Influence of single-sided deafness on the auditory capacity of the better ear.

BACKGROUND: Patients with single-sided deafness (SSD) are limited by their asymmetric hearing in various areas of everyday life. OBJECTIVE: The aim of this investigation was to perform an age-correlated comparison of the hearing threshold of the better ear of SSD patients with a normal-hearing (NH) reference cohort. In addition, the potential influence of etiology, duration of deafness, and cochlear implantation (CI) of the poorer ear on the peripheral hearing ability of the better ear was investigated. MATERIALS AND METHODS: In a multicenter study, the mean bone conduction hearing threshold of the better ear of 413 adult SSD patients was compared with that of an NH cohort drawn from ISO 7029:2017 for the frequencies 0.5, 1, 2, and 4 kHz. RESULTS: SSD patients showed significantly poorer hearing in the better ear compared to the age-correlated group of NH subjects. CI, duration of deafness, and etiology had no significant effect on the hearing ability of the better ear. CONCLUSION: The origin of the poorer hearing of the better-hearing ear of SSD patients compared to an age-correlated NH cohort is still unclear. It is most likely a combination of different anatomical, immunological, etiological, and microcirculatory causes, which lead to poorer hearing of the better-hearing ear in SSD patients.

[Influence of single-sided deafness on the auditory capacity of the better ear. German version]. / Einfluss einseitiger Taubheit auf das Hörvermögen des besseren Ohrs.

BACKGROUND: Patients with single-sided deafness (SSD) are limited by their asymmetric hearing in various areas of everyday life. OBJECTIVE: The aim of this investigation was to perform an age-correlated comparison of the hearing threshold of the better ear of SSD patients with a normal-hearing (NH) reference cohort. In addition, the potential influence of etiology, duration of deafness, and cochlear implantation (CI) of the poorer ear on the peripheral hearing ability of the better ear was investigated. MATERIALS AND METHODS: In a multicenter study, the mean bone conduction hearing threshold of the better ear of 413 adult SSD patients was compared with that of an NH cohort drawn from ISO 7029:2017 for the frequencies 0.5, 1, 2, and 4 kHz. RESULTS: SSD patients showed significantly poorer hearing in the better ear compared to the age-correlated group of NH subjects. CI, duration of deafness, and etiology had no significant effect on the hearing ability of the better ear. CONCLUSION: The origin of the poorer hearing of the better-hearing ear of SSD patients compared to an age-correlated NH cohort is still unclear. It is most likely a combination of different anatomical, immunological, etiological, and microcirculatory causes, which lead to poorer hearing of the better-hearing ear in SSD patients.

[Cochlear implant treatment in Germany]. / Cochleaimplantatversorgung in Deutschland.

INTRODUCTION: Restoration of impaired auditory function through cochlear implant is possible, with high reliably and great success. Nevertheless, there are regular disputes between patients and insurance companies due to high costs. In Germany, approx. 1.9 Mio. people are severely hearing impaired. It can be estimated that for adequate hearing rehabilitation about 30,000 cochlear implants/year are necessary. Currently, less than 10% of those affected are offered cochlear implant. DISCUSSION: A handicap is defined if there is deviation from normal hearing for more than 6 months. This sets a time frame for the supply with cochlear implant after sudden deafness. The professional code requires to advice all medical options to a person seeking help for hearing loss. This includes benefit-risk consideration. At this point, the economic aspect plays no role. The indication for medical treatment is only subject to the treating physician and should not be modified by non-physicians or organizations. It should be noted that a supply of hearing aids is qualitatively different to the help from a cochlear implant, which provides a restoration of lost function. In social law (SGB V and IX) doctors are requested to advise and recommend all measures which contribute to normal hearing (both sides). This indicates that doctors may be prosecuted for not offering help when medically possible, just because health insurance employees did not approve the cost balance. CONCLUSION: The current situation, with insufficient medical care for the hearing impaired, needs clarifying. To do this, patients, health insurance companies, the political institutions, legislation and professional societies need to accept their responsibilities.

[Audiological results with cochlear implants for single-sided deafness]. / Audiologische Ergebnisse mit Cochlear implant bei einseitiger Taubheit.

INTRODUCTION: Single-sided deafness has a strong impact on quality of life. Besides the difficulties in sound localization, patients also require increased effort to hear. The latter makes it difficult to follow conversations for an extended period, leading to social isolation. Cochlear implantation (CI) represents a possible treatment option for deafness in one ear. METHODS: In the present study, 13 patients with unilateral deafness where treated with CI. All patients were examined by pure tone audiometry and speech tests (Freiburger; HSM; OlSa), as well as sound localisations tests. The single-sided deaf situation is compared to CI-aided binaural hearing. RESULTS: At 100%, the acceptance rate was very high. The two different auditory inputs were well integrated. Patients reported satisfactory restoration of acoustic orientation and sound localization as well as great ease of listening in noisy surroundings. There was no negative impact on the normal hearing side. CONCLUSION: These preliminary results confirm the effectiveness of CI treatment in unilateral deafness.

[Analysis of spinal stress during surgery in otolaryngology]. / Analyse der Wirbelsäulenbelastung bei Operationstätigkeiten in der HNO-Heilkunde.

BACKGROUND: Back pain is a common cause of sick leave in industrialized countries. Performing surgery is often associated with considerable cervical spine disorders. However, only a few studies have examined to what extent working posture or individual surgical techniques can be seen as stress indicators. MATERIAL AND METHODS: Posture and movement of the spine and trunk were assessed by means of a newly developed analysis system (3-D-SMG). The individual-case study was carried out during six sinus operations using varying techniques (microscope, endoscope or headlamp only). RESULTS: Spine and trunk deviation from neutral position (upright standing) was strongest in the sagittal plane. Awkward distortions were primarily observed in the cervical and lumbar spine. The analysis of work characteristics revealed static postures in 65-90% of sinus operations. Isometric positions were mainly related to microscopic surgery. CONCLUSIONS: The data from this explorative individual-case study indicate that prevalence and magnitude of forced isometric and awkward postures are strongly associated with work-related spinal stress in sinus surgery. The new measurement device enables not only the recommendation of individual preventive strategies but also the objective evaluation of ergonomics.

Comparison of the TEMPO+ ear-level speech processor and the cis pro+ body-worn processor in adult MED-EL cochlear implant users.

A study was conducted to compare the new MED-EL TEMPO+ ear-level speech processor with the CIS PRO+ body-worn processor in the COMBI 40/COMBI 40+ implant system. Speech tests were performed in 46 experienced subjects in two test sessions approximately 4 weeks apart. Subjects were switched over from the CIS PRO+ to the TEMPO+ in the first session and used only the TEMPO+ in the time between the two sessions. Speech tests included monosyllabic word tests and sentence tests via the telephone. An adaptive noise method was used to adjust each subject's scores to approximately 50%. Additionally, subjects had to complete a questionnaire based on their 4 weeks of experience with the TEMPO+. The speech test results showed a statistically significant improvement in the monosyllabic word scores with the TEMPO+. In addition, in the second session, subjects showed a significant improvement when using the telephone with the TEMPO+, indicating some learning in this task. In the questionnaire, the vast majority of subjects found that the TEMPO+ allows equal or better speech understanding and rated the sound quality of the TEMPO+ higher. All these objective and subjective results indicate the superiority of the TEMPO+ and are mainly attributed to a new coding strategy called CIS+ and its implementation in the TEMPO+. In other words, based on the results of this study, it appears that after switching over from the CIS PRO+ to the TEMPO+, subjects are able to maintain or even improve their own speech understanding capability.

[Laryngeal manifestations in patients with Parkinson disease]. / Kehlkopfbefunde bei Patienten mit Morbus Parkinson.

BACKGROUND: Impairments of articulation, respiration, and phonation are a common symptom of Parkinson's disease and may result in reduced communication. Previous observations have shown a high incidence of laryngeal abnormalities. However, no relevant data were available for gender differences of laryngeal abnormalities in Parkinson's disease. METHOD: Thirty-nine female and 61 male patients with Parkinson's disease were examined. The laryngeal function was explored by laryngoendoscopy and laryngostroboscopy in respiration and production of [i:] during normal pitch and normal loudness. RESULTS: Abnormal function of vocal cord abduction and adduction were observed in 54% of the women and 39% of the men; more patients had reduced abduction. Bilateral vocal fold atrophy was seen in 36% of the women and 56% of the men, while 41% of the women and 57% of the men had a bilateral hypertrophy ventricular fold. Phase closure incompetence was found in 60.5% of the women and 49% of the men. Abnormal amplitude and mucosal waveform were seen in more male patients, while 30.7% of the women and 25% of the men had a laryngeal tremor. Gender differences were observed with respect to common laryngeal symptoms. CONCLUSION: This study concludes that laryngeal abnormalities in Parkinson's disease show a high degree of gender differences. The percentage of patients with abnormal abduction of the vocal cord was higher than has been reported in other studies. Vocal-fold bowing appear to be related to vocal fold atrophy. Although patients with Parkinson's disease frequently exhibit vocal fold atrophy, other mechanisms and causes should be discussed. Patients with tremor and common laryngeal symptoms were observed. These findings were not expected and further studies of this phenomena would be useful.