Does having a job improve the quality of life among post-lingually deafened Swedish adults with severe-profound hearing impairment?

The purpose of the present study was to measure health-related quality of life (HRQL), personal harmony and work-induced problems, and to identify typical personal traits among Swedish adults with a severe-profound hearing impairment who were employed full-time. In comparison with hearing people aged <65 years, the hearing-impaired individuals working full-time differed only as regards energy and social isolation. Compared to another group of hearing-impaired subjects (working either part-time or retired) the study group scored better on most dimensions. Personal harmony of the hearing-impaired group working full-time did not differ from that of average employed Swedish people. The work situation of the group was generally reported to be busy but rewarding, especially concerning contact with fellow workers and management. Among various personal traits examined, strong will-power and stress tolerance were the most significant. However, due to the small sample size, it is not possible to state that the results indicate a general situation or were just due to the study subjects constituting an elite sample of hearing-impaired individuals.     

Speech perception results in children implanted with Clarion® devices: Hi-resolution™ and standard resolution modes

Conclusions Formal testing showed that HiRes users seem to make significant use of acoustic information. Furthermore, from observations reported by experienced care-givers, for example, family, teachers and speech therapists, these children learn a lot from their surrounding environment. Incidental learning, which takes place when acquiring skills or knowledge through naturally occurring events, is a key become available to these deaf paediatric cochlear implant recipients.

Objective To compare speech perception skills in children with a Clarion® cochlear implant using different speech coding strategies, such as continuous interleaved sampling (CIS), simultaneous analogue stimulation (SAS) and Hi-Resolution (HiRes)?.

Material and methods The study population comprised 40 children, 17 implanted with a Clarion Hi-Focus 1.2 and 23 with a Clarion CII. All children were pre-lingually deaf and differed in terms of age and cause of deafness. All children had undergone a trial (minimum 6 months) with hearing aids before implantation. Children implanted with a Clarion 1.2 were either CIS or SAS users [Standard Resolution mode (SRM) group]; children implanted with a Clarion CII were Hi-Resolution users [Hi-Resolution mode (HRM) group]. Findings were assessed according to Erber's hierarchical model (detection, discrimination, identification, recognition and comprehension), making use of a battery of speech perception tests calibrated to the age of the child. Further information concerning use of the implant in everyday situations was obtained by means of the Meaningful Auditory Integration Scale (MAIS) questionnaire, which was administered to the parents. Tests were carried out prior to each fitting session, at switch-on and then at 3, 6, 9 and 12 months. Findings at pre-implantation and at 12 months follow-up were collected for both the SRM and HRM groups. Speech perception results were analysed for the SRM and HRM groups, independent of age at implantation, for five subgroups of children according to the paediatric test battery in use and for two subgroups of children, one<?and one?>5 years of age.

Results Clarion-implanted children using the Hi-Resolution strategy can develop better speech perception skills at 12 months post-implantation compared to children fitted with the SAS or CIS strategy. SAS or CIS users implanted before the age of 5 years tend to achieve better results at 1 year follow-up than children implanted later. In contrast, in Hi-Resolution users, a trend towards better results for recognition and comprehension tasks was observed in children implanted after 5 years of age.     

Combined electric and acoustic hearing performance with Zebra® speech processor: Speech reception,place, and temporal coding evaluation

Abstract

Objective

To assess the auditory performance of Digisonic^® cochlear implant users with electric stimulation (ES) and electro-acoustic stimulation (EAS) with special attention to the processing of low-frequency temporal fine structure.

Method

Six patients implanted with a Digisonic^® SP implant and showing low-frequency residual hearing were fitted with the Zebra^® speech processor providing both electric and acoustic stimulation. Assessment consisted of monosyllabic speech identification tests in quiet and in noise at different presentation levels, and a pitch discrimination task using harmonic and disharmonic intonating complex sounds ( ). These tests investigate place and time coding through pitch discrimination. All tasks were performed with ES only and with EAS.

Results

Speech results in noise showed significant improvement with EAS when compared to ES. Whereas EAS did not yield better results in the harmonic intonation test, the improvements in the disharmonic intonation test were remarkable, suggesting better coding of pitch cues requiring phase locking.

Discussion

These results suggest that patients with residual hearing in the low-frequency range still have good phase-locking capacities, allowing them to process fine temporal information. ES relies mainly on place coding but provides poor low-frequency temporal coding, whereas EAS also provides temporal coding in the low-frequency range. Patients with residual phase-locking capacities can make use of these cues.     

Experimental study of the use of auricular cartilage with and without Gelfoam® on the nasal dorsum of rabbits,

IntroductionsThere are several materials for reconstruction of nasal dorsum deformities, which are divided into four categories: autologous, homologous, heterologous, and alloplastic grafts.ObjectiveTo compare experimental conditions through inflammatory time reactions in ear cartilage grafts with and without Gelfoam® when grafted on the nasal dorsum of rabbits.MethodsThis study included 30 rabbits, divided into two groups of 15 rabbits each (Gelfoam® and cartilage group and cartilage group), and then divided into three sub-groups of 7, 30, and 60 days of follow-up, where the 1.5 cm long and 0.5 wide grafts were placed in the stock grafting on the nasal dorsum of rabbits, half with and half without Gelfoam®. After the specified period, the rabbits in each group were euthanized, and the grafts were then submitted to a histological study.ResultsThe experimental group revealed more neovascularization and granulation tissue formation; in terms of the presence of acute and chronic inflammatory process, the results were virtually identical in rabbits from both the control and experimental models in all three groups.ConclusionThere was no statistical difference to justify the use of Gelfoam® surrounding cartilage graft for nasal dorsum reconstruction.© 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.     

The Hebrew and the Arabic version of the LittlEARS® auditory questionnaire for the assessment of auditory development: results in normal hearing children and children with cochlear implants

Objective

With more children receiving cochlear implants at an early age, there is a need for evaluation and assessment of early auditory behavior. We present the translation of the LittlEARS^® Auditory Questionnaire into Hebrew and into Arabic. First the validation of the LittlEARS^® Auditory Questionnaire in normal hearing children was evaluated. Second, the auditory behavior and the progress in hearing skills of a group of children with cochlear implants were assessed.

Methods

A “back-translation” method was used to translate and adapt the LittlEARS^® Auditory Questionnaire into Hebrew and into Arabic. Normal hearing participants included 70 Hebrew speaking and 97 Arabic speaking parents of children from 1 to 24 months of age with normal hearing. An additional group of 42 parents of children with cochlear implants with a hearing age of up to 24 months completed the LittlEARS^® Auditory Questionnaire. 27 of them completed the questionnaire more than once at intervals, so that change and development could be recorded. Scores on the LittlEARS^® Auditory Questionnaire were compared to results of SIR and CAP scales and other available auditory data.

Results

The results of the first study show that the curves found for the Hebrew and the Arabic translations of the LittlEARS^® Auditory Questionnaire are essentially similar to those previously found for other languages. These curves reflect the age dependency of auditory skills. Furthermore, in the group with cochlear implants the developmental pattern was different than that of the normal hearing group, with an initial steep increase and a later slower improvement. This trend appeared both in curves of groups and in curves of individuals (individuals whose parents completed the questionnaire at several points in time). There was a high correlation between scores on the LittlEARS^® Auditory Questionnaire and results of other audiologic tests, showing validity of results with the LittlEARS^® Auditory Questionnaire.

Conclusion

Both the Hebrew and Arabic versions of the LittlEARS^® Auditory Questionnaire were found to be reliable and valid tools for assessment of the development of auditory behavior in children up to the age of 24 months. Furthermore, the LittlEARS^® Auditory Questionnaire in both languages is useful in monitoring the progress of children with cochlear implant.     

Anatomic study of maximum intensity projection of the membranous labyrinth and the internal auditory meatus – MRI scan in 16 Chinese adults

Conclusion. Three-dimensional reconstruction of maximum intensity projection (MIP) might document objectively, stereoscopically and directly the minute structures of the membranous labyrinth and internal auditory meatus. In this study, we establish magnetic resonance imaging (MRI) measurement criteria of the inner ear in Chinese adults. Objective. The goal of this study was to provide an anatomic basis for otolosurgery and neurosurgery in Chinese adults. Materials and methods. Sixteen healthy volunteer subjects were scanned by a GE-signa 1.5T MRI scanner. All original images were transferred to an MRI workstation and all the structures of the inner ear were reconstructed, rotated at various angles and measured with an MIP program. Results. Anatomic structures of the membranous labyrinth and internal auditory meatus were well demonstrated in MIP images in all volunteers. All inner ear structures including utricle, saccule, cochlear duct, internal auditory meatus and three semicircular ducts produced high intensity signals.     

Older adults’ performance on the speech,spatial, and qualities of hearing scale (SSQ): Test-retest reliability and a comparison of interview and self-administration methods

Abstract

The purposes of the study were to examine the test-retest properties of the speech, spatial, and qualities of hearing scale (SSQ) and to determine if the method of test administration affected these properties. Four groups of 40 older adult participants completed the SSQ twice at an interval of about a half year, using either the same or different administration methods at the two test times. The SSQ was administered using an interview method and/or it was self-administered and then returned by mail. Although the method of test administration did not systematically affect scores on the SSQ, the highest test-retest correlation (r = 0.83) was observed using the interview method at both test times, making it the best choice for the purpose of demonstrating the effectiveness of interventions. The other three combinations of dual-administration in this study also provided reliable results and may be preferable because the self-administration method is less time-consuming and labour-intensive. In conclusion, both the interview and self-administration methods are recommended, but with the best choice depending on the goals of the tester.

Sumario

El propósito de este estudio fue examinar las propiedades test-retest de la escala de audición del habla, espacial y de cualidades (SSQ) y determinar si el método de administración de la prueba afecta esas propiedades. Cuatro grupos de 40 participantes adultos mayores completaron el SSQ dos veces con un intervalo de cerca de medio año, usando (tanto) el mismo o un diferente método de administración en los dos tiempos de la prueba. El SSQ se administró usando un método de entrevista y/o por la auto aplicación y luego, enviado por correo. No obstante que el método de administración de la prueba no afectó sistemáticamente las puntuaciones del SSQ, la mayor correlación test-retest (r = 0.83) se observó usando el método de entrevista en los dos tiempos de la prueba, haciendo de él la mejor selección para demostrar la efectividad de las intervenciones. Las otras tres combinaciones de la administración doble en este estudio, dieron resultados confiables y pueden ser preferibles, porque el método de auto aplicación consume menos tiempo y requiere menor trabajo intensivo. En conclusión, se recomiendan tanto los métodos de entrevista como el de auto aplicación, pero la mejor selección dependerá de las metas del examinador.     

Accuracy of auditory steady state and auditory brainstem responses to detect the preventive effect of polyphenols on age-related hearing loss in Sprague–Dawley rats

Aging causes histological, electrophysiological and molecular changes in the cochlea. The free radical theory of aging, has obtained consensus, and the mitochondrion is reported to play a key role in aging as a major source of reactive oxygen species. In the last years, there has been a significant increase in the interest in polyphenols because of the antioxidant properties and their role in the prevention of various diseases associated with oxidative stress, including aging. The aim of this study was to evaluate the preventive effect of different polyphenols on ARHL with auditory-evoked potentials. 100 Healthy female Sprague–Dawley (SD) rats were used for this study. Five groups were created based on the age of the rats, in months: 3, 6, 12, 18 and 24 months old. Two additional groups were created based on the treatment received. In the control group, 50 animals were assigned to no treatment. In the treated group, 50 animals were given a vehicle mixture of polyphenols for the half of the life before euthanization. Nine frequencies were tested (0.5–16 kHz) with ASSR and tone-burst ABR, performed on all of the rats prior to sacrifice. 100-μs auditory clicks ABRs were also recorded. A significant decrease in the audition was detected with ABR and ASSR in both treated and non-treated groups, as the different groups became older. This deterioration was more accurately measured at acute frequencies. Significantly lower thresholds were observed in the treated rats in the 6, 12 and 18-month-old group in the treated rats compared with the control group. All of the thresholds elicited using the ASSR technique were lower than the thresholds obtained using the ABR, regardless of the stimulus type. The present study demonstrated the benefits of the polyphenols, which generated a significant protection against ARHL, with significantly improved ASSR and tone-burst ABR auditory thresholds in rats receiving treatment with polyphenols.     

The relationship between cortical auditory evoked potentials (CAEPs) and speech perception in children with Nurotron® cochlear implants during four years of follow-up

ObjectiveThe purpose of the current study was to evaluate the relationship between the presence or absence of cortical auditory evoked potentials (CAEPs) to speech stimuli and the performance of speech perception in Chinese pediatric recipients of the Nurotron^® cochlear implant (CI).We also wanted to determine how the CAEPs might be used as an indicator for predicting early speech perception and could provide objective evidence for clinical applications of CAEPs.Methods23 pediatric unilateral CI recipients participated in this study. 15 males 8 females, and their ages at implantation ranged from 13 to 68 months, with a mean age of 36 months. CAEPs and Mandarin Early Speech Perception (MESP) tests were used to evaluate the audibility and speech perception of these CI users. The tests were administered at the first, second, third, and fourth year after the CI surgery.ResultsAll the subjects demonstrated improvements in detection of speech sounds with CI. The percentages of participants who could detect all three stimuli were 26% (6/23) at first year, to 100% (23/23) at the fourth year post-implantation. The percentages of participants who passed the Category 6 of MESP were from 9% (2/23) at first year, to 91% (21/23) at the fourth year post-implantation. Significant correlations (p < 0.05) were found between CAEP scores and MESP at the first, second, third year after the CI surgery. The multiple regression equation for prediction of MESP categories from CAEP scores and hearing ages was MESP = 1.088 + (0.504 × CAEP score) + (0.964 × hearing ages) (F = 72.919, p < 0.001, R² = 0.621).ConclusionThe results of this study suggested that aided cortical assessment was a useful tool to evaluate the outcomes of cochlear implantation. Cortical outcomes had a significant positive relationship with the MESP, which predicted the early speech perception of CI recipients.     

Production and evaluation of a Spanish version of the LittlEARS® Auditory Questionnaire for the assessment of auditory development in children

Background and aimsTo adapt the LittlEARS^® Auditory Questionnaire (LEAQ) into Spanish and evaluate the psychometric properties of the Spanish version of the questionnaire.MethodsThe LEAQ was translated into Spanish by a back-translation design. Following the Guidelines for Adapting Tests of the International Test Commission (ITC), for the first time with the LEAQ adaptations, two qualitative methods were used to evaluate the translated version of the LEAQ: an expert appraisal method followed by cognitive interviewing. Having improved the Spanish version of the LEAQ with these evaluations, a psychometric analysis was conducted. 215 parents of children with normal hearing aged between 1.7 and 24.0 months participated in the study. Corrected item-total correlations were calculated to analyze to what extent items distinguish levels of auditory development of assessed children. Cronbach's alpha coefficient – to evaluate internal consistency across items – was also calculated. To obtain validity evidence, correlations between item-total score and age were calculated. A non-linear regression model was also estimated to obtain normative data for expected and minimum value of total scores from the questionnaire according to age.ResultsExpert appraisal and cognitive interviewing pointed out some translation errors and difficulties parents had while responding to the Spanish LEAQ. Such errors and difficulties were fixed in the Spanish LEAQ version applied for psychometric analysis. Corrected item-total correlations ranged from 0.15 to 0.75. Cronbach's alpha coefficient value was 0.92, indicating that the measurements are highly reliable. The value of the correlation between total scores and age was 0.86 (p < 001). The regression analysis conducted to obtain normative data shows that 79% of the variation in the total scores can be explained by age.ConclusionsThe results of psychometric analyses provide evidence supporting the use of the Spanish version of the LEAQ as a valid and culturally appropriate tool to assess the development of auditory behaviour in Spanish children who are 24 months old or younger.     

The use of cochlear's SCAN and wireless microphones to improve speech understanding in noise with the Nucleus6® CP900 processor

Objectives: The newest Nucleus CI processor, the CP900, has two new options to improve speech-in-noise perception: (1) use of an adaptive directional microphone (SCAN mode) and (2) wireless connection to MiniMic1 and MiniMic2 wireless remote microphones. Design: An analysis was made of the absolute and relative benefits of these technologies in a real-world mimicking test situation. Speech perception was tested using an adaptive speech-in-noise test (sentences-in-babble noise). In session A, SRTs were measured in three conditions: (1) Clinical Map, (2) SCAN and (3) MiniMic1. Each was assessed for three distances between speakers and CI recipient: 1 m, 2 m and 3 m. In session B, the benefit of the use of MiniMic2 was compared to benefit of MiniMic1 at 3 m. Study sample: A group of 13 adult CP900 recipients participated. Results: SCAN and MiniMic1 improved performance compared to the standard microphone with a median improvement in SRT of 2.7–3.9?dB for SCAN at 1 m and 3 m, respectively, and 4.7–10.9?dB for the MiniMic1. MiniMic1 improvements were significant. MiniMic2 showed an improvement in SRT of 22.2?dB compared to 10.0?dB for MiniMic1 (3 m). Conclusions: Digital wireless transmission systems (i.e. MiniMic) offer a statistically and clinically significant improvement in speech perception in challenging, realistic listening conditions.     

The effect of a Heat and Moisture Exchanger (Provox® HME) on pulmonary protection after total laryngectomy: a randomized controlled study

The goal of this randomized controlled study was to investigate the effect of Heat and Moisture Exchanger use on pulmonary symptoms and quality of life aspects in laryngectomized patients. Eighty laryngectomized patients were included and randomized into an HME and Control group. The effect of the HME was evaluated by means of Tally Sheets and Structured Questionnaires. The results showed a significant decrease in the frequency of coughing, forced expectoration, and stoma cleaning in the HME group. There were trends for the prosthetic speakers to report more fluent speech with the HME and for the HME group to report fewer sleeping problems. In conclusion, this study, performed in Poland, confirms the results of previous studies performed in other countries, showing that pulmonary symptoms decrease significantly with HME use and that related aspects such as speech and sleeping tend to improve, regardless of country or climate.     

Does parental experience of the diagnosis and intervention process differ for children with auditory neuropathy?

ObjectivesThis study compared parental experience of the audiological diagnosis and intervention process in children with auditory neuropathy spectrum disorder and sensory neural hearing loss.MethodsA matched group survey was used with parents of children with auditory neuropathy spectrum disorder (ANSD) matched with a control group of parents and children with sensorineural hearing loss (SNHL). The two groups were matched in terms of the child's gender, age, amplifications used, social background and utilisation of private or public health care sectors. An interview questionnaire, consisting of 45 questions in six categories (1. biographic information, 2. experiences of audiological diagnosis, 3. hearing aid benefit, 4. parental experience of the rehabilitation decision making process, 5. parental needs for emotional support and 6. parental needs for information) using a 5-point Likert scale for categories 2–7, was administered by the same audiologist.ResultsChildren with ANSD experienced a significantly longer waiting period from diagnosis to hearing aid fitting (p = 0.025) and/or cochlear implantation (p = 0.036). Parents of children with ANSD reported significantly different experiences of the diagnostic process (p = 0.001) with poorer understanding of the diagnosis and reporting insufficient time allowed for asking questions. During the rehabilitation decision-making process 47% of parents with ANSD children (vs. 0% of parents with SNHL children) reported receiving conflicting information. Parents of children with ANSD were also less likely to recommend hearing aids to other parents. Information needs were similar between groups.ConclusionsParents of children with ANSD have different experiences and greater uncertainty during the diagnostic and rehabilitation process. Providing regular consultation and structured timelines through the diagnostic process and decision-making process may facilitate this process with less uncertainty.     

Is there any synergic effect for coadministration of mitomycin C and halofuginone on the skin wound healing?

Objective

This study compared the potencies of the antifibrotic agents mitomycin C (MMC) and halofuginone (HFN) and investigated whether coadministration of these agents produces synergic effects in an animal skin wound model.

Subjects and methods

Twenty male Sprague-Dawley rats were used for this study. After a full-thickness excisional wound was made on the dorsum of each rat, each rat was treated with topical mitomycin, intraperitoneal HFN, or both. Wound surface areas were measured over time, and histologic analysis was performed after wounds healed completely.

Results

The groups treated with MMC alone, HFN alone, and a combination of the two all exhibited delayed wound healing compared with the untreated group. Histologically, fibrosis and matrix metalloproteinase-2 expression were significantly inhibited in the treated groups. However, there were no gross or histologic differences between the MMC-treated group, the HFN-treated group, and the combination-treatment group.

Conclusions

Both MMC and HFN inhibited excessive fibrosis. However, there was no significant difference in the antifibrotic effects of MMC and HFN on surgically induced skin wounds. Moreover, combination treatment with both MMC and HFN failed to confer an additional antifibrotic effect on skin wounds when compared with treatment with MMC or HFN alone.