Monthly Archives: October 2009
Computer-Assisted Assessment of Hyoid Bone Motion from Videofluoroscopic Swallow Studies
Abstract Videofluoroscopic examination of swallowing remains the standard for evaluation of patients with swallowing complaints. Although attempts have been made to objectify aspects of the study, findings from the study are largely subjective and reliant on clinician training and judgment leading to considerable inter-rater variability. We describe a computerized image analysis program designed to objectify one component of the swallow study, the movement of the hyoid bone. Hyoid motion has been shown to be different in dysphagic versus non-dysphagic patients. Reduced hyoid elevation is also considered a risk factor for aspiration; however, there has not been much work done on actually quantifying hyoid motion and associating it with other aspects of the swallow study. The clinician is prompted to define the hyoid bone in a calibration frame, and the system then tracks that region of interest throughout the rest of the study. This system shows strong correlations with manual analysis and can account for head position changes during the study. While the hyoid bone was reported on in this study, other regions of interest within the image field could also be tracked using this technique. A more quantitative analysis such as this has the opportunity to improve the inter-rater reliability of the test and therefore lead to more consistent findings from swallow studies.
from Dysphagia
Fluoroscopic Surrogate for Pharyngeal Strength: The Pharyngeal Constriction Ratio (PCR)
Abstract The pharyngeal constriction ratio (PCR), derived directly from videofluoroscopy without the need for manometry, requires validation as a surrogate for pharyngeal strength. A correlation of −0.70 was previously identified between PCR and pharyngeal clearing pressures (PP) on separate fluoroscopic and manometric studies. As PP increases, PCR decreases. The objective of the current study was to evaluate the correlation between PCR and PP in 25 patients undergoing simultaneous fluoroscopy and pharyngeal manometry. The effect of the manometric catheter on PCR was also investigated. The correlation between the PCR and averaged pharyngeal clearing pressures was −0.72 (p 0.25 had a PP < 60 mmHg. PCR did not differ significantly as a consequence of the manometric catheter. Results suggest the utility of an objective fluoroscopic measure in assessing pharyngeal strength when manometry may not be available or possible.
from Dysphagia
Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study
Conclusion
Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia.
from Head & Face Medicine
Age-Related Loss of Spiral Ganglion Neurons
Spiral ganglion neurons (SGNs) are the relay station for auditory information between hair cells and central nervous system. Age-related decline of auditory function due to SGN loss can not be ameliorated by hearing aids or cochlear implants. Recent findings clearly indicate that survival of SGNs during aging depends on genetic and environmental interactions, which can be demonstrated at the systemic, tissue, cellular, and molecular levels. At the systemic level, both insulin/insulin-like growth factor-1 and lipophilic/steroid hormone pathways influence SGN survival during aging. At the level of organ of the Corti, it is difficult to determine whether age-related SGN loss is primary or secondary degeneration. However, a late stage of SGN degeneration may be independent of age-related loss of hair cells. At the cellular and molecular level, several pathways, particularly free radical and calcium signaling pathways, can influence age-related SGN loss, and further studies should determine how these pathways contribute to SGN loss, such as whether they directly or indirectly act on SGNs. With the advancement of recent genetic and pharmacologic tools, we should not only understand how SGNs die during aging, but also find ways to delay this loss.
from Hearing Research
Recession Affects The University of Florida’s Communication Science Departments
A recent article in Advance for Speech-Language Pathologists & Audiologists details how the state budget shortfall in the state of Florida has caused the school to consolidate two communication science departments to form the largest academic program of its kind in Florida. The department of the communication sciences and disorders in the College of Liberal Arts and Sciences is merging with the department of communicative disorders in the College of Public Health and Health Professions as part of a series of university cost-cutting measures.
from Presence TeleCare
The Children Born in 2001 at Kindergarten Entry: First Findings From the Kindergarten Data Collections of the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B)
Using data from the final two rounds of the ECLS-B, a longitudinal study begun in 2001, this First Look provides a snapshot of the demographic characteristics, reading and mathematics knowledge, fine motor skills, school characteristics, and before- and after-school care arrangements of the cohort at the time they first began kindergarten. Information has been collected from and about these children when they were 9 months old, 2 years old, 4 years old, and at kindergarten entry. This survey provides a comprehensive and reliable data about children’s early development; their home learning experiences; their experiences in early care and education programs; their health care, nutrition, and physical well-being; and how their early experiences relate to their later development, learning, and success in school.
from the U.S. Department of Education, Institute of Education Sciences
Depressive emotioning in adolescents with cochlear implant and normal hearing
Conclusions
As a result of these findings, it was thought that cochlear implantation had a positive effect on life quality and it was suggested that the adolescents and their families should get assistance from experts about the characteristics and principles of approaching the child in this period. The adolescent should be directed towards social activities and courses, their positive sides should be supported and further studies should be carried out with different case groups on this matter. In addition to, examining the interactions of hearing loss effects can help professionals determine the individuals who are at a higher risk for developing mental distress.
from the International Journal of Pediatric Otorhinolaryngology
The impact of chronic suppurative otitis media on children’s and teenagers’ hearing
Results and conclusions
Air conduction, bone conduction thresholds and air-bone gaps in children and teenagers with CCOM are significantly greater. There were no significative differences between air-bone gaps in epitympanic and posterior mesotympanic cholesteatomas. In NCCOM, the gap value is positively correlated with the number of quadrants with tympanic perforation. There was no significative difference between the air-bone gaps in tympanic perforations affecting the posterior and anterior quadrants.
from the International Journal of Pediatric Otorhinolaryngology
Listening to children with communication impairment talking through their drawings
Including children as research participants is an important new direction in early childhood research. However, it is rare for such studies to include the voices of children with significant communication impairment. This article suggests that drawing may be an appropriate non-verbal method for ‘listening’ to these children’s ideas and recording their perspectives. Three areas of inquiry are reviewed: (1) the use of drawings as a method of listening respectfully to children; (2) approaches to the analysis of children’s drawings; and (3) the analysis of drawings completed by children with communication impairment. We identify six aspects of children’s drawings — facial expressions, accentuation of body features (e.g. mouth and ears), portrayal of talking/listening, colours used, conversational partners, and sense of self — that are potentially pertinent for children with communication impairment.
from the Journal of Early Childhood Research
Epithelial differentiation of adipose-derived stem cells for laryngeal tissue engineering
Conclusions:
A three-dimensional structure of fibrin and adipose-derived stem cells was created as a prototype vocal fold replacement. Two segregated cell phenotypes occurred, producing a bilayered structure resembling epithelium over lamina propria. This preliminary work demonstrates the feasibility of tissue engineering to produce structures for vocal fold replacement. Laryngoscope, 2009
from The Laryngoscope
Outcome of severe unilateral cerebellar hypoplasia
Interpretation Severe UCH is a residual change after a disruptive prenatal cerebellar insult, most likely haemorrhagic. The outcome is variable, ranging from almost normal development to marked developmental impairment. Ataxia is a frequent but not a leading sign. It seems that involvement of the cerebellar vermis is often, but not consistently, associated with a poorer cognitive outcome, whereas an intact vermis is associated with normal outcome and no truncal ataxia.
Better fitting of cochlear implants: modeling loudness for acoustic and electric stimuli
Abstract. It is becoming more common for cochlear implant (CI) recipients to have some useful acoustic hearing post-operatively. Such CI users may benefit from simultaneous use of an acoustic hearing aid (HA). To provide a satisfactory fitting of both types of devices, it is helpful to make the loudness perceived via each device as similar as possible. In practice, this is usually attempted by adjusting the sensitivity and/or gain of each device during fitting, but it is often not clear whether or how well the loudness of the devices has been matched for each user. In this study, established numerical models of loudness for both acoustic and electric stimulation were used to investigate this problem. The models’ outputs were compared to published psychophysical data and were found to approximate the main patterns observed in those data. They also showed that, theoretically, there would be differences in the loudness perceived with each type of device when sounds with varying frequency content and level were heard. Future sound processors and/or fitting techniques developed specifically for CI recipients with usable acoustic hearing could apply such computational models of loudness to improve simultaneous use of the two types of device.
from the Journal of Neural Engineering
Effects of Selective Serotonin Reuptake Inhibitor on Treating Tinnitus in Patients Stratified for Presence of Depression or Anxiety
We evaluated the effects of a selective serotonin reuptake inhibitor, paroxetine, on treating tinnitus.Tinnitus patients stratified for the presence of depression and anxiety were studied retrospectively. Fifty-six patients were observed for more than 6 months. They were initially treated with paroxetine only at a dose of 10 mg/day for 2-4 weeks; thereafter, the dose was increased to 20 mg/day. Tinnitus distress was evaluated with the Tinnitus Handicap Inventory (THI) and with visual analog scales (VASs) for tinnitus loudness and annoyance. Depression and anxiety were measured with the Self-Rating Depression Scale (SDS) and the trait section of the State-Trait Anxiety Inventory (STAI). The patients were grouped according to their SDS and STAI scores, and each variable was compared at baseline and the 6-month follow-up. Changes among these variables were also examined to determine whether reduced tinnitus distress was related to the improvement of depression or anxiety. Patients with both depression and anxiety showed better results (decrease in THI, VASs, SDS and STAI scores) than patients with anxiety alone, or patients without depression and anxiety. In patients with depression and anxiety, changes in tinnitus variables and changes in depression and anxiety scores were strongly correlated. In other patients, however, changes in tinnitus variables and changes in depression and anxiety scores were not correlated. These results suggest that paroxetine is effective in treating distressed tinnitus patients with depression and anxiety by reducing their tinnitus severity as well as their depression and anxiety.
Neural synchrony in ventral cochlear nucleus neuron populations is not mediated by intrinsic processes but is stimulus induced: implications for auditory brainstem implants
Abstract. The aim of this investigation was to elucidate if neural synchrony forms part of the spike time-based theory for coding of sound information in the ventral cochlear nucleus (VCN) of the auditory brainstem. Previous research attempts to quantify the degree of neural synchrony at higher levels of the central auditory system have indicated that synchronized firing of neurons during presentation of an acoustic stimulus could play an important role in coding complex sound features. However, it is unknown whether this synchrony could in fact arise from the VCN as it is the first station in the central auditory pathway. Cross-correlation analysis was conducted on 499 pairs of multiunit clusters recorded in the urethane-anesthetized rat VCN in response to pure tones and combinations of two tones to determine the presence of neural synchrony. The shift predictor correlogram was used as a measure for determining the synchrony owing to the effects of the stimulus. Without subtraction of the shift predictor, over 65% of the pairs of multiunit clusters exhibited significant correlation in neural firing when the frequencies of the tones presented matched their characteristic frequencies (CFs). In addition, this stimulus-evoked neural synchrony was dependent on the physical distance between electrode sites, and the CF difference between multiunit clusters as the number of correlated pairs dropped significantly for electrode sites greater than 800 µm apart and for multiunit cluster pairs with a CF difference greater than 0.5 octaves. However, subtraction of the shift predictor correlograms from the raw correlograms resulted in no remaining correlation between all VCN pairs. These results suggest that while neural synchrony may be a feature of sound coding in the VCN, it is stimulus induced and not due to intrinsic neural interactions within the nucleus. These data provide important implications for stimulation strategies for the auditory brainstem implant, which is used to provide functional hearing to the profoundly deaf through electrical stimulation of the VCN.
from the Journal of Neural Engineering
