Now available at a chemist near you… the tiny hearing aid which boosts the sound of speech

from the Daily Mail.uk.co

A newly launched over-the-counter device could help thousands of people with mild to moderate hearing loss.

The jelly-bean-sized gadget is designed to help boost the sound of speech only – it is being targeted at people who struggle to hear what’s being said in crowded places (such as in meetings or at parties) or on the TV.

MRI Detects Soft Tissue Damage Affecting Kids’ Hearing

from HealthCentral.com

TUESDAY, Sept. 16 (HealthDay News) — Soft-tissue defects that contribute to hearing loss in children can be detected using MRI, say U.S. researchers who analyzed the medical records of hundreds of children diagnosed with sensorineural (related to sensory nerves) hearing loss.

Buying or Selling an Audiology Business

from the ASHA Leader

The hearing industry is ripe for audiologists to increase their presence in the market. With the move to advanced degrees and greater autonomy, audiologists can position themselves as primary health care professionals to individuals with hearing loss. Audiologists traditionally work in clinics, hospitals and physicians’ offices—important delivery models for audiology care—but many audiologists are embracing autonomy with ownership of a private practice.

Audiology Convention Program Expands

from the ASHA Leader

This year’s convention theme is “Celebrating the Winds of Change.” It may sound a little corny, but it is very appropriate. The audiology program, for example, will present many changes. Our objective was to make the program bigger, better, and more accessible, with “all things audiology” in one place with an outstanding group of speakers.

Functional soft palate reconstruction: A comprehensive surgical approach

from Head and Neck

Background.
Dysfunction of the soft palate is devastating to the patient’s quality of life, resulting in unintelligible speech and poor swallowing. Reconstruction of the soft palate is complex because the dynamic fibromuscular structure cannot be duplicated. The efficacy of soft palate reconstruction has therefore been called into question. The purpose of this article is: (1) to describe our comprehensive surgical paradigm for soft palate reconstruction, (2) to provide details of the surgical techniques used, and (3) to report on patient functional outcomes.

Methods.
Fifty-two patients spanning 3 different size-based categories of soft palate reconstruction were included in the final analysis. Using videofluoroscopic studies of swallowing, the presence of nasopharyngeal reflux and any instance of aspiration of a bolus into the airway was noted. In addition, a simple diet survey was completed, and the use of a g-tube was noted.

Results.
The results revealed that our protocol for soft palate reconstruction provided the majority of our patients with separation of the oropharynx and nasopharynx, while maintaining nasal patency. Restoration of swallowing function was timely, with 91% of the patients returning to an oral diet at the early postoperative visit and only 14% of patients demonstrating mild nasopharyngeal reflux.

Conclusion.
We have developed a comprehensive reconstructive protocol that provides patients with separation of the oropharynx and nasopharynx, while maintaining nasal patency. Restoration of function is timely, with reestablishment of normal intelligibility and resonance of speech as well as safe and efficient swallowing function. © 2008 Wiley Periodicals, Inc. Head Neck, 2008

Validation and assessment of voice-related quality of life in Indian patients undergoing total laryngectomy and primary tracheoesophageal puncture

from Head and Neck

Background.
Voice-related quality of life (V-RQOL) has never been studied in Indian patients. This study was planned to validate and assess V-RQOL in patients using tracheoesophageal puncture (TEP).

Methods.
A cross-sectional study was undertaken to validate V-RQOL questionnaire by testing reliability, validity, and responsiveness. V-RQOL was assessed in patients undergoing total laryngectomy with primary TEP.

Results.
One hundred thirty-two patients filled 188 questionnaires. Analysis was carried out on 122 patients. Reliability and validity of questionnaire were tested by Cronbach’s alpha (.84-.91) and item-scale correlation (.67-.86). Median V-RQOL-Total score was 76.2 indicating excellent V-RQOL. Higher scores were observed in patients less than 50 years (82.5 vs 72.5, p = .08). There was no effect of time interval between laryngectomy and assessment of questionnaire on the V-RQOL scores.

Conclusion.
V-RQOL questionnaire can be used reliably to assess V-RQOL, which is found to be excellent in Indian patients undergoing TEP. © 2008 Wiley Periodicals, Inc. Head Neck, 2008

A water-resistant speech processor

from Cochlear Implants Internations

Cochlear implant systems are used in diverse environments and should function during work, exercise and play as people go about their daily lives. This is a demanding requirement, with exposure to liquid and other contaminant ingress from many sources. For reliability, it is desirable that the speech processor withstands these exposures. This design challenge has been addressed in the Nucleus® FreedomTM speech processor. The Nucleus Freedom speech processor complies with International Standard IEC 60529, as independently certified. Tests include spraying the processor with water followed by immediate verification of functionality including microphone response, radio frequency link and processor controls. The processor has met level IP44 of the Standard. Copyright © 2006 John Wiley & Sons, Ltd.

Auditory speech sounds evaluation (A§E®): a new test to assess detection, discrimination and identification in hearing impairment

from Cochlear Implants Internations

This paper describes a set of suprathreshold tests, available as a software package (A§E®), for the auditory evaluation of the hearing impaired. It uses isolated speech sounds as test material for a discrimination, identification and detection test, and is specifically suited to test preverbal children. All tests allow strict analytical interpretation. The test material and procedures are described. Their clinical use is illustrated. The authors claim that suprathreshold tests are feasible in the preverbal child, allowing analytical evaluation of the auditory capacities. These tests are complementary to the routinely used detection tests and add significantly to the hearing evaluation in preverbal children. The authors recommend the phoneme discrimination test for selection of cochlear implant candidates and for the evaluation and fitting of cochlear implants. Copyright © 2006 John Wiley & Sons, Ltd.

Children’s communication mode five years after cochlear implantation: changes over time according to age at implant

from Cochlear Implants Internations

One hundred and seventy six children who had received cochlear implants at one centre in the UK were followed up for five years post-implant. The cohort was divided into three groups by age at implant. 1: Under three years of age; 2: Between three and five; 3: Over five. Their mode of communication was noted at four key intervals – pre-implant; 1, 3 and 5 years post-implant. It was classified as either oral or sign. By five years post-implant, 83% of group 1 were using oral communication, 63.5% of group 2 and 45.1% of group 3. The results showed that the mode of communication five years post-implant is statistically related to age at implantation with more children implanted younger using an oral mode of communication (p = 0.001). Children implanted younger are more likely to change communication mode over time from sign to oral, and do so more quickly than those implanted later. Copyright © 2006 John Wiley & Sons, Ltd.

Chronic suppurative otitis media following paediatric cochlear implantation

from Cochlear Implants Internations

The objective of this study was to report and discuss the management of chronic suppurative otitis media (CSOM) following cochlear implantation in children. The study was a retrospective review of 650 patients receiving an implant at two paediatric tertiary referral centres for cochlear implantation. Nine patients were identified who developed CSOM following cochlear implantation (incidence 1.38%). The mean time interval between implantation and symptom development was 3.66 years (range 2-8 years) and the mean time interval between implantation and CSOM surgery was 5.02 years (range 2.2-8 years). All patients presented with otorrhoea and/or abscess formation over the implant site. Two patients underwent a modified radical mastoidectomy and seven underwent a combined approach tympanoplasty, three of whom required posterior canal wall reconstruction with cortical bone and one with cartilage. In four cases it was possible to remove the cholesteatoma without removing the implant. All but two patients were fitted with a contralateral implant. In the explanted ears the cochlear implant electrode was cut at the cochleostomy site, which was then covered with muscle. Chronic suppurative otitis media following cochlear implantation may occur either as a result of a posterior canal wall defect related to surgery or possibly de novo. Attempts should be made to save the implant, but explantation with reimplantation of the contralateral ear may be the only option. In these cases the intracochlear part of the electrode array should be left in situ to facilitate possible future reimplantation. Surgical options for management of CSOM should be individualized and may include both canal-wall up and canal-wall down techniques. To reduce the incidence of CSOM following implantation the authors recommend: (1) prompt treatment and careful follow-up of patients with a history of otitis media with effusion, (2) avoidance of excessive thinning of the posterior canal wall during mastoidectomy and (3) reconstruction of any accidental trauma to the annulus or posterior canal wall during posterior tympanotomy. Copyright © 2006 John Wiley & Sons, Ltd.

Cochlear implantations in children with Waardenburg syndrome: an electrophysiological and psychophysical review

from Cochlear Implants Internations

Waardenburg syndrome presents with dystopia canthorum, pigmentary abnormalities of hair, iris and skin (often a white forelock and heterochromia iridis) and sensorineural deafness. The authors review the electrophysiological and psychophysical findings of implanted children with Waardenburg syndrome at the Sydney Cochlear Implant Centre. Twenty children with Waardenburg syndrome received cochlear implants between 1985 and 2001. Electrical auditory brainstem response (EABR) was performed in all of these patients intra-operatively as part of the routine investigations. Only 13 of these patients were assessed one year or more post-operatively by means of the Melbourne Categories (0-7). Four patients (20%) were found to have abnormal EABR recordings. The mode of Melbourne Categories in this group (n = 3) was 1 at one year post-operation. The other 16 patients were found to have normal EABR and the mode of Melbourne Categories in this group (n = 10) was 7. A poor outcome after cochlear implantation was associated with abnormal EABR recordings (a true auditory neuropathy) and was found in a significant proportion of patients with Waardenburg syndrome. Copyright © 2006 John Wiley & Sons, Ltd.

Conversation repair and adult cochlear implantation: a qualitative case study

from Cochlear Implants Internations

Conversation breakdown and repair has been suggested to be a common site of the disability arising from acquired hearing impairment in adults. This qualitative case study reports on certain consequences of the use of general versus specific conversation repair initiators for the resolution of repair sequences. The 47 repair sequences analysed in this paper arose in a single 20-minute free and unstructured conversation between an adult bilateral cochlear implantee and his wife, audio-recorded in a clinic setting. The repairs analysed in this paper were undertaken in response to either general (n = 18) or specific (n = 29) repair requests. No difference was found in the number of turns taken to resolve repairs in response to general or specific repair requests. Qualitative analysis demonstrated that uttering the repair initiator in the immediate vicinity of the miscommunicated portion of talk provided the primary cue to the conversation partner about the location and the content of what had been misunderstood. These preliminary findings imply a change to rehabilitation counselling offered to familiar communication partners. Copyright © 2006 John Wiley & Sons, Ltd.

Evaluation of a non-linear spectral subtraction noise suppression scheme in cochlear implant users

from Cochlear Implants Internations

The aim of the study was to determine benefit to speech recognition in noise by adult cochlear implant users with the non-linear spectral subtraction (NSS) noise suppression strategy. Users of the Nucleus 22 or Nucleus 24 cochlear implant systems were tested with sentence materials combined with stationary noise at +5 and +10 dB signal to noise ratio (SNR), with and without NSS processing applied offline. Sentence scores were significantly higher with NSS processing, for both SNRs. The effect was greater at +5 dB SNR (12% improvement with NSS) than at +10 dB SNR (5% improvement with NSS). These results are promising and suggest that online implementation of NSS as part of cochlear implant processors has the potential to yield benefits for speech recognition in noise. Copyright © 2006 John Wiley & Sons, Ltd.

Exploration of the cognitive and behavioural consequences of paediatric cochlear implantation

from Cochlear Implants Internations

This study followed the progress of young deaf children undergoing cochlear implantation, in terms of their non-verbal cognitive abilities and their emotional/behavioural development. A consecutive series of 20 children, between the ages of 2 and 5 years, were assessed using the Leiter International Performance Scale – Revised (LIPS-R) and the Child Behaviour Checklist (CBCL), prior to receiving a Nucleus 24 cochlear implant. They were assessed again one year after the device was switched on. Scores on seven of the 13 subtests and composite scales of the LIPS-R increased significantly during the first year of cochlear implant use. Cognitive functions post-implant (Sequential Order, Fluid Reasoning, Full IQ and Attention Sustained) were positively related to behavioural outcomes. These results may be explained by an increased capacity of the implanted children to use verbal concepts to encode visual material. There was also evidence for a reduction in internalizing behaviour problems. The results are discussed in the context of previous research, clinical and theoretical perspectives. Copyright © 2006 John Wiley & Sons, Ltd.

Ineraid to Med-El Combi 40+ upgrade: a case report

from Cochlear Implants Internations

Continual changes in cochlear implant technology have resulted in the development of superior implants which improve quality of life of users. We present the case of a taxi driver who has been in our cochlear implant programme since 1991 and has required reimplantation. We discuss the benefits of the new implant on his life and work. A novel technique to successfully reimplant the ipsilateral cochlea is highlighted. Copyright © 2006 John Wiley & Sons, Ltd.