Do the Blind Hear Better? Investigations on Auditory Processing in Congenital or Early Acquired Blindness I. Peripheral Functions

18 normally hearing blind students and 18 matched normal-sighted students were compared with regard to differential auditory sensitivity and acoustic reflex thresholds. Evaluation of interaural time differences for directional hearing and acoustic reflex thresholds showed no differences between the groups. The difference limen for intensity when interpreted by the SISI test, and the difference limen for frequency revealed a slightly optimizing trend in the blind group. However, differences missed statistical significance as to difference limen for intensity and, in the 3-σ range, also as to difference limen for frequency. Any superior hearing of the blind was not mirrored by a corresponding superiority in peripheral supraliminal performance.

On suppose depuis longtemps que les aveugles entendent mieux que les voyants. Nous pensions que cette meilleure performance pouvait ětre due à une meilleure capacité d'analyse périphérique de l'information auditive. Pour vérifier cette hypothèse, nous avons comparé chez 18 jeunes aveugles et 18 jeunes voyants, tous normo-entendants, les paramètres suivants: la différence de temps interaurale nécessaire à la localisation droite-gauche; le seuil différentiel d'intensité par le test SISI, le seuil différentiel de fréquence et le seuil du réflexe stapédien controlatéral. Nos résultats montrent que l'aveugle ne présente ni un seuil différentiel affiné en ce qui concerne la durée, l'intensité ou la fréquence, ni une sensibilité plus grande pour les intensités sonores supraliminaires.     

Physiological Maturation of Auditory Function between 3 and 13 years of Age

A group of 70 unselected children aged between 3 and 13 with a normal hearing curve and a normal IQ have been submitted to the following hearing tests; (1) assessment of threshold hearing for pure tones; (2) speech intelligibility scores; (3) adaptation test; (4) fatigue test; (5) Lüscher test; (6) masking pattern with narrow bands of noise; (7) masking of speech by continuous noise; (8) auditory threshold variability.

The data obtained from this series of tests are discussed and compared to those previously presented by other investigators. It is confirmed that hearing abilities undergo a marked maturation in children starting at the age of 3 and reach a maximum at various ages (up to 13) according to the type of test employed.     

Cross-Modal Matching of Loudness and Brightness as a Recruitment Test for Hearing-Impaired Children

Normal 5-year-olds have been reported to be able, in a simple game situation, to match brightness to loudness in the same way as a control group of adults. This study investigated supplanting the normal ear in an alternate binaural loudness balance test (ABLB) with the visual modality, as a recruitment test designed especially for bilaterally hearing-impaired children. The results of normal 10-year-olds, with simulated hearing losses, suggest that category scaling was adopted naturally as a simplifying strategy in preference to ratio scaling (absolute judgements). No proportional increase in the matching function slope was evident, despite the amount of recruitment measured with an ABLB. The instructions needed to combat this strategy render the test unfeasible with hearing-impaired children.     

Masking level difference: A measure of auditory processing capability

MLDs are evidence of the superiority of the binaural auditory system. Cochlear lesions do not necessarily impair the MLD and persons with cortical lesions are also able to produce normal MLDs. The evidence for intermediate level auditory pathway lesions is more equivocal. The MLD is not the only measure of binaural hearing and binaural hearing is itself only one measure of a number of complex auditory processes. In this experiment measures of MLDs, localization, temporal integration, central masking and difference limen for intensity were made on 11 persons with normal hearing. Correlational analyses including factor analysis indicated that the MLD is a fairly independent measure but that central masking, brief tone audiometry and difference limen for intensity represent related auditory tasks. The relationship of localization tasks in this picture is unclear.     

前庭自旋转试验和冷热试验在突发性聋预后评估中的应用比较

目的 在突发性聋患者诊治过程中运用前庭自旋转试验(vestibular autorotation test,VAT)和冷热试验(caloric test,CT)技术进行半规管功能检测,探讨两种方法在突发性耳聋预后评估中作用的差异性.方法 对23例突发性聋患者进行前庭功能检查(VAT,CT)及听力学检查(纯音测听、声导抗测试、听性脑干反应);用Stata 4.0统计软件做统计分析,分别按痊愈、显效、有效、无效,听力曲线类型及是否伴眩晕进行分组,用R×C联表对各计数因素行卡方检验.结果 统计结果表明两种方法差异无统计学意义(P>0.05).结论 前庭自旋转试验和冷热试验在突发性聋预后评估中的作用无差异.有无眩晕仅在前庭功能异常时对突聋的预后有较大的影响.突聋伴发的眩晕不一定是前庭损害的结果.     

蝶塞及毗邻关系的解剖对蝶窦手术重要性探讨

蝶窦居于颅底，毗邻结构复杂，常有变异。本文报告开展各类型蝶窦手术１２５例，并就蝶窦区域应用解剖对蝶窦手术的重要性，进行研究与探讨。     

Prevalence of Self-reported Allergic and Non-allergic Rhinitis Symptoms in Stockholm: Relation to Age,Gender, Olfactory Sense and Smoking

Objective--To estimate the prevalence of isolated self-reported allergic and non-allergic rhinitis symptoms in an adult population and to explore the relations to age, gender, olfaction and smoking habits. Material and methods--Self-judged health and environmental exposures were investigated by means of a questionnaire survey administered to a stratified random sample of 15,000 adults in Stockholm County. Results--A total of 10,670 individuals were included in the analysis, corresponding to a response rate of 73%. The results revealed a high prevalence of self-reported non-allergic rhinitis, 19%, almost as high as the prevalence of self-reported allergic rhinoconjunctivitis, 24%. In contrast to current clinical opinion, we did not find a significant increase in the prevalence of non-allergic symptoms with increased age. There were no statistically significant gender differences in the prevalence of either allergic or non-allergic symptoms. A reduced sense of smell was twice as common in the non-allergic group, 23%, as in the healthy population. The prevalence of rhinitis symptoms differed according to smoking habits. Conclusion--Both self-reported allergic rhinitis symptoms and non-allergic nasal symptoms are frequent in the population sample. Self-reported non-allergic nasal symptoms seem to occur independent of age and reduced olfactory sense is a common complaint among these subjects. The prevalence of self-reported allergic and non-allergic nasal symptoms did not differ much between men and women or between individuals with different smoking habits.     

Cricoid Area of the Larynx: Its Physiological and Pathological Significance

The three-dimensional distribution of the cricoid area was investigated using computer graphics and its histological structure and pathology were studied using whole-organ serial sections. A total of 26 adult human larynges were examined. The findings were as follows: 1. Cricoid areas were located along the superior portion of the cricoid arch on both sides. 2. The cricoid area was surrounded by the perichondrium of the cricoid cartilage, the conus elasticus and the fibrous layer of the subglottic mucosa. 3. The cricoid area was a loose areolar area, mainly composed of adipose tissue and loose elastic and collagenous fibers. 4. Many vessels were present in the cricoid area and a superficial branch of the cricothyroid artery ran through it. 5. Vessels in the cricoid area penetrated the anteroinferior portion of the conus elasticus and extended into the prelaryngeal region. 6. In larynges with laryngeal carcinoma, cancer invasion into the cricoid area and intravascular tumor invasion facilitated metastasis to the prelaryngeal, pretracheal and/or paratracheal regions and stomal recurrence. Cricoid areas were related to the growth pattern of laryngeal cancer.     

不同分期梅尼埃病患者眼肌前庭诱发肌源性电位及冷热试验检测分析

目的 探讨不同听力分期梅尼埃病(Meniere disease,MD)患者眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)及冷热试验(caloric test)的特征及临床意义.方法 对确诊的MD患者55例(52.8±15.8岁),按MD听力分期标准分为1期9例(48.8±13.8岁),2期9例(46.0±16.3岁),3期23例(50.3±13.5岁),4期14例(53.5±16.2岁),分别行oVEMP检测及冷热试验,分析其结果.结果 1、2、3、4期MD患者oVEMP异常率分别为55.6%(5/9)、66.7%(6/9)、78.3%(18/23)、78.6%(11/14),冷热试验异常率分别为22.2%(2/9)、33.3%(3/9)、78.3%(18/23)、85.7%(12/14);可引出oVEMP的1、2、3、4期MD患者其振幅分别为4.3±4.0、3.5±2.3、2.5±2.4、1.3±0.5 μV.结论 MD患者oVEMP及冷热试验异常率随其听力受损程度加重呈上升趋势,oVEMP振幅呈下降趋势,提示椭圆囊与水平半规管的损伤加重.     

Relation of binaural interaction and spectro-temporal characteristics in the auditory midbrain of the grassfrog

The relation between binaural interaction type and spectro-temporal characteristics was studied for single units in the auditory midbrain of the grassfrog. Tonal and continuous wideband noise ensembles have been used as stimuli. Spectro-temporal sensitivities were determined for ipsi-, contra- and bilateral stimulus presentation by a closed sound system. Binaural interaction was classified in monaural EO (one ear excitatory), binaural EE (both ears excitatory) and EI (one ear excitatory, the other inhibitory) and purely inhibitory categories. Binaural interaction appeared to be rather invariant to alterations in stimulus intensity and type. A very clear correlation was observed between best frequency and binaural interaction type: EE units are predominantly of high best frequency, whereas EI units are predominantly of low best frequency. The correlation with latency was less significant: EE units tended to have somewhat shorter latencies that EI units. EO units take an intermediate position. Comparisons of ipsi-, contra- and bilateral spectro-temporal sensitivities, revealed differences in best frequency, latency and temporal discharge pattern. In some units a complex interplay of excitatory and inhibitory monaural influences was demonstrated. A number of units was recorded, which were characterized by multiple activation or suppression areas. The majority of these units exhibited frequency-dependent binaural interaction types. In some units it was noticed that binaural interaction type can be dependent on state of adaptation. A comparison of binaural interaction types of neighbouring units provided only weak evidence for a binaural organization in the anuran auditory midbrain, since simultaneously recorded pairs shared the same binaural interaction type only slightly more than expected by mere chance (chi 2-test, P less than 0.10).     

Interindividual Variation of Sensitivity to Frequency Modulation: Its Relation with Click-Evoked and Distortion Product Otoacoustic Emissions

The frequency modulation detection limen (FMDL) with a low modulation rate has been used as a measure of the listener’s sensitivity to the temporal fine structure of a stimulus, which is represented by the pattern of neural phase locking at the auditory periphery. An alternative to the phase locking cue, the excitation pattern cue, has been suggested to contribute to frequency modulation (FM) detection. If the excitation pattern cue has a significant contribution to low-rate FM detection, the functionality of cochlear mechanics underlying the excitation pattern should be reflected in low-rate FMDLs. This study explored the relationship between cochlear mechanics and low-rate FMDLs by evaluating physiological measures of cochlear functions, namely distortion product otoacoustic emissions (DPOAEs) and click-evoked otoacoustic emissions (CEOAEs). DPOAEs and CEOAEs reflect nonlinear cochlear gain. CEOAEs have been considered also to reflect the degree of irregularity, such as spatial variations in number or geometry of outer hair cells, on the basilar membrane. The irregularity profile could affect the reliability of the phase locking cue, thereby influencing the FMDLs. The features extracted from DPOAEs and CEOAEs, when combined, could account for more than 30 % of the inter-listener variation of low-rate FMDLs. This implies that both cochlear gain and irregularity on the basilar membrane have some influence on sensitivity to low-rate FM: the loss of cochlear gain or broader tuning might influence the excitation pattern cue, and the irregularity on the basilar membrane might disturb the ability to use the phase locking cue.     

水通道蛋白-1,2在大鼠内耳中表达的研究

目的 通过研究水通道蛋白1（aquaporin 1,AQP1）和水通道蛋白2（aquaporin 2,AQP2）在大鼠内耳组织中的表达及分布,为临床治疗梅尼埃病提供实验依据.方法选取6只健康雄性SD大鼠,断头后行内耳组织切片,用兔抗大鼠AQP1和AQP2的特异性多克隆抗体分别进行免疫组织化学染色,观察AQP1和AQP2在内耳组织中的表达情况.结果 AQP1在内耳组织中的分布有一定的规律,主要分布于血管纹的中间细胞,螺旋韧带Ⅲ型纤维细胞,基底膜以及圆窗膜,染色强度为中重度,前庭阶及鼓阶的外淋巴表面的细胞呈现较弱的阳性反应,其余部位为阴性反应.AQP2主要表达于螺旋韧带Ⅱ、Ⅳ及Ⅴ型纤维细胞,呈中重度染色反应,圆窗膜也有轻度表达,其余部位为阴性反应.结论 AQP1和AQP2分布于内耳中水及离子代谢的重要部位,提示两种蛋白可能参与内耳内环境稳态的调节.     

前庭功能检查在飞行错觉诊断和鉴定中的应用

目的 评价前庭功能检查在飞行员飞行错觉分类诊断中的意义及医学鉴定价值.方法 回顾性分析因飞行错觉入院诊治的75例飞行员的临床资料,对其进行分类,分析前庭功能检查(ENG或VNG)结果与飞行结论的关系.结果 ①75例83例次飞行错觉(少数飞行员有两种感觉器所致的飞行错觉)中前庭本体性错觉62例次,其中25例次前庭功能检查异常(40.30%,25/62);视性错觉10例次,其中2例次前庭功能检查异常(20 %,2/10);中枢性错觉11例次,其中3例次前庭功能检查异常(27.3%,3/11);三组前庭功能检查异常率比较差异无统计学意义(P>0.05).②75例飞行错觉者前庭功能检查异常30例,其中19例飞行不合格做停飞处理(63.3%,19/30),11例康复治疗和训练后恢复飞行;45例前庭功能检查正常者中9例永久停飞(20%,9/45),36例恢复飞行.两组停飞率比较,前庭功能异常组高于正常组,差异有统计学意义(P<0.05).结论 前庭功能检查对飞行错觉的分类诊断和医学鉴定具有重要的参考价值,可为飞行结论提供较科学的依据.     

Relationship between the Korean Version of the Sniffin' Stick Test and the T&T Olfactometer in the Korean Population

Objectives

The Korean version of the Sniffin'' stick (KVSS) test is widely used in Korea to evaluate olfactory function. However, its validity and reliability have not been studied well. In this study, the authors administered the KVSS and the T%T olfactometer test to evaluate olfactory function and to establish relationships between these two test measures.

Methods

Two hundred and eleven patients participated in this prospective randomized study. One hundred and nine patients with no olfactory symptoms and 102 patients with decreased olfaction participated. All participants were underwent KVSS II and T&T olfactometer testing.

Results

The mean recognition threshold of the T&T olfactometer was -1.8±0.9 for patients with normal olfaction and 4.0±2.6 for patients with decreased olfaction. The mean Threshold-Discrimination-Identification score of the KVSS II was 30.0±3.8 for patients with normal olfaction and 15.9±7.1 for patients with decreased olfaction. Correlation coefficient between the two tests was significantly high (r_s=-0.725, P<0.01).

Conclusion

The KVSS and T&T olfactometry test are both reliable tests of olfactory function and their results are well correlated with each other.     

Perception of hearing impairment and the willingness to use hearing aids in an elderly population in southern Taiwan: A community-based study

Objectives: To estimate the prevalence and severity of hearing impairment (HI), the self-perception of HI, and the willingness to use a hearing aid (HA) in the elderly population in southern Taiwan. Design: This community-based study was performed in a metropolitan hospital. A questionnaire about the perception of HI and the willingness to use a HA was used. The severity of HI in speech-frequency pure-tone average (PTA) was evaluated. The associations between sex, age, severity of HI, self-perception of HI, and the willingness to use a HA were analysed. Study sample: A total of 599 volunteers were recruited from the health management center; 324 (54.1%) males and 275 (45.9%) females, who were 65 years of age or older. Results: The prevalence of HI?>25 dBHL in the elderly was 78%. The predicted levels for elderly persons to perceive HI and hearing difficulties were 34.38 dBHL and 54.38 dBHL, respectively. Males and younger participants were more willing to use HA. The primary reasons for refusing HA use were discomfort (25.1%) and a self-perception that the HA was unnecessary (19.7%). Conclusions: The prevalence of HI was high among the elderly population in southern Taiwan. Age and sex were the determinants of HA use.     

聋儿康复专业队伍建设存在的问题与对策

人才队伍是决定一个事业能否发展的关键因素。2003年,为了对目前聋儿康复专业队伍状况有一个整体,清晰、细致的把握,我们组织了专项调查。此次调查共收到反映专业人员基本情况的材料3013份(中国聋儿康复研究中心的专业人员除外),符合填写要求的3011份,符合率为99．9％。调查结果显示,现有的专业人员队伍存在人数偏低,专业水平亟待提高等问题。对此,我们提出了全面加强聋儿康复专业队伍规范管理及提高听力语言康复服务专业化水平的对策。     

睡眠质量对听力正常青年人DPOAE和噪声下言语识别的影响

目的 初步研究睡眠质量对听力正常青年人DPOAE和噪声下言语识别的影响.方法 将50例听力正常在校大学生根据匹兹堡睡眠质量指数量表(Pittsburgh sleep qualily index,PSQI)评分分为睡眠质量较差组(PSQI评分≥7分,25例)和睡眠质量较好组(PSQI评分<7分,25例),对两组进行DPO...     

美国听障教育辅助技术应用现状及启示

本文从美国听障教育辅助技术发展的角度出发,探讨了信息时代美国听障教育辅助技术的应用现状及全纳教育理念指导下的相关技术支持.同时,笔者结合我国听障教育辅助技术的发展情况,提出了适合国内发展的听障辅具应用策略.     

变应性鼻炎专病门诊对促进疾病规范化诊疗的意义

目的　评价开展变应性鼻炎（allergic rhinitis, AR）专病门诊对患者进行系统教育和管理的效果。方法　从AR专病门诊和非专病门诊各入组中重度持续性AR患者180例,首次就诊3个月后电话随访。结果　专病门诊组所有患者均为综合诊断,而非专病门诊组综合诊断的比例为38.2%。比较两组患者用药的依从性,对疾病的认知情况以及对治疗的满意度,专病门诊组均明显高于非专病门诊组。结论 专病门诊的管理模式具有明显的优势,开展专病门诊是有助于推行AR规范化诊疗的形式之一。     

A possible objective test to detect benign paroxysmal positional vertigo. The role of the caloric and video-head impulse tests in the diagnosis

Background:Benign paroxysmal positional vertigo(BPPV)is characterized by vertigo lasting from seconds to minutes,induced by head movements.Objectives:Our study aimed to investigate the clinical significance of the caloric vestibular and video head-impulse tests(vHIT)diagnosing the disorder.Methods:68 patients suffering from posterior canal BPPV(25 male,43 females,mean age±SD,54.5±13.2 years)and 56 patients with a normal functioning vestibular system as control were investigated.Bithermal caloric test and vHIT was performed during the same medical check-up.Canal paresis(CP%),gain(GA)and asymmetry(GA%)parameters were calculated.Results:The Dix-Hallpike manoeuvre was only positive in 4%of this population.The CP%parameter was only pathologic in two patients,and there was no significant difference between control and BPPV patients(p=0.76).The GA value was never under 0.8 in this population,but GA%was abnormal in 63.2%.A significant difference comparing the GA%values to the control group was seen(p=0.034).There was no correlation detected between the CP%and GA%values in BPPV.Regarding the GA%value,61%sensitivity and 76%specificity was seen.Conclusion:The Dix-Hallpike manoeuvre was not often positive in the non-acute phase of BPPV;therefore,objective testing is essential.The caloric test does not have clinical significance in BPPV,but vHIT can be helpful based on the GA%parameter。