Auditory performance characteristics of the Computerized Revised Token Test (CRTT).

PURPOSE: To assess the Computerized Revised Token Test (CRTT) performance of individuals with normal hearing under several intensity conditions and under several spectral and temporal perturbation conditions. METHOD: Sixty normal-hearing listeners were randomly assigned to 1 of 3 groups. Group 1 provided performance-intensity information about CRTT performance using uncompressed acoustic stimuli. Groups 2 and 3 completed the CRTT using temporally and spectrally compressed and expanded stimuli. CRTT performance functions were plotted for each group. RESULTS: Group 1 required minimal audibility to perform maximally on this task. As expected, Groups 2 and 3 showed significant differences across subtests, regardless of distortion condition. Mean differences in performance between successive conditions for Group 2 increased beyond 40% time compressed. There was 1 significant difference for the time-expanded condition. There were no differences across frequency compressed and expanded conditions. CONCLUSION: Young listeners require limited signal gain on the CRTT to achieve maximum performance. Time and frequency compression and expansion results were consistent with previous findings with varying types of speech stimuli. The results have implications for administration and interpretation of the CRTT administered to persons from other populations and will help in the development of a normative database for the CRTT.     

Difference in standard scores of adults on the Peabody Picture Vocabulary Test (Revised and Third Edition).

Differences in the standard scores for the Peabody Picture Vocabulary Test-Revised (PPVT-R; L. M. Dunn and L. M. Dunn, 1981) and the PPVT-Third Edition (PPVT-III; Dunn and Dunn, 1997b) are known to exist for children, with typically higher scores occurring on the PPVT-III. However, these tests are administered into adulthood as well, and score equivalence must be evaluated for this age range. Analysis of data from the PPVT-R and PPVT-III tests from 76 adult participants revealed significant score differences. Participants with poor language skills scored significantly higher on the PPVT-III than on the PPVT-R. The control group showed no significant difference between the PPVT-R and PPVT-III scores. The results suggest that the two tests should not be considered interchangeable.     

A new physiological scale for assessing posttraumatic disability in stomatology

Establishing post-traumatic disability according to the present scale raises problems in relation to patients with 100% disability who cannot, under existing conditions, be compensated for further injuries. A complete reorganization of this system is proposed in which total 100% invalidity corresponds to death of the patient. For patients with some, even limited, capacities, the post-traumatic physiologic disability + remaining capacity would be equal to 100%. Proposed scales are reviewed and classified into 5 groups.     

A novel behavioral paradigm for assessing tinnitus using schedule-induced polydipsia avoidance conditioning (SIP-AC)

A behavioral technique was developed that allowed the onset and recovery of tinnitus to be measured in individual rats treated with different doses of salicylate. Food-restricted rats were self-trained to lick for water during the time between scheduled delivery of food pellets, i.e., schedule-induced polydipsia (SIP). SIP-induced licking was placed under stimulus control by administering foot shock if licks occurred when sound (one of six stimuli, 40 dB SPL) was present; rats were allowed to lick during quiet. After the number of licks-in-quiet (correct response) exceeded 90% of total licks, rats were treated with saline and four different doses of salicylate (50, 100, 150 and 350 mg/kg, intraperitoneally (i.p.); 2 days). Performance was assessed before, during and after treatment. Licks-in-sound remained extremely low with saline and all four salicylate doses indicating that the sounds were audible under all treatment conditions. Licks-in-quiet remained high during the saline control and 50 mg/kg dose of salicylate, behavior consistent with the absence of tinnitus. However, licks-in-quiet showed a statistically significant decline with the 150 and 350 mg/kg dose, behavior consistent with the presence of tinnitus. Licks-in-quiet gradually recovered to baseline level 2–3 days following high-dose salicylate treatments, behavior consistent with the gradual disappearance of tinnitus. The salicylate dose needed to induce tinnitus and the length of recovery are consistent with previous reports, providing support for the method. The ability to obtain sequential estimates of tinnitus-like behavior in an animal after administering a tinnitus-inducing agent could aid in understanding the underlying neural mechanisms and assessing potential treatments.     

Evaluation of a Revised Speech in Noise (RSIN) test

A revised version of the Speech in Noise (SIN) test was developed by reallocating the recorded test material on the compact disc into different lists (blocks). The goal was to increase the equivalence and reliability of the test blocks to enhance their usefulness in research settings. The Revised Speech in Noise test has four blocks of sentences. Each block comprises twice as many sentences as in the original SIN test. There are also practice sentences for each condition. Forty-two elderly subjects with normal hearing for their age and gender provided data on the equivalence of the new test blocks. The remaining inequalities in mean scores were mostly eliminated using score weighting. Critical differences were developed to promote interpretation of scores from the same individual under different conditions. The revisions substantially improved the equivalence of test blocks and their sensitivity to performance changes. Increased test time is the associated drawback.     

Objectivating nasality in healthy and velopharyngeal insufficient children with the Nasalance Acquisition System (NasalView). Defining minimal required speech tasks assessing normative values for Dutch language

OBJECTIVES: (1) To define normative nasalance data for Dutch language with "the NasalView System", and obtain a reference for normality when nasality is evaluated in children. (2) To investigate the minimal number of required speech tasks for a reliable nasalance measurement. METHODS: 55 children (30 normal and 25 velopharyngeal insufficient), aged between 4 and 11 were included. All children had to read or repeat two Dutch passages ((one with a normal amount of nasal consonants (normal passage) and one with none (nonnasal passage)). Further, one normal and one velopharyngeal insufficient subject read a passage in repetition to test the NasalViews reproducibility: (1) For both passages, group means (GM) and standard deviations (S.D.) were used to compute "pathological nasalance boundaries" [GM +/- (2 x S.D.)], in combination with the coefficient of variation (CV), sensitivity, specificity and positive predictive values. (2) With ANOVA all sentences within each passage were tested for significant differences in nasalance. RESULTS: (1) The pathological boundaries were 28.6-41.4% (GM: 35.0) and 21.4-34.7% (GM: 28.1), for the normal and nonnasal passage, respectively. For the normal passage a sensitivity of 96%, a specificity of 93% and a positive predictive value of 92% was computed. For the nonnasal passage these parameters were 96, 95 and 96%, respectively. Intra subject CVs of 3.6% (normal subject) and 1.5% (VI subject) showed good reproducibility of measurements. (2) Within the normal passage only the third sentence was significantly different in nasalance, compared to the entire passage (31.2% versus 35.0%). Within the nonnasal passage the second and fifth sentences were significantly different (23.8 and 24.8% versus 28.1%). However, the individual nonsignificantly different sentences showed a higher variation in nasalance compared to the entire passages. CONCLUSIONS: The NasalView System seems to be reliable and quantifies valid nasalance values when nasality is evaluated. Within both passages high levels of sensitivity, specificity and positive predictive values were obtained. The nonnasal passage discriminates slightly better for hypernasal speech. For the most reliable nasalance measurements, the entire passage should be used.     

A Spanish matrix sentence test for assessing speech reception thresholds in noise

Objective: To develop, optimize, and evaluate a new Spanish sentence test in noise. Design: The test comprises a basic matrix of ten names, verbs, numerals, nouns, and adjectives. From this matrix, test lists of ten sentences with an equal syntactical structure can be formed at random, with each list containing the whole speech material. The speech material represents the phoneme distribution of the Spanish language. The test was optimized for measuring speech reception thresholds (SRTs) in noise by adjusting the presentation levels of the individual words. Subsequently, the test was evaluated by independent measurements investigating the training effects, the comparability of test lists, open-set vs. closed-set test format, and performance of listeners of different Spanish varieties. Study sample: In total, 68 normal-hearing native Spanish-speaking listeners. Results: SRTs measured using an adaptive procedure were 6.2 ± 0.8 dB SNR for the open-set and 7.2 ± 0.7 dB SNR for the closed-set test format. The residual training effect was less than 1 dB after using two double-lists before data collection. Conclusions: No significant differences were found for listeners of different Spanish varieties indicating that the test is applicable to Spanish as well as Latin American listeners. Test lists can be used interchangeably.     

A comparison of different methods for assessing the 'intensity' of tinnitus

Questions are raised about the technical and psychological interpretation of loudness match measures in the assessment of tinnitus "intensity". The effect of hearing threshold on loudness matches expressed in sensation level (SL) was investigated by selecting subjects with different degrees of hearing loss. The loudness match expressed in SL was found to be a function of threshold. Correlations were then determined between psychological scales of tinnitus complaint (reported loudness, distress, intrusiveness, and others) and loudness match expressed in HL, SL, sones, or personal loudness units (PLUs). Only matches expressed in PLUs were significantly correlated with reported loudness or other psychological scales. The PLU transformation, derived from an individually determined loudness function, produces values that are generally independent of other audiometric measures. It is therefore recommended for assessing tinnitus "intensity".     

A long-term observation of spontaneous oto-acoustic emissions (SOAEs).

In a follow-up study of 22 ears made after a mean interval of 68 months, spontaneous oto-acoustic emissions (SOAEs) showed marked changes. At follow-up visits, fewer SOAEs were recorded than at the first examination. As the set-up employed at follow-ups was much more sensitive, this observation gains even more weight, because--given identical cochlear structures--a greater number of SOAEs ought to have been recorded. In analogy to age-related high-frequency hearing loss, SOAEs recorded at the follow-up examination were found at lower frequencies. This was associated with yet another phenomenon: Precise frequency data (derived from a 4,000 line spectrum) available for 13 SOAEs (7 subjects) from the first examination showed that SOAE frequencies had dropped slightly in all subjects. In 5 of them the frequency drop was significant (p less than 1/1000 in each case).     

A case of multiple symmetrical lipomatosis (Madelung's disease).

Multiple symmetrical lipomatosis (Madelung's disease) is a rare disease with multiple symmetrical unencapsulated fatty accumulation diffusely involving the neck, the shoulders and the upper extremities (Kohan et al. Otolaryngol. Head Neck Surg. 1993;108:156-159). We describe a 48-year-old Japanese man with a history of alcoholism and liver cirrhosis who reported gradually enlarging masses in his cervical region for 4 years. MRI revealed large masses suggesting lipomas in the neck. The patient underwent a two-stage lipectomy. This patient is the 13th case reported in Japan since 1978, though over 200 cases have been reported since 1846 in Europe, most of them from the Mediterranean (Kitano et al. ORL 1994;56:177 180; Kaku et al. Endocrinol. Diabetol. 1997;4:103-106).     

The effects of temperature change and transient hypoxia on auditory nerve fiber response in the goldfish (Carassius auratus).

Temperature change and hypoxia produce consistent, reversible effects on the response of single auditory nerve fibers in the goldfish. Cooling and hypoxia produce reductions of a cell's spontaneous activity, sensitivity, most excitatory or best frequency (BF) at a given signal level, and overall responsiveness to acoustic stimulation. Warming above ambient temperatures increases a cell's spontaneous activity, sensitivity, BF, and responsiveness. Adaptation, or the tendency for responsiveness to decline with time during a stimulus, increases during hypoxia and cooling, and decreases during warming. The effects of temperature change and hypoxia on a fiber's BF are similar to the effects of overall sound level. Since BF normally increases with sound level, the BF-shift with temperature change and hypoxia can be understood as a change in sensitivity or the overall effectiveness of a stimulus at a given sound level. The effects on neural response of temperature change and hypoxia are probably due in part to changes in the release and replenishment of neurotransmitter at the synapses between hair cells and auditory nerve fibers.     

Qualind: A method for assessing the accuracy of automated tests

As audiology strives for cost containment, standardization, accuracy of tests, and accountability, greater use of automated tests is likely. Highly skilled audiologists employ quality control factors that contribute to test accuracy, but they are not formally included in test protocols, resulting in a wide range of accuracy, owing to the various skill and experience levels of clinicians. A method that incorporates validated quality indicators may increase accuracy and enhance access to accurate hearing tests. This report describes a quality assessment method that can be applied to any test that (1) requires behavioral or physiologic responses, (2) is associated with factors that correlate with accuracy, and (3) has an available independent measure of the dimension being assessed, including tests of sensory sensitivity, cognitive function, aptitude, academic achievement, and personality. In this report the method is applied to AMTAS, an automated method for diagnostic pure-tone audiometry.     

Allergic reaction in therapy with naftidrofuryl (Dusodril). A case report

There are many drugs marketed for the purpose of altering vascular blood flow in various regions, especially of the central nervous system and in peripheral arterial insufficiency. More than 50 different methods are described for the treatment of sudden deafness. Considerations of the therapy of sudden deafness are influenced by the fact that the cause of the disease is unknown. The dysfunction of the hair-cells of the organ of CORTI is thought to be caused by a deficit of oxygen due to disorders of micro-circulation in the inner ear. The infusion of vaso-active drugs in the early state of disease can lead to a remarkable improvement of hearing whereas the prospect of improvement without treatment remains uncertain. Nevertheless it may be difficult to distinguish the beneficial effects of vasodilator agents from spontaneous improvement. Naftidrofuryl oxalate (dusodril) has been in use for many years and proved its therapeutic value in many studies. It is regarded as non-toxic and is used extensively in Europe. Side effects are only reported rarely, and include decrease of cerebral blood flow, abdominal distension, diarrhoea, oesophageal ulceration, epileptic seizures, aphasia, disturbances of consciousness, hypotension, hypertensive crisis, vertigo and dizziness, depression of cardiac conduction, thrombophlebitis, and allergy. This case report of allergic reaction in a young female patient demonstrates that the intravenous application of this drug may lead to severe complications.     

Glomus jugulare tumours. (A series of 21 cases).

Twenty-one cases of glomus jugulare tumours were analysed in retrospect. Six had been treated surgically, ten by irradiation, and five by a combination of incomplete surgical excision followed by irradiation. Recurrences appeared in four cases, but no patient has died of the tumour during the follow-up period which is from a few months to eleven years. Metastases were not found in any case. The optimal time of irradiation in combined treatment is discussed.     

Non-suppurative otitis media in children. (A retrospective study of 100 cases).

This is a retrospective study of 100 cases of non-suppurative otitis media among children who presented to the E.N.T. Department at Poole General Hospital between 1975 and 1978. Their histories, investigations and management are reported, with special emphasis on the significance of surgical treatment, and its value in the prognosis of such cases.     

《修订学前儿童语言障碍评量表》适用性的初步研究

目的：通过《修订学前儿童语言障碍评量表》的适用性研究,初步考察该量表能否作为大陆地区儿童语言障碍的鉴定工具。方法使用该量表对浙江省衢州市七彩桥幼儿园20名4周岁儿童施测,分析量表在受试人群中使用的信度、效度。结果《修订学前儿童语言障碍评量表》中分测验二的信度系数为0.595,表明该分测验不能稳定地测量所选样本的语言理解能力;分测验四的信度系数为0.655,表明该分测验能测量所选样本的口语表达能力;分测验二与分测验四的总信度系数为0.688,表明该量表能测量所选样本的语言发展能力。结论《修订学前儿童语言障碍评量表》中语言发展能力内部一致性信度较高,可作为鉴定大陆地区儿童语言障碍的工具;分测验四可单独作为评鉴儿童口语表达能力的工具;分测验二不可单独作为评鉴儿童语言理解能力的工具。     

A test protocol for assessing the hearing status of students with special needs

Objectives

Individuals with disabilities are often reported to have a high prevalence of undetected hearing disorders/loss, but there is no standardized hearing test protocol for this population. The purposes of this study were (1) to examine the hearing status of students with special needs in Taiwan, and (2) to investigate the use of an on-site hearing test protocol that would adequately detect hearing problems in this population and reduce unnecessary referrals for off-site follow-up services.

Methods

A total of 238 students enrolled in two schools for special education and one habilitation center participated in the study. Most students had intellectual disabilities and some also had additional syndromes or disorders. A hearing screening protocol including otoscopy, tympanometry, and distortion product otoacoustic emissions was administered to examine students’ outer, middle, and inner ear functions, respectively. Pure tone tests were then administered as an on-site follow-up for those who failed or could not be tested using the screening protocol.

Results

Only 32.4% of students passed. When administered alone, the referral rate of otoscopy, tympanometry, and otoacoustic emissions were 38.7%, 46.0%, and 48.5%, respectively. The integration of these subtests revealed 52.1% of students needed follow-up services, 11.8% could not be tested, 2.5% had documented hearing loss, and 1.3% needed to be monitored because of negative middle ear pressure. The inclusion of pure tone audiometry increased the passing rate by 9.9% and provided information on hearing sensitivity for an additional 8.6% of students.

Conclusion

Hearing assessments and regular hearing screening should be provided as an integral part of health care services for individuals with special needs because of high occurrences of excessive cerumen, middle ear dysfunction, and sensorineural hearing loss. The training of care-givers and teachers of students with special needs is encouraged so that they can help identify hearing problems and reduce the negative impact of hearing disorders and hearing loss. The screening protocol needs to include subtests that examine the status of different parts of their auditory system. The addition of pure tone audiometry as an on-site follow-up tool reduced the rate of off-site referrals and provided more information on hearing sensitivity.     

Atomic force microscope (AFM). A nanomanipulator for biophysical studies of stereocilia of the cochlear hair cells

OBJECTIVES: Studies of the mechanoelectrical sensor system of the hair cell bundle in the cochlea require a manipulation device that enables controlled force application and movement of individual stereocilia in the nanometer range. METHODS: In our atomic force microscope (AFM) setup, the scan is directly controlled in an upright differential interference contrast (DIC) infrared video microscope with a water immersion objective and in the measured AFM image. Here we present studies on hair cells of the mammalian cochlea. RESULTS AND CONCLUSIONS: The resulting images revealed the tips of individual stereocilia of living sensory cells of the organ of Corti and the typical shape of the ciliary bundle. Scanning electron-microscopic (SEM) images of the identical hair bundles obtained after AFM investigation demonstrated that up to four AFM manipulations on the same cell did not cause obvious damage to the surface morphology of the stereocilia.