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Objectives@#. The recent expansion of eligibility for cochlear implantation (CI) by the U.S. Food and Drug Administration (FDA) to include infants as young as 9 months has reignited debates concerning the clinically appropriate cut-off age for pediatric CI. Our study compared the early postoperative trajectories of receptive and expressive language development in children who received CI before 9 months of age with those who received it between 9 and 12 months. This study involved a unique pediatric cohort with documented etiology, where the timing of CI was based on objective criteria and efforts were made to minimize the influence of parental socioeconomic status. @*Methods@#. A retrospective review of 98 pediatric implantees recruited at a tertiary referral center was conducted. The timing of CI was based on auditory and language criteria focused on the extent of delay corresponding to the bottom 1st percentile of language development among age-matched controls, with patients categorized into very early (CI at 9 months), in children with profound deafness who have a clear deafness etiology and language development delays (<1st percentile).
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Temporal bone trauma can cause hearing loss and in case of prolonged conductive hearing loss, traumatic ossicular injury should be considered. Separation of the incudostapedial joint is the most common lesion, and stapediovestibular dislocation is relatively rare but can easily cause perilymphatic fistula. Here, we report a very rare case of external stapediovestibular dislocation after trauma, ending up with successful surgical outcome. A 27-year-old man with non-progressive hearing loss on the right side since childhood visited the clinic. Audiogram showed a conductive hearing loss with air-bone gap of 55 dB on the right side. Temporal bone CT revealed the disruption of ossicular chain. An exploratory tympanotomy identified multiple ossicular disruptions including external stapediovestibular dislocation with shiny fibrous membrane sealing the oval window. Ossicular chain reconstruction was performed using the total ossicular replacement prosthesis of titanium. A postoperative audiogram showed a recovery of air-bone gap less than 10 dB. To the best of our knowledge, this is the first case of external long-standing stapediovestibular dislocation, with oval window completely sealed with fibrous membrane, ending up with successful hearing recovery by surgery. This case would help dealing with such condition which can be encountered in the clinic.
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Background@#This study examined possible risk factors for myringosclerosis formation after ventilation tube insertion (VTI). @*Methods@#A retrospective study was performed in a single tertiary referral center. A total of 582 patients who underwent VTI were enrolled in this study. Patients were divided into two groups based on the presence or absence of myringosclerosis: MS+ and MS−. Characteristics of patients were collected through medical chart review; these included age, gender, nature and duration of effusion, type of ventilation tube (VT), duration and frequency of VTI, incidence of post-VTI infection, incidence of intraoperative bleeding, and presence of postoperative perforation. Incidences of risk factors for myringosclerosis and the severity of myringosclerosis in association with possible risk factors were analyzed. @*Results@#Myringosclerosis developed in 168 of 582 patients (28.9%) after VTI. Patients in the MS+ group had an older mean age than those in the MS− group. The rates of myringosclerosis were higher in patients with older age, serous otitis media, type 2 VT, post-VTI perforation, and frequent VTI. However, there were no differences in occurrence of myringosclerosis based on gender, duration of effusion, duration of VT placement, incidence of post-VTI infection, or incidence of intraoperative bleeding. The severity of myringosclerosis was associated with the duration of effusion and frequency of VTI. @*Conclusion@#Older age, serous effusion, type 2 VT, presence of post-VTI perforation, and frequent VTI may be risk factors for myringosclerosis after VTI; the severity of myringosclerosis may vary based on the duration of effusion and frequency of VTI.
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Background@#This study examined possible risk factors for myringosclerosis formation after ventilation tube insertion (VTI). @*Methods@#A retrospective study was performed in a single tertiary referral center. A total of 582 patients who underwent VTI were enrolled in this study. Patients were divided into two groups based on the presence or absence of myringosclerosis: MS+ and MS−. Characteristics of patients were collected through medical chart review; these included age, gender, nature and duration of effusion, type of ventilation tube (VT), duration and frequency of VTI, incidence of post-VTI infection, incidence of intraoperative bleeding, and presence of postoperative perforation. Incidences of risk factors for myringosclerosis and the severity of myringosclerosis in association with possible risk factors were analyzed. @*Results@#Myringosclerosis developed in 168 of 582 patients (28.9%) after VTI. Patients in the MS+ group had an older mean age than those in the MS− group. The rates of myringosclerosis were higher in patients with older age, serous otitis media, type 2 VT, post-VTI perforation, and frequent VTI. However, there were no differences in occurrence of myringosclerosis based on gender, duration of effusion, duration of VT placement, incidence of post-VTI infection, or incidence of intraoperative bleeding. The severity of myringosclerosis was associated with the duration of effusion and frequency of VTI. @*Conclusion@#Older age, serous effusion, type 2 VT, presence of post-VTI perforation, and frequent VTI may be risk factors for myringosclerosis after VTI; the severity of myringosclerosis may vary based on the duration of effusion and frequency of VTI.
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BACKGROUND AND OBJECTIVES@#The Musical Background Questionnaire (MBQ) has been developed to assess formal musical training and listening enjoyment. The aims of this study were to translate MBQ into Korean with subsequent linguistic validation and to evaluate the effectiveness of the Korean version of MBQ (K-MBQ).SUBJECTS AND METHOD: Between 2013 and 2014, a panel affiliated with the questionnaire committee of the Korean Audiological Society reconciled the first draft K-MBQ translated by a bilingual person. A separate bilingual translator, who had never seen the original MBQ, translated the draft K-MBQ back into English, and subsequently, the panel reviewed its equivalence to the original one. K-MBQ was administered to 29 adults (M:F=15:14; aged 21 to 76 years) for cognitive debriefing. Pure tone and speech audiometry were performed in all participants.@*RESULTS@#The translation of K-MBQ was completed through a multi-step process of forward translation, reconciliation, reverse translation, cognitive debriefing and proofreading. Thirteen (45%) of 29 subjects reported formal musical training, and 16 participants (55%) judged themselves as having no musical education and background. No significant correlation was found between musical background and hearing level, whereas self-perceived quality of music and self-perception of music elements quantified by K-MBQ were associated with hearing ability in terms of pure-tone and speech audiometry.@*CONCLUSION@#K-MBQ was translated and linguistically validated. The use of this questionnaire can provide further evaluation of musical background in patients with hearing loss or cochlear implant users.
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BACKGROUND AND OBJECTIVES: The Speech, Spatial and Qualities of Hearing Scale (SSQ) was designed to measure self-reported auditory disability in a wide variety of listening situations. Its 49 items cover many aspects of speech perception, spatial hearing, and qualities of hearing, which constitute the three parts of SSQ. However, there has been no reliable and valid Korean version of SSQ (K-SSQ), which made the measurement of auditory disability difficult. The aim of this study is to develop a K-SSQ and to determine its reliability and validity for clinical or academic use. SUBJECTS AND METHOD: An expert panel translated the original SSQ into Korean. A bilingual translator back-translated the translated version into English, which was then compared with the original version. After cognitive debriefing, K-SSQ was administered to 400 patients with hearing disability in 14 referral hospitals. Reliability was assessed using Cronbach's alpha coefficient and correlation study. Validity was evaluated by factor analysis and criterion validity based on the results of pure tone audiometry. RESULTS: K-SSQ showed good reliability with high internal consistency (Cronbach's α=0.99), and strong positive correlations across all three parts of SSQ. Construct validity was confirmed by the results of factor analysis and criterion validity demonstrated positive correlations between each part of SSQ and the results of pure tone audiometry. CONCLUSION: The K-SSQ is a reliable and valid tool for use as a behavioral measure of hearing ability in Korean-speaking patients, and it will provide a very useful evaluation tool for both clinicians and researchers.
Subject(s)
Humans , Audiometry , Hearing , Methods , Referral and Consultation , Reproducibility of Results , Speech Perception , Statistics as TopicABSTRACT
BACKGROUND AND OBJECTIVES: The quantification of hearing aid benefit is important in hearing aid fitting. The abbreviated profile of hearing aid benefit (APHAB) is a useful tool for measuring the benefit of using hearing aids. In this study, we developed a Korean version of APHAB (K-APHAB) and determined its validity and reliability. SUBJECTS AND METHOD: An expert panel translated the original version of APHAB into Korean language. Two bilingual translators back-translated the first translated version into English and it was compared with the original version. After cognitive debriefing, the translation of APHAB into the Korean version was completed. One hundred ninety-seven subjects using hearing aids participated in this study and completed K-APHAB. Reliability was assessed using Cronbach's alpha coefficient, and validity was evaluated by factor analysis and criterion validity. RESULTS: K-APHAB had a good internal consistency (α=0.80). Confirmatory factor analysis showed that K-APHAB is comprised of four subsections, namely ‘communication in daily life’, ‘aversiveness’, communication in ‘background noise’ or ‘reverberation’. CONCLUSION: The K-APHAB is a useful tool for evaluating the benefit of hearing aids in Korean hearing-impaired individuals.
Subject(s)
Hearing Aids , Hearing , Methods , Reproducibility of ResultsABSTRACT
BACKGROUND AND OBJECTIVES: Client Oriented Scale of Improvement (COSI) has been designed to identify client needs, changes in listening ability, and final listening ability in situations important to each client. The aim of this study was to translate COSI into Korean with subsequent linguistic validation and to determine the reliability of the Korean version of the COSI (K-COSI). SUBJECTS AND METHOD: An expert panel translated the original version of COSI into the Korean language. A bilingual translator back-translated the translated version into English, which was subsequently compared with the original English version. K-COSI was administered at 14 referral hospitals, to 128 patients with hearing disability after cognitive debriefing. Reliability was assessed using correlation study. RESULTS: K-COSI showed an excellent test-retest correlation and high reliability in degree of change (Spearman correlation=0.89, interclass correlation coefficient=0.922). It also showed a fair test-retest correlation and high reliability in final hearing ability (Spearman correlation=0.49, interclass correlation coefficient=0.353) CONCLUSION: K-COSI proved to be highly reliable. The results suggest that the adapted Korean version of COSI is a reliable and valid measure for Korean-speaking patients with hearing loss.
Subject(s)
Humans , Hearing , Hearing Aids , Hearing Loss , Linguistics , Methods , Referral and Consultation , Statistics as TopicABSTRACT
BACKGROUND AND OBJECTIVES: A rotation chair test has been used to evaluate the function of the horizontal semicircular canals. Currently, two chair systems according to the presence of cylindrical darkroom are used in a clinic setting. However, it has not been thoroughly investigated whether one system is superior to the other system or not. In this study, we aimed to compare test outcomes and subject convenience between two systems. SUBJECTS AND METHODS: Twenty subjects with no history of otologic disease were enrolled. Subjects were tested with two systems: system [A] with a cylindrical chamber and system [B] with no chamber. The results of sinusoidal harmonic acceleration (SHA), step velocity (SV), and visual fixation (VFX) tests were compared between the systems. Subject convenience was assessed with a questionnaire survey and results were compared between the systems. RESULTS: There were no significant differences in gain or asymmetry in SHA test between the systems. However, the phase of system [A] was significantly lower than that of system [B] at 0.16 Hz. There was no significant difference between the systems in directional preponderance (DP) gain or DP time constant. Regarding the VFX test, gain was higher in system [A] than system [B]. Subjects reported less stuffiness and less anxiety with system [B] than system [A], while preferring the system [A] goggles. CONCLUSIONS: A rotation chair system without a darkroom can provide a more comfortable experience for subjects in terms of stuffiness and anxiety, while showing comparable results in SHA and SV tests with a darkroom system.
Subject(s)
Acceleration , Anxiety , Ear Diseases , Eye Protective Devices , Semicircular CanalsABSTRACT
We report a case of Mumps deafness with acute vestibular symptoms in a 13-year-old boy, who developed both parotid swelling preceded by acute right hearing loss and vertigo with spontaneous nystagmus. He was diagnosed as Mumps when the antibody of Mumps virus was detected in the serum. To our knowledge, this is the first case of Mumps infection, where parotitis was preceded by hearing loss and vertigo. This study indicates that the first symptom of Mumps virus infection could be hearing loss or vertigo.
Subject(s)
Adolescent , Humans , Male , Deafness , Hearing Loss , Mumps virus , Mumps , Parotitis , VertigoABSTRACT
BACKGROUND AND OBJECTIVES: ZLow frequency hearing loss is known to be the most common hearing loss form in Meniere's disease (MD) and episodic dizziness with low frequency sensorineural hearing loss is considered a very crucial symptom for the diagnosis of MD. However, flat or high frequency hearing loss is also commonly encountered in the Ear, Nose and Throat clinic. The aim of this study is to investigate the differences in clinical manifestation between episodic dizzy patients with low frequency hearing loss (LFHL) group and non-low frequency hearing loss (non-LFHL) group. SUBJECTS AND METHOD: We reviewed medical records of 78 patients (36 of LFHL group and 42 of non-LFHL group) who had episodic dizziness with unilateral hearing loss and analyzed clinical characteristics according to hearing loss pattern. RESULTS: The clinical features of LFHL include a predominance of female sufferers, high incidence of tinnitus and short duration of dizziness. There was no significant difference in frequency, nature of dizziness, and results of vestibular function test. Although the proportion of patients diagnosed with definite MD was higher in LFHL group at initial and final diagnosis, there were no statistically significant differences between two groups. CONCLUSION: Therefore, when episodic dizziness is accompanied with unilateral hearing loss, not only low frequency but flat or high frequency hearing loss could be considered as a critical sign for possible progression to Meniere's disease and careful observation should be taken.
Subject(s)
Female , Humans , Diagnosis , Dizziness , Ear , Hearing Loss , Hearing Loss, Sensorineural , Hearing Loss, Unilateral , Incidence , Medical Records , Meniere Disease , Nose , Pharynx , Tinnitus , Vestibular Function TestsABSTRACT
BACKGROUND AND OBJECTIVES: Cervical vestibular evoked myogenic potentials (cVEMP) test has been widely used to assess the function of the saccule and inferior vestibular nerve. Electrode location and stimulating sound are important factors which might affect the test results. Today those parameters are usually selected to maximize the waveform response. In this study, we tried to find the optimal condition to minimize the range of normal value of cVEMP. SUBJECTS AND METHOD: Thirteen normal subjects (26 ears) were included. We placed electrodes at five different locations over the sternocleidomastoid muscle (SCM) and used four different stimulation sounds. Variances of parameters, including interpeak amplitude, interaural difference (IAD) and normal value were analyzed and compared. RESULTS: When using the classical condition (mid point of SCM and 500 Hz) without rectification, IAD ratio was 20.8+/-14.2% and the range of normal value was 39%. When we used 2000 Hz tone burst sound at the classical electrodes site, IAD ratio and normal value were minimized, resulting in 18.7+/-14.3% and 31% respectively. After the rectification, when using the classical condition, IAD ratio was 26.4+/-22.3% and the range of normal value was 49%. The minimum IAD ratio was measured as 17.4+/-13.7% when we used click sound at SCM at the level of mandibular angle. And the minimum normal value of 32% was measured when we used 1000 Hz tone burst sound at SCM at the level of mandibular angle. CONCLUSION: Although the condition was not optimal for maximizing the interpeak amplitude, we could alternatively use the condition to minimize the normal value.
Subject(s)
Electrodes , Reference Values , Saccule and Utricle , Vestibular Evoked Myogenic Potentials , Vestibular NerveABSTRACT
The carcinoid tumors of middle ear are very rare, however, more than 50 cases including 2 cases in Korea have been reported since 1980. A 36-year-old male had been managed under the diagnostic impression of hemotympanum due to head trauma in 2005; he revisited our clinic after 8 years with sudden facial paralysis and external auditory canal mass. Canal wall down mastoidectomy and tympanoplasty were performed and pathologic results revealed a carcinoid tumor of the middle ear. A facial paralysis of this patient was cured after the treatment.
Subject(s)
Adult , Humans , Male , Carcinoid Tumor , Craniocerebral Trauma , Ear Canal , Ear, Middle , Facial Paralysis , Korea , TympanoplastyABSTRACT
BACKGROUND AND OBJECTIVES: Caloric test and rotatory chair test have been adopted in diagnosing bilateral vestibulopathy. However, most of patients who were confirmed by the diagnostic testing not complained typical symptoms of bilateral vestibulopathy such as ossilopsia and ataxia. Patients who do not have typical symptoms of bilateral vestibulopathy, were often diagnosed with bilateral vestibulopathy by caloric test and slow harmonic acceleration test (SHA). The aim of this study is to assess the clinical features between groups classified according to the caloric test and SHA test, and possibly to investigate the representative test in the diagnosis of bilateral vestibulopathy. MATERIALS AND METHODS: Seventy-five patients were divided into three groups: (A) patients diagnosed with the caloric test only, (B) patients diagnosed with SHA test only, (C) patients satisfying the diagnostic criteria of both tests. Clinical characteristics, the results of physical examination, hearing test and vestibular function test (VFT) were compared among three groups. Results: There was no difference in clinical characteristics and results of physical examination among three groups. Regarding VFT results, only in step velocity test, The proportion of patients who showed low gain value on both sides were higher in group C than that of group A and B. No difference was observed in the other VFT results among three groups. RESULTS: There was no difference in clinical characteristics and results of physical examination among three groups. Regarding VFT results, only in step velocity test, The proportion of patients who showed low gain value on both sides were higher in group C than that of group A and B. No difference was observed in the other VFT results among three groups. CONCLUSION: We could not predict the clinical features of bilateral vestibulopathy by the results of VFT, and could not find preferable test in diagnosing bilateral vestibulopathy.
Subject(s)
Humans , Acceleration , Ataxia , Caloric Tests , Diagnosis , Diagnostic Tests, Routine , Hearing Tests , Physical Examination , Vestibular Function TestsABSTRACT
OBJECTIVES: The purpose of this study was to evaluate the therapeutic effect of three different types of sounds on tinnitus patients undergoing tinnitus retraining therapy (TRT). METHODS: This is a single-institution retrospective study, performed in one tertiary otological referral center. Thirty-eight adults with subjective idiopathic tinnitus who were followed for at least 9 weeks were enrolled. Sound therapy was delivered in 3 different ways: narrowband noise TRT (nTRT); mixed band noise TRT (mTRT); broadband noise TRT (bTRT). Treatment response was measured through validated psychometric questionnaires: Tinnitus Handicap Inventory (THI), visual analog scale (VAS) on annoyance, and numerical description of hours of tinnitus perception (awareness hours). RESULTS: A total of 38 patients were followed for at least 9 weeks. In nTRT group, all outcome measures including THI, VAS, and the awareness hours, decreased over 9 weeks with no statistical significance. In mTRT group, all outcome measures except for awareness hours significantly improved 9 weeks after the beginning of the treatment. In bTRT group, all outcome measures decreased significantly in 9 weeks. When therapeutic success is defined as improvement in THI 7 or more, bTRT group (77.8%) showed a higher success rate than other groups for 38 patients with the minimum follow-up of 9 weeks. CONCLUSION: All three sounds can provide relief in patients with annoying tinnitus after TRT. However, there is difference in the therapeutic effect according to sound types. Broadband sound seems to be better than narrowband sound or mixed sound in relieving the patients from tinnitus. Therefore, sound therapy with broadband noise may be more appropriate during TRT, but further evidence is needed for precise conclusion.
Subject(s)
Adult , Humans , Follow-Up Studies , Noise , Outcome Assessment, Health Care , Psychometrics , Referral and Consultation , Retrospective Studies , Tinnitus , Treatment Outcome , Visual Analog Scale , Surveys and QuestionnairesABSTRACT
Aging is one of the most evident biological processes, but its mechanisms are still poorly understood. Studies of cognitive aging suggest that age is associated with cognitive decline; however, there may be individual differences such that not all older adults will experience cognitive decline. That is, cognitive decline is not intrinsic to aging, but there is some heterogeneity. Many researchers have shown that speech recognition declines with increasing age. Some of the age-related decline in speech perception can be accounted for by peripheral sensory problems but cognitive aging can also be a contributing factor. The potential sources of reduced recognition for rapid speech in the aged are reduction in processing time and reduction of the acoustic information in the signal. However, other studies also indicated that speech perception does not decline with age. Cognitive abilities are inherently involved in speech processing. Two cognitive factors that decline with age may influence speech perception performance. The first factor is working memory capacity and the second factor concerns the rate of information processing, defined generally as the speed at which an individual can extract content and construct meaning from a rapid signal. Cognitive function shows the adaptive processes with age which are consistent with the view that the brain itself has potentially a life-long capacity for neural plasticity. Assessing the speech perception difficulty in older adults, cognitive function could be considered in the evaluation and management of speech perception problem.
Subject(s)
Adult , Aged , Humans , Acoustics , Aging , Electronic Data Processing , Biological Phenomena , Brain , Cognition , Fibrinogen , Individuality , Memory, Short-Term , Plastics , Population Characteristics , Speech PerceptionABSTRACT
BACKGROUND AND OBJECTIVES: Rectified vestibular evoked myogenic potential (rVEMP) is a relatively new method that simultaneously measures the muscle contraction power during VEMP recording and corrects the difference of contraction power afterwards. Several studies showed rVEMP is more reliable than non-rectified VEMP (nVEMP). However, those studies evaluated usefulness of rVEMP in patients with normal vestibular function. Thus, we evaluate the effect of rectification to predict lesion side in unilateral vestibulopathy patients. MATERIALS AND METHODS: One-hundred nine acute unilateral vestibulopathy patients whom VEMP were performed in were included retrospectively. We regarded hearing loss side as lesion side in sudden hearing loss (n=33), meniere's disease (n=29) and in vestibular neuritis (n=45), the side of positive head thrust test with canal paresis >30% was regarded as a lesion side. We excluded bilateral vestibulopathy. The inter-aural amplitude difference (IAD) ratio was calculated by the nVEMP and rVEMP. RESULTS: Mismatch rate between nVEMP and rVEMP was 36.61%, match rate was 49.54%, opposition rate was 13.76%. rVEMP predicted lesion side on 15 patients of mismatch group correctly, while nVEMP predicted lesion side on 25 patients of mismatch group. There was no significant difference in IAD ratio between nVEMP and rVEMP in patients who showed lesion side weakness on both nVEMP and rVEMP. But, the younger the patient was, the more chance of mismatch was significantly (p=0.03). CONCLUSION: There was no more corrective role in determining lesion side by rectification in unilateral vestibulopathy. Thus rVEMP might not be helpful for predicting lesion side in unilateral vestibulopathy.
Subject(s)
Humans , Head , Hearing Loss , Hearing Loss, Sudden , Meniere Disease , Methods , Muscle Contraction , Paresis , Retrospective Studies , Vestibular NeuronitisABSTRACT
The main objective of this review is to describe the new sequencing technologies called next generation sequencing (NGS) and its utility as a molecular genetic diagnosis tool in a medical field. Sanger method has dominated the genome sequencing industry for the past 30 years since its invention in 1975. It produced first human genome and still remains the gold standard for genome sequencing. However, it cannot meet the needs for enormous genetic data gathering and process because of its relatively long sequencing time and high cost per sample. NGS which parallelise the sequencing process, thereby increasing processing speed at a reduced cost per sample emerged to compensate for the weakness of the previous method. Currently NGS is used in some medical areas and its use is being widened. NGS also plays an important role in a study of genetically heterogenous hearing diseases. NGS is expected to mark a significant milestone in genomic research filed in a near future.