Objective: The aim of this article is to report on the long-term follow-up of a new semi-implantable middle ear device utilized for restoration of moderate-to-severe sensorineural hearing loss in a first series of subjects.
Methods: Three subjects, affected by sensorineural hearing loss, have undergone implantation of Maxum® middle ear implant, via a transcanal approach. They all underwent an auditory assessment, paying particular attention on the pre- versus post-operative hearing levels under the unaided, best-fitted hearing aided and implant-aided conditions. The audiometric evaluation has been repeated 3 years after implantation and implemented by questionnaires aiming at the evaluation of the quality of life.
Results: The post-operative hearing threshold and discrimination in quiet appear to be similar or better than those provided by conventional hearing aids, with a concomitant improvement of the subjects’ quality of life. The application of the present device showed to be easy and reproducible, with no severe adverse effects recorded at the 3-years follow-up. Mild issues due to the external component were also observed, such as difficulty of keeping it continuously in place due to excess canal sweating in one subject, and a temporary loss of stability due to occurring irregularities of the external coating in another subject.
Conclusions: Long-term, preliminary data reveal that the Maxum® device may provide equal or better functional gain and word recognition scores in quiet in patients with moderate-to-severe sensorineural hearing loss, in comparison to optimally fitted hearing aids, with a satisfactory improvement of their quality of life. 相似文献
Objectives: To evaluate long-term benefits of atresiaplasty on hearing and the impact of surgery on quality of life (QoL) in congenital aural atresia (CAA) patients.Methods: We evaluated the long-term hearing results, the impact of atresiaplasty on QoL, the meatal diameter of the operated ear canal, and the cumulative number of post-operative hospital visits in 14 CAA patients, on average, 12 years (range: 4–17 years) post-operatively.Results: The mean preoperative pure tone average (PTA) was 61?dB HL. The postoperative short-term PTA was 36?dB HL and the long-term PTA was 51?dB HL. The mean total Glasgow Benefit Inventory (GBI) score was 16 (range: ?11–39), showing the positive benefit of atresiaplasty on QoL. The mean postoperative diameter of the auditory meatus was 6?mm. The average number of hospital outpatient visits during the first postoperative year was 10.Conclusion: Surgery for CAA is a demanding operation with variable anatomical and hearing outcomes. Atresiaplasty operations should be centralized to hospitals with large numbers of such patients to ensure sufficient levels of surgical experience. Bone-anchored hearing devices or middle-ear implants should be considered as a first-line option because they offer good hearing predictability. 相似文献
To evaluate the effect of intratympanic steroid injection frequency on hearing outcomes for patients with idiopathic sudden sensorineural hearing loss.
Materials and methods
A retrospective chart review was performed from 2007 to 2015 at a neurotology tertiary referral center. Adults who met academy criteria for idiopathic sudden sensorineural hearing loss within two months of onset and negative imaging were grouped based on injection frequency. Injection schedules were every 1–4 (group 1), 5–10 (group 2), or 11–30 (group 3) days. All patients had at least two injections with Dexamethasone 10?mg/ml. All patients had pre- and post-injection audiograms.
Results
Seventy patients met inclusion criteria (group 1, n?=?21; group 2, n?=?29; group 3, n?=?20). There was no significant difference between group demographics or baseline audiometric data. Mean gains were significant and similar between groups for pure tone average (group 1?=??23.6?±?22.0?dB; group 2?=??19.7?±?18.4?dB; group 3?=??24.9?±?24.7?dB; p?=?0.67) and word recognition score (group 1?=?+26.3?±?34.8%; group 2?=?+23.3?±?29.9%; group 3?=?+33.4?±?28.9%; p?=?0.53).
Conclusions
Frequency of intratympanic steroid injections does not significantly affect hearing outcomes. Following injection therapy, hearing outcomes improved regardless of prior or concomitant oral steroid regimen. Earlier time to initiating injections yielded a higher rate of hearing improvement. Long term hearing outcomes >6?months did not show significant additional improvement. 相似文献
NIHL is a common problem, and steroids are the most effective treatment option. In this study, we aimed to evaluate the protective effects of the synthetic adrenocorticotropic hormone (ACTH) analogues, which induce endogenous steroid secretion, against noise-induced hearing loss (NIHL) and to compare their effectiveness with that of steroid treatment.
Methods
Twenty-four male Sprague–Dawley albino rats were divided into four subgroups as follows: group 1 (n = 6) control, group 2 (n = 6) saline, group 3 (n = 6) dexamethasone (2 mg/kg/day intramuscularly [IM]), group 4 (n = 6) ACTH analogue (0,4 mg/kg/day IM), respectively. Three groups (groups 2–4) were exposed to white noise (105 dB SPL, 12 h). All the rats were evaluated for hearing thresholds of 10 kHz, 20 kHz, and 32 kHz via acoustic brainstem responses (ABR) measurement. After the basal threshold measurements, measurements were repeated immediately after the noise and on day 7 and day 21.
Results
Both steroid and ACTH analogue groups showed significantly better hearing outcomes than the saline group on day 7 (p < 0.001) and day 21 (p < 0.001) after the noise exposure. No superior treatment effect was demonstrated in either the steroid or ACTH analogue group. None of the related intervention groups reached the basal hearing thresholds.
Conclusion
Steroids were effective drugs for the treatment of NIHL. ACTH analogues also demonstrated promising therapeutic effects for NIHL. Further studies to establish ACTH analogues as an alternative NIHL treatment option to steroids are needed. 相似文献
Objectives: The performance outcome with Freedom? Hybrid? versus the CP900 series sound processor with Hybrid Hearing was investigated. In addition, a preliminary evaluation was conducted to consider the feasibility of upgrading experienced electric-only cochlear implant (CI) users who had substantial residual hearing to Hybrid Hearing.Methods: This study was a single-centre prospective, non-inferiority design with repeated measures conducted at Hannover Medical School (MHH). The randomized AABB cross-over design to compensate for learning effects included two test groups. Group 1 compared two systems for Hybrid Hearing (Freedom Hybrid sound processor versus CP900 series sound processor) and Group 2 compared CP900 series sound processor (electric-only) versus the CP900 with Hybrid Hearing in experienced CI users who had confirmed residual low-frequency hearing. Groups 1 and 2 were composed of different participants.Results: Group 1 (n?=?24) performance on speech perception tests was equivalent or superior with the CP900 series sound processor showing a statistically significant mean improvement of 1.87?dB in background noise (P?0.001). The mean speech understanding in quiet showed a better performance by 5% (P?=?0.064) for participants tested with the CP900. The patient-reported outcome questionnaire confirmed the beneficial performance with the CP900 series sound processor with Hybrid Hearing. The feasibility portion of the study (Group 2, n?=?14) showed an average benefit of 0.54?dB in background noise when using the CP900 with Hybrid Hearing function versus electric-only stimulation.Conclusions: The outcome presents sufficient evidence to show the effectiveness of the CP900 series sound processor with Hybrid Hearing over the Freedom Hybrid for participants with substantial residual hearing. Positive outcomes were observed for improved speech understanding and subjective hearing performance. Further, a trend was demonstrated in the data towards better performance with CP900 with Hybrid Hearing versus electric-only stimulation. Hybrid Hearing users showed a clinically relevant and statistically a significant benefit from the current CP900 series sound processor generation supporting its recommendation, on a case-by-case basis, to current electric-only users. More research is needed to confirm these findings. 相似文献
Objectives: This study describes older adults’ experiences with a new hearing aid (HA) during the first 6 months after fitting. Design: In a longitudinally designed study, experiences and issues with HA use were assessed at a six-month follow-up appointment in individual structured interviews lasting 30?min. Associations between HA experiences and demographic factors, degree of hearing loss, and an objective measure of HA use (datalogging) were also examined. Study sample: 181?HA recipients (≥60 years) attending a six-month follow-up appointment. Results: Participants reported an average of 1.4 issues (range 0–5, median?=?1, mode?=?1) with HA use, the most common pertaining to the earmold (26.5%), sound quality (26.0%) and handling (25.5%). Participants who reported at least one issue had fewer hours of use per day, but were not more likely to be non-users (<30?min/day). Non-users (15.5%) were more likely to report no need for a HA and handling issues. Conclusions: Most older adults use their HAs regardless of reported issues. However, handling issues and no perceived need may interfere with HA usage among some adults with hearing impairment. Moreover, reported issues were associated with less frequent HA use. Follow-up support is thus important to address issues that may interfere with optimal use. 相似文献
Objective: This study evaluated the cost and outcome of a community-based hearing screening programme in which village health workers (VHWs) screened children in their homes using a two-step DPOAE screening protocol. Children referred in a second screening underwent tele diagnostic ABR testing in a mobile tele-van using satellite connectivity or at local centre using broadband internet at the rural location. Design: Economic analysis was carried out to estimate cost incurred and outcome achieved for hearing screening, follow-up diagnostic assessment and identification of hearing loss. Two-way sensitivity analysis determined the most beneficial cost-outcome. Study sample: 1335 children under 5?years of age underwent screening by VHWs. Results: Nineteen of the 22 children referred completed the tele diagnostic evaluation. Five children were identified with hearing loss. The cost-outcomes were better when using broadband internet for tele-diagnostics. The use of least expensive human resources and equipment yielded the lowest cost per child screened (Rs.1526; $23; €21). When follow-up expenses were thus maximised, the cost per child was reduced considerably for diagnostic hearing assessment (Rs.102,065; $1532; €1368) and for the cost per child identified (Rs.388,237; $5826; €5204). Conclusion: Settings with constrained resources can benefit from a community-based programme integrated with tele diagnostics. 相似文献
Objective: The device-oriented subjective outcome (DOSO) is a device-oriented questionnaire, intended to minimise the influence of personality on self-reported measures. The aim of this study was to provide normative data with 2015-era hearing aid technologies. Design: This retrospective study evaluated data from records of three clinical trials. The DOSO was administered for the participants’ own devices as a part of the intake and after using research devices in the field. Study sample: The DOSO data were collected from 132 experienced bilateral hearing aid wearers who participated in the clinical trials. Results: The DOSO data collected with the participants’ own devices were compared to the interim normative data collected between 2004 and 2005. The DOSO subscale scores from the participants’ own devices were significantly higher than those from the interim norms, except Listening Effort subscale. To demonstrate the utility of the new norms, a separate set of DOSO data collected from the same participants after using research hearing aids were contrasted to the new normative data. After accounting for possible placebo effects, the DOSO data with research devices revealed additional self-reported benefit of technological advancements. Conclusions: Norms for the DOSO are recommended for evaluating hearing aids with more recent technologies. 相似文献
Objective: Internet interventions for hearing aid (HA) users have been shown to be effective in helping persons with hearing problems. As earlier research refers to objective data on these effects, little is known about how participants experience the Internet interventions subjectively. The aim of the present study was to explore participants’ experiences of an Internet-based aural rehabilitation (IAR) program for HA-users, and to explore the possible subjective benefits of such a program.Design: A qualitative exploratory design was implemented involving semi-structured telephone interviews. The interviews were transcribed and analysed using content analysis.Study sample: Interviews were conducted with 20 participants (9 men and 11 women) who had completed an IAR program for HA-users. The participants were 57–81?years old and had used HAs for 2–25?years.Results: The results are organised in three main categories: general experiences associated with participating in the program, knowledge obtained from the program and perceived impact of taking part in the program.Conclusions: The overall results indicate positive experiences of the IAR program, and an overreaching theme of increased self-esteem was identified. The findings provide some valuable information for developers of future IAR programs. 相似文献