Monthly Archives: June 2010
CO2 laser-assisted microsurgery for intracordal cysts: technique and results of 49 patients
Microsurgery for intracordal cysts is a challenging procedure, because cysts are close to the vocal ligament and the risk of inducing a scar is high. In this retrospective study, our experience with the CO2-laser scanning system (Acublade®) is reported on 49 patients. There were 41% epidermoid cysts and 59% mucous retention cysts. A quarter of the patients presented with bilateral cystic lesions and 59% had a contralateral lesion other than a cyst. The cyst was removed after a minimicroflap. It was dissected away from the lamina propria and the epithelium. Collagen was injected intraoperatively if the glottal gap was considered important. The epithelium was redraped using Tissucol (Baxter, Vienna, Austria). The mean follow-up time was 160 days. We noted a statistically significant improvement in the grade of the dysphonia according to Hirano’s perceptual scale (G pre = 2, G post = 1, p = 0.002); the Vocal Handicap Index (VHI pre = 51, VHI post = 28, p = 0.001) and the maximal phonation time in milliseconds (MPT pre = 11, 1 MPT post = 12.7, p = 0.033) in all the patients. In the professional voice subgroup (20/49 patients), there was a significant improvement in the frequency range (FR pre = 310 Hz, FR post = 434 Hz, p = 0.001). The CO2-laser scanning system is reliable in the treatment of intracordal cysts.
Aging effect on dichotic listening of Cantonese
Cantonese dichotic digits recognition was evaluated in free-recall, directed-attention right, and directed-attention left response conditions. All participants were right-handed and included a group of young adults with normal hearing and a group of older adults with minimal sensorineural hearing loss. In all conditions, performance by the young adults was better than performance by the older adults. A right-ear advantage was observed for both groups. Due to a greater deficit in dichotic digits recognition performance in the left ear of older subjects their right-ear advantages were larger than those for the young adults. The results support an age-related disadvantage in recognition performance for dichotic stimuli presented to the left ear of older subjects that is not entirely accounted for by differences in hearing sensitivity between subject groups but may be related to a primary cognitive deficit.
from the International Journal of Audiology
Causes and time-course of vertigo in an ear, nose, and throat clinic
The purpose of this study is to review etiologies and identify the time-course of vertigo presenting in an ear, nose, and throat clinic, and serve as a reference guide for other clinics. The study includes retrospective chart review in a tertiary care, university hospital. The patient data with reported ICD-10 codes as causes of vertigo between April 2005 and December 2007 were extracted from the database. At each visit, the main diagnosis as to etiology, characteristics of the vertigo, its time-course, and patient demographic data were recorded. Of 547 cases, 17 diagnoses were made in 73.9%. Diagnostic categories included peripheral vertigo 72.9%, central vertigo 0.8%, psychogenic cause 0.2%, and unknown 26.1%. Common causes of vertigo were benign paroxysmal positional vertigo (BPPV) 52.5%, Meniere’s disease 14.6%, and sudden idiopathic hearing loss 2.9%. Less common diagnoses were benign paroxysmal vertigo of childhood 0.7%, labyrinthitis 0.7%, and vestibular schwannoma 0.3%. Rare conditions were delayed endolymphatic hydrops, Ramsey Hunt syndrome, otosyphilis, vestibular neuritis, temporal bone fracture, post-concussion syndrome, cerebellar infarction, epilepsy, cervical vertigo, Streptococcus suis meningitis, and psychogenic vertigo. Ninety-nine cases who reported remission of vertigo during the study period had median onset of the remission at 4 weeks. In the ear, nose, and throat clinic at Chiang Mai University, a tertiary university hospital, peripheral vestibular disorders were the main etiology of vertigo. The three most common causes were BPPV, Meniere’s disease, and sudden idiopathic hearing loss. Half of the cases who returned for follow up had remitted symptoms within 4 weeks.
Determination and evaluation of clinically efficient stopping criteria for the multiple auditory steady-state response technique
The proposed stopping rules can be used in adults to determine accurate ASSR thresholds within a time-frame of about 1h.
Effects of unilateral dysfunction of the inferior vestibular nerve system on postural stability
Foam posturography is useful for making a preliminary assessment of unilateral vestibulopathy with abnormal cVEMPs. Selective damage of the unilateral IVN system could affect postural stability.
Rapid acoustic processing in the auditory brainstem is not related to cortical asymmetry for the syllable rate of speech
Brainstem processing of rapid elements in speech is not functionally related to rightward cortical asymmetry associated with the processing of syllable-rate features in speech. Viewed together with previous evidence linking brainstem timing with leftward cortical asymmetry for faster acoustic features, findings support the existence of distinct mechanisms for encoding rapid vs. slow elements of speech.
The Nature of the Automatization Deficit in Chinese Children with Dyslexia
Clarifying whether automatization deficits constitute the primary causes or symptoms of developmental dyslexia, we focused on three critical issues of the dyslexic automatization deficit, namely universality, domain specificity, and severity. Thirty Chinese dyslexic children (mean age 10 years and 5 months), 30 chronological-age-, and 30 reading-level-matched children were tested in 4 areas of automaticity: motor, visual search, Stroop facilitation effects, and automatic word recognition. The results showed that the dyslexic children performed significantly worse than the CA-controls but not the RL-controls in all the tasks except for Stroop congruent-color words, on which they performed worse than children in both control groups. The deficits reflect a lag in reading experiences rather than a persistent cognitive deficit.
Evaluation of an audiological rehabilitation program for spouses of people with hearing loss.
When PHLs participate in an AR program, they receive significant improvements in QOL (quality of life). Congruence (as defined by similar scores) between SP and PHL assessments of HL-QOL improved in the experimental group, suggesting that the principal impact of the AR program on SPs was improved understanding of PHL experiences with hearing loss.
Evaluation of audiometric threshold shift criteria for ototoxicity monitoring.
An ototoxicity monitoring protocol that uses an individualized, one-octave range of frequencies tested in (1/6)-octave steps is quick to administer and has an acceptable FP rate. Similar test performance can be achieved using (1/3)-octave test frequencies, which further reduces monitoring test time.
National Survey of Pediatricians’ Opinions about and Practices for Acute Otitis Media and Xylitol Use.
Most of these Peds adhered to the AAP/AAFP guideline. They were not using CAMs like xylitol for preventing AOM in children. Future research should focus on prevention and the use of xylitol as a possible prophylaxis regimen for AOM in patients.
The Detection of Infant Cortical Auditory Evoked Potentials (CAEPs) Using Statistical and Visual Detection Techniques.
Background: With the advent of newborn hearing screening programs, the need to verify the fit of hearing aids in young infants has increased. The recording of cortical auditory evoked potentials (CAEPs) for this purpose is quite feasible, but rapid developmental changes that affect response morphology and the presence of electrophysiological noise can make subjective response detection challenging. Purpose: The purpose of this study was to investigate the effectiveness of an automated statistic versus experienced examiners in detecting the presence of infant CAEPs when stimuli were present and reporting the absence of CAEPs when no stimuli were present. Research Design: A repeated-measures design was used where infant-generated CAEPs were interpreted by examiners and an automated statistic. Study Sample: There were nine male and five female infants (mean age, 12 mo; SD, 3.4) who completed behavioral and electrophysiological testing using speech-based stimuli. Data Collection and Analysis: In total, 87 infant CAEPs were recorded to three sensation levels, 10, 20 and 30 dB relative to the behavioral thresholds and to nonstimulus trials. Three examiners were presented with these responses: (1) “in series,” where waveforms were presented in order of decreasing stimulus presentation levels, and (2) “nonseries,” where waveforms were randomized completely and presented as independent waveforms. The examiners were given no information about the stimulus levels and were asked to determine whether responses to auditory stimulation could be observed and their degree of certainty in making their decision. Data from the CAEP responses were also converted to multiple dependent variables and analyzed using Hotelling’s T(2). Results from both methods of response detection were analyzed using a repeated measures ANOVA (analysis of variance) and parameters of signal detection theory known as d-prime (d’) and the area under the receiver operating characteristic (ROC) curve. Results: Results showed that as the stimulus level increased, the sensitivity index, d’, increased for both methods of response detection, but neither reached the maximum possible d’ value with a sensation level of 30 dB. The examiners with the greatest experience and Hotelling’s T(2) were equally sensitive in differentiating the CAEP from noise. Conclusions: Hotelling’s T(2) appears to detect CAEPs from normal hearing infants at a rate equal to that of an experienced examiner. A clinical instrument that applies Hotelling’s T(2) on-line, so that the likelihood of response detection can be assessed objectively, should be of particular benefit to the novice or less experienced examiner.
Transforming Superior Canal Dehiscence to Chronic Subjective Dizziness: From SCD to CSD.
Patients presenting with chronic dizziness and no identifiable vestibular impairments have been described as having “extravestibular” symptoms, or “psychogenic dizziness.” In 2005, Staab and Ruckenstein described a syndrome they referred to as “chronic subjective dizziness” (CSD), which characterized this concept more clearly. According to Staab and Ruckenstein (2003), the primary physical symptoms of CSD are continual nonvertiginous dizziness or subjective imbalance that persists for 3 mo or longer. Patients suffering from CSD often describe their dizziness as a rocking or swaying when sitting or standing. This case study describes a 41-yr-old female who originally presented with complaints of noise-induced vertigo. The patient’s history, imaging studies, and balance function examinations led to the diagnosis of a right-sided superior canal dehiscence (SCD). After surgical repair of the dehiscence, the quantitative electrophysiological tests returned to normal. However, the patient’s scores on measures of anxiety, depression, and self-perceived dizziness handicap increased significantly postoperatively. This case illustrates the transformation of a peripheral end-organ impairment (i.e., SCD) into a psychiatric condition (i.e., CSD).
Bridging the gap between speech segmentation and word-to-world mappings: Evidence from an audiovisual statistical learning task
How are adult second language learners able to segment words and map them to referents in the new language? The present study explores this unresolved issue by using a new multimodal learning paradigm that tracks the first steps in learning new words and their mappings to visual referents. It encompasses a continuous audiovisual stream in which transitional probability of syllables is the only acoustic cue available to segment the stream into words, and a visual stream of object images that accompanies the novel words. The objects are systematically varied in terms of constancy of word-picture association and meaningfulness. The results indicated good word-referent mapping and word segmentation after short exposure to the audiovisual stream. Mapping words with pictures was more effective when the visual referents were meaningful objects. In word segmentation, the consistency of the word-picture association affected segmentation performance. The effect of associative strength on segmentation performance was most prominent with meaningful objects, albeit associative strength did not interact significantly with meaningfulness. The present results suggest that word segmentation and word-referent mapping are closely related processes: word segmentation is affected by the consistency of the mapping relationship and both segmentation and mapping can be accomplished under the same short exposure.
from the Journal of Memory and Language
Auditory function in patients with systemic lupus erythematosus
Auditory system involvement ought to be considered as one of elements of the clinical picture of systemic lupus erythematosus while determination of its character, original or secondary, requires further research.
from Auris Nasus Larynx
