Intratympanic Dexamethasone Role in Hearing Protection in Cancer Patients.

Introduction The study aims to determine the role of intratympanic dexamethasone (ITD) on the hearing profile of patients with head and neck cancer post-chemoradiotherapy. Study design This study employs a prospective case-control design. Subjects and methods In total 834 patients were evaluated for eligibility. Seven hundred and eleven were excluded because they didn't meet the inclusion criteria. A hundred cases out of 123 were diagnosed with head and neck cancer for which the treatment protocol included cisplatin concurrent to radiotherapy recruited. Before each cisplatin treatment session, ITD was injected into one ear (experimental ear) while the other ear of the same patient served as the control. Pure-tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE) test results of the baseline and follow-up examinations in the sixth and 12th weeks were compared within and between the study and control ears. Results For pure tone thresholds, significant hearing threshold change was noticed at 8 kHz in the experimental group at six weeks and at ≥ 6 kHz in the control group. At 12 weeks, high frequencies were significantly affected at ≥ 4 kHz in the control group. When the baseline was compared across the groups in the 12th week, for otoacoustic emissions, high frequencies showed a loss in the control group more compared to the experimental side (Wilcoxon signed-rank test). Conclusion ITD functions less effectively at higher frequencies because the basal turn of the cochlea is more susceptible to cisplatin ototoxicity. ITD might have potential in the reduction of cisplatin-induced hearing loss.

Using cocreated visually informed community mental health education in low- and middle-income countries: A case study of youth substance misuse in Assam, India.

INTRODUCTION: Our aim is to evaluate the visually informed community mental health education materials cocreated in our research on youth substance misuse in Assam, India, and to reflect on what we might learn for similar initiatives in low- and middle-income countries. METHODS: Materials consist of: (i) images participants brought to the interview; (ii) 30 posters cocreated by participants to convey key messages from their interview; (iii) six short films on the implications of addiction, and (iv) an animation of our Pathways to Recovery model. We also created a community education package that incorporated these materials. We analyse feedback from three groups of events and a social media campaign, which drew variably across our materials and engaged a range of audiences. RESULTS: Outcomes indicate the cocreation process and focus on the visual was successful in promoting young people's voice, increasing awareness and has potential for stigma reduction. Our educational package was deemed useful in increasing awareness and has potential for prevention and treatment. CONCLUSIONS: Our case study offers insights into community mental health education in low- and middle-income countries, confirming the importance of cocreation, the usefulness of visual materials and the potential of social media campaigns while acknowledging the importance of local context in health messaging, particularly for stigmatized topics. PATIENT OR PUBLIC CONTRIBUTION: Service users were involved in the cocreation of the materials evaluated in this study and contributed as presenters in one of the events reported. Members of the public took part in events in which the materials were shared and provided us with the feedback analysed in this article.

Unilateral auditory deprivation in humans: Effects on frequency discrimination and auditory memory span in the normal ear.

Hearing with one ear is associated with auditory deprivation leading to cortical neuronal reorganization. Despite evidence for substantial effects of unilateral input on cortical and sub-cortical structures, the functional consequences of such alterations on human hearing is underexplored. Unilateral hearing impairment offers a unique model to study the perceptual consequences of cortical reorganization. The present study provides evidence for larger (poorer) difference limens for frequency for sounds heard by the normal ear of listeners with unilateral hearing loss relative to bilaterally normal-hearing controls. This difference in frequency discrimination ability was observed for the low (250 Hz), but not for the high-frequency tone (4000 Hz). Besides auditory perceptual effects, we also found reduced working memory capacity as revealed by forward and backward digit span measures. Contrary to the expectation, there was no significant association between frequency discrimination and working memory capacity in listeners with unilateral hearing loss. Auditory deprivation associated with unilateral hearing impairment affects low-frequency (pitch) discrimination and working memory capacity despite normal hearing in the intact ear. Such deficits in basic auditory processes and memory span for sounds heard by the normal ear may contribute to the hearing and communication difficulties experienced by listeners with unilateral or single-sided deafness.

Temporal Resolution of the Normal Ear in Listeners with Unilateral Hearing Impairment.

Unilateral hearing loss (UHL) leads to an imbalanced input to the brain and results in cortical reorganization. In listeners with unilateral impairments, while the perceptual deficits associated with the impaired ear are well documented, less is known regarding the auditory processing in the unimpaired, clinically normal ear. It is commonly accepted that perceptual consequences are unlikely to occur in the normal ear for listeners with UHL. This study investigated whether the temporal resolution in the normal-hearing (NH) ear of listeners with long-standing UHL is similar to those in listeners with NH. Temporal resolution was assayed via measuring gap detection thresholds (GDTs) in within- and between-channel paradigms. GDTs were assessed in the normal ear of adults with long-standing, severe-to-profound UHL (N = 13) and age-matched, NH listeners (N = 22) at two presentation levels (30 and 55 dB sensation level). Analysis indicated that within-channel GDTs for listeners with UHL were not significantly different than those for the NH subject group, but the between-channel GDTs for listeners with UHL were poorer (by greater than a factor of 2) than those for the listeners with NH. The hearing thresholds in the normal or impaired ears were not associated with the elevated between-channel GDTs for listeners with UHL. Contrary to the common assumption that auditory processing capabilities are preserved for the normal ear in listeners with UHL, the current study demonstrated that a long-standing unilateral hearing impairment may adversely affect auditory perception--temporal resolution--in the clinically normal ear. From a translational perspective, these findings imply that the temporal processing deficits in the unimpaired ear of listeners with unilateral hearing impairments may contribute to their overall auditory perceptual difficulties.