Hearing Disorders - Science topic

Sound sensitivity and light sensitivity go with brain inflammation from the above causes. Many then have trouble handling their surroundings.

Definite MD

A. Two or more spontaneous episodes of vertigo(1,2), each lasting 20 minutes to 12 hours(3).

B. Audiometrically documented low- to mediumfrequency sensorineural hearing loss(4,5) in one ear, defining the affected ear on at least one occasion before, during or after one of the episodes of vertigo(6,7).

C. Fluctuating aural symptoms (hearing, tinnitus or fullness) in the affected ear(8). D. Not better accounted for by another vestibular diagnosis(9).

I think the following article will be useful

Best Regards Wesam Salah Mohamed Ibrahim

Dear @Pradeep, there were many similar research questions, with lot of fine answers and resources available. I hope this links will help to your research.

Successful bone-anchored hearing aid implantation in a patient with osteogenesis imperfecta

Article in The Journal of Laryngology & Otology 129(11):1-4 · September 2015

DOI: 10.1017/S0022215115002510

Acoustic reflexes would likely not be present even in the event of a sensory loss due to elevated thresholds. I would suggest testing otoacoustic reflexes, auditory  brainstem response, and try to elicit an acoustic startle. I would suspect that the OAEs would be absent and the ABR to click stimuli present with prolonged wave V latencies. You may get a startle reflex if you use a broadband stimulus of high enough intensity. If OAEs are present you should perform electrocochleography looking for coclear microphonic - suspect auditory neuropathy/dysynchrony.

thank you for the details

Hi all, I just came across this thread. My research interest is in this topic for the very reasons pointed out here. I would like to talk with anyone involved in this area of research so we can collaborate and strengthen this body of research then moving it to action research.

environmental Factors are the most important

I understood deaf and hard of hearing. Rather, the phrase regarding "evaluation" was unclear. Why type of evaluation? Hearing, speech, language, production, reception, etc.

Numbas is free.  Numbas is an easy way to create online tests. Our free web-based system helps you build the exams you need to challenge your students, complete with videos and interactive diagrams.

In my clinical work with patients with tinnitus and hearing loss, with tinnitus and normal hearing, and hearing loss without tinnitus, I gave up on trying to determine an association. I did know that in most cases of tinnitus with hearing loss, the tinnitus was often resolved when hearing aids were worn. For those with tinnitus and normal hearing, hearing aids were inappropriate and tinnitus maskers were as often ineffective as effective. Of course, for those with hearing loss and no tinnitus, I often worried that hearing aids might be the trigger for tinnitus and in one case  I came in late (a hearing aid fit by  another practitioner had triggered tinnitus). 

So, in answer to your question, there may be a relation between tinnitus and hearing loss such that the tinnitus might be at the same frequency as the frequency of maximum hearing loss (assuming a NI notch). But, there is no relation for those with normal hearing (such as myself - I am listening to a 6400 Hz , or so, tone in my right ear while typing this and listening to television). 

As to research,, there is insufficient research to provide anything other than a vague answer to your question. It remains a patient-by-patient issue.

For empathy, you could look at what these people did: Empathy Development in Deaf Preadolescents.

I don't know about the validity of their results, but they state:  "The results demonstrate that deaf preadolescents have more difficulty with empathy development than hearing children, and this ability is related to onset of deafness."

A few things to keep in mind are that music appreciation and music perception are different. So is the aim to improve perceptual accuracy for music (i.e. pitch perception, psychoacoustic tasks, recognising instruments etc) - OR is it music appreciation (i.e. sound quality, enjoyment of music)? They are not the same, and research I've done and others (e.g. Kate Gfeller) has shown only weak correlations between accuracy & enjoyment.

Also keep in mind that music has so many different styles. So to 'give a better experience' for music may require different things for different styles.

Also keep in mind the level of hearing loss (& type of hearing loss) of your HA wearer. For example, Brian Moore & colleagues have shown that a moderate or worse sensorineural hearing loss leads to wider auditory filter bandwidths that would then affect frequency resolution and specificity. So in addition to the technology in the HA, you have to also consider the physiological changes in the cochlea, and the resulting psychoacoustic impact.

If you haven't already, talk to Hugh McDermott down there at the Bionic Institute for the signal processing side of things, and Colette McKay for the psychophysics. 

The literature related to CI+HA can't really be directly applied to HA only - as usually in bimodal stimulation (i.e. HA with CI), for the conventional CI user, the HA is fit to 'work with' the CI - i.e. more low frequency amplification, loudness balancing etc. And the hearing thresholds & configuration of the hearing loss for someone using bimodal (or EAS) stimulation would be somewhat different to your 'run of the mill' HA user.

The research that was the basis for my M.S.(1968) was looking to see the ideal place for injection of polytetrafluoroethylene (PTFE) to treat patulous Eustachian tubes. 

I developed a method for measuring ET patency in anesthetized dogs using an air flow system through a myringotomy. The back flow in a manometer would show the opening pressure of the ET. There were two possible places for the injection. 1. behind the torus tubarius  2.in front into the tensor veli palatini. The tensor injection reduced the patency without causing serous otitis media. The behind the torus injection did not change the patency as expected but produced serous otitis media in all dogs. The latter revealed that ET obstruction was not a necessary etiology for serous otitis media.

Clinically the PTFE injection was effective, but its exact placement in the human was difficult and lead to at least two deaths and was subsequently abandoned.

Clinically, now when expected, the diagnosis is confirmed with the ET insufflation of a boric acid/salicylic acid powder. If confirmed the patient can be instructed in self ET catheterization with insufflation of the powder as necessary. In some instances presumably by producing some chronic inflammation of the ET mucosa the symptom disappears.

Dennis Poe has been performing the leading edge endonasal contemporary surgical management.

 http://www.ncbi.nlm.nih.gov/pubmed/18959577

My answer will be relevant to young children who have shown ANSD from birth. Hearing aid(s) should not be fitted until behavioral thresholds of audibility can be obtained. One would most likely not fit a hearing aid for a child with ANSD whose thresholds are nearly normal or severe-profound. Those with mild to moderately severe loss who benefit from hearing aids tend to be the same ones who have cortical auditory evoked potentials. Assuming CAEPs are not clinically readily available in the situation you describe, a quick and dirty way to guess whether a hearing aid might help is to measure even rudimentary speech recognition in each ear separately at (for example) 50dBHL and again at 70-80dBHL. If the child's speech recognition clearly improves at a higher intensity, a hearing aid should be fitted, appropriate to the thresholds of audibility, while visual supports for communication are maintained. Gary Rance's research has suggested that roughly half of children with ANSD can benefit from hearing aids. 

Dear colleagues,  

a few years ago I faced exactly the same problem in one implantation after more than 18 years of experience. 

After drilling longer than expected, in the usual position and angle for the cochleostomy   some bleeding appeared and I had to end surgery without implanting. The cochlea was patent in the preop CT. After a postop CT, we realized that the cochlea was slightly rotated, the direction of drilling was inappropriately tangential and it reached the carotid. One week later in a new a surgery, I thinned the promontory, I exposed the stria line and proceed to implant easily.

Fortunately (for the attendants) it was during our temporal dissection and otosurgery and now I offer my experience for if it is useful to any colleague.

Prof.Dr Rafael Urquiza MD PhD

University of Malaga. Spain

I agree with Anthony.

To be honest, physical activity can be helpful in all vestibular pathologies as it improves integration of information from the different modalities (visual, vestibular and proprioceptive) and therefore encourages posture and gait improvement. Some recent papers also focused on the advantages of virtual reality and Wii-therapy in vestibular patients, which is cheap, easily implemented and has a low drop-out because it's also fun (although, sometimes difficult for elderly due to the technical challenge). 

A good paper on vestibular rehab and exercises is this one: "Vestibular rehabilitation: rationale and indications" (http://www.ncbi.nlm.nih.gov/pubmed/24057831), but there are quite some review papers on the topic. 

In any case, it's worth the try in Usher patients, don't think it can really hurt them! Would be interesting to focus some research on the topic. 

Best wishes,

Angelique 

Thanks again. Dear prof. Badr, the article, mentioned below is my institute experience regarding implanting radical mastoid cavities, either by non-obliterative technique or partially obliterating the mastoid cavity & the results was comparable with the world wide results. Do you think that CT-Scan alone is enough to follow up implanting such cases by your preferable blind sac technique?  We noted that the partially obliterated case had longer interval than the non-obliterative other case. Would you mention the outcomes of your blind sac cases.

Article: Cochlear Implantation in Patients with Radical Mastoid Cavities.

Mohammed S. Attallah, Hamad S. Al-Muhaimeed, Hazem Y. Abdelwahed

[Detail of the article is present in my researchgate website.]

Abstract: In the past, cochlear implantation was a contraindicated procedure in profoundly deaf patients with radical mastoid cavities. This was due to high risk of infection spread into cochlea with possible destruction of the remained surviving cochlear neural elements. We report on King Abdulaziz University Hospital experience in managing by cochlear implantation two postlingual profoundly deaf patients (both male and adult) with radical mastoid cavities due to chronic cholesteatomatous otitis media. Two different open techniques were used, cochlear implantation with (in the first patient) and without (in the second patient) obliteration of the pre-existed mastoid cavity. One patient (first) suffered infection of mastoid cavity with extrusion of electrode, 55 months post-implantation. The infection could not be controlled without explantation, so the patient was explanted. The other (second) patient suffered facial nerve twitching, ear discharge and later failure of the implant as proved by integrity testing, 22 months post-implantation. The infection was subsided after explantation. We recommend regular clinical and audiological follow-up of such patients in the same cochlear implantation center to avoid any complications which may lead to implant failure or electrode extrusion. This is also useful to discover and treat early any potential recurrent infection or cholesteatoma. High-resolution computed tomography scan of temporal bone is a good tool in the follow-up of patient with post-implantation complications or those implanted with closed blind sac technique which may be a better alternative technique than the open technique. Key words: Radical mastoid cavities, Bilateral profound sensorineural hearing loss, Cochlear implantation, Open technique.

Saudi Journal of Oto-Rhino-Laryngology Head and Neck Surgery (SJORLHNS). 01/2013; 15(1):1-5.      

While the causes of Tullio phenomenon are diverse, I believe the commonest we encounter here in sub-saharan Africa is due to Superior canal dehiscience. I agree with Eduardo Martin-Sqnz that surgical options is only beneficial with large dehiscience.

Description of normality is difficult item in all scientific branches. I like description of normal in geometry to explain "what normality concept means" to the students:

"In geometry, a normal is an object such as a line or vector that is perpendicular to a given object."

That means, first you need a "reference" to describe normal; that means it could be subjective according to your reference, or to put it other words, it may be "normal" according to only one view of angle. 

So I agree with Ms Garcia that, in human sciences, we have to completely avoid the word "normal", and also "the handicapped". 

There are instances of using singing training as a therapy for hearing impaired adults. USually about improving their speech feedback loop, rather than their singing, but from memory i think they were more vocally in tune afterwards aswell. I could track down references if you wanted to know more, but it was a topic i only briefly considered including in a literature review on a related hearing loss field, but discarded as it wasnt relevent enough.

Would you clarify your question. What does "FNS" means? Do you want to ask about preoperative detection of  facial nerve tumor in spite it is presented clinically by only audiological symptoms? Do you want to differentiate between audiological symptoms due to acoustic nerve tumor versus facial nerve tumor? Please, you would clarify your question for focused answer.

There is a recent research work on this topic published in Ear and Hearing. You may be able to find more clear answers in that article. Its a very good study with good literature review.  Please find the link.

Warm Regard and Wishes,

Prashanth

Agree with Dr. Boemo.  It's not a contraindication but a situation which requires a deliberate and planned approach.  The important concept is to have definitively managed the cholesteatoma and infection prior to implant.   Canal wall down or even radical mastoidectomy with or without over closure of the ear canal are considerations.  Cholesteatoma surgery after CI is the situation to be avoided if at all possible.  Continued follow on care is necessary to a greater extent than CI and even cholesteatoma patients independently.

Hi Rachel

The platin induced toxicity is similar in both the ears and the kidneys and most often they develop simultaneously. We run a pharmacotherapy induced ototoxic clinic and what we often see is high frequency hearing loss with a reduction in the GFR.

Does this help?

Research suggests that the prevalence of hearing loss in diabetes patients is higher than in non-diabetic controls. Prior to the emergence of clinical hearing loss there do also appear to be sub-clinical changes in audiometric tests such as ABR and TOAEs that suggest central as well as peripheral neuropathy.

My reading of the evidence is that hearing loss is more prevalent in the diabetic population as a whole. I'm not sure whether anyone has compared type 1 and type 2 directly. There is a link with glycaemic control but this does not account for the whole variance in thresholds. For example length since onset of diabetes seems to be a factor regardless of glycaemic control.

In children there are some good recent papers on type 1 diabetes and I suspect type 2 will be becoming more of an issue as the incidence rises in the paediatric population. There is evidence for audiometric consequences of type 1 diabetes in children.

I know that there ia quite a bit of work going on in Saudi looking at diabetes in general and this might be a good place to look for audiology related papers.