ABSTRACT
Cochlear implants are largely unable to encode voice pitch information, which hampers the perception of some prosodic cues, such as intonation. This study investigated whether children with a cochlear implant in one ear were better able to detect differences in intonation when a hearing aid was added in the other ear ("bimodal fitting"). Fourteen children with normal hearing and 19 children with bimodal fitting participated in two experiments. The first experiment assessed the just noticeable difference in F0, by presenting listeners with a naturally produced bisyllabic utterance with an artificially manipulated pitch accent. The second experiment assessed the ability to distinguish between questions and affirmations in Dutch words, again by using artificial manipulation of F0. For the implanted group, performance significantly improved in each experiment when the hearing aid was added. However, even with a hearing aid, the implanted group required exaggerated F0 excursions to perceive a pitch accent and to identify a question. These exaggerated excursions are close to the maximum excursions typically used by Dutch speakers. Nevertheless, the results of this study showed that compared to the implant only condition, bimodal fitting improved the perception of intonation.
Subject(s)
Cochlear Implants , Correction of Hearing Impairment/psychology , Cues , Hearing Aids , Persons With Hearing Impairments/rehabilitation , Pitch Perception , Speech Intelligibility , Speech Perception , Acoustic Stimulation , Adolescent , Audiometry, Pure-Tone , Audiometry, Speech , Auditory Threshold , Case-Control Studies , Child , Discrimination, Psychological , Female , Humans , Language , Male , Otoacoustic Emissions, Spontaneous , Persons With Hearing Impairments/psychology , Recognition, Psychology , Speech AcousticsABSTRACT
The aims of the study were to investigate whether sound localization acuity improved when children with 1 cochlear implant use a hearing aid in the contralateral ear (bimodal fitting), and whether this enabled them to benefit from a binaural masking level difference. Four different noise bursts were used as stimuli for a minimal audible angle localization test. On average, localization acuity remained poor with the cochlear implant alone, but also with bimodal fitting. A significant benefit of bimodal fitting was only shown when the most complicated stimulus with roved amplitude and spectrum was presented (minimal audible angle of 151 degrees with bimodal fitting vs. 175 degrees with cochlear implant alone). No significant binaural masking level difference was found between the cochlear implant alone and the bimodal condition.
Subject(s)
Auditory Threshold/physiology , Deafness/therapy , Hearing Aids , Hearing/physiology , Sound Localization/physiology , Acoustic Stimulation , Adolescent , Analysis of Variance , Audiometry, Pure-Tone , Child , Female , Humans , Male , Statistics, Nonparametric , Young AdultABSTRACT
The aim of this multicentre study was to compare T1 with T2 weighted MRI scans of the labyrinth after meningitis and to investigate whether waiting with scanning improved the reliability of diagnosing an ongoing process such as cochlear osteogenesis. Forty-five patients were included who suffered from meningitis induced hearing loss (radiological imaging <1 year after meningitis). Twenty-one gadolinium enhanced T1 and 45 T2 weighted MRI scans were scored by two radiologists regarding the condition of the labyrinth. These radiological observations were compared with the condition of the cochlea as described during cochlear implantation. A higher percentage of agreement with surgery was found for T2 (both radiologists 73%) than for T1 weighted MRI scans (radiologist 1: 62%, radiologist 2: 67%), but this difference is not significant. There was no significant difference between early (0-3 months) and late (>3 months) scanning, showing that radiological imaging soon after meningitis allows early diagnosis without suffering from a lower agreement with surgical findings.
Subject(s)
Ear, Inner/pathology , Hearing Loss/diagnosis , Magnetic Resonance Imaging/methods , Meningitis/complications , Adolescent , Adult , Aged , Child , Child, Preschool , Cochlea/pathology , Cochlear Implantation/methods , Diagnosis, Differential , Female , Follow-Up Studies , Hearing Loss/etiology , Hearing Loss/surgery , Humans , Infant , Infant, Newborn , Male , Meningitis/diagnosis , Middle Aged , Reproducibility of Results , Young AdultABSTRACT
OBJECTIVE: Analyse the difference in school careers and secondary school qualification levels between unilateral hearing aid users and bilateral hearing aid users. STUDY DESIGN: Retrospective questionnaire study. SETTING: Postal-based questionnaire. PARTICIPANTS: Names of adults known to have been fitted with unilateral or bilateral hearing aids during childhood were retrieved. This resulted in 292 names. Participants were selected using the following criteria: availability of the medical record, presence of bilateral hearing loss, completed secondary school education, normal IQ and a minimum aided word-recognition score of 70% at 10 years of age. The questionnaire was sent to 50 potential participants of whom 40 responded, resulting in two groups comprising 19 unilateral and 21 bilateral hearing aid users. METHODS: A questionnaire was developed to obtain data on secondary school levels and aspects of the school careers, such as type of schools attended (mainstream versus special), repeating a school year and additional assistance (speech and language therapy, personal frequency modulation systems). MAIN OUTCOME MEASURES: Comparison of the benefit of bilateral hearing aid fitting versus unilateral hearing aid fitting on secondary school qualification level, type of school the children attended, class failure and additional assistance used. RESULTS: The group of bilaterally fitted hearing aid users eventually completed secondary school at a superior level than the unilaterally fitted users. 33% of binaural hearing aid users achieved qualifications giving access to a bachelors degree compared with 21% of unilateral users. There were no differences between those fitted with unilateral and bilateral hearing aids in the type of schools attended, repeating a school year and additional assistance. CONCLUSIONS: The bilateral hearing aid users obtained superior secondary school qualifications than the unilateral users but their school careers were comparable.
Subject(s)
Education, Special/statistics & numerical data , Educational Status , Hearing Aids , Hearing Loss, Bilateral/rehabilitation , Mainstreaming, Education , Adolescent , Adult , Auditory Threshold , Child , Combined Modality Therapy/statistics & numerical data , Female , Health Surveys , Hearing Loss, Bilateral/epidemiology , Humans , Language Development Disorders/epidemiology , Language Development Disorders/rehabilitation , Language Therapy/statistics & numerical data , Mainstreaming, Education/statistics & numerical data , Male , Netherlands , Rehabilitation, Vocational/statistics & numerical data , Speech Therapy/statistics & numerical data , Surveys and QuestionnairesABSTRACT
BACKGROUND: The combination of cyclophosphamide, thioTEPA and carboplatin is used in our Institute for the treatment of breast or germ cell cancer. ThioTEPA inhibits the bioactivation of cyclophosphamide, and platinum drugs are known to interfere with the hepatic metabolism of several anticancer drugs. Of the co-administered drugs to prevent unwanted side effects, some are enzyme inducers, cytochrome P450 inhibitors or substrates. The aim of this study was to investigate the influence of co-medicated drugs on the biotransformation of thioTEPA. METHODS: The possible inhibition of the metabolism of thioTEPA to TEPA was investigated in human microsomes. Influences on the conversion of thioTEPA to monoglutathionylthioTEPA, was studied by the incubation of thioTEPA with glutathione and glutathione S-transferase. RESULTS: No inhibition of the metabolism of thioTEPA to form TEPA was observed for cyclophosphamide and carboplatin, or any other co-medicated drug (ciproflocaxin, amphotericin B, itraconazol, fluconazol, ondansetron, dexamethasone, granisetron, aciclovir, ranitidine, lorazepam). The conversion of thioTEPA to monoglutathionylthioTEPA was inhibited by cyclophosphamide, itraconazol, amphotericin B and ondansetron with IC50 values of 58, 256, 55 and 40 mM, respectively, which are far higher than therapeutic drug levels. CONCLUSION: No clinically relevant drug-drug interactions occur in the CTC regimen as applied in our Institute.
