Effects of Cytomegalovirus (CMV) Related Deafness on Pediatric Cochlear Implant Outcomes

OBJECTIVE: Human cytomegalovirus (CMV) is a commonly recognized viral cause of perinatal sensorineural hearing loss. CMV-infected infants are also at risk for developmental neurological deficits. This retrospective study assesses the impact of CMV-induced deafness on pediatric cochlear implant outcomes. STUDY DESIGN AND SETTING: Thirteen patients from the Johns Hopkins pediatric cochlear implant database were identified with CMV-related deafness. A retrospective review of the medical records of the Johns Hopkins Hospital was performed. RESULTS: The mean age at implantation was 5.6 years. Follow-up audiometric data ranged from 6 to 48 months postoperatively. Mean speech perception scores were 4.5 (out of 6) following implantation. CONCLUSION: We have shown that cochlear implants can provide useful speech comprehension to patients with CMV-related deafness. Speech recognition scores were within the range established by our overall pediatric implant population. SIGNIFICANCE: This observation underscores the importance of a multidisciplinary rehabilitation program following implantation in these patients at risk for cognitive delay.     

Communication issues in Attention-deficit Hyperactivity Disorder

Children with Attention-deficit Hyperactivity Disorder (ADHD) evidence a variety of pragmatic deficits and are particularly at risk for other speech and language disorders. Speech and language pathologists in educational settings have the special expertise needed for interpretation and treatment of communication issues associated with ADHD. They should contribute more directly to the multi-modality treatment team in creating management programs for these children.     

The role of the speech and language clinician on a multidisciplinary team

This article describes the role of the speech and language clinician on a psychoeducational multidisciplinary team. The effects of language disorders on childrens' behavior and treatment are discussed along with specific ways in which the speech and language clinician can intervene.     

Diagnosis and treatment of unilateral cricothyroid muscle paralysis with a modified Isshiki type 4 thyroplasty

Cricothyroid adduction increases tension to the vocal folds, thus increasing fundamental frequency and upper pitch range. We treated 10 patients with cricothyroid muscle dysfunction using this technique. Preoperative electromyographic, acoustic, and perceptual analysis was performed. Intraoperatively the effect of increasing tension on the fundamental, falsetto, and basal frequencies was measured by using a strain gauge to the adducting suture at several tensions and a cervical microphone connected to a pitch meter. Postoperative acoustic and perceptual analysis was then performed up to 18 months later. Analysis of pitch vs. tension curves indicates a near-linear relationship until very high tensions are applied. Statistically significant improvement was achieved in both acoustic and perceptual analysis, although some deterioration was noted between early and late results. Cricothyroid adduction is indicated for a large range of vocal fold tension problems. (OTOLARYNGOL HEAD NECK SURG 1995;113:679-88.)     

Effects of Bolus Consistency on Timing and Safety of Swallow in Patients with Parkinson’s Disease

Aspiration pneumonia is the leading cause of death in Parkinson’s disease (PD) patients. In clinical practice, the videofluoroscopic examination (VFE) is the most common method for evaluation of swallowing disorders. One of the variables manipulated during the VFE is consistency of the bolus. The results of this examination greatly influence the recommendations made by speech-language pathologists regarding swallow therapy and/or intervention. The primary aim of this study was to investigate the effects of bolus consistency on penetration-aspiration (P-A) score and timing of swallow of persons with PD. The videoradiographic images of ten participants with PD swallowing six thin and six pudding-thick boluses were analyzed. Swallow timing and P-A were measured. (i.e., oral transit time, pharyngeal transit time, number of tongue pumps, and P-A score). The results demonstrated various significant differences and relationships among the dependent variables. Implications for further research and clinical practice are discussed.