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Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss after Failure from Oral and Intratympanic Corticosteroid.

Thanarath IMSUWANSRI ; Pipat POONSAP ; Kornkiat SNIDVONGS

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S99-S102.

Systemic and intratympanic steroids are most widely used for treating idiopathic sudden sensorineural hearing loss. Other treatments include vasodilator, immunosuppressant and antiviral medication. However, only 61% of patients achieve full recovery, and controversies about the standard treatment still exist. In this case report, we present a patient with idiopathic sudden sensorineural hearing loss who failed to respond to systemic and intratympanic steroid treatments but subsequently recovered after undergoing hyperbaric oxygen therapy.
Hearing Loss, Sensorineural ; Humans ; Hyperbaric Oxygenation ; Steroids

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Cochlear Implant Outcomes: A Comparison between Irradiated and Non-irradiated Ears.

Jie Min SOH ; Vishal Deepak D'SOUZA ; Gopal Krishna SAREPAKA ; Win Nie NG ; Chun Suan ONG ; Wong Kein LOW

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S93-S98.

OBJECTIVES: Radiotherapy for head and neck tumors is known to potentially induce sensorineural hearing loss, which is possibly due to damage to the cochlear and/or auditory pathways. Since the success of cochlear implantation depends on a functional auditory nerve, this paper aims to study the hearing outcomes of cochlear implantation in irradiated ears. METHODS: A retrospective study of cochlear implant recipients from our institution who had previously received radiotherapy for head and neck cancers was performed. A control group with cochlear implants who did not receive radiotherapy was recruited. A review of case records, speech discrimination scores (SDS), and a validated subjective questionnaire in the form of the Abbreviated Profile of Hearing Aid Benefit (APHAB) was administered to the study group who fulfilled the inclusion criteria. Global and category scores in both groups were averaged and statistically compared via non-inferiority (NI) testing. RESULTS: With the control group (n=8) as the reference, the -DeltaNI was defined, and a one-tailed lower 95% confidence interval was used for the irradiated group (n=8). The APHAB degree of improvement (%) results were as follows: global, 28.9% (19.32%, -DeltaNI=16.3%); ease of communication, 67.0% (58.36%, -DeltaNI=37.5%); background noise, 53.2% (44.14%, -DeltaNI=26.8%); reverberation, 41.7% (28.85%, -DeltaNI=32.7%); and aversiveness, -46.2% (-67.80%, -DeltaNI=-56.9%). The SDS was 66.9% (56.02%, -DeltaNI=51.0%). From the results, lower 95% confidence interval limits of global APHAB, SDS, ease of communication, and background noise scores of the irradiated group were within the defined -DeltaNI boundary and hence are not inferior to the control. The categories of reverberation and aversiveness could not be proven, however. CONCLUSION: This study demonstrated marked improvements in hearing measured both objectively and subjectively. The overall hearing outcomes after cochlear implantation for post-irradiated patients were not worse than patients who have had no prior irradiation to ear structures.
Auditory Pathways ; Cochlear Implantation ; Cochlear Implants ; Cochlear Nerve ; Deafness ; Ear ; Head ; Hearing ; Hearing Aids ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Nasopharyngeal Neoplasms ; Neck ; Noise ; Retrospective Studies ; Speech Perception ; Surveys and Questionnaires

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Evaluation of the ClearVoice Strategy in Adults Using HiResolution Fidelity 120 Sound Processing.

Anna Chi Shan KAM ; Iris Hoi Yee NG ; Margaret Man Yi CHENG ; Terence Ka Cheong WONG ; Michael Chi Fai TONG

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S89-S92.

OBJECTIVES: This study aimed to evaluate the benefits of ClearVoice strategy on speech perception in noise and in everyday listening situations in Cantonese-speaking cochlear implant users. METHODS: Twelve experienced adult users of the Harmony implant and HiRes 120 sound processing participated in the study. The study employed a prospective within-subjects design wherein speech recognition in adults using HiRes 120 without ClearVoice turned on (control option) was compared to their performance with HiRes 120 with ClearVoice turned on. Each subject was evaluated with two different ClearVoice gain settings: -12 dB (ClearVoice medium) and -18 dB (ClearVoice high) after one-week of use. The Cantonese hearing in noise test and a questionnaire were used as the outcome measures. RESULTS: Subjects performed significantly better with ClearVoice medium than with control option in noise. No significant difference in performance was noted among the 3 settings in quiet. Most subjects reported high level of satisfaction with ClearVoice in daily listening situations and preferred to keep ClearVoice on. CONCLUSION: ClearVoice can help cochlear implant recipients to hear better in noise.
Adult ; Cochlear Implantation ; Cochlear Implants ; Hearing ; Humans ; Noise ; Prospective Studies ; Speech Perception ; Surveys and Questionnaires

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Outcome of Vibrant Soundbridge Middle Ear Implant in Cantonese-Speaking Mixed Hearing Loss Adults.

Joannie Ka Yin YU ; Willis Sung Shan TSANG ; Terence Ka Cheong WONG ; Michael Chi Fai TONG

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S82-S88.

OBJECTIVES: To investigate the aided benefits, speech recognition in quiet and in noise, change in hearing and subjective report of satisfaction on mixed hearing loss adults implanted with Vibrant Soundbridge (VSB) middle ear implant. METHODS: Eight Cantonese speaking adult patients with mixed hearing loss were enrolled in a single-subject, repeated measures prospective study design. Audiometric testing, including air and bone conduction and word recognition under sound-field were conducted before surgery. Device activation was arranged 8 weeks after operation. Audiometric testing was taken to evaluate the change in hearing. Patients were asked to wear the device and come back for fine tuning as needed. Outcome measurements were undertaken at 3 and 6 months after device activation. The outcome measures included sound-field thresholds, Cantonese Hearing in Noise Test (CHINT), Abbreviated Profile of Hearing Aid Benefit (APHAB) and International Outcome Inventory for Hearing Aids (IOI-HA). RESULTS: The application of the VSB improved the aided thresholds and improved speech intelligibility in quiet and noise without significant changes in hearing thresholds. CONCLUSION: VSB is considered as a safe, effective and reliable auditory rehabilitation option for Cantonese speaking adults with mixed hearing loss.
Adult ; Bone Conduction ; Ear, Middle ; Hearing ; Hearing Aids ; Hearing Loss, Mixed Conductive-Sensorineural ; Humans ; Noise ; Ossicular Prosthesis ; Outcome Assessment (Health Care) ; Prospective Studies ; Speech Intelligibility

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Hearing Performance Benefits of a Programmable Power Baha(R) Sound Processor with a Directional Microphone for Patients with a Mixed Hearing Loss.

Mark C FLYNN ; Annelen HEDIN ; Glenn HALVARSSON ; Tobias GOOD ; Andre SADEGHI

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S76-S81.

OBJECTIVES: New signal processing technologies have recently become available for Baha(R) sound processors. These technologies have led to an increase in power and to the implementation of directional microphones. For any new technology, it is important to evaluate the degree of benefit under different listening situations. METHODS: Twenty wearers of the Baha osseointegrated hearing system participated in the investigation. The control sound processor was the Baha Intenso and the test sound processor was the Cochlear(TM) Baha(R) BP110power. Performance was evaluated in terms of free-field audibility with narrow band noise stimuli. Speech recognition of monosyllabic phonetically balanced (PB) words in quiet was performed at three intensity settings (50, 65, and 80 dB sound pressure level [SPL]) with materials presented at 0 degrees azimuth. Speech recognition of sentences in noise using the Hearing in Noise Test (HINT) in an adaptive framework was performed with speech from 0 degrees and noise held constant at 65 dB SPL from 180 degrees. Testing was performed in both the omni and directional microphone settings. Loudness growth was assessed in randomly presented 10 dB steps between 30 and 90 dB SPL to narrow band noise stimuli at 500 Hz and 3,000 Hz. RESULTS: The test sound processor had significantly improved high frequency audibility (3,000-8,000 Hz). Speech recognition of PB words in quiet at three different intensity levels (50, 65, and 80 dB SPL) indicated a significant difference in terms of level (P<0.0001) but not for sound processor type (P>0.05). Speech recognition of sentences in noise demonstrated a 2.5 dB signal-to-noise ratio (SNR) improvement in performance for the test sound processor. The directional microphone provided an additional 2.3 dB SNR improvement in speech recognition (P<0.0001). Loudness growth functions demonstrated similar performance, indicating that both sound processors had sufficient headroom and amplification for the required hearing loss. CONCLUSION: The test sound processor demonstrated significant improvements in the most challenging listening situation (speech recognition in noise). The implementation of a directional microphone demonstrated a further potential improvement in hearing performance. Both the control and test sound processors demonstrated good performance in terms of audibility, word recognition in quiet and loudness growth.
Bone Conduction ; Hearing ; Hearing Aids ; Hearing Loss, Mixed Conductive-Sensorineural ; Humans ; Noise ; Osseointegration ; Sensory Aids ; Signal-To-Noise Ratio

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Speech Recognition Performance under Noisy Conditions of Children with Hearing Loss.

Hui Mei YANG ; Yi Jung HSIEH ; Jiunn Liang WU

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S73-S75.

OBJECTIVES: In order to understand the communicative abilities of hearing impaired children in noisy situations and their communication problems, this study was undertaken to examine speech recognition at different background noise levels, and to compare how context cues in noisy situations affect speech recognition. METHODS: Thirty-four children with severe/profound hearing impairment were enrolled. Fifteen children had cochlear implants (CIs) and 19 used hearing aids (HAs). The Mandarin Speech Perception in Noise (SPIN) test was performed under two levels of background noise, signal-to-noise ratio (SNR) 10 dB and SNR 0 dB (high and low levels, respectively). High predictive (HP) and low predictive (LP) sentences SPIN test scores were recorded to test the effect of context cues on speech recognition. RESULTS: Performance was significantly better in children with CIs (SNR 10: mean, 49.44, standard deviation [SD], 13.90; SNR 0: mean, 31.95, SD, 15.72) than in children with HAs (SNR 10: mean, 33.33, SD, 9.72; SNR 0: mean, 19.52, SD, 6.67; P<0.05) in both noise backgrounds, but no significant interaction was found between devices and background noise level. Hearing-impaired children performed better at SNR 10 dB (mean, 40.44; SD, 14.12) than at SNR 0 dB (mean, 25.0; SD, 12.98), significantly (P<0.001). Performance for HP sentences (mean, 38.6; SD, 12.66) was significantly (P<0.001) better than that for LP sentences (mean, 25.25; SD, 12.93). An interaction was found to between background noise level and contextual cues in sentences (F=8.47, P<0.01). CONCLUSION: The study shows that SNR conditions significantly influence speech recognition performance in children with severe/profound hearing impairment. Under better SNR listening situations, children have better speech recognition when listening to sentences with contextual cues. Children with CIs perform better than children with HAs at both noise levels.
Child ; Cochlear Implants ; Cues ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Noise ; Signal-To-Noise Ratio ; Speech Perception

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Preoperative Voice Parameters Affect the Postoperative Speech Intelligibility in Patients with Cochlear Implantation.

Yun Suk AN ; Seong Tae KIM ; Jong Woo CHUNG

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S69-S72.

OBJECTIVES: Verbal communication depends on a good function of voice and speech organs. Some of the voice characteristics of deaf people differ considerably from those of speakers with normal hearing. After cochlear implantation (CI), auditory control of voice production is possible and the quality of the voice is improved. CI improves quality of voice, speech and hearing with deafness. The aim of our study was to investigate the relationship between acoustic analysis before CI and the speech intelligibility before and after CI. METHODS: Twelve prelingually deafened children implanted unilaterally at the age of 3.4-9 years were included in the study. For all of the children an acoustic analysis of the Slovene vowel 'a' was performed before CI. The fundamental frequency (F0), jitter, shimmer and noise-to-harmonic ratio (NHR) were studied before the implantation. For all of the children the speech intelligibility was performed before and 12 months after CI. Preoperative hearing was divided on existing residual hearing. The results of the acoustic analyses and speech intelligibility before and after CI were compared for preoperative hearing. The results of the speech intelligibility were compared for the age of operation and preoperative acoustic analysis (F0, jitter, shimmer, NHR). RESULTS: Preoperative hearing had no influence on preoperative voice analysis. The children with residual hearing had a high grade of speech intelligibility before and after CI. The preoperative shimmer had positive correlation with postoperative 12 month speech intelligibility (r=0.618, P=0.032). The preoperative jitter had positive correlation with postoperative 12 month speech intelligibility, but was not statistically significant (r=0.479, P=0.116). CONCLUSION: Shimmer on preoperative voice analyses had influence on speech intelligibility after CI.
Acoustics ; Child ; Cochlear Implantation ; Cochlear Implants ; Deafness ; Hearing ; Humans ; Speech Intelligibility ; Voice

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Noise Reduction Using Wavelet Thresholding of Multitaper Estimators and Geometric Approach to Spectral Subtraction for Speech Coding Strategy.

Kai Chuan CHU ; Charles T M CHOI

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S65-S68.

OBJECTIVES: Noise reduction using wavelet thresholding of multitaper estimators (WTME) and geometric approach to spectral subtraction (GASS) can improve speech quality of noisy sound for speech coding strategy. This study used Perceptual Evaluation of Speech Quality (PESQ) to assess the performance of the WTME and GASS for speech coding strategy. METHODS: This study included 25 Mandarin sentences as test materials. Environmental noises including the air-conditioner, cafeteria and multi-talker were artificially added to test materials at signal to noise ratio (SNR) of -5, 0, 5, and 10 dB. HiRes 120 vocoder WTME and GASS noise reduction process were used in this study to generate sound outputs. The sound outputs were measured by the PESQ to evaluate sound quality. RESULTS: Two figures and three tables were used to assess the speech quality of the sound output of the WTME and GASS. CONCLUSION: There is no significant difference between the overall performance of sound quality in both methods, but the geometric approach to spectral subtraction method is slightly better than the wavelet thresholding of multitaper estimators.
Clinical Coding ; Cochlear Implants ; Noise ; Signal-To-Noise Ratio ; Speech Production Measurement

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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.

Yukihiko KANDA ; Hidetaka KUMAGAMI ; Minoru HARA ; Yuzuru SAINOO ; Chisei SATO ; Tomomi YAMAMOTO-FUKUDA ; Haruo YOSHIDA ; Akiko ITO ; Chiharu TANAKA ; Kyoko BABA ; Ayaka NAKATA ; Hideo TANAKA ; Kunihiro FUKUSHIMA ; Norio KASAI ; Haruo TAKAHASHI

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S59-S64.

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.
Aphasia ; Asian Continental Ancestry Group ; Child ; Child Development Disorders, Pervasive ; Cochlear Implants ; Communication Disorders ; Comprehension ; Hearing ; Hearing Aids ; Hearing Loss ; Humans ; Japan ; Language Development ; Mass Screening ; Mathematics ; Rehabilitation Centers ; Vocabulary ; Weights and Measures ; Writing

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Music Perception Ability of Korean Adult Cochlear Implant Listeners.

Eunoak KIM ; Hyo Jeong LEE ; Hyung Jong KIM

Clinical and Experimental Otorhinolaryngology.2012;5(Suppl 1):S53-S58.

OBJECTIVES: Although the cochlear implant (CI) is successful for understanding speech in patients with severe to profound hearing loss, listening to music is a challenging task to most CI listeners. The purpose of this study was to assess music perception ability and to provide clinically useful information regarding CI rehabilitation. METHODS: Ten normal hearing and ten CI listeners with implant experience, ranging 2 to 6 years, participated in the subtests of pitch, rhythm, melody, and instrument. A synthesized piano tone was used as musical stimuli. Participants were asked to discriminate two different tones during the pitch subtest. The rhythm subtest was constructed with sets of five, six, and seven intervals. The melody & instrument subtests assessed recognition of eight familiar melodies and five musical instruments from a closed set, respectively. RESULTS: CI listeners performed significantly poorer than normal hearing listeners in pitch, melody, and instrument identification tasks. No significant differences were observed in rhythm recognition between groups. Correlations were not found between music perception ability and word recognition scores. CONCLUSION: The results are consistent with previous studies that have shown that pitch, melody, and instrument identifications are difficult to identify for CI users. Our results can provide fundamental information concerning the development of CI rehabilitation tools.
Adult ; Cochlear Implants ; Hearing ; Hearing Loss ; Humans ; Music ; Perception

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