronic hearing loss ,Long-term hearing loss ,Migraine ,Otologic migraine ,Sudden sensorineural hearing loss ,Word recognition score ,Zoology ,Public Health and Health Services ,Otorhinolaryngology ,Clinical sciences ,Allied health and rehabilitation science - Abstract
ObjectivesTo describe a cohort of patients presenting with long-term sudden sensorineural hearing loss (SSNHL) treated with prophylactic migraine and intratympanic steroid therapy.MethodsPatients presenting to a neurotology clinic at least 6 weeks from SSNHL onset were included. All patients received migraine prophylactic medication (nortriptyline, topiramate, and/or verapamil) and lifestyle changes for at least 6 weeks, as well as intratympanic steroid injections, if appropriate.ResultsTwenty-one patients (43% female) with a mean age of 64 ± 11 years who presented 9 ± 8 months (median = 5) from symptom onset were included. Posttreatment hearing thresholds were significantly improved compared with pretreatment thresholds at 500 Hz (49 ± 19 dB versus 55 ± 20 dB, p = 0.01), 1000 Hz (52 ± 19 dB versus 57 ± 21 dB, p = 0.03), low-frequency pure-tone average (53 ± 15 dB versus 57 ± 17 dB, p = 0.01), and speech-frequency pure-tone average (57 ± 13 dB versus 60 ± 15 dB, p = 0.02). Posttreatment word-recognition-score (WRS) and speech-recognition-threshold (SRT) were also significantly improved (45 ± 28% versus 70 ± 28% and 57 ± 18 dB versus 50 ± 16 dB, respectively, both p 50% WRS with an average improvement of 39 ± 9%.ConclusionsMigraine medications in addition to intratympanic steroid injections significantly improved SRT and hearing frequencies in 40% and 29% of SSNHL patients, respectively, while significant WRS recovery was observed in most (68%) patients. This suggests SSNHL may be an otologic migraine phenomenon, which may be at least partially reversible even after the traditional 30-day postonset window.
- Published
- 2021
6. Treatment of Long-term Sudden Sensorineural Hearing Loss as an Otologic Migraine Phenomenon.
- Author
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Goshtasbi, Khodayar, Chua, Janice T, Risbud, Adwight, Sarna, Brooke, Jamshidi, Shahrnaz, Abouzari, Mehdi, and Djalilian, Hamid R
- Subjects
Humans ,Hearing Loss ,Sensorineural ,Hearing Loss ,Sudden ,Dexamethasone ,Glucocorticoids ,Audiometry ,Pure-Tone ,Treatment Outcome ,Retrospective Studies ,Aged ,Middle Aged ,Female ,Male ,Migraine Disorders ,Chronic hearing loss ,Long-term hearing loss ,Migraine ,Otologic migraine ,Sudden sensorineural hearing loss ,Word recognition score ,Rehabilitation ,Brain Disorders ,Neurosciences ,Otorhinolaryngology ,Zoology ,Clinical Sciences ,Public Health and Health Services - Abstract
ObjectivesTo describe a cohort of patients presenting with long-term sudden sensorineural hearing loss (SSNHL) treated with prophylactic migraine and intratympanic steroid therapy.MethodsPatients presenting to a neurotology clinic at least 6 weeks from SSNHL onset were included. All patients received migraine prophylactic medication (nortriptyline, topiramate, and/or verapamil) and lifestyle changes for at least 6 weeks, as well as intratympanic steroid injections, if appropriate.ResultsTwenty-one patients (43% female) with a mean age of 64 ± 11 years who presented 9 ± 8 months (median = 5) from symptom onset were included. Posttreatment hearing thresholds were significantly improved compared with pretreatment thresholds at 500 Hz (49 ± 19 dB versus 55 ± 20 dB, p = 0.01), 1000 Hz (52 ± 19 dB versus 57 ± 21 dB, p = 0.03), low-frequency pure-tone average (53 ± 15 dB versus 57 ± 17 dB, p = 0.01), and speech-frequency pure-tone average (57 ± 13 dB versus 60 ± 15 dB, p = 0.02). Posttreatment word-recognition-score (WRS) and speech-recognition-threshold (SRT) were also significantly improved (45 ± 28% versus 70 ± 28% and 57 ± 18 dB versus 50 ± 16 dB, respectively, both p 50% WRS with an average improvement of 39 ± 9%.ConclusionsMigraine medications in addition to intratympanic steroid injections significantly improved SRT and hearing frequencies in 40% and 29% of SSNHL patients, respectively, while significant WRS recovery was observed in most (68%) patients. This suggests SSNHL may be an otologic migraine phenomenon, which may be at least partially reversible even after the traditional 30-day postonset window.
- Published
- 2021
7. Characteristics of Mid-Frequency Sensorineural Hearing Loss Progression.
- Author
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Birkenbeuel, Jack, Abouzari, Mehdi, Goshtasbi, Khodayar, Moshtaghi, Omid, Sahyouni, Ronald, Moshtaghi, Afsheen, Cheung, Dillon, Gelnett, Donna, Lin, Harrison W, and Djalilian, Hamid R
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Clinical Research ,Aging ,Hearing Loss ,Adolescent ,Adult ,Age of Onset ,Aged ,Audiometry ,Pure-Tone ,Child ,Child ,Preschool ,Cohort Studies ,Disease Progression ,Female ,Hearing Loss ,Sensorineural ,Humans ,Infant ,Male ,Middle Aged ,Retrospective Studies ,Young Adult ,Audiometry ,Cookie bite hearing loss ,Mid-frequency sensorineural hearing loss ,Pediatric ,Zoology ,Public Health and Health Services ,Otorhinolaryngology ,Clinical sciences ,Allied health and rehabilitation science - Abstract
OBJECTIVES:To characterize the progression of mid-frequency sensorineural hearing loss (MFSNHL) over time. METHODS:A retrospective chart review spanning 2012 to 2017 was performed at a tertiary care audiology and neurotology center. Our cohort included 37 patients met the criteria for MFSNHL also known as "cookie bite hearing loss." It was defined as having a 1, 2, and 4 kHz average pure tone audiometry greater than 10 dB in intensity compared with the average threshold at 500 Hz and 8 kHz. RESULTS:Average age at initial presentation was 11.8 years (range, 8 mo to 70 yr). Across all individuals, the average mid-frequency threshold was 47 dB, compared with 27 dB at 500 Hz and 8 kHz. Twenty-three patients (62%) had multiple audiograms with 4-year median follow up time. Average values across all frequencies (0.5, 1, 2, 4, 8 kHz) in the initial audiogram was 37 dB, compared with an average of 39 dB demonstrated on final audiogram. Of those with serial audiograms, only five patients demonstrated threshold changes of 10 dB or more. Of these five patients, only one was found to have clinical worsening of MFSNHL. CONCLUSIONS:MFSNHL is an uncommon audiometric finding with unspecified long-term outcomes. We demonstrated that most patients (96%) with MFSNHL do not experience clinical worsening of their hearing threshold over almost 4 years of follow up. Future prospective studies aimed at collecting longer-term data are warranted to further elucidate the long-term trajectory of MFSNHL patients.
- Published
- 2019
8. Characteristics of Mid-Frequency Sensorineural Hearing Loss Progression.
- Author
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Birkenbeuel, Jack, Abouzari, Mehdi, Goshtasbi, Khodayar, Moshtaghi, Omid, Sahyouni, Ronald, Moshtaghi, Afsheen, Cheung, Dillon, Gelnett, Donna, Lin, Harrison W, and Djalilian, Hamid R
- Subjects
Brain Disorders ,Clinical Research ,Adolescent ,Adult ,Age of Onset ,Aged ,Audiometry ,Pure-Tone ,Child ,Child ,Preschool ,Cohort Studies ,Disease Progression ,Female ,Hearing Loss ,Sensorineural ,Humans ,Infant ,Male ,Middle Aged ,Retrospective Studies ,Young Adult ,Audiometry ,Cookie bite hearing loss ,Mid-frequency sensorineural hearing loss ,Pediatric ,Zoology ,Clinical Sciences ,Public Health and Health Services ,Otorhinolaryngology - Abstract
OBJECTIVES:To characterize the progression of mid-frequency sensorineural hearing loss (MFSNHL) over time. METHODS:A retrospective chart review spanning 2012 to 2017 was performed at a tertiary care audiology and neurotology center. Our cohort included 37 patients met the criteria for MFSNHL also known as "cookie bite hearing loss." It was defined as having a 1, 2, and 4 kHz average pure tone audiometry greater than 10 dB in intensity compared with the average threshold at 500 Hz and 8 kHz. RESULTS:Average age at initial presentation was 11.8 years (range, 8 mo to 70 yr). Across all individuals, the average mid-frequency threshold was 47 dB, compared with 27 dB at 500 Hz and 8 kHz. Twenty-three patients (62%) had multiple audiograms with 4-year median follow up time. Average values across all frequencies (0.5, 1, 2, 4, 8 kHz) in the initial audiogram was 37 dB, compared with an average of 39 dB demonstrated on final audiogram. Of those with serial audiograms, only five patients demonstrated threshold changes of 10 dB or more. Of these five patients, only one was found to have clinical worsening of MFSNHL. CONCLUSIONS:MFSNHL is an uncommon audiometric finding with unspecified long-term outcomes. We demonstrated that most patients (96%) with MFSNHL do not experience clinical worsening of their hearing threshold over almost 4 years of follow up. Future prospective studies aimed at collecting longer-term data are warranted to further elucidate the long-term trajectory of MFSNHL patients.
- Published
- 2019
9. Characteristics of Mid-Frequency Sensorineural Hearing Loss Progression.
- Author
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Birkenbeuel, Jack, Abouzari, Mehdi, Goshtasbi, Khodayar, Moshtaghi, Omid, Sahyouni, Ronald, Moshtaghi, Afsheen, Cheung, Dillon, Gelnett, Donna, Lin, Harrison W, and Djalilian, Hamid R
- Subjects
Humans ,Hearing Loss ,Sensorineural ,Disease Progression ,Audiometry ,Pure-Tone ,Retrospective Studies ,Cohort Studies ,Age of Onset ,Adolescent ,Adult ,Aged ,Middle Aged ,Child ,Child ,Preschool ,Infant ,Female ,Male ,Young Adult ,Otorhinolaryngology ,Zoology ,Clinical Sciences ,Public Health and Health Services - Abstract
ObjectivesTo characterize the progression of mid-frequency sensorineural hearing loss (MFSNHL) over time.MethodsA retrospective chart review spanning 2012 to 2017 was performed at a tertiary care audiology and neurotology center. Our cohort included 37 patients met the criteria for MFSNHL also known as "cookie bite hearing loss." It was defined as having a 1, 2, and 4 kHz average pure tone audiometry greater than 10 dB in intensity compared with the average threshold at 500 Hz and 8 kHz.ResultsAverage age at initial presentation was 11.8 years (range, 8 mo to 70 yr). Across all individuals, the average mid-frequency threshold was 47 dB, compared with 27 dB at 500 Hz and 8 kHz. Twenty-three patients (62%) had multiple audiograms with 4-year median follow up time. Average values across all frequencies (0.5, 1, 2, 4, 8 kHz) in the initial audiogram was 37 dB, compared with an average of 39 dB demonstrated on final audiogram. Of those with serial audiograms, only five patients demonstrated threshold changes of 10 dB or more. Of these five patients, only one was found to have clinical worsening of MFSNHL.ConclusionsMFSNHL is an uncommon audiometric finding with unspecified long-term outcomes. We demonstrated that most patients (96%) with MFSNHL do not experience clinical worsening of their hearing threshold over almost 4 years of follow up. Future prospective studies aimed at collecting longer-term data are warranted to further elucidate the long-term trajectory of MFSNHL patients.
- Published
- 2019
10. Characteristics of Mid-Frequency Sensorineural Hearing Loss Progression.
- Author
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Birkenbeuel, Jack, Abouzari, Mehdi, Goshtasbi, Khodayar, Moshtaghi, Omid, Sahyouni, Ronald, Moshtaghi, Afsheen, Cheung, Dillon, Gelnett, Donna, Lin, Harrison W, and Djalilian, Hamid R
- Subjects
Audiometry ,Cookie bite hearing loss ,Mid-frequency sensorineural hearing loss ,Pediatric ,Otorhinolaryngology ,Zoology ,Clinical Sciences ,Public Health and Health Services - Abstract
OBJECTIVES:To characterize the progression of mid-frequency sensorineural hearing loss (MFSNHL) over time. METHODS:A retrospective chart review spanning 2012 to 2017 was performed at a tertiary care audiology and neurotology center. Our cohort included 37 patients met the criteria for MFSNHL also known as "cookie bite hearing loss." It was defined as having a 1, 2, and 4 kHz average pure tone audiometry greater than 10 dB in intensity compared with the average threshold at 500 Hz and 8 kHz. RESULTS:Average age at initial presentation was 11.8 years (range, 8 mo to 70 yr). Across all individuals, the average mid-frequency threshold was 47 dB, compared with 27 dB at 500 Hz and 8 kHz. Twenty-three patients (62%) had multiple audiograms with 4-year median follow up time. Average values across all frequencies (0.5, 1, 2, 4, 8 kHz) in the initial audiogram was 37 dB, compared with an average of 39 dB demonstrated on final audiogram. Of those with serial audiograms, only five patients demonstrated threshold changes of 10 dB or more. Of these five patients, only one was found to have clinical worsening of MFSNHL. CONCLUSIONS:MFSNHL is an uncommon audiometric finding with unspecified long-term outcomes. We demonstrated that most patients (96%) with MFSNHL do not experience clinical worsening of their hearing threshold over almost 4 years of follow up. Future prospective studies aimed at collecting longer-term data are warranted to further elucidate the long-term trajectory of MFSNHL patients.
- Published
- 2019
11. A Case Series of Granulomatosis With Polyangiitis Primarily Diagnosed by Otological Manifestations.
- Author
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Sahyouni, Ronald, Moshtaghi, Omid, Abouzari, Mehdi, Le, Phuonganh, Birkenbeuel, Jack, Cheung, Dillon, Lin, Harrison W, and Djalilian, Hamid R
- Subjects
Eustachian Tube ,Humans ,Hearing Loss ,Otitis Media with Effusion ,Diagnosis ,Differential ,Audiometry ,Retrospective Studies ,Adult ,Aged ,Middle Aged ,Female ,Male ,Young Adult ,Granulomatosis with Polyangiitis ,ANCA associated vasculitis ,Wegener’s granulomatosis ,granulomatosis with polyangiitis ,hearing loss ,otology ,Infectious Diseases ,Clinical Research ,Otitis Media ,2.1 Biological and endogenous factors ,Aetiology ,Wegener's granulomatosis ,Clinical Sciences ,Otorhinolaryngology - Abstract
ObjectiveTo describe a case series of previously undiagnosed granulomatosis with polyangiitis (GPA) patients who presented primarily with otological manifestations.MethodWe report a series of patients visited at a neurotology clinic who were eventually diagnosed with GPA based on their otologic complaints and had no prior knowledge of having this condition.ResultsIn this series, 10 (91%) patients presented with hearing loss (HL), more than half of which were bilateral (60%). Upon audiometric examination, all but 1 patient had mixed, conductive, or sensorineural HL. All patients presented with eustachian tube dysfunction (ETD), otitis media with effusion (OME), or both. Nasal endoscopy showed intranasal pathology in 3 (27%) patients. Otologic symptoms were improved in all patients after treatment with an average of 4 in-office follow-up appointments.ConclusionGPA should be included in the differential diagnosis of adults with unexplained mixed hearing loss, new onset serous effusion, or acute otitis media in the absence of a previous history of ETD. Laboratory tests (ie, anti-neutrophil cytoplasmic autoantibody, erythrocyte sedimentation rate, and C-reactive protein) along with a urinalysis can aid in screening these patients. In cases in which the index of suspicion is high, repeated testing could reduce the risk of false negative findings.
- Published
- 2019
12. A Case Series of Granulomatosis With Polyangiitis Primarily Diagnosed by Otological Manifestations.
- Author
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Sahyouni, Ronald, Moshtaghi, Omid, Abouzari, Mehdi, Le, Phuonganh, Birkenbeuel, Jack, Cheung, Dillon, Lin, Harrison W, and Djalilian, Hamid R
- Subjects
Eustachian Tube ,Humans ,Hearing Loss ,Otitis Media with Effusion ,Diagnosis ,Differential ,Audiometry ,Retrospective Studies ,Adult ,Aged ,Middle Aged ,Female ,Male ,Young Adult ,Granulomatosis with Polyangiitis ,ANCA associated vasculitis ,Wegener’s granulomatosis ,granulomatosis with polyangiitis ,hearing loss ,otology ,Wegener's granulomatosis ,Clinical Research ,Otitis Media ,Infectious Diseases ,2.1 Biological and endogenous factors ,Clinical Sciences ,Otorhinolaryngology - Abstract
ObjectiveTo describe a case series of previously undiagnosed granulomatosis with polyangiitis (GPA) patients who presented primarily with otological manifestations.MethodWe report a series of patients visited at a neurotology clinic who were eventually diagnosed with GPA based on their otologic complaints and had no prior knowledge of having this condition.ResultsIn this series, 10 (91%) patients presented with hearing loss (HL), more than half of which were bilateral (60%). Upon audiometric examination, all but 1 patient had mixed, conductive, or sensorineural HL. All patients presented with eustachian tube dysfunction (ETD), otitis media with effusion (OME), or both. Nasal endoscopy showed intranasal pathology in 3 (27%) patients. Otologic symptoms were improved in all patients after treatment with an average of 4 in-office follow-up appointments.ConclusionGPA should be included in the differential diagnosis of adults with unexplained mixed hearing loss, new onset serous effusion, or acute otitis media in the absence of a previous history of ETD. Laboratory tests (ie, anti-neutrophil cytoplasmic autoantibody, erythrocyte sedimentation rate, and C-reactive protein) along with a urinalysis can aid in screening these patients. In cases in which the index of suspicion is high, repeated testing could reduce the risk of false negative findings.
- Published
- 2019
13. Use of otoacoustic emissions to improve outcomes and reduce disparities in a community preschool hearing screening program
- Author
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Cedars, Elizabeth, Kriss, Hayley, Lazar, Ann A, Chan, Curtis, and Chan, Dylan K
- Subjects
Biomedical and Clinical Sciences ,Allied Health and Rehabilitation Science ,Health Services and Systems ,Clinical Sciences ,Health Sciences ,Clinical Research ,Prevention ,Pediatric ,Health Services ,Detection ,screening and diagnosis ,4.2 Evaluation of markers and technologies ,Audiometry ,Child ,Preschool ,Community Health Services ,Female ,Follow-Up Studies ,Health Plan Implementation ,Health Status Disparities ,Hearing Loss ,Sensorineural ,Humans ,Incidence ,Male ,Mass Screening ,Otoacoustic Emissions ,Spontaneous ,Outcome and Process Assessment ,Health Care ,Poverty ,Program Evaluation ,Referral and Consultation ,General Science & Technology - Abstract
IntroductionHearing loss substantially impacts pediatric development, and early identification improves outcomes. While intervening before school-entry is critical to optimize learning, early-childhood hearing screening practices are highly variable. Conditioned play audiometry (CPA) is the gold standard for preschool hearing screening, but otoacoustic emission (OAE) testing provides objective data that may improve screening outcomes.ObjectivesTo compare outcomes of a community-based low-income preschool hearing program before and after implementation of OAE in a single-visit, two-tiered paradigm. We hypothesized that this intervention would reduce referral rates and improve follow-up while maintaining stable rates of diagnosed sensorineural hearing loss.MethodsWe performed a cohort study of 3257 children screened from July 2014-June 2016. Department of Public Health data were analyzed pre- and post-implementation of second-line OAE testing for children referred on CPA screening with targeted follow-up by DPH staff. Primary outcomes included referral rates, follow-up rates, and diagnosis of sensorineural hearing loss.ResultsDemographics, pure-tone pass rates, and incidence of newly-diagnosed permanent hearing loss were similar across years. After intervention, overall pass rates increased from 92% to 95% (P = 0.0014), while only 0.7% remained unable to be tested (P
- Published
- 2018
14. Use of otoacoustic emissions to improve outcomes and reduce disparities in a community preschool hearing screening program.
- Author
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Cedars, Elizabeth, Kriss, Hayley, Lazar, Ann A, Chan, Curtis, and Chan, Dylan K
- Subjects
Humans ,Hearing Loss ,Sensorineural ,Audiometry ,Mass Screening ,Incidence ,Follow-Up Studies ,Program Evaluation ,Otoacoustic Emissions ,Spontaneous ,Poverty ,Child ,Preschool ,Community Health Services ,Health Plan Implementation ,Referral and Consultation ,Female ,Male ,Health Status Disparities ,Outcome and Process Assessment ,Health Care ,Hearing Loss ,Sensorineural ,Otoacoustic Emissions ,Spontaneous ,Child ,Preschool ,Outcome and Process Assessment ,Health Care ,General Science & Technology - Abstract
IntroductionHearing loss substantially impacts pediatric development, and early identification improves outcomes. While intervening before school-entry is critical to optimize learning, early-childhood hearing screening practices are highly variable. Conditioned play audiometry (CPA) is the gold standard for preschool hearing screening, but otoacoustic emission (OAE) testing provides objective data that may improve screening outcomes.ObjectivesTo compare outcomes of a community-based low-income preschool hearing program before and after implementation of OAE in a single-visit, two-tiered paradigm. We hypothesized that this intervention would reduce referral rates and improve follow-up while maintaining stable rates of diagnosed sensorineural hearing loss.MethodsWe performed a cohort study of 3257 children screened from July 2014-June 2016. Department of Public Health data were analyzed pre- and post-implementation of second-line OAE testing for children referred on CPA screening with targeted follow-up by DPH staff. Primary outcomes included referral rates, follow-up rates, and diagnosis of sensorineural hearing loss.ResultsDemographics, pure-tone pass rates, and incidence of newly-diagnosed permanent hearing loss were similar across years. After intervention, overall pass rates increased from 92% to 95% (P = 0.0014), while only 0.7% remained unable to be tested (P
- Published
- 2018
15. Masking release by combined spatial and masker-fluctuation effects in the open sound field.
- Author
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Middlebrooks, John C
- Subjects
Humans ,Audiometry ,Pure-Tone ,Acoustic Stimulation ,Cues ,Auditory Perception ,Auditory Threshold ,Perceptual Masking ,Sound Localization ,Noise ,Adolescent ,Adult ,Female ,Male ,Signal Detection ,Psychological ,Young Adult ,Acoustics - Abstract
In a complex auditory scene, signals of interest can be distinguished from masking sounds by differences in source location [spatial release from masking (SRM)] and by differences between masker-alone and masker-plus-signal envelopes. This study investigated interactions between those factors in release of masking of 700-Hz tones in an open sound field. Signal and masker sources were colocated in front of the listener, or the signal source was shifted 90° to the side. In Experiment 1, the masker contained a 25-Hz-wide on-signal band plus flanking bands having envelopes that were either mutually uncorrelated or were comodulated. Comodulation masking release (CMR) was largely independent of signal location at a higher masker sound level, but at a lower level CMR was reduced for the lateral signal location. In Experiment 2, a brief signal was positioned at the envelope maximum (peak) or minimum (dip) of a 50-Hz-wide on-signal masker. Masking was released in dip more than in peak conditions only for the 90° signal. Overall, open-field SRM was greater in magnitude than binaural masking release reported in comparable closed-field studies, and envelope-related release was somewhat weaker. Mutual enhancement of masking release by spatial and envelope-related effects tended to increase with increasing masker level.
- Published
- 2017
16. Sensorimotor adaptation affects perceptual compensation for coarticulation
- Author
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Schuerman, William L, Nagarajan, Srikantan, McQueen, James M, and Houde, John
- Subjects
Biomedical and Clinical Sciences ,Allied Health and Rehabilitation Science ,Clinical Sciences ,Health Sciences ,Psychology ,Clinical Research ,Acoustic Stimulation ,Adult ,Audiometry ,Speech ,Cues ,Feedback ,Sensory ,Female ,Humans ,Male ,Speech Acoustics ,Speech Production Measurement ,Voice Quality ,Young Adult ,Acoustics - Abstract
A given speech sound will be realized differently depending on the context in which it is produced. Listeners have been found to compensate perceptually for these coarticulatory effects, yet it is unclear to what extent this effect depends on actual production experience. In this study, whether changes in motor-to-sound mappings induced by adaptation to altered auditory feedback can affect perceptual compensation for coarticulation is investigated. Specifically, whether altering how the vowel [i] is produced can affect the categorization of a stimulus continuum between an alveolar and a palatal fricative whose interpretation is dependent on vocalic context is tested. It was found that participants could be sorted into three groups based on whether they tended to oppose the direction of the shifted auditory feedback, to follow it, or a mixture of the two, and that these articulatory responses, not the shifted feedback the participants heard, correlated with changes in perception. These results indicate that sensorimotor adaptation to altered feedback can affect the perception of unaltered yet coarticulatorily-dependent speech sounds, suggesting a modulatory role of sensorimotor experience on speech perception.
- Published
- 2017
17. Human Envelope Following Responses to Amplitude Modulation
- Author
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Dimitrijevic, Andrew, Alsamri, Jamal, John, M Sasha, Purcell, David, George, Sahara, and Zeng, Fan-Gang
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Neurosciences ,Behavioral and Social Science ,Clinical Research ,Basic Behavioral and Social Science ,Adolescent ,Adult ,Aged ,Aged ,80 and over ,Aging ,Audiometry ,Pure-Tone ,Evoked Potentials ,Auditory ,Evoked Potentials ,Auditory ,Brain Stem ,Female ,Hearing ,Humans ,Male ,Middle Aged ,Young Adult ,Amplitude modulation ,ASSR ,Auditory ,Auditory steady-state response ,Cortical potentials ,EFR ,Envelope following response ,Temporal processing ,Otorhinolaryngology ,Allied health and rehabilitation science - Abstract
ObjectiveTo record envelope following responses (EFRs) to monaural amplitude-modulated broadband noise carriers in which amplitude modulation (AM) depth was slowly changed over time and to compare these objective electrophysiological measures to subjective behavioral thresholds in young normal hearing and older subjects.DesignParticipantsthree groups of subjects included a young normal-hearing group (YNH 18 to 28 years; pure-tone average = 5 dB HL), a first older group ("O1"; 41 to 62 years; pure-tone average = 19 dB HL), and a second older group ("O2"; 67 to 82 years; pure-tone average = 35 dB HL). Electrophysiology: In condition 1, the AM depth (41 Hz) of a white noise carrier, was continuously varied from 2% to 100% (5%/s). EFRs were analyzed as a function of the AM depth. In condition 2, auditory steady-state responses were recorded to fixed AM depths (100%, 75%, 50%, and 25%) at a rate of 41 Hz. Psychophysics: A 3 AFC (alternative forced choice) procedure was used to track the AM depth needed to detect AM at 41 Hz (AM detection). The minimum AM depth capable of eliciting a statistically detectable EFR was defined as the physiological AM detection threshold.ResultsAcross all ages, the fixed AM depth auditory steady-state response and swept AM EFR yielded similar response amplitudes. Statistically significant correlations (r = 0.48) were observed between behavioral and physiological AM detection thresholds. Older subjects had slightly higher (not significant) behavioral AM detection thresholds than younger subjects. AM detection thresholds did not correlate with age. All groups showed a sigmoidal EFR amplitude versus AM depth function but the shape of the function differed across groups. The O2 group reached EFR amplitude plateau levels at lower modulation depths than the normal-hearing group and had a narrower neural dynamic range. In the young normal-hearing group, the EFR phase did not differ with AM depth, whereas in the older group, EFR phase showed a consistent decrease with increasing AM depth. The degree of phase change (or phase slope) was significantly correlated to the pure-tone threshold at 4 kHz.ConclusionsEFRs can be recorded using either the swept modulation depth or the discrete AM depth techniques. Sweep recordings may provide additional valuable information at suprathreshold intensities including the plateau level, slope, and dynamic range. Older subjects had a reduced neural dynamic range compared with younger subjects suggesting that aging affects the ability of the auditory system to encode subtle differences in the depth of AM. The phase-slope differences are likely related to differences in low and high-frequency contributions to EFR. The behavioral-physiological AM depth threshold relationship was significant but likely too weak to be clinically useful in the present individual subjects who did not suffer from apparent temporal processing deficits.
- Published
- 2016
18. Objective and subjective evaluations of the Nurotron Venus cochlear implant system via animal experiments and clinical trials
- Author
-
Gao, Na, Xu, Xin-Da, Chi, Fang-Lu, Zeng, Fan-Gang, Fu, Qian-Jie, Jia, Xian-Hao, Yin, Yan-Bo, Ping, Li-Chuan, Kang, Hou-Yong, Feng, Hai-Hong, Wu, Yong-Zhen, and Jiang, Ye
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Assistive Technology ,Rehabilitation ,Bioengineering ,Prevention ,Clinical Research ,Adolescent ,Adult ,Animals ,Audiometry ,Pure-Tone ,Cadaver ,Cats ,Child ,Cochlear Implantation ,Cochlear Implants ,Hearing Loss ,Humans ,Magnetic Resonance Imaging ,Middle Aged ,Young Adult ,Cochlear implant ,electrically evoked auditory brainstem responses ,electrically evoked stapedius reflex threshold ,MRI ,Nurotron ,pitch ranking ,speech perception ,Otorhinolaryngology ,Public Health ,Dentistry ,Allied health and rehabilitation science - Abstract
ConclusionThis study described objective and subjective evaluations of the Nurotron® Venus™ Cochlear Implant System and indicated that this system produced a satisfactory performance.ObjectiveTo observe the performance of the Nurotron® Venus™ cochlear implant (CI) system via electrophysiological and psychophysical evaluations.MethodsA 26-electrode CI system was specially designed. The performance of MRI in animal and cadaveric head experiments, EABR in cats experiment, the correlation between ESRT and C level, and psychophysics evaluations in clinical trials were observed.ResultsIn the animal and cadaveric head experiments, magnet dislocation could not be prevented in the 1.5 T MRI without removal of the internal magnet. The EABR was clearly elicited in cat experiment. In the clinical trial, the ESRT was strongly correlated with C level (p
- Published
- 2016
19. Audiometric Profiles in Autism Spectrum Disorders: Does Subclinical Hearing Loss Impact Communication?
- Author
-
Demopoulos, Carly and Lewine, Jeffrey
- Subjects
audiology ,auditory brainstem response ,autism ,communication ,hearing ,Adolescent ,Audiometry ,Pure-Tone ,Auditory Threshold ,Autism Spectrum Disorder ,Child ,Child ,Preschool ,Communication ,Female ,Hearing Loss ,Humans ,Male - Abstract
Rates of hearing impairment in individuals with Autism Spectrum Disorders (ASD) are higher than those reported in the general population. Although ASD is not caused by hearing impairment, it may exacerbate symptomatology. Participants with ASD (N = 60) and typically developing peers (N = 16) aged 5-18 years underwent a comprehensive audiological screening (pure tone audiometry, uncomfortable loudness level, tympanometry, acoustic reflexes, distortion product otoacoustic emissions, and auditory brainstem response) and assessment of communication abilities (expressive/receptive language, articulation, phonological awareness, and vocal affect recognition). Incidence of abnormal findings on at least one measure of audiological functioning was higher for the ASD group (55%) than controls (14.9%) or the general population estimate (6%). The presence of sound sensitivity was also considerably higher for the ASD group (37%) compared with controls (0%) or general population estimates (8-15%). When participants with ASD were dichotomized into groups with and without evidence of clinical audiological abnormality, no significant differences were identified on measures of communication; however, results of correlational analyses indicated that variability in hearing thresholds at middle range frequencies (2000 Hz) was significantly related to performance on all measures of speech articulation and language after correction for multiple comparisons (r = -0.48 to r = -0.53, P
- Published
- 2016
20. Surgical and Audiometric Outcomes for Repair of Congenital Aural Atresia and Hypoplasia
- Author
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Moss, William J, Lin, Harrison W, and Cueva, Roberto A
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Pediatric ,Clinical Research ,Patient Safety ,Prevention ,6.4 Surgery ,Evaluation of treatments and therapeutic interventions ,Adolescent ,Adult ,Aged ,Audiometry ,Auditory Threshold ,Child ,Child ,Preschool ,Congenital Abnormalities ,Ear ,Female ,Hearing ,Humans ,Male ,Middle Aged ,Retrospective Studies ,Treatment Outcome ,Young Adult ,Clinical sciences ,Dentistry ,Allied health and rehabilitation science - Abstract
ImportanceSurgical repair of congenital aural atresia and hypoplasia (CAAH) is technically challenging. Long-term surgical and audiologic outcomes of atresiaplasty are incompletely understood.ObjectivesTo review the surgical outcomes for CAAH and analyze the hearing results.Design, setting, and participantsA retrospective medical record review of CAAH outcomes was performed during an 11-year period from January 1, 2004, through December 31, 2014. The data analysis was undertaken from December 1, 2014, through January 31, 2015. The mean clinic follow-up time was 3.9 years, and the mean audiologic follow-time was 2.8 years. The study included 98 patients aged 5 to 66 years (mean age, 16.6 years) with CAAH who underwent a total of 104 operations.InterventionsSurgical repair of CAAH.Main outcomes and measuresPreoperative and postoperative pure-tone averages (PTAs), speech reception thresholds (SRTs), air-bone gaps (ABGs), and interaural PTA and SRT differences were compared. Factors that affect hearing outcomes were analyzed. The complication rates were reviewed and compared with results from similar studies.ResultsIn the 98 patients with CAAH, the mean improvement in ABGs and SRTs was 26.7 and 25.9 dB, respectively, resulting in a postoperative ABG of 30 dB or less in 4 of 5 cases. The mean postoperative PTAs and SRTs were 36.9 and 34.3 dB, respectively. Patients with a functional native ossicular chain (36 of 104 [34.6%]) had significantly superior audiometric outcomes when compared with patients in whom a reconstruction prosthesis was required during primary or revision operations. Audiometric results from hypoplasia surgery were not significantly different from those of atresia surgery; results in patients with craniofacial syndromes were similarly not significantly different from those in patients with sporadic CAAH. We report a low incidence of meatal stenosis.Conclusions and relevanceThe mean hearing outcomes for this group compared favorably with other series. The need for ossicular chain reconstruction was associated with poorer audiometric outcomes. The safety profile and the demonstrated hearing improvement of CAAH surgery suggest that it remains a favorable option for patients.
- Published
- 2016
21. Surgical and Audiometric Outcomes for Repair of Congenital Aural Atresia and Hypoplasia.
- Author
-
Moss, William J, Lin, Harrison W, and Cueva, Roberto A
- Subjects
Ear ,Humans ,Audiometry ,Treatment Outcome ,Retrospective Studies ,Auditory Threshold ,Hearing ,Adolescent ,Adult ,Aged ,Middle Aged ,Child ,Child ,Preschool ,Female ,Male ,Congenital Abnormalities ,Young Adult ,Preschool - Abstract
ImportanceSurgical repair of congenital aural atresia and hypoplasia (CAAH) is technically challenging. Long-term surgical and audiologic outcomes of atresiaplasty are incompletely understood.ObjectivesTo review the surgical outcomes for CAAH and analyze the hearing results.Design, setting, and participantsA retrospective medical record review of CAAH outcomes was performed during an 11-year period from January 1, 2004, through December 31, 2014. The data analysis was undertaken from December 1, 2014, through January 31, 2015. The mean clinic follow-up time was 3.9 years, and the mean audiologic follow-time was 2.8 years. The study included 98 patients aged 5 to 66 years (mean age, 16.6 years) with CAAH who underwent a total of 104 operations.InterventionsSurgical repair of CAAH.Main outcomes and measuresPreoperative and postoperative pure-tone averages (PTAs), speech reception thresholds (SRTs), air-bone gaps (ABGs), and interaural PTA and SRT differences were compared. Factors that affect hearing outcomes were analyzed. The complication rates were reviewed and compared with results from similar studies.ResultsIn the 98 patients with CAAH, the mean improvement in ABGs and SRTs was 26.7 and 25.9 dB, respectively, resulting in a postoperative ABG of 30 dB or less in 4 of 5 cases. The mean postoperative PTAs and SRTs were 36.9 and 34.3 dB, respectively. Patients with a functional native ossicular chain (36 of 104 [34.6%]) had significantly superior audiometric outcomes when compared with patients in whom a reconstruction prosthesis was required during primary or revision operations. Audiometric results from hypoplasia surgery were not significantly different from those of atresia surgery; results in patients with craniofacial syndromes were similarly not significantly different from those in patients with sporadic CAAH. We report a low incidence of meatal stenosis.Conclusions and relevanceThe mean hearing outcomes for this group compared favorably with other series. The need for ossicular chain reconstruction was associated with poorer audiometric outcomes. The safety profile and the demonstrated hearing improvement of CAAH surgery suggest that it remains a favorable option for patients.
- Published
- 2016
22. Objective and subjective evaluations of the Nurotron Venus cochlear implant system via animal experiments and clinical trials.
- Author
-
Gao, Na, Xu, Xin-Da, Chi, Fang-Lu, Zeng, Fan-Gang, Fu, Qian-Jie, Jia, Xian-Hao, Yin, Yan-Bo, Ping, Li-Chuan, Kang, Hou-Yong, Feng, Hai-Hong, Wu, Yong-Zhen, and Jiang, Ye
- Subjects
Animals ,Cats ,Humans ,Hearing Loss ,Cadaver ,Magnetic Resonance Imaging ,Audiometry ,Pure-Tone ,Cochlear Implantation ,Cochlear Implants ,Adolescent ,Adult ,Middle Aged ,Child ,Young Adult ,Cochlear implant ,MRI ,Nurotron ,electrically evoked auditory brainstem responses ,electrically evoked stapedius reflex threshold ,pitch ranking ,speech perception ,Audiometry ,Pure-Tone ,Otorhinolaryngology ,Public Health ,Clinical Sciences - Abstract
ConclusionThis study described objective and subjective evaluations of the Nurotron® Venus™ Cochlear Implant System and indicated that this system produced a satisfactory performance.ObjectiveTo observe the performance of the Nurotron® Venus™ cochlear implant (CI) system via electrophysiological and psychophysical evaluations.MethodsA 26-electrode CI system was specially designed. The performance of MRI in animal and cadaveric head experiments, EABR in cats experiment, the correlation between ESRT and C level, and psychophysics evaluations in clinical trials were observed.ResultsIn the animal and cadaveric head experiments, magnet dislocation could not be prevented in the 1.5 T MRI without removal of the internal magnet. The EABR was clearly elicited in cat experiment. In the clinical trial, the ESRT was strongly correlated with C level (p
- Published
- 2016
23. Canalplasty for Exostoses With Maximal Skin Preservation With Temporoparietal Fascia Grafting and Use of Bone Wax for Skin Flap Protection
- Author
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Moss, William J, Lin, Harrison W, and Cueva, Roberto A
- Subjects
Clinical Research ,Evaluation of treatments and therapeutic interventions ,6.4 Surgery ,Adult ,Aged ,Audiometry ,Pure-Tone ,Bone Conduction ,Ear Canal ,Exostoses ,Fascia ,Graft Survival ,Humans ,Male ,Middle Aged ,Retrospective Studies ,Scalp ,Surgical Flaps ,Waxes ,Wound Healing ,exostoses ,canalplasty ,skin preservation ,Clinical Sciences ,Otorhinolaryngology - Abstract
BackgroundExternal auditory canal exostoses are benign, bony overgrowths that arise in patients who experience chronic cold water exposure. While considerable advancement has been made in canalplasty techniques in recent decades, many patients continue to experience prolonged healing periods and recurrent stenosis following surgery.ObjectiveTo perform a retrospective outcomes analysis of our experience with a skin-preserving canalplasty technique with temporoparietal fascia grafting and use of bone wax for skin flap protection.Study designRetrospective review.Subjects and methodsThirty-four patients (41 ears) underwent canalplasty from 2008 to 2014 at a tertiary referral center. Primary outcome measures included rates of prolonged healing and restenosis, need for revision surgery, and audiometric results. Rates of intraoperative and postoperative complications were also tabulated.ResultsNo patient experienced recurrent stenosis or required a revision surgery within the follow-up period. All but one patient (97%) achieved complete healing within 8 weeks. Minimal intraoperative complications were found. Statistically significant improvements in air pure tone averages and air-bone gaps were achieved.ConclusionThe proposed technique is a safe and effective method of canalplasty for exostoses that imparts accelerated wound healing and minimizes the rate of recurrent stenosis.
- Published
- 2015
24. Audibility, speech perception and processing of temporal cues in ribbon synaptic disorders due to OTOF mutations
- Author
-
Santarelli, Rosamaria, del Castillo, Ignacio, Cama, Elona, Scimemi, Pietro, and Starr, Arnold
- Subjects
Neurosciences ,Pediatric ,Assistive Technology ,Bioengineering ,Aetiology ,2.1 Biological and endogenous factors ,Ear ,Acoustic Stimulation ,Animals ,Audiometry ,Evoked Response ,Auditory Pathways ,Auditory Threshold ,Cochlea ,Cochlear Implantation ,Cochlear Microphonic Potentials ,Cochlear Nerve ,Cues ,Genetic Predisposition to Disease ,Glutamic Acid ,Hearing ,Hearing Loss ,Humans ,Loudness Perception ,Membrane Proteins ,Mutation ,Persons With Hearing Impairments ,Phenotype ,Reaction Time ,Speech Intelligibility ,Speech Perception ,Synaptic Transmission ,Time Factors ,Auditory neuropathy ,Electrocochleography ,Cochlear implant ,Hearing aids ,Ribbon synaptic disorders ,Clinical Sciences ,Medical Physiology ,Otorhinolaryngology - Abstract
Mutations in the OTOF gene encoding otoferlin result in a disrupted function of the ribbon synapses with impairment of the multivesicular glutamate release. Most affected subjects present with congenital hearing loss and abnormal auditory brainstem potentials associated with preserved cochlear hair cell activities (otoacoustic emissions, cochlear microphonics [CMs]). Transtympanic electrocochleography (ECochG) has recently been proposed for defining the details of potentials arising in both the cochlea and auditory nerve in this disorder, and with a view to shedding light on the pathophysiological mechanisms underlying auditory dysfunction. We review the audiological and electrophysiological findings in children with congenital profound deafness carrying two mutant alleles of the OTOF gene. We show that cochlear microphonic (CM) amplitude and summating potential (SP) amplitude and latency are normal, consistently with a preserved outer and inner hair cell function. In the majority of OTOF children, the SP component is followed by a markedly prolonged low-amplitude negative potential replacing the compound action potential (CAP) recorded in normally-hearing children. This potential is identified at intensities as low as 90 dB below the behavioral threshold. In some ears, a synchronized CAP is superimposed on the prolonged responses at high intensity. Stimulation at high rates reduces the amplitude and duration of the prolonged potentials, consistently with their neural generation. In some children, however, the ECochG response only consists of the SP, with no prolonged potential. Cochlear implants restore hearing sensitivity, speech perception and neural CAP by electrically stimulating the auditory nerve fibers. These findings indicate that an impaired multivesicular glutamate release in OTOF-related disorders leads to abnormal auditory nerve fiber activation and a consequent impairment of spike generation. The magnitude of these effects seems to vary, ranging from no auditory nerve fiber activation to an abnormal generation of EPSPs that occasionally trigger a synchronized electrical activity, resulting in high-threshold CAPs.
- Published
- 2015
25. Canalplasty for Exostoses With Maximal Skin Preservation With Temporoparietal Fascia Grafting and Use of Bone Wax for Skin Flap Protection: A Retrospective Case Series.
- Author
-
Moss, William J, Lin, Harrison W, and Cueva, Roberto A
- Subjects
Scalp ,Fascia ,Ear Canal ,Surgical Flaps ,Humans ,Exostoses ,Waxes ,Audiometry ,Pure-Tone ,Retrospective Studies ,Wound Healing ,Graft Survival ,Bone Conduction ,Adult ,Aged ,Middle Aged ,Male ,canalplasty ,exostoses ,skin preservation ,Audiometry ,Pure-Tone ,Otorhinolaryngology ,Clinical Sciences - Abstract
BackgroundExternal auditory canal exostoses are benign, bony overgrowths that arise in patients who experience chronic cold water exposure. While considerable advancement has been made in canalplasty techniques in recent decades, many patients continue to experience prolonged healing periods and recurrent stenosis following surgery.ObjectiveTo perform a retrospective outcomes analysis of our experience with a skin-preserving canalplasty technique with temporoparietal fascia grafting and use of bone wax for skin flap protection.Study designRetrospective review.Subjects and methodsThirty-four patients (41 ears) underwent canalplasty from 2008 to 2014 at a tertiary referral center. Primary outcome measures included rates of prolonged healing and restenosis, need for revision surgery, and audiometric results. Rates of intraoperative and postoperative complications were also tabulated.ResultsNo patient experienced recurrent stenosis or required a revision surgery within the follow-up period. All but one patient (97%) achieved complete healing within 8 weeks. Minimal intraoperative complications were found. Statistically significant improvements in air pure tone averages and air-bone gaps were achieved.ConclusionThe proposed technique is a safe and effective method of canalplasty for exostoses that imparts accelerated wound healing and minimizes the rate of recurrent stenosis.
- Published
- 2015
26. Audibility, speech perception and processing of temporal cues in ribbon synaptic disorders due to OTOF mutations.
- Author
-
Santarelli, Rosamaria, del Castillo, Ignacio, Cama, Elona, Scimemi, Pietro, and Starr, Arnold
- Subjects
Auditory Pathways ,Cochlear Nerve ,Cochlea ,Animals ,Humans ,Hearing Loss ,Genetic Predisposition to Disease ,Glutamic Acid ,Membrane Proteins ,Audiometry ,Evoked Response ,Acoustic Stimulation ,Cochlear Implantation ,Speech Intelligibility ,Cues ,Auditory Threshold ,Loudness Perception ,Speech Perception ,Reaction Time ,Hearing ,Synaptic Transmission ,Cochlear Microphonic Potentials ,Phenotype ,Mutation ,Time Factors ,Persons With Hearing Impairments ,Auditory neuropathy ,Cochlear implant ,Electrocochleography ,Hearing aids ,Ribbon synaptic disorders ,Audiometry ,Evoked Response ,Otorhinolaryngology ,Clinical Sciences ,Neurosciences ,Medical Physiology - Abstract
Mutations in the OTOF gene encoding otoferlin result in a disrupted function of the ribbon synapses with impairment of the multivesicular glutamate release. Most affected subjects present with congenital hearing loss and abnormal auditory brainstem potentials associated with preserved cochlear hair cell activities (otoacoustic emissions, cochlear microphonics [CMs]). Transtympanic electrocochleography (ECochG) has recently been proposed for defining the details of potentials arising in both the cochlea and auditory nerve in this disorder, and with a view to shedding light on the pathophysiological mechanisms underlying auditory dysfunction. We review the audiological and electrophysiological findings in children with congenital profound deafness carrying two mutant alleles of the OTOF gene. We show that cochlear microphonic (CM) amplitude and summating potential (SP) amplitude and latency are normal, consistently with a preserved outer and inner hair cell function. In the majority of OTOF children, the SP component is followed by a markedly prolonged low-amplitude negative potential replacing the compound action potential (CAP) recorded in normally-hearing children. This potential is identified at intensities as low as 90 dB below the behavioral threshold. In some ears, a synchronized CAP is superimposed on the prolonged responses at high intensity. Stimulation at high rates reduces the amplitude and duration of the prolonged potentials, consistently with their neural generation. In some children, however, the ECochG response only consists of the SP, with no prolonged potential. Cochlear implants restore hearing sensitivity, speech perception and neural CAP by electrically stimulating the auditory nerve fibers. These findings indicate that an impaired multivesicular glutamate release in OTOF-related disorders leads to abnormal auditory nerve fiber activation and a consequent impairment of spike generation. The magnitude of these effects seems to vary, ranging from no auditory nerve fiber activation to an abnormal generation of EPSPs that occasionally trigger a synchronized electrical activity, resulting in high-threshold CAPs.
- Published
- 2015
27. Pathophysiological mechanisms and functional hearing consequences of auditory neuropathy
- Author
-
Rance, Gary and Starr, Arnold
- Subjects
Neurodegenerative ,Assistive Technology ,Neurosciences ,Prevention ,Peripheral Neuropathy ,Bioengineering ,Neurological ,Ear ,Audiometry ,Auditory Threshold ,Dendrites ,Evoked Potentials ,Auditory ,Brain Stem ,Hair Cells ,Auditory ,Inner ,Hearing Loss ,Central ,Humans ,Nerve Fibers ,Myelinated ,Otoacoustic Emissions ,Spontaneous ,Spiral Ganglion ,auditory neuropathy ,auditory brainstem response ,presynaptic ,postsynaptic ,cochlear implant ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Neurology & Neurosurgery - Abstract
The effects of inner ear abnormality on audibility have been explored since the early 20th century when sound detection measures were first used to define and quantify 'hearing loss'. The development in the 1970s of objective measures of cochlear hair cell function (cochlear microphonics, otoacoustic emissions, summating potentials) and auditory nerve/brainstem activity (auditory brainstem responses) have made it possible to distinguish both synaptic and auditory nerve disorders from sensory receptor loss. This distinction is critically important when considering aetiology and management. In this review we address the clinical and pathophysiological features of auditory neuropathy that distinguish site(s) of dysfunction. We describe the diagnostic criteria for: (i) presynaptic disorders affecting inner hair cells and ribbon synapses; (ii) postsynaptic disorders affecting unmyelinated auditory nerve dendrites; (iii) postsynaptic disorders affecting auditory ganglion cells and their myelinated axons and dendrites; and (iv) central neural pathway disorders affecting the auditory brainstem. We review data and principles to identify treatment options for affected patients and explore their benefits as a function of site of lesion.
- Published
- 2015
28. Pathophysiological mechanisms and functional hearing consequences of auditory neuropathy.
- Author
-
Rance, Gary and Starr, Arnold
- Subjects
Spiral Ganglion ,Dendrites ,Nerve Fibers ,Myelinated ,Humans ,Hearing Loss ,Central ,Audiometry ,Auditory Threshold ,Evoked Potentials ,Auditory ,Brain Stem ,Otoacoustic Emissions ,Spontaneous ,Hair Cells ,Auditory ,Inner ,auditory brainstem response ,auditory neuropathy ,cochlear implant ,postsynaptic ,presynaptic ,Neurology & Neurosurgery ,Medical and Health Sciences ,Psychology and Cognitive Sciences - Abstract
The effects of inner ear abnormality on audibility have been explored since the early 20th century when sound detection measures were first used to define and quantify 'hearing loss'. The development in the 1970s of objective measures of cochlear hair cell function (cochlear microphonics, otoacoustic emissions, summating potentials) and auditory nerve/brainstem activity (auditory brainstem responses) have made it possible to distinguish both synaptic and auditory nerve disorders from sensory receptor loss. This distinction is critically important when considering aetiology and management. In this review we address the clinical and pathophysiological features of auditory neuropathy that distinguish site(s) of dysfunction. We describe the diagnostic criteria for: (i) presynaptic disorders affecting inner hair cells and ribbon synapses; (ii) postsynaptic disorders affecting unmyelinated auditory nerve dendrites; (iii) postsynaptic disorders affecting auditory ganglion cells and their myelinated axons and dendrites; and (iv) central neural pathway disorders affecting the auditory brainstem. We review data and principles to identify treatment options for affected patients and explore their benefits as a function of site of lesion.
- Published
- 2015
29. Influence of language experience on digit recognition by English and Chinese listeners
- Author
-
Zhou, Xiaoqing, Yuan, Wei, Galvin, John J, Fu, Qian-Jie, and Zhang, Ying
- Subjects
Language ,Communication and Culture ,Linguistics ,Acoustic Stimulation ,Audiometry ,Pure-Tone ,Audiometry ,Speech ,Auditory Perception ,Cognition ,Humans ,Mental Recall ,Noise ,Perceptual Masking ,Phonetics ,Recognition ,Psychology ,Speech Intelligibility ,Acoustics - Abstract
Digit recognition was measured in quiet and in two noise conditions by English-native (EN) and Chinese-native (CN) listeners. EN listeners were tested using English digits and CN listeners were tested using both English and Chinese digits. In quiet, forward digit span recall worsened for both groups as the number of digits was increased. Significant effects of language experience were observed with five or more digits. Language experience had a significant effect on digit recognition in babble but not in steady noise. These results suggest that understanding of a nonnative language can be influenced by both cognitive load and listening environment.
- Published
- 2015
30. Dose Effect of Intratympanic Dexamethasone for Idiopathic Sudden Sensorineural Hearing Loss
- Author
-
Alexander, Thomas H, Harris, Jeffrey P, Nguyen, Quyen T, and Vorasubin, Nopawan
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Clinical Trials and Supportive Activities ,Brain Disorders ,Pediatric ,Clinical Research ,Neurosciences ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Anti-Inflammatory Agents ,Audiometry ,Pure-Tone ,Dexamethasone ,Female ,Hearing Loss ,Sensorineural ,Hearing Loss ,Sudden ,Humans ,Hyperbaric Oxygenation ,Injection ,Intratympanic ,Male ,Middle Aged ,Prednisone ,Prospective Studies ,Retrospective Studies ,Speech Perception ,Speech Reception Threshold Test ,Treatment Outcome ,Tympanic Membrane ,Idiopathic sudden sensorineural hearing loss ,Intratympanic dexamethasone ,Zoology ,Public Health and Health Services ,Otorhinolaryngology ,Clinical sciences ,Allied health and rehabilitation science - Abstract
ObjectiveTo compare outcomes in patients with idiopathic sudden sensorineural hearing loss (ISSNHL) treated with intratympanic (IT) dexamethasone (DEX) at either 10 mg/mL or 24 mg/mL.Study designRetrospective case series.SettingTertiary referral center.PatientsThirty-seven adults with ISSNHL.InterventionsIn addition to concurrent prednisone taper, patients received a series of IT DEX injections for 2 weeks with either 10 mg/mL or 24 mg/mL.Main outcome measureGreater than 30-dB improvement in pure-tone average (PTA).ResultsBaseline characteristics were similar between groups. Mean follow-up was 10 weeks. Ten (53%) of 19 patients treated with 24 mg/mL had greater than 30-dB improvement in PTA compared with 3 (17%) of 18 treated with 10 mg/mL (p = 0.0382, Fisher's exact test). There was a trend toward improved word recognition score outcome with 24 mg/mL. The interval between onset and initiation of IT DEX significantly affected outcome, with earlier treatment resulting in greater improvement in PTA and word recognition score. Multivariate logistic regression confirmed that IT DEX dose and interval to starting treatment were both independent predictors of PTA outcome. Change in PTA was not significantly affected by age, sex, pretreatment hearing levels, or concurrent treatment with hyperbaric oxygen.ConclusionTo our knowledge, this is the first demonstration of superiority of IT DEX at 24 mg/mL for the treatment of ISSNHL, with significantly better recovery of PTA. Our data suggest that treatment should be initiated as soon as possible. A prospective randomized trial to confirm the optimal dose is warranted.
- Published
- 2015
31. Association of Hearing Impairment with Declines in Physical Functioning and the Risk of Disability in Older Adults
- Author
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Chen, David S, Betz, Joshua, Yaffe, Kristine, Ayonayon, Hilsa N, Kritchevsky, Stephen, Martin, Kathryn R, Harris, Tamara B, Purchase-Helzner, Elizabeth, Satterfield, Suzanne, Xue, Qian-Li, Pratt, Sheila, Simonsick, Eleanor M, and Lin, Frank R
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Aging ,Brain Disorders ,Neurosciences ,Clinical Research ,Rehabilitation ,Prevention ,Activities of Daily Living ,Aged ,Audiometry ,Pure-Tone ,Disability Evaluation ,Female ,Geriatric Assessment ,Hearing Loss ,Humans ,Incidence ,Male ,Prospective Studies ,Risk Factors ,Self Report ,Tennessee ,Physical function ,Physical performance ,Epidemiology ,Health ABC study ,Epidemiology. ,Gerontology ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundIdentifying factors associated with functional declines in older adults is important given the aging of the population. We investigated if hearing impairment is independently associated with objectively measured declines in physical functioning in a community-based sample of older adults.MethodsProspective observational study of 2,190 individuals from the Health, Aging, and Body Composition study. Participants were followed annually for up to 11 visits. Hearing was measured with pure-tone audiometry. Physical functioning and gait speed were measured with the Short Physical Performance Battery (SPPB). Incident disability and requirement for nursing care were assessed semiannually through self-report.ResultsIn a mixed-effects model, greater hearing impairment was associated with poorer physical functioning. At both Visit 1 and Visit 11, SPPB scores were lower in individuals with mild (10.14 [95% CI 10.04-10.25], p < .01; 7.35 [95% CI 7.12-7.58], p < .05) and moderate or greater hearing impairment (10.04 [95% CI 9.90-10.19], p < .01; 7.00 [95% CI 6.69-7.32], p < .01) than scores in normal hearing individuals (10.36 [95% CI 10.26-10.46]; 7.71 [95% CI 7.49-7.92]). We observed that women with moderate or greater hearing impairment had a 31% increased risk of incident disability (Hazard ratio [HR] =1.31 [95% CI 1.08-1.60], p < .01) and a 31% increased risk of incident nursing care requirement (HR = 1.31 [95% CI 1.05-1.62], p = .02) compared to women with normal hearing.ConclusionsHearing impairment is independently associated with poorer objective physical functioning in older adults, and a 31% increased risk for incident disability and need for nursing care in women.
- Published
- 2015
32. Development and evaluation of the Nurotron 26-electrode cochlear implant system
- Author
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Zeng, Fan-Gang, Rebscher, Stephen J, Fu, Qian-Jie, Chen, Hongbin, Sun, Xiaoan, Yin, Li, Ping, Lichuan, Feng, Haihong, Yang, Shiming, Gong, Shusheng, Yang, Beibei, Kang, Hou-Yong, Gao, Na, and Chi, Fanglu
- Subjects
Assistive Technology ,Bioengineering ,Clinical Research ,Rehabilitation ,Prevention ,5.3 Medical devices ,Development of treatments and therapeutic interventions ,Acoustic Stimulation ,Acoustics ,Adolescent ,Adult ,Audiometry ,Speech ,Auditory Pathways ,Auditory Perception ,Auditory Threshold ,Child ,China ,Cochlear Implantation ,Cochlear Implants ,Electric Stimulation ,Female ,Humans ,Loudness Perception ,Male ,Materials Testing ,Middle Aged ,Persons With Hearing Impairments ,Prosthesis Design ,Recovery of Function ,Signal Processing ,Computer-Assisted ,Sound Spectrography ,Speech Perception ,Young Adult ,Clinical Sciences ,Neurosciences ,Medical Physiology ,Otorhinolaryngology - Abstract
Although the cochlear implant has been widely acknowledged as the most successful neural prosthesis, only a fraction of hearing-impaired people who can potentially benefit from a cochlear implant have actually received one due to its limited awareness, accessibility, and affordability. To help overcome these limitations, a 26-electrode cochlear implant has been developed to receive China's Food and Drug Administration (CFDA) approval in 2011 and Conformité Européenne (CE) Marking in 2012. The present article describes design philosophy, system specification, and technical verification of the Nurotron device, which includes advanced digital signal processing and 4 current sources with multiple amplitude resolutions that not only are compatible with perceptual capability but also allow interleaved or simultaneous stimulation. The article also presents 3-year longitudinal evaluation data from 60 human subjects who have received the Nurotron device. The objective measures show that electrode impedance decreased within the first month of device use, but was stable until a slight increase at the end of two years. The subjective loudness measures show that electric stimulation threshold was stable while the maximal comfort level increased over the 3 years. Mandarin sentence recognition increased from the pre-surgical 0%-correct score to a plateau of about 80% correct with 6-month use of the device. Both indirect and direct comparisons indicate indistinguishable performance differences between the Nurotron system and other commercially available devices. The present 26-electrode cochlear implant has already helped to lower the price of cochlear implantation in China and will likely contribute to increased cochlear implant access and success in the rest of the world. This article is part of a Special Issue entitled .
- Published
- 2015
33. Development and evaluation of the Nurotron 26-electrode cochlear implant system.
- Author
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Zeng, Fan-Gang, Rebscher, Stephen J, Fu, Qian-Jie, Chen, Hongbin, Sun, Xiaoan, Yin, Li, Ping, Lichuan, Feng, Haihong, Yang, Shiming, Gong, Shusheng, Yang, Beibei, Kang, Hou-Yong, Gao, Na, and Chi, Fanglu
- Subjects
Auditory Pathways ,Humans ,Audiometry ,Speech ,Acoustic Stimulation ,Cochlear Implantation ,Prosthesis Design ,Materials Testing ,Electric Stimulation ,Sound Spectrography ,Cochlear Implants ,Auditory Perception ,Auditory Threshold ,Loudness Perception ,Speech Perception ,Recovery of Function ,Acoustics ,Signal Processing ,Computer-Assisted ,Adolescent ,Adult ,Middle Aged ,Child ,China ,Female ,Male ,Young Adult ,Persons With Hearing Impairments ,Otorhinolaryngology ,Clinical Sciences ,Neurosciences ,Medical Physiology - Abstract
Although the cochlear implant has been widely acknowledged as the most successful neural prosthesis, only a fraction of hearing-impaired people who can potentially benefit from a cochlear implant have actually received one due to its limited awareness, accessibility, and affordability. To help overcome these limitations, a 26-electrode cochlear implant has been developed to receive China's Food and Drug Administration (CFDA) approval in 2011 and Conformité Européenne (CE) Marking in 2012. The present article describes design philosophy, system specification, and technical verification of the Nurotron device, which includes advanced digital signal processing and 4 current sources with multiple amplitude resolutions that not only are compatible with perceptual capability but also allow interleaved or simultaneous stimulation. The article also presents 3-year longitudinal evaluation data from 60 human subjects who have received the Nurotron device. The objective measures show that electrode impedance decreased within the first month of device use, but was stable until a slight increase at the end of two years. The subjective loudness measures show that electric stimulation threshold was stable while the maximal comfort level increased over the 3 years. Mandarin sentence recognition increased from the pre-surgical 0%-correct score to a plateau of about 80% correct with 6-month use of the device. Both indirect and direct comparisons indicate indistinguishable performance differences between the Nurotron system and other commercially available devices. The present 26-electrode cochlear implant has already helped to lower the price of cochlear implantation in China and will likely contribute to increased cochlear implant access and success in the rest of the world. This article is part of a Special Issue entitled .
- Published
- 2015
34. Association of Hearing Impairment and Mortality in Older Adults
- Author
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Genther, Dane J, Betz, Joshua, Pratt, Sheila, Kritchevsky, Steven B, Martin, Kathryn R, Harris, Tamara B, Helzner, Elizabeth, Satterfield, Suzanne, Xue, Qian-Li, Yaffe, Kristine, Simonsick, Eleanor M, and Lin, Frank R
- Subjects
Bioengineering ,Clinical Research ,Aging ,Rehabilitation ,Brain Disorders ,Neurosciences ,Assistive Technology ,Prevention ,Ear ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Audiometry ,Female ,Hearing Loss ,Humans ,Male ,Pennsylvania ,Proportional Hazards Models ,Prospective Studies ,Risk Factors ,Tennessee ,Epidemiology ,Longevity ,Outcomes ,Public health ,Successful aging ,Health ABC Study ,Successful aging. ,Clinical Sciences ,Gerontology - Abstract
BackgroundHearing impairment (HI) is highly prevalent in older adults and is associated with social isolation, depression, and risk of dementia. Whether HI is associated with broader downstream outcomes is unclear. We undertook this study to determine whether audiometric HI is associated with mortality in older adults.MethodsProspective observational data from 1,958 adults ≥70 years of age from the Health, Aging, and Body Composition Study were analyzed using Cox proportional hazards regression. Participants were followed for 8 years after audiometric examination. Mortality was adjudicated by obtaining death certificates. Hearing was defined as the pure-tone average of hearing thresholds in decibels re: hearing level (dB HL) at frequencies from 0.5 to 4kHz. HI was defined as pure-tone average >25 dB HL in the better ear.ResultsOf the 1,146 participants with HI, 492 (42.9%) died compared with 255 (31.4%) of the 812 with normal hearing (odds ratio = 1.64, 95% CI: 1.36-1.98). After adjustment for demographics and cardiovascular risk factors, HI was associated with a 20% increased mortality risk compared with normal hearing (hazard ratio = 1.20, 95% CI: 1.03-1.41). Confirmatory analyses treating HI as a continuous predictor yielded similar results, demonstrating a nonlinear increase in mortality risk with increasing HI (hazard ratio = 1.14, 95% CI: 1.00-1.29 per 10 dB of threshold elevation up to 35 dB HL).ConclusionsHI in older adults is associated with increased mortality, independent of demographics and cardiovascular risk factors. Further research is necessary to understand the basis of this association and whether these pathways might be amenable to hearing rehabilitation.
- Published
- 2015
35. Prenatal and Postnatal Serum PCB Concentrations and Cochlear Function in Children at 45 Months of Age
- Author
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Jusko, Todd A, Sisto, Renata, Iosif, Ana-Maria, Moleti, Arturo, Wimmerová, Sonˇa, Lancz, Kinga, Tihányi, Juraj, Šovčiková, Eva, Drobná, Beata, Palkovičová, L’ubica, Jurečková, Dana, Thevenet-Morrison, Kelly, Verner, Marc-André, Sonneborn, Dean, Hertz-Picciotto, Irva, and Trnovec, Tomáš
- Subjects
Biomedical and Clinical Sciences ,Environmental Sciences ,Pollution and Contamination ,Health Sciences ,Pediatric ,Clinical Research ,Reproductive health and childbirth ,Adult ,Audiometry ,Pure-Tone ,Child ,Preschool ,Environmental Pollutants ,Female ,Fetal Blood ,Hearing Loss ,Humans ,Male ,Maternal Exposure ,Multivariate Analysis ,Otoacoustic Emissions ,Spontaneous ,Polychlorinated Biphenyls ,Pregnancy ,Prenatal Exposure Delayed Effects ,Slovakia ,Medical and Health Sciences ,Toxicology ,Biomedical and clinical sciences ,Environmental sciences ,Health sciences - Abstract
BackgroundSome experimental and human data suggest that exposure to polychlorinated biphenyls (PCBs) may induce ototoxicity, though results of previous epidemiologic studies are mixed and generally focus on either prenatal or postnatal PCB concentrations exclusively.ObjectivesOur aim was to evaluate the association between pre- and postnatal PCB concentrations in relation to cochlear status, assessed by distortion product otoacoustic emissions (DPOAEs), and to further clarify the critical periods in development where cochlear status may be most susceptible to PCBs.MethodsA total of 351 children from a birth cohort in eastern Slovakia underwent otoacoustic testing at 45 months of age. Maternal pregnancy, cord, and child 6-, 16-, and 45-month blood samples were collected and analyzed for PCB concentrations. At 45 months of age, DPOAEs were assessed at 11 frequencies in both ears. Multivariate, generalized linear models were used to estimate the associations between PCB concentrations at different ages and DPOAEs, adjusting for potential confounders.ResultsMaternal and cord PCB-153 concentrations were not associated with DPOAEs at 45 months. Higher postnatal PCB concentrations at 6-, 16-, and 45-months of age were associated with lower (poorer) DPOAE amplitudes. When all postnatal PCB exposures were considered as an area-under-the-curve metric, an increase in PCB-153 concentration from the 25th to the 75th percentile was associated with a 1.6-dB SPL (sound pressure level) decrease in DPOAE amplitude (95% CI: -2.6, -0.5; p = 0.003).ConclusionsIn this study, postnatal rather than maternal or cord PCB concentrations were associated with poorer performance on otoacoustic tests at age 45 months.
- Published
- 2014
36. Prenatal and postnatal serum PCB concentrations and cochlear function in children at 45 months of age.
- Author
-
Jusko, Todd A, Sisto, Renata, Iosif, Ana-Maria, Moleti, Arturo, Wimmerová, Sonˇa, Lancz, Kinga, Tihányi, Juraj, Sovčiková, Eva, Drobná, Beata, Palkovičová, L'ubica, Jurečková, Dana, Thevenet-Morrison, Kelly, Verner, Marc-André, Sonneborn, Dean, Hertz-Picciotto, Irva, and Trnovec, Tomáš
- Subjects
Fetal Blood ,Humans ,Hearing Loss ,Prenatal Exposure Delayed Effects ,Polychlorinated Biphenyls ,Environmental Pollutants ,Audiometry ,Pure-Tone ,Multivariate Analysis ,Maternal Exposure ,Pregnancy ,Otoacoustic Emissions ,Spontaneous ,Adult ,Child ,Preschool ,Slovakia ,Female ,Male ,Audiometry ,Pure-Tone ,Otoacoustic Emissions ,Spontaneous ,Child ,Preschool ,Toxicology ,Environmental Sciences ,Medical and Health Sciences - Abstract
BackgroundSome experimental and human data suggest that exposure to polychlorinated biphenyls (PCBs) may induce ototoxicity, though results of previous epidemiologic studies are mixed and generally focus on either prenatal or postnatal PCB concentrations exclusively.ObjectivesOur aim was to evaluate the association between pre- and postnatal PCB concentrations in relation to cochlear status, assessed by distortion product otoacoustic emissions (DPOAEs), and to further clarify the critical periods in development where cochlear status may be most susceptible to PCBs.MethodsA total of 351 children from a birth cohort in eastern Slovakia underwent otoacoustic testing at 45 months of age. Maternal pregnancy, cord, and child 6-, 16-, and 45-month blood samples were collected and analyzed for PCB concentrations. At 45 months of age, DPOAEs were assessed at 11 frequencies in both ears. Multivariate, generalized linear models were used to estimate the associations between PCB concentrations at different ages and DPOAEs, adjusting for potential confounders.ResultsMaternal and cord PCB-153 concentrations were not associated with DPOAEs at 45 months. Higher postnatal PCB concentrations at 6-, 16-, and 45-months of age were associated with lower (poorer) DPOAE amplitudes. When all postnatal PCB exposures were considered as an area-under-the-curve metric, an increase in PCB-153 concentration from the 25th to the 75th percentile was associated with a 1.6-dB SPL (sound pressure level) decrease in DPOAE amplitude (95% CI: -2.6, -0.5; p = 0.003).ConclusionsIn this study, postnatal rather than maternal or cord PCB concentrations were associated with poorer performance on otoacoustic tests at age 45 months.
- Published
- 2014
37. Auditory cortex activation to natural speech and simulated cochlear implant speech measured with functional near-infrared spectroscopy
- Author
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Pollonini, Luca, Olds, Cristen, Abaya, Homer, Bortfeld, Heather, Beauchamp, Michael S, and Oghalai, John S
- Subjects
Neurosciences ,Prevention ,Clinical Research ,Assistive Technology ,Bioengineering ,Rehabilitation ,Ear ,Acoustic Stimulation ,Adult ,Audiometry ,Speech ,Auditory Cortex ,Auditory Threshold ,Brain Mapping ,Cochlear Implants ,Evoked Potentials ,Auditory ,Female ,Humans ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Predictive Value of Tests ,Signal Processing ,Computer-Assisted ,Spectroscopy ,Near-Infrared ,Speech Intelligibility ,Speech Perception ,Time Factors ,Young Adult ,Clinical Sciences ,Medical Physiology ,Otorhinolaryngology - Abstract
The primary goal of most cochlear implant procedures is to improve a patient's ability to discriminate speech. To accomplish this, cochlear implants are programmed so as to maximize speech understanding. However, programming a cochlear implant can be an iterative, labor-intensive process that takes place over months. In this study, we sought to determine whether functional near-infrared spectroscopy (fNIRS), a non-invasive neuroimaging method which is safe to use repeatedly and for extended periods of time, can provide an objective measure of whether a subject is hearing normal speech or distorted speech. We used a 140 channel fNIRS system to measure activation within the auditory cortex in 19 normal hearing subjects while they listed to speech with different levels of intelligibility. Custom software was developed to analyze the data and compute topographic maps from the measured changes in oxyhemoglobin and deoxyhemoglobin concentration. Normal speech reliably evoked the strongest responses within the auditory cortex. Distorted speech produced less region-specific cortical activation. Environmental sounds were used as a control, and they produced the least cortical activation. These data collected using fNIRS are consistent with the fMRI literature and thus demonstrate the feasibility of using this technique to objectively detect differences in cortical responses to speech of different intelligibility.
- Published
- 2014
38. Auditory cortex activation to natural speech and simulated cochlear implant speech measured with functional near-infrared spectroscopy.
- Author
-
Pollonini, Luca, Olds, Cristen, Abaya, Homer, Bortfeld, Heather, Beauchamp, Michael S, and Oghalai, John S
- Subjects
Auditory Cortex ,Humans ,Magnetic Resonance Imaging ,Spectroscopy ,Near-Infrared ,Audiometry ,Speech ,Acoustic Stimulation ,Brain Mapping ,Predictive Value of Tests ,Cochlear Implants ,Speech Intelligibility ,Auditory Threshold ,Speech Perception ,Evoked Potentials ,Auditory ,Time Factors ,Signal Processing ,Computer-Assisted ,Adult ,Middle Aged ,Female ,Male ,Young Adult ,Clinical Sciences ,Neurosciences ,Medical Physiology ,Otorhinolaryngology - Abstract
The primary goal of most cochlear implant procedures is to improve a patient's ability to discriminate speech. To accomplish this, cochlear implants are programmed so as to maximize speech understanding. However, programming a cochlear implant can be an iterative, labor-intensive process that takes place over months. In this study, we sought to determine whether functional near-infrared spectroscopy (fNIRS), a non-invasive neuroimaging method which is safe to use repeatedly and for extended periods of time, can provide an objective measure of whether a subject is hearing normal speech or distorted speech. We used a 140 channel fNIRS system to measure activation within the auditory cortex in 19 normal hearing subjects while they listed to speech with different levels of intelligibility. Custom software was developed to analyze the data and compute topographic maps from the measured changes in oxyhemoglobin and deoxyhemoglobin concentration. Normal speech reliably evoked the strongest responses within the auditory cortex. Distorted speech produced less region-specific cortical activation. Environmental sounds were used as a control, and they produced the least cortical activation. These data collected using fNIRS are consistent with the fMRI literature and thus demonstrate the feasibility of using this technique to objectively detect differences in cortical responses to speech of different intelligibility.
- Published
- 2014
39. Automated Audiometry Using Apple iOS‐Based Application Technology
- Author
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Foulad, Allen, Bui, Peggy, and Djalilian, Hamid
- Subjects
Assistive Technology ,Clinical Research ,Rehabilitation ,Bioengineering ,Audiometry ,Computers ,Handheld ,Equipment Design ,Feasibility Studies ,Hearing ,Hearing Disorders ,Humans ,Prospective Studies ,Reproducibility of Results ,Software Design ,audiometry ,hearing ,test ,automated ,iOS ,iPhone ,iPod ,iPad ,audiogram ,Clinical Sciences ,Otorhinolaryngology - Abstract
ObjectiveThe aim of this study is to determine the feasibility of an Apple iOS-based automated hearing testing application and to compare its accuracy with conventional audiometry.Study designProspective diagnostic study. Setting Academic medical center.Subjects and methodsAn iOS-based software application was developed to perform automated pure-tone hearing testing on the iPhone, iPod touch, and iPad. To assess for device variations and compatibility, preliminary work was performed to compare the standardized sound output (dB) of various Apple device and headset combinations. Forty-two subjects underwent automated iOS-based hearing testing in a sound booth, automated iOS-based hearing testing in a quiet room, and conventional manual audiometry.ResultsThe maximum difference in sound intensity between various Apple device and headset combinations was 4 dB. On average, 96% (95% confidence interval [CI], 91%-100%) of the threshold values obtained using the automated test in a sound booth were within 10 dB of the corresponding threshold values obtained using conventional audiometry. When the automated test was performed in a quiet room, 94% (95% CI, 87%-100%) of the threshold values were within 10 dB of the threshold values obtained using conventional audiometry. Under standardized testing conditions, 90% of the subjects preferred iOS-based audiometry as opposed to conventional audiometry.ConclusionApple iOS-based devices provide a platform for automated air conduction audiometry without requiring extra equipment and yield hearing test results that approach those of conventional audiometry.
- Published
- 2013
40. Automated audiometry using apple iOS-based application technology.
- Author
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Foulad, Allen, Bui, Peggy, and Djalilian, Hamid
- Subjects
Humans ,Hearing Disorders ,Audiometry ,Prospective Studies ,Feasibility Studies ,Reproducibility of Results ,Equipment Design ,Hearing ,Computers ,Handheld ,Software Design ,audiogram ,audiometry ,automated ,hearing ,iOS ,iPad ,iPhone ,iPod ,test ,Computers ,Handheld ,Otorhinolaryngology ,Clinical Sciences - Abstract
ObjectiveThe aim of this study is to determine the feasibility of an Apple iOS-based automated hearing testing application and to compare its accuracy with conventional audiometry.Study designProspective diagnostic study. Setting Academic medical center.Subjects and methodsAn iOS-based software application was developed to perform automated pure-tone hearing testing on the iPhone, iPod touch, and iPad. To assess for device variations and compatibility, preliminary work was performed to compare the standardized sound output (dB) of various Apple device and headset combinations. Forty-two subjects underwent automated iOS-based hearing testing in a sound booth, automated iOS-based hearing testing in a quiet room, and conventional manual audiometry.ResultsThe maximum difference in sound intensity between various Apple device and headset combinations was 4 dB. On average, 96% (95% confidence interval [CI], 91%-100%) of the threshold values obtained using the automated test in a sound booth were within 10 dB of the corresponding threshold values obtained using conventional audiometry. When the automated test was performed in a quiet room, 94% (95% CI, 87%-100%) of the threshold values were within 10 dB of the threshold values obtained using conventional audiometry. Under standardized testing conditions, 90% of the subjects preferred iOS-based audiometry as opposed to conventional audiometry.ConclusionApple iOS-based devices provide a platform for automated air conduction audiometry without requiring extra equipment and yield hearing test results that approach those of conventional audiometry.
- Published
- 2013
41. The prevalence and characteristics of tinnitus in the youth population of the United States
- Author
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Mahboubi, Hossein, Oliaei, Sepehr, Kiumehr, Saman, Dwabe, Sami, and Djalilian, Hamid R
- Subjects
Prevention ,Pediatric ,2.3 Psychological ,social and economic factors ,2.1 Biological and endogenous factors ,Aetiology ,Ear ,Acoustic Impedance Tests ,Adolescent ,Audiometry ,Child ,Cross-Sectional Studies ,Female ,Humans ,Male ,Occupational Exposure ,Prevalence ,Risk Factors ,Tinnitus ,United States ,Young Adult ,pediatric population ,noise exposure ,smoking ,loud music ,ear infection ,Clinical Sciences ,Otorhinolaryngology - Abstract
Objectives/hypothesisTo evaluate the prevalence, characteristics, and associated risk factors of tinnitus in U.S. adolescents.Study designCross-sectional analyses of U.S. representative demographic and audiometric data, the National Health and Nutrition Examination Survey (NHANES) 2005 to 2008.MethodsThe study population consisted of 3,520 individuals aged 12 to 19 years with complete tinnitus-related data. Tinnitus was defined as the presence of ringing or buzzing in the ears lasting for at least 5 minutes during the preceding 12 months. In addition, we defined a chronic tinnitus subgroup as being bothered by tinnitus for more than 3 months. Demographic and other data regarding tinnitus, smoking, body mass index (BMI), anemia, hypertension, history of ear infections, tympanostomy tube placement, otoscopy, tympanometry and hearing thresholds, history of firearm use, and recreational and occupational exposure to noise were extracted and analyzed.ResultsOverall, tinnitus lasting 5 minutes or more in the preceding 12 months was reported by 7.5% of the 12- to 19-year-old population. This represents about 2.5 million adolescents in the United States. The prevalence of chronic tinnitus was 4.7%, corresponding to about 1.6 million adolescents in the United States. Multivariable-adjusted analysis revealed that both overall and chronic tinnitus were associated with female gender, low income, exposure to passive smoking, type A tympanogram, and occupational and recreational noise exposure. History of ≥ 3 ear infections and history of tympanostomy tube placement were associated only with overall tinnitus.ConclusionsTinnitus afflicts a substantial portion of the youth population. Further investigation of the association between tinnitus and the identified risk factors is warranted.
- Published
- 2013
42. Bayesian adaptive estimation of the auditory filter
- Author
-
Shen, Yi and Richards, Virginia M
- Subjects
Ear ,Acoustic Stimulation ,Adult ,Attention ,Audiometry ,Pure-Tone ,Auditory Pathways ,Auditory Perception ,Auditory Threshold ,Bayes Theorem ,Female ,Humans ,Male ,Models ,Psychological ,Noise ,Perceptual Masking ,Pressure ,Psychoacoustics ,Signal Detection ,Psychological ,Sound Spectrography ,Young Adult ,Acoustics - Abstract
A Bayesian adaptive procedure for estimating the auditory-filter shape was proposed and evaluated using young, normal-hearing listeners at moderate stimulus levels. The resulting quick-auditory-filter (qAF) procedure assumed the power spectrum model of masking with the auditory-filter shape being modeled using a spectrally symmetric, two-parameter rounded-exponential (roex) function. During data collection using the qAF procedure, listeners detected the presence of a pure-tone signal presented in the spectral notch of a noise masker. Dependent on the listener's response on each trial, the posterior probability distributions of the model parameters were updated, and the resulting parameter estimates were then used to optimize the choice of stimulus parameters for the subsequent trials. Results showed that the qAF procedure gave similar parameter estimates to the traditional threshold-based procedure in many cases and was able to reasonably predict the masked signal thresholds. Additional measurements suggested that occasional failures of the qAF procedure to reliably converge could be a consequence of incorrect responses early in a qAF track. The addition of a parameter describing lapses of attention reduced the likelihood of such failures.
- Published
- 2013
43. Level dominance for the detection of changes in level distribution in sound streams.
- Author
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Richards, Virginia M, Shen, Yi, and Chubb, Charles
- Subjects
Humans ,Observer Variation ,Audiometry ,Acoustic Stimulation ,Analysis of Variance ,Logistic Models ,Reproducibility of Results ,Sound Spectrography ,Auditory Perception ,Auditory Threshold ,Judgment ,Psychoacoustics ,Acoustics ,Sound ,Motion ,Time Factors ,Signal Detection ,Psychological ,Young Adult ,Signal Detection ,Psychological - Abstract
Sound streams were generated by randomly choosing the levels of tone pips from two different distributions, A and B. Of the 18 tone pips, the first nine were drawn from distribution A and the second nine from distribution B, or the opposite. The listeners' task was to indicate order, A-B or B-A. In two conditions the A and B distributions differed in mean (condition 1) or variance (condition 2). In contrast to an ideal observer, listeners' strategies were consistent across the two conditions. Analyses suggest that listeners relied primarily on the more intense tone pips in making their decisions.
- Published
- 2013
44. The prevalence and characteristics of tinnitus in the youth population of the United States.
- Author
-
Mahboubi, Hossein, Oliaei, Sepehr, Kiumehr, Saman, Dwabe, Sami, and Djalilian, Hamid R
- Subjects
Humans ,Tinnitus ,Acoustic Impedance Tests ,Audiometry ,Prevalence ,Risk Factors ,Cross-Sectional Studies ,Occupational Exposure ,Adolescent ,Child ,United States ,Female ,Male ,Young Adult ,ear infection ,loud music ,noise exposure ,pediatric population ,smoking ,Otorhinolaryngology ,Clinical Sciences - Abstract
Objectives/hypothesisTo evaluate the prevalence, characteristics, and associated risk factors of tinnitus in U.S. adolescents.Study designCross-sectional analyses of U.S. representative demographic and audiometric data, the National Health and Nutrition Examination Survey (NHANES) 2005 to 2008.MethodsThe study population consisted of 3,520 individuals aged 12 to 19 years with complete tinnitus-related data. Tinnitus was defined as the presence of ringing or buzzing in the ears lasting for at least 5 minutes during the preceding 12 months. In addition, we defined a chronic tinnitus subgroup as being bothered by tinnitus for more than 3 months. Demographic and other data regarding tinnitus, smoking, body mass index (BMI), anemia, hypertension, history of ear infections, tympanostomy tube placement, otoscopy, tympanometry and hearing thresholds, history of firearm use, and recreational and occupational exposure to noise were extracted and analyzed.ResultsOverall, tinnitus lasting 5 minutes or more in the preceding 12 months was reported by 7.5% of the 12- to 19-year-old population. This represents about 2.5 million adolescents in the United States. The prevalence of chronic tinnitus was 4.7%, corresponding to about 1.6 million adolescents in the United States. Multivariable-adjusted analysis revealed that both overall and chronic tinnitus were associated with female gender, low income, exposure to passive smoking, type A tympanogram, and occupational and recreational noise exposure. History of ≥ 3 ear infections and history of tympanostomy tube placement were associated only with overall tinnitus.ConclusionsTinnitus afflicts a substantial portion of the youth population. Further investigation of the association between tinnitus and the identified risk factors is warranted.
- Published
- 2013
45. A novel approach for surgical repair of dehiscent high jugular bulb
- Author
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Shaikh, Mohammad F, Mahboubi, Hossein, German, Michael, and Djalilian, Hamid R
- Subjects
Adolescent ,Audiometry ,Pure-Tone ,Diagnosis ,Differential ,Fascia ,Female ,Gelatin Sponge ,Absorbable ,Hearing Loss ,Conductive ,Hearing Loss ,Unilateral ,Humans ,Jugular Veins ,Semicircular Canals ,Surgical Flaps ,Tomography ,X-Ray Computed ,Clinical Sciences ,Otorhinolaryngology - Published
- 2013
46. A novel approach for surgical repair of dehiscent high jugular bulb.
- Author
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Shaikh, Mohammad F, Mahboubi, Hossein, German, Michael, and Djalilian, Hamid R
- Subjects
Fascia ,Jugular Veins ,Semicircular Canals ,Surgical Flaps ,Humans ,Hearing Loss ,Conductive ,Hearing Loss ,Unilateral ,Diagnosis ,Differential ,Tomography ,X-Ray Computed ,Audiometry ,Pure-Tone ,Gelatin Sponge ,Absorbable ,Adolescent ,Female ,Otorhinolaryngology ,Clinical Sciences - Published
- 2013
47. Systematic Assessment of Noise Amplitude Generated by Toys Intended for Young Children
- Author
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Mahboubi, Hossein, Oliaei, Sepehr, Badran, Karam W, Ziai, Kasra, Chang, Janice, Zardouz, Shawn, Shahriari, Shawn, and Djalilian, Hamid R
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Pediatric ,Age Factors ,Analysis of Variance ,Audiometry ,Auditory Threshold ,California ,Child Welfare ,Child ,Preschool ,Consumer Product Safety ,Female ,Hearing Loss ,Noise-Induced ,Humans ,Infant ,Male ,Marketing ,Needs Assessment ,Noise ,Play and Playthings ,Retrospective Studies ,Risk Assessment ,acoustic trauma ,noise-induced hearing loss ,pediatric noise exposure ,toys ,sensorineural hearing loss ,Otorhinolaryngology ,Clinical sciences - Abstract
ObjectiveTo systematically evaluate the noise generated by toys targeted for children and to compare the results over the course of 4 consecutive holiday shopping seasons.Study designExperimental study.SettingAcademic medical center.Subjects and methodsDuring 2008-2011, more than 200 toys marketed for children older than 6 months were screened for loudness. The toys with sound output of more than 80 dBA at speaker level were retested in a soundproof audiometry booth. The generated sound amplitude of each toy was measured at speaker level and at 30 cm away from the speaker.ResultsNinety different toys were analyzed. The mean (SD) noise amplitude was 100 (8) dBA (range, 80-121 dBA) at the speaker level and 80 (11) dBA (range, 60-109 dBA) at 30 cm away from the speaker. Eighty-eight (98%) had more than an 85-dBA noise amplitude at speaker level, whereas 19 (26%) had more than an 85-dBA noise amplitude at a 30-cm distance. Only the mean noise amplitude at 30 cm significantly declined during the studied period (P < .001). There was no significant difference in mean noise amplitude of different toys specified for different age groups.ConclusionOur findings demonstrate the persistence of extremely loud toys marketed for very young children. Acoustic trauma from toys remains a potential risk factor for noise-induced hearing loss in this age group, warranting promotion of public awareness and regulatory considerations for manufacture and marketing of toys.
- Published
- 2013
48. Systematic assessment of noise amplitude generated by toys intended for young children.
- Author
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Mahboubi, Hossein, Oliaei, Sepehr, Badran, Karam W, Ziai, Kasra, Chang, Janice, Zardouz, Shawn, Shahriari, Shawn, and Djalilian, Hamid R
- Subjects
Humans ,Hearing Loss ,Noise-Induced ,Audiometry ,Analysis of Variance ,Risk Assessment ,Retrospective Studies ,Auditory Threshold ,Noise ,Consumer Product Safety ,Age Factors ,Child Welfare ,Needs Assessment ,Play and Playthings ,Marketing ,Child ,Preschool ,Infant ,California ,Female ,Male ,acoustic trauma ,noise-induced hearing loss ,pediatric noise exposure ,sensorineural hearing loss ,toys ,Hearing Loss ,Noise-Induced ,Child ,Preschool ,Otorhinolaryngology ,Clinical Sciences - Abstract
ObjectiveTo systematically evaluate the noise generated by toys targeted for children and to compare the results over the course of 4 consecutive holiday shopping seasons.Study designExperimental study.SettingAcademic medical center.Subjects and methodsDuring 2008-2011, more than 200 toys marketed for children older than 6 months were screened for loudness. The toys with sound output of more than 80 dBA at speaker level were retested in a soundproof audiometry booth. The generated sound amplitude of each toy was measured at speaker level and at 30 cm away from the speaker.ResultsNinety different toys were analyzed. The mean (SD) noise amplitude was 100 (8) dBA (range, 80-121 dBA) at the speaker level and 80 (11) dBA (range, 60-109 dBA) at 30 cm away from the speaker. Eighty-eight (98%) had more than an 85-dBA noise amplitude at speaker level, whereas 19 (26%) had more than an 85-dBA noise amplitude at a 30-cm distance. Only the mean noise amplitude at 30 cm significantly declined during the studied period (P < .001). There was no significant difference in mean noise amplitude of different toys specified for different age groups.ConclusionOur findings demonstrate the persistence of extremely loud toys marketed for very young children. Acoustic trauma from toys remains a potential risk factor for noise-induced hearing loss in this age group, warranting promotion of public awareness and regulatory considerations for manufacture and marketing of toys.
- Published
- 2013
49. Perception of Pure Tones and Iterated Rippled Noise for Normal Hearing and Cochlear Implant Users
- Author
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Penninger, Richard T, Chien, Wade W, Jiradejvong, Patpong, Boeke, Emily, Carver, Courtney L, and Limb, Charles J
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Rehabilitation ,Prevention ,Clinical Research ,Bioengineering ,Assistive Technology ,Acoustic Stimulation ,Adult ,Aged ,Audiometry ,Pure-Tone ,Case-Control Studies ,Cochlear Implantation ,Cochlear Implants ,Correction of Hearing Impairment ,Electric Stimulation ,Female ,Hearing Loss ,Humans ,Linear Models ,Male ,Middle Aged ,Music ,Persons With Hearing Impairments ,Pitch Discrimination ,Recognition ,Psychology ,Sound Spectrography ,Time Factors ,cochlear implants ,pitch perception ,melody recognition ,iterated rippled noise ,Otorhinolaryngology - Abstract
Cochlear Implant (CI) users typically perform poorly on musical tasks, especially those based on pitch ranking and melody recognition. It was hypothesized that CI users would demonstrate deterioration in performance for a pitch ranking and a melody recognition task presented with iterated rippled noise (IRN) in comparison to pure tones (PT). In Addition, it was hypothesized that normal hearing (NH) listeners would show fewer differences in performance between IRN and PT for these two tasks. In this study, the ability of CI users and NH subjects to rank pitches and to identify melodies created with IRN and PT was assessed in free field in a sound-isolated room. CI subjects scored significantly above chance level with PT stimuli in both tasks. With IRN stimuli their performance was around chance level. NH subjects scored significantly above chance level in both tasks and with all stimuli. NH subjects performed significantly better than CI subjects in both tasks. These results illustrate the difficulties of CI subjects to rank pitches and to identify melodies.
- Published
- 2013
50. Hearing Loss and Cognitive Decline in Older Adults
- Author
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Lin, Frank R, Yaffe, Kristine, Xia, Jin, Xue, Qian-Li, Harris, Tamara B, Purchase-Helzner, Elizabeth, Satterfield, Suzanne, Ayonayon, Hilsa N, Ferrucci, Luigi, Simonsick, Eleanor M, and Group, for the Health ABC Study
- Subjects
Allied Health and Rehabilitation Science ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Assistive Technology ,Clinical Research ,Bioengineering ,Aging ,Brain Disorders ,Behavioral and Social Science ,Mental health ,Ear ,Aged ,Aged ,80 and over ,Audiometry ,Cognition Disorders ,Female ,Hearing Loss ,Humans ,Incidence ,Linear Models ,Male ,Neuropsychological Tests ,Proportional Hazards Models ,Prospective Studies ,Risk Factors ,Health ABC Study Group ,Opthalmology and Optometry ,Public Health and Health Services ,Clinical sciences ,Health services and systems - Abstract
BACKGROUND Whether hearing loss is independently associated with accelerated cognitive decline in older adults is unknown. METHODS We studied 1984 older adults (mean age, 77.4 years) enrolled in the Health ABC Study, a prospective observational study begun in 1997-1998. Our baseline cohort consisted of participants without prevalent cognitive impairment (Modified Mini-Mental State Examination [3MS] score, ≥80) who underwent audiometric testing in year 5. Participants were followed up for 6 years. Hearing was defined at baseline using a pure-tone average of thresholds at 0.5 to 4 kHz in the better-hearing ear. Cognitive testing was performed in years 5, 8, 10, and 11 and consisted of the 3MS (measuring global function) and the Digit Symbol Substitution test (measuring executive function). Incident cognitive impairment was defined as a 3MS score of less than 80 or a decline in 3MS score of more than 5 points from baseline. Mixed-effects regression and Cox proportional hazards regression models were adjusted for demographic and cardiovascular risk factors. RESULTS In total, 1162 individuals with baseline hearing loss (pure-tone average >25 dB) had annual rates of decline in 3MS and Digit Symbol Substitution test scores that were 41% and 32% greater, respectively, than those among individuals with normal hearing. On the 3MS, the annual score changes were -0.65 (95% CI, -0.73 to -0.56) vs -0.46 (95% CI, -0.55 to -0.36) points per year (P = .004). On the Digit Symbol Substitution test, the annual score changes were -0.83 (95% CI, -0.94 to -0.73) vs -0.63 (95% CI, -0.75 to -0.51) points per year (P = .02). Compared to those with normal hearing, individuals with hearing loss at baseline had a 24% (hazard ratio, 1.24; 95% CI, 1.05-1.48) increased risk for incident cognitive impairment. Rates of cognitive decline and the risk for incident cognitive impairment were linearly associated with the severity of an individual's baseline hearing loss. CONCLUSIONS Hearing loss is independently associated with accelerated cognitive decline and incident cognitive impairment in community-dwelling older adults. Further studies are needed to investigate what the mechanistic basis of this association is and whether hearing rehabilitative interventions could affect cognitive decline.
- Published
- 2013
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