Monthly Archives: January 2008
The aim of this qualitative study was to interview a group of tinnitus patients (n = 7) who were or had been involved in psychological treatment for their tinnitus. Following semi-structured interviews all conversations were transcribed and later categorized using methods inspired by grounded theory. Results revealed a higher order concept labelled ‘Mixed feelings about living with tinnitus’. Three descriptive categories were derived: 1) Consequences; 2) Treatment experiences; and 3) Tinnitus identity. Results are discussed in relation to the literature on tinnitus, and the future application of qualitative methods in tinnitus research is encouraged.
Can Intratympanic Dexamethasone Added to Systemic Steroids Improve Hearing Outcome in Patients With Sudden Deafness?
Objective: To evaluate the therapeutic efficacy of intratympanic dexamethasone (ITD) injections added to systemic steroids in patients with idiopathic sudden sensorineural hearing loss (HL).
Materials and Methods: A total of 120 patients diagnosed with sudden HL were treated with ITD injections (0.3 mL on days 1, 3, and 5) plus 48 mg methylprednisolone (ITD group) or methylprednisolone alone (control group).
Results: The total recovery rate after the treatment was 73.3% in the ITD group and 70.0% in the control group. Although improvements in pure-tone average were the same in the two groups, the ITD group showed significantly better hearing improvement at 250 Hz than the control group.
Conclusion: The addition of ITD to systemic steroids did not result in significant improvements in the treatment of idiopathic sudden HL.
Objectives: To compare speech test performance of adults with partial deafness cochlear implantation (PDCI) with that of adults with cochlear implant (CI). Based on the results, our objective is to determine the efficacy of the two applications of cochlear implantation, the first characterized by a shallow electrode insertion and preservation of low-frequency natural hearing for partial deafness, and the second characterized by a very deep electrode insertion used in subjects with severe to profound deafness. All the PDCI participants in this study were fitted with a recently upgraded DUET Hearing System from Med-El Corporation, Innsbruck, Austria.
Study Design: This is a two-group comparison study. Eleven experienced PDCI adults and 22 postlingually deafened CI adults participated in this study. Subjects were implanted with either COMBI 40+ or PULSAR cochlear implant.
Methods: Subjects were tested with monosyllable and sentence tests in Polish in quiet and under various signal-to-noise ratio (SNR) in the conditions of DUET only, CI only, DUET hearing aid (HA) only, and best aided (DUET plus contralateral hearing). CI subjects were tested with their CI.
Results: PDCI subjects performed significantly better than CI subjects did. Speech tests demonstrated the best results in the conditions of best aided and DUET only. The poorest results were obtained in the condition DUET HA only. Results show a greater benefit for the PDCI group of subjects fitted with the DUET, compared to the CI alone group.
Conclusions: The shallow electrode array insertion with preserved low-frequency hearing is a highly effective method for the treatment of partial deafness. The combination of HA and CI processor, i.e., the DUET, is beneficial in noise and in quiet.
from NIH News.gov
For children who struggle to learn language, the choice between various interventions may matter less than the intensity and format of the intervention, a new study sponsored by the National Institute on Deafness and Other Communication Disorders (NIDCD) suggests. The study, led by Ronald B. Gillam, Ph.D., of Utah State University is online in the February 2008 Journal of Speech, Language, and Hearing Research. NIDCD is one of the National Institutes of Health.
This study investigated the relationship between receptive and productive vocabulary size. The experimental design expanded upon earlier methodologies by using equivalent receptive and productive test formats with different receptive and productive target words to provide more accurate results. Translation tests were scored at two levels of sensitivity to measure receptive and productive knowledge of meaning and form. The results showed that total receptive vocabulary size was larger than productive vocabulary. When responses were scored for fuller knowledge, receptive vocabulary size was also found to be greater than productive vocabulary size in each of three word frequency bands, with the difference between receptive and productive knowledge increasing as the frequency of the words decreased. However, when responses were scored for partial knowledge, there was little difference among vocabulary sizes at each frequency band. The findings also indicated that receptive vocabulary size might give some indication of productive vocabulary size. Learners who have a larger receptive vocabulary are likely to know more of those words productively than learners who have a smaller receptive vocabulary.
Interaction research that has investigated the relationship between language production and second language (L2) development has largely focused on learners’ immediate responses to interactional feedback. However, other speech production processes might help account for the beneficial relationship between interaction and L2 development. The current study examines whether syntactic priming—the tendency to produce a syntactic structure encountered in the recent discourse—is associated with English as a second language (ESL) question development. The participants were intermediate-level Thai learners of English (N = 46) at a large public university in northern Thailand. In two 20-min sessions, the participants carried out communicative activities with a more advanced L2 English interlocutor who had been scripted with developmentally advanced question forms. They also completed an oral pretest and two posttests that consisted of activities similar to those carried out during the treatment sessions. The results indicated that participants who evidenced high levels of syntactic priming were likely to advance to a higher stage in the developmental sequence of ESL question formation.
from the International Journal of Audiology
The profession of audiology took root in Brazil nearly a half a century ago and has since blossomed into a flourishing, well-developed field. Currently, audiologists in Brazil work at private institutions, including private medical practices and dedicated speech and hearing clinics. They are also employed in a wide array of public institutions, including community clinics, elementary schools, colleges, and universities. In both the private sector and health clinics, audiologists perform diagnostic evaluations of auditory and vestibular disorders, select and fit hearing aids, and provide aural rehabilitation. At the public level, they assist with workers’ health programs, dispense hearing aids, and aural rehabilitation. There is always room to grow, however, and the future of audiology in Brazil holds both challenges and opportunity. The following article will sketch the development of audiology training and practice in Brazil, provide a picture of how the field stands today, and summarize the unique challenges which the profession faces in this large and diverse nation.
Auditory rehabilitation for interaural asymmetry: Preliminary evidence of improved dichotic listening performance following intensive training
from the International Journal of Audiology
Children with dichotic left ear deficits received intensive training in phase I and phase II clinical trials designed to establish the efficacy of directly training dichotic listening. Dichotic verbal material was presented in the sound field with intensity adjusted separately for each speaker. Output from the right-sided speaker was initially 20-30 db HL lower than for the left-sided speaker, resulting in excellent performance in the left ear. Intensities were adaptively adjusted throughout training in 1, 2, and 5-dB steps in order to keep performance high across dichotic tasks. In both phase I (n=8) and phase II (n=13) trials, children demonstrated significant gains in dichotic left ear performance after training. In phase II, children also demonstrated significant gains in right ear performance. Overall results from the two trials support the feasibility of this training approach for improving a larger than normal interaural asymmetry on dichotic listening tasks. Significant improvements in language comprehension and word recognition in phase II suggest that this type of training may also facilitate language skills in some children.
from the International Journal of Audiology
Changes in pitch perception and hearing thresholds over time have been observed in subjects with monaural fluctuating low-frequency hearing loss and Ménière’s disease. Long-term suprathreshold audiometry and binaural pitch matches could provide information of these changes. Ten normal subjects were tested for stability of binaural intensity and pitch matches during 9-22 days in their homes with newly developed portable test equipment. Binaural pitch matches were measured using a 0.25- or 1-kHz reference tone presented at 60 dB SPL to one ear, and a loudness-matched test tone of adjustable frequency presented to the other ear. The results showed stable binaural intensity matches (individual inter-quartile ranges, IQRs, 1.2 to 5.7 dB), but binaural pitch matches varied greatly (IQR -0.6 to 5.3% at 0.25 kHz; IQR -1.6 to 7.9% at 1 kHz). Binaural pitch-matching was much better in subjects who could define pitch precisely during monaural pitch matching. It was concluded that in future long-term evaluations of patients with fluctuating inner-ear function, binaural intensity matches could be suitable for all, but binaural pitch matching only for selected patients.
from the International Journal of Audiology
Digital feedback suppression (DFS) enables users of hearing instruments (HI) to benefit from amplification levels that normally would provoke whistling or poor sound quality. A standardized test for the measurement of DFS benefit is not available. This paper proposes and evaluates an objective method for assessment of extra feedback-free amplification (headroom) provided by a given DFS. It is shown that the whistle-free loop gain can be calculated from data obtained with simulated real-ear measurements with the modified pressure method. Test-retest trials were carried out to assess the reliability of the proposed method. Also, a method was developed for defining an appropriate gain level at which the proposed measurement should be carried out. It is concluded that the proposed method needs to be modified to provide useful information.
from the International Journal of Audiology
The goal of this study was to examine the effect of race and gender on transient evoked otoacoustic emission (TEOAE) characteristics. TEOAE amplitude, noise levels, and hearing thresholds were compared in 81 Caucasian (mean age: 27.8 years) and 81 Chinese (mean age: 24.7 years) young adults with normal hearing. TEOAE amplitude was significantly higher in females than males and in the Chinese group than the Caucasian group. Females had better hearing sensitivity than males consistent with TEOAE results. Hearing sensitivity was not statistically different between the two racial groups; however, the interaction between race and hearing thresholds was significant. As the noise levels between the two racial groups were not statistically different, the observed differences are most likely related to differences in middle-ear transmission properties or to differences in cochlear mechanisms. Documentation of gender and racial differences and understanding the underlying mechanism of these differences will not only assist us in understanding how TEOAE will be affected by middle-ear transmission properties but also will help us in establishing normative data in clinical settings.
In an article now online and set to be published in the Feb. 15 issue of the American Journal of Medical Genetics, University of Michigan C.S. Mott Children’s Hospital researcher and lead author Beth A. Tarini, M.D., says waiving informed consent for population-based newborn screening research would allow for a more complete evaluation of the safety and effectiveness of these tests before broad implementation.
from Hearing Research
It is generally believed that both sensory immaturity and inattention contribute to the poor listening of some children. However, the relative contribution of each factor, within and between individuals, and the nature of the inattention are poorly understood. In three experiments we examined the threshold and response variability of 6–11 y.o. children on pure tone frequency discrimination (FD) tasks. We first confirmed that younger children had both higher thresholds and greater within- and between-listener variability than older children and adults. Higher thresholds were mostly attributed to high response variability due to poor sustained attention. We next compared performance on the auditory FD task with that on visual spatial FD. No correlation was found between the thresholds or variability of individuals on the two tasks, suggesting involvement of modality-specific attention. Finally, we found lower thresholds for 8–9 y.o. children performing auditory FD training in a classroom than in the laboratory, possibly due to training session length or to a more familiar, motivating and focussed training environment. The adult-like performance of many younger children at times during their testing or training, together with the high response variability of immature performers, suggested that most elevated FD thresholds in children are due to inattention.
Long-term outcome of speech and language in children after corrective surgery for cyanotic or acyanotic cardiac defects in infancy
The purpose of this prospective study was to assess whether outcome of speech and language in children 5–10 years after corrective surgery for tetralogy of Fallot (TOF) or ventricular septal defect (VSD) in infancy was influenced by the preoperative condition of hypoxemia or cardiac insufficiency and whether it was associated with perioperative risk factors and neurodevelopmental outcome.
A total of 35 unselected children, 19 with TOF and hypoxemia and 16 with VSD and cardiac insufficiency, operated with combined deep hypothermic circulatory arrest and low-flow cardiopulmonary bypass at mean age 0.7±0.3 (mean±standard deviation) years, underwent, at mean age 7.4±1.6 years, standardized evaluation of speech and language functions. Results were compared between subgroups and related to perioperative factors, sociodemographic and neurodevelopmental status.
Age at testing, socioeconomic status and history of speech and language development were not different between the subgroups. In contrast, total scores on oral and speech motor control functions (TFS) as well as on oral and speech apraxia (Mayo Test) were significantly reduced (p<0.02 to <0.05), and scores on anatomical oral structures tended to be lower (p<0.09) in the TOF group as compared to the VSD group. No differences were found for auditory word recognition and phonological awareness as assessed by the Auditory Closure subtest of the Illinois Test of Psycholinguistic Abilities and the test of auditory analysis skills, respectively. In all children, higher age at testing and better socioeconomic status were associated with better results in all domains of assessment (p<0.001 to <0.04). Consistent impairments of all oral and speech motor control functions (TFS and Mayo Test) were present in 29% of all children with a mean age of 6.5 years in contrast to 43% with normal performance and a mean age of 8.3 years. On the receptive speech tasks, only 6% scored below the normal range of their age group. TFS subscores were significantly correlated with age, bypass duration and motor function, but not correlated with socioeconomic status, duration of cardiac arrest, intelligence and academic achievement.
Children with preoperative hypoxemia due to cyanotic cardiac defects in infancy are at higher risk for dysfunction in speech and language than those with cardiac insufficiency due to acyanotic heart defects. Age at testing, socioeconomic status, and duration of cardiopulmonary bypass influenced test results. Long-term outcome in speech and language functions can be considered as a sensitive indicator of overall child development after cardiac surgery.
from Cerebral Cortex
Inhibitory neurotransmission is a critical determinant of neuronal network gain and dynamic range, suggesting that network properties are shaped by activity during development. A previous study demonstrated that sensorineural hearing loss (SNHL) in gerbils leads to smaller inhibitory potentials in L2/3 pyramidal neurons in the thalamorecipient auditory cortex, ACx. Here, we explored the mechanisms that account for proper maturation of -amino butyric acid (GABA)ergic transmission. SNHL was induced at postnatal day (P) 10, and whole-cell voltage-clamp recordings were obtained from layer 2/3 pyramidal neurons in thalamocortical slices at P16–19. SNHL led to an increase in the frequency of GABAzine-sensitive (antagonist) spontaneous (s) and miniature (m) inhibitory postsynaptic currents (IPSCs), accompanied by diminished amplitudes and longer durations. Consistent with this, the amplitudes of minimum-evoked IPSCs were also reduced while their durations were longer. The 1- and β2/3 subunit–specific agonists zolpidem and loreclezole increased control but not SNHL sIPSC durations. To test whether SNHL affected the maturation of GABAergic transmission, sIPSCs were recorded at P10. These sIPSCs resembled the long SNHL sIPSCs. Furthermore, zolpidem and loreclezole were ineffective in increasing their durations. Together, these data strongly suggest that the presynaptic release properties and expression of key postsynaptic GABAA receptor subunits are coregulated by hearing.