Binaural Perception in Single-Sided Deaf Cochlear Implant Users with Unrestricted or Restricted Acoustic Hearing in the Non-Implanted Ear

2018 ◽  
Vol 23 (3) ◽  
pp. 187-197 ◽  
Author(s):  
Camille Dorbeau ◽  
John Galvin ◽  
Qian-Jie Fu ◽  
Elsa Legris ◽  
Mathieu Marx ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Tinnitus Severity ◽  
Speech Understanding In Noise ◽  
Significant Difference ◽  
Acoustic Hearing ◽  
Speech Cues ◽  
Contralateral Ear ◽  
Speech Reception Thresholds ◽  
One Year ◽  
Single Sided Deafness

Cochlear implantation (CI) can benefit patients with single-sided deafness (SSD) in terms of sound localization, speech understanding in noise, tinnitus severity, and quality of life (QoL). In previous studies, CI outcomes have been largely reported for SSD patients with normal “unrestricted” hearing in the contralateral ear. However, SSD patients may often have some degree of hearing loss in the contralateral ear (“restricted” acoustic hearing). In this study, we report results from a French clinical trial for CI in in SSD patients (NCT02204618). Localization, speech reception thresholds (SRTs) in noise, tinnitus severity, and QoL were evaluated in 18 SSD patients 1 year after CI. Data were analyzed for 2 subject groups according to the pure-tone average thresholds in the non-implanted ear: unrestricted acoustic hearing (UNRES; ≤25 dB HL; n = 10) and restricted acoustic hearing (RES; > 25 dB HL; n = 8). Across all subjects, localization was significantly better with the CI on than off (p = 0.005); there was no significant difference between subject groups (p = 0.301). When speech and noise were co-located (S0N0), there was no significant difference in SRTs with the CI on or off (p = 0.480); SRTs were significantly better for the UNRES than for the RES group (p = 0.005). When speech and noise were spatially separated (SCINNH), SRTs were significantly better with the CI on than off (p < 0.001). While SRTs were better for the UNRES than for the RES group (p = 0.024), the CI benefit was more than 50% greater for the RES group due to the restoration of high-frequency speech cues. Questionnaire data showed that tinnitus severity was significantly reduced (p = 0.045) and QoL was significantly improved after one year of experience with the CI (p < 0.001). Age at testing was significantly correlated with SRTs for the S0N0 condition; duration of deafness was correlated with SRTs for the SCINNH condition. There were relatively few correlations between behavioral and subjective measures, suggesting that both were valuable when assessing CI benefits for SSD patients. The present data suggest that indications for CI should be expanded to include unilaterally deaf patients who have normal hearing or mild-to-moderate hearing loss in the non-implanted ear.

scholarly journals Speech Understanding and Sound Localization with a New Nonimplantable Wearing Option for Baha

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Tom Gawliczek ◽  
Wilhelm Wimmer ◽  
Fabio Munzinger ◽  
Marco Caversaccio ◽  
Martin Kompis
Keyword(s):  
Hearing Loss ◽  
Sound Localization ◽  
Bone Conduction ◽  
Speech Understanding ◽  
Bilateral Hearing Loss ◽  
Speech Understanding In Noise ◽  
Speech Reception ◽  
Significant Difference ◽  
Speech Reception Thresholds ◽  
Sound Processor

Objective. To measure the audiological benefit of the Baha SoundArc, a recently introduced nonimplantable wearing option for bone conduction sound processor, and to compare it with the known softband wearing option in subjects with normal cochlear function and a purely conductive bilateral hearing loss.Methods. Both ears of 15 normal hearing subjects were occluded for the time of the measurement, yielding an average unaided threshold of 49 dB HL (0.5 – 4 kHz). Soundfield thresholds, speech understanding in quiet and in noise, and sound localization were measured in unaided conditions and with 1 or 2 Baha 5 sound processors mounted on either a softband or a SoundArc device.Results. Soundfield thresholds and speech reception thresholds were improved by 19.5 to 24.8 dB (p<.001), when compared to the unaided condition. Speech reception thresholds in noise were improved by 3.7 to 4.7 dB (p<.001). Using 2 sound processors rather than one improved speech understanding in noise for speech from the direction of the2nddevice and sound localization error by 23° to 28°. No statistically significant difference was found between the SoundArc and the softband wearing options in any of the tests.Conclusions. Bone conduction sound processor mounted on a SoundArc or on a softband resulted in considerable improvements in hearing and speech understanding in subjects with a simulated, purely conductive, and bilateral hearing loss. No significant difference between the 2 wearing options was found. Using 2 sound processors improves sound localization and speech understanding in noise in certain spatial settings.

scholarly journals On the Effect of Bimodal Rehabilitation in Asymmetric Hearing Loss

2021 ◽  
Vol 10 (17) ◽  
pp. 3927
Author(s):  
Simonetta Monini ◽  
Chiara Filippi ◽  
Alessandra De Luca ◽  
Gerardo Salerno ◽  
Maurizio Barbara
Keyword(s):  
Hearing Loss ◽  
Hearing Aid ◽  
Free Field ◽  
Hearing Threshold ◽  
Beneficial Effects ◽  
Auditory Performance ◽  
Contralateral Ear ◽  
Single Sided Deafness ◽  
Asymmetric Hearing Loss

Background: Bone conductive implants (BCI) have been reported to provide greater beneficial effects for the auditory and perceptual functions of the contralateral ear in patients presenting with asymmetric hearing loss (AHL) compared to those with single-sided deafness (SSD). The aim of the study was to assess the effects of wearing a conventional hearing aid in the contralateral ear on BCI in terms of an improved overall auditory performance. Methods: eleven AHL subjects wearing a BCI in their worse hearing ear underwent an auditory evaluation by pure tone and speech audiometry in free field. This study group was obtained by adding to the AHL patients those SSD subjects that, during the follow-up, showed deterioration of the hearing threshold of the contralateral ear, thus presenting with the features of AHL. Four different conditions were tested and compared: unaided, with BCI only, with contralateral hearing aid (CHA) only and with BCI combined with CHA. Results: all of the prosthetic conditions caused a significant improvement with respect to the unaided condition. When a CHA was adopted, its combination with the BCI showed significantly better auditory performances than those achieved with the BCI only. Conclusions: the present study suggests the beneficial role of a CHA in BCI-implanted AHL subjects in terms of overall auditory performance.

scholarly journals Study of Various Prognostic Factors Affecting Successful Myringoplasty in a Tertiary Care Centre

2016 ◽  
Vol 21 (03) ◽  
pp. 250-254 ◽  
Author(s):  
Kripa Dangol ◽  
Rakesh Shrivastav
Keyword(s):  
Prognostic Factors ◽  
Otitis Media ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Poor Prognostic Factor ◽  
Hearing Results ◽  
Pure Tone Audiogram ◽  
Significant Difference ◽  
Contralateral Ear ◽  
One Year

Introduction Myringoplasty is a commonly performed otologic surgery. Objectives The objective of this study is to evaluate the effect of prognostic factors like - size, site of perforation, status of operating ear, approach, status of contralateral ear, experience of surgeon, primary or revision myringoplasty, and smoking in graft uptake, as well as to evaluate the hearing results after myringoplasty. Methods This is a prospective study. We included in our sample patients aged over 13 years with a Tubotympanic Chronic Otitis Media diagnosis. The patients underwent preoperative evaluation and Pure Tone Audiogram within one week prior to surgery. We performed myringoplasty using temporalis fascia graft with conventional underlay technique. We evaluated postoperative graft uptake and various factors related to the study and did a Pure Tone Audiogram at one year after surgery. Results The graft uptake rate after myringoplasty was 83.1% at one year in 219 patients. Graft uptake with normal opposite ear was 88.2%, and with Tubotympanic Chronic Otitis Media was 75% (statistically significant). We found no statistically significant difference in graft uptake results with other factors. We calculated hearing results of 132 patients with normal ossicular status who underwent myringoplasty. The average Air Conduction Threshold improvement was 11.44dB (p < 0.001) and the average Air-Bone Gap closure was 8.89dB, highly statistically significant (p < 0.001). Conclusion Diseased contralateral ear was a statistically significant poor prognostic factor for graft uptake after myringoplasty. Other factors studied were not statistically significant determining factor for graft uptake. Hearing improves significantly after myringoplasty if the ossicles are normal.

Speech-Language Pathologists' Perceptions of School-Based Services for Children With Hearing Loss

2020 ◽  
Vol 51 (2) ◽  
pp. 469-478
Author(s):  
Sarah Allen ◽  
Robert Mayo
Keyword(s):  
Hearing Loss ◽  
Online Survey ◽  
Working Relationships ◽  
Speech Language Pathologists ◽  
School Aged Children ◽  
School Based ◽  
Significant Difference ◽  
Positive Feelings ◽  
Children With Hearing Loss ◽  
Perceptions Of School

Purpose School-aged children with hearing loss are best served by a multidisciplinary team of professionals. The purpose of this research was to assess school-based speech-language pathologists' (SLPs) perceptions of their access to, involvement of, and working relationships with educational audiologists in their current work setting. Method An online survey was developed and distributed to school-based SLPs in North Carolina. Results A significant difference in access to and involvement of educational audiologists across the state was found. Conclusions This research contributes to professional knowledge by providing information about current perceptions in the field about interprofessional practice in a school-based setting. Overall, SLPs reported positive feelings about their working relationship with educational audiologists and feel the workload is distributed fairly.

Risk of venous thromboembolism following surgical treatment of superficial venous incompetence

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Tom Barker ◽  
Felicity Evison ◽  
Ruth Benson ◽  
Alok Tiwari
Keyword(s):  
Venous Thromboembolism ◽  
Varicose Vein ◽  
Lower Incidence ◽  
Varicose Veins ◽  
Secondary Data ◽  
Foam Sclerotherapy ◽  
Increased Risk ◽  
Significant Difference ◽  
Chi Squared ◽  
One Year

Abstract. Background: The invasive management of varicose veins has a known risk of post-operative deep venous thrombosis and subsequent pulmonary embolism. The aim of this study was to evaluate absolute and relative risk of venous thromboembolism (VTE) following commonly used varicose vein procedures. Patients and methods: A retrospective analysis of secondary data using Hospital Episode Statistics database was performed for all varicose vein procedures performed between 2003 and 2013 and all readmissions for VTE in the same patients within 30 days, 90 days, and one year. Comparison of the incidence of VTEs between procedures was performed using a Pearson’s Chi-squared test. Results: In total, 261,169 varicose vein procedures were performed during the period studied. There were 686 VTEs recorded at 30 days (0.26 % incidence), 884 at 90 days (0.34 % incidence), and 1,246 at one year (0.48 % incidence). The VTE incidence for different procedures was between 0.15–0.35 % at 30 days, 0.26–0.50 % at 90 days, and 0.46–0.58 % at one year. At 30 days there was a significantly lower incidence of VTEs for foam sclerotherapy compared to other procedures (p = 0.01). There was no difference in VTE incidence between procedures at 90 days (p = 0.13) or one year (p = 0.16). Conclusions: Patients undergoing varicose vein procedures have a small but appreciable increased risk of VTE compared to the general population, with the effect persisting at one year. Foam sclerotherapy had a lower incidence of VTE compared to other procedures at 30 days, but this effect did not persist at 90 days or at one year. There was no other significant difference in the incidence of VTE between open, endovenous, and foam sclerotherapy treatments.

Levels of Prothrombin Fragment F1+2 in Patients with Hyperhomocysteinemia and a History of Venous Thromboembolism

1997 ◽  
Vol 78 (05) ◽  
pp. 1327-1331 ◽  
Author(s):  
Paul A Kyrle ◽  
Andreas Stümpflen ◽  
Mirko Hirschl ◽  
Christine Bialonczyk ◽  
Kurt Herkner ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Thrombin Generation ◽  
Oral Anticoagulant Therapy ◽  
Oral Anticoagulants ◽  
Control Group ◽  
Prothrombin Fragment ◽  
Hemostatic System ◽  
Significant Difference ◽  
System Activation ◽  
One Year

SummaryIncreased thrombin generation occurs in many individuals with inherited defects in the antithrombin or protein C anticoagulant pathways and is also seen in patients with thrombosis without a defined clotting abnormality. Hyperhomocysteinemia (H-HC) is an important risk factor of venous thromboembolism (VTE). We prospectively followed 48 patients with H-HC (median age 62 years, range 26-83; 18 males) and 183 patients (median age 50 years, range 18-85; 83 males) without H-HC for a period of up to one year. Prothrombin fragment Fl+2 (Fl+2) was determined in the patient’s plasma as a measure of thrombin generation during and at several time points after discontinuation of secondary thromboprophylaxis with oral anticoagulants. While on anticoagulants, patients with H-HC had significantly higher Fl+2 levels than patients without H-HC (mean 0.52 ± 0.49 nmol/1, median 0.4, range 0.2-2.8, versus 0.36 ± 0.2 nmol/1, median 0.3, range 0.1-2.1; p = 0.02). Three weeks and 3,6,9 and 12 months after discontinuation of oral anticoagulants, up to 20% of the patients with H-HC and 5 to 6% without H-HC had higher Fl+2 levels than a corresponding age- and sex-matched control group. 16% of the patients with H-HC and 4% of the patients without H-HC had either Fl+2 levels above the upper limit of normal controls at least at 2 occasions or (an) elevated Fl+2 level(s) followed by recurrent VTE. No statistical significant difference in the Fl+2 levels was seen between patients with and without H-HC. We conclude that a permanent hemostatic system activation is detectable in a proportion of patients with H-HC after discontinuation of oral anticoagulant therapy following VTE. Furthermore, secondary thromboprophylaxis with conventional doses of oral anticoagulants may not be sufficient to suppress hemostatic system activation in patients with H-HC.

Comparative Study between Endoscopic Aided Septoplasty with Two Handed Technique using Endoholder and Conventional Septoplasty

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Apar Pokharel ◽  
Naganawalachullu Jaya Prakash Mayya ◽  
Nabin Gautam
Keyword(s):  
Comparative Study ◽  
Nasal Septum ◽  
Deviated Nasal Septum ◽  
Endoscopic Septoplasty ◽  
Septal Surgery ◽  
Significant Difference ◽  
Common Causes ◽  
Prospective Comparative Study ◽  
Evolutionary Step ◽  
One Year

Introduction: Deviated nasal septum is one of the most common causes for the nasal obstruction. The objective of this study is to compare the surgical outcomes in patients undergoing conventional septoplasty and endoscopic septoplasty in the management of deviated nasal septum. Methods:  Prospective comparative study was conducted on 60 patients who presented to the Department of ENT, College of Medical sciences, during a period of one year. The severity of the symptoms was subjectively assessed using NOSE score and objectively assessed using modified Gertner plate. Results: There was significant improvement in functional outcome like NOSE Score and area over the Gertner plate among patients who underwent endoscopic septoplasty. Significant difference in incidence of post-operative nasal synechae and haemorrhage was seen in conventional group compared to endoscopic group. Conclusions: Endoscopic surgery is an evolutionary step towards solving the problems related to deviated nasal septum. It is safe, effective and conservative, alternative to conventional septal surgery.

EVALUTING THE EFFECTS OF EARLY INTERVENTION PROGRAM FOR CHILDREN WITH DEVELOPMENTAL DISABILITIES IN COMMUNITY

2011 ◽  
pp. 70-76
Author(s):  
Keyword(s):  
Social Cognition ◽  
Early Intervention ◽  
Developmental Delay ◽  
Intervention Program ◽  
Language Skills ◽  
Early Intervention Program ◽  
Self Help ◽  
Home Based ◽  
Significant Difference ◽  
One Year

Objectives: To evualate the effects of early intervention program after one year for 33 disabled children in Hue city in 2010. Objects and Methods: Conduct with practical work and assessment on developing levels at different skills of the children with developmental delay under 6 years old who are the objects of the program. Results: With the Portage checklist used as a tool for implementing the intervention at the community and assessing developing skills on Social, Cognition, Motor, Self-help and Language skills for children with developmental delay, there still exists significant difference (p ≤ 0.05) at developing level of all areas in the first assessment (January, 2010) and the second assessment (December, 2010) after 12 months. In comparison among skills of different types of disabilities, there is significant difference of p ≤ 0.05 of social, cognition and language skills in the first assessment and of social, cognition, motor and language skills in the second assessment. Conclusion: Home-based Early Intervention Program for children with developmental delay has achieved lots of progress in improving development skills of the children and enhancing the parents’ abilities in supporting their children at home.

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