What factors are associated with good performance in children with cochlear implants? From the outcome of various language development tests, research on sensory and communicative disorders project in Japan: nagasaki experience.

OBJECTIVES: We conducted multi-directional language development tests as a part of the Research on Sensory and Communicative Disorders (RSVD) in Japan. This report discusses findings as well as factors that led to better results in children with severe-profound hearing loss. METHODS: We evaluated multiple language development tests in 33 Japanese children with cochlear implants (32 patients) and hearing aid (1 patient), including 1) Test for question and answer interaction development, 2) Word fluency test, 3) Japanese version of the Peabody picture vocabulary test-revised, 4) The standardized comprehension test of abstract words, 5) The screening test of reading and writing for Japanese primary school children, 6) The syntactic processing test of aphasia, 7) Criterion-referenced testing (CRT) for Japanese language and mathematics, 8) Pervasive development disorders ASJ rating scales, and 9) Raven's colored progressive matrices. Furthermore, we investigated the factors believed to account for the better performances in these tests. The first group, group A, consisted of 14 children with higher scores in all tests than the national average for children with hearing difficulty. The second group, group B, included 19 children that scored below the national average in any of the tests. RESULTS: Overall, the results show that 76.2% of the scores obtained by the children in these tests exceeded the national average scores of children with hearing difficulty. The children who finished above average on all tests had undergone a longer period of regular habilitation in our rehabilitation center, had their implants earlier in life, were exposed to more auditory verbal/oral communication in their education at affiliated institutions, and were more likely to have been integrated in a regular kindergarten before moving on to elementary school. CONCLUSION: In this study, we suggest that taking the above four factors into consideration will have an affect on the language development of children with severe-profound hearing loss.

Bilateral cochlear implantation for children in nagasaki, Japan.

OBJECTIVES: The number of patients with bilateral cochlear implant (CI) has gradually increased as patients and/or parents recognize its effectiveness. The purpose of this report is to evaluate the efficacy of 29 bilateral CI out of 169 pediatric CI users, who received auditory-verbal/oral habilitation at our hearing center. METHODS: We evaluated the audiological abilities 29 Japanese children with bilateral CIs including wearing threshold, word recognition score, speech discrimination score at 1 m from front speaker (SP), 1 m from second CI side SP, speech discrimination score under the noise (S/N ratio=80 dB sound pressure level [SPL]/70 dB SPL, 10 dB) at 1 m from front SP, word recognition score under the noise (S/N ratio=80 dB SPL/70 dB SPL, 10 dB) at 1 m from front SP. RESULTS: Binaural hearing using bilateral CI is better than first CI in all speech understanding tests. Especially, there were significant differences between the results of first CI and bilateral CI on SDS at 70 dB SPL (P=0.02), SDS at 1 m from second CI side SP at 60 dB SPL (P=0.02), word recognition score (WRS) at 1 m from second CI side SP at 60 dB SPL (P=0.02), speech discrimination score (SDS) at 1 m from front SP under the noise (S/N=80/70; P=0.01) and WRS at 1 m from front SP under the noise (S/N=80/70; P=0.002). At every age, a second CI is very effective. However, the results of under 9 years old were better than of over 9 years old on the mean SDS under the noise (S/N=80/70) on second CI (P=0.04). About use of a hearing aid (HA) in their opposite side of first CI, on the WRS and SDS under the noise, there were significant differences between the group of over 3 years and the group of under 10 months of HA non user before second CI. CONCLUSION: These results may show important binaural effectiveness such as binaural summation and head shadow effect. Bilateral CI is very useful medical intervention for many children with severe-to-profound hearing loss in Japan as well as elsewhere.

Binocular and monocular measurements of subjective visual vertical in vestibular loss.

The objective of this study was to investigate the possibility to omit the time-consuming monocular vision measurement in the subjective visual vertical (SVV) test by demonstrating that there is no difference in the results between binocular and monocular measurements. Thirty-one patients with unilateral vestibular schwannoma and 20 normal subjects as controls were involved. Both binocular and monocular measurements of SVV were performed. The main outcome of this study was the difference in the results of SVV between binocular and monocular measurements. There were no significant differences in the tilts of the SVV between binocular and monocular measurements in vestibular schwannoma patients as well as in the controls. Abnormal tilts of SVV may be evaluated precisely only by binocular vision instead of monocular vision.

Adenosquamous carcinoma arising in a thyroglossal duct cyst: report of a case.

A 61-year-old Japanese woman had an 11-year history of an enlarging anterior neck mass that was diagnosed otolaryngologically as a thyroglossal duct cyst. Preoperatively, fine-needle aspiration cytology suggested a neoplastic lesion, but no obvious malignancy was clinically evident. Sistrunk's operation was performed. An adenosquamous carcinoma arising in a thyroglossal duct cyst was found on pathological examination. Carcinoma arising in a thyroglossal duct cyst is rare, and only approximately 200 cases have been reported, most of which were papillary carcinoma. Only 21 cases of squamous cell carcinoma arising in a thyroglossal duct cyst have been reported. The present case is the first report of adenosquamous carcinoma arising in a thyroglossal duct cyst.

Subjective visual vertical in acute attacks of Ménière's disease.

OBJECTIVES: To investigate whether or not and how often there is otolith dysfunction in an acute attack of Ménière's disease. PATIENTS: Twenty-two definite cases of unilateral Ménière's disease diagnosed in accordance with the 1995 criteria of the American Academy of Otolaryngology-Head and Neck Surgery for Ménière's disease. INTERVENTION: Subjective visual vertical (SVV) test was performed before, at, and after acute attacks on 22 patients with unilateral Ménière's disease who showed normal tilts of SVV before acute attacks. MAIN OUTCOME MEASURE: Abnormal tilts of SVV. RESULTS: Of 22 cases, 14 (63.6%) with unilateral Ménière's disease showed abnormal tilts of SVV in acute attacks. The tilts were toward the side of the affected ear in 13 (92.9%) of them. Abnormal tilts returned to normal within a few weeks after the acute attacks in 12 (85.7%) of the 14 cases with unilateral Ménière's disease. CONCLUSION: Otolith dysfunction occurred in acute attacks in a considerable number of patients with Ménière's disease. Subjective visual vertical can be used as a good tool for the evaluation of otolith dysfunction at acute attacks in patients with Ménière's disease.