Screening methods for age-related hearing loss in older patients with cancer: A review of the literature

© 2018 by the authors. As people grow older, they may experience loss in hearing sensitivity. Age-related hearing loss may negatively affect the patient's quality of life as it may lead to social isolation. In older patients with cancer, hearing loss can seriously interfere with the patient's ability to deal properly with all aspects of their disease, and may have a cumulative effect on their already decreased quality of life. Therefore, the proper screening of those conditions is essential in order to optimise the patient's comfort during and after treatment. This review article aims at providing a concise image of the nature of age-related hearing loss, and provides an overview of the screening methods that could be used in older patients with cancer

Bilateral cochlear implantation or bimodal listening in the paediatric population : retrospective analysis of decisive criteria

Introduction: In children with bilateral severe to profound hearing loss, bilateral hearing can be achieved by either bimodal stimulation (CIHA) or bilateral cochlear implantation (BICI). The aim of this study was to analyse the audiologic test protocol that is currently applied to make decisions regarding the bilateral hearing modality in the paediatric population. Methods: Pre- and postoperative audiologic test results of 21 CIHA, 19 sequential BICI and 12 simultaneous BICI children were examined retrospectively. Results: Deciding between either simultaneous BICI or unilateral implantation was mainly based on the infant's preoperative Auditory Brainstem Response thresholds. Evolution from CIHA to sequential BICI was mainly based on the audiometric test results in the contralateral (hearing aid) ear after unilateral cochlear implantation. Preoperative audiometric thresholds in the hearing aid ear were significantly better in CIHA versus sequential BICI children (p < 0.001 and p = 0.001 in unaided and aided condition, respectively). Decisive values obtained in the hearing aid ear in favour of BICI were: An average hearing threshold measured at 0.5, 1, 2 and 4 kHz of at least 93 dB HL without, and at least 52 dB HL with hearing aid together with a 40% aided speech recognition score and a 70% aided score on the phoneme discrimination subtest of the Auditory Speech Sounds Evaluation test battery. Conclusions: Although pure tone audiometry offers no information about bimodal benefit, it remains the most obvious audiometric evaluation in the decision process on the mode of bilateral stimulation in the paediatric population. A theoretical test protocol for adequate evaluation of bimodal benefit in the paediatric population is proposed

Avaliação do desempenho de aparelhos de amplificação sonora individual com base em normas internacionais

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico, Programa de Pós-Graduação em Engenharia Mecânica, Florianópolis, 2016.Os aparelhos de amplificação sonora individual (AASI) são atualmente as próteses mais utilizadas para reabilitação de pessoas com deficiência auditiva. Conhecer a performance eletroacústica do AASI e equipará-las com as necessidades do indivíduo é um fator crítico para o sucesso da adaptação do AASI à necessidade do usuário. Procedimentos para avaliação da performance eletroacústica dos aparelhos são descritos pelas principais normas de avaliação de AASI que incluem a série IEC 60118, a qual é composta por 15 partes. A parte 0 apresenta procedimentos para a determinação das principais informações que devem constar na folha de dados, enquanto a parte 7 estabelece procedimentos e tolerâncias para avaliações de controle de qualidade. Já a parte 8 utiliza um manequim para simular a performance do AASI em um individuo e inclui ensaios para a análise das características direcionais. Entretanto, o desempenho dos AASI em indivíduos reais podem diferir significativamente dos obtidos através das técnicas da série IEC 60118. Em vista disso, a IEC 61669 estipula uma série de procedimentos para realização de ensaios em orelha real, que são fundamentais para o processo de adaptação do AASI. O presente trabalho tem por objetivo implementar e avaliar os resultados obtidos através dos procedimentos estabelecidos pelas normas supracitadas. Os requisitos das normas foram analisados e soluções em termos de equipamentos foram propostas, seguidas por uma análise de incerteza das grandezas medidas. A implementação da parte 0 foi comparada e validada com base nos resultados produzidos por um laboratório acreditado. Seis AASIs comerciais foram avaliados segundo as tolerâncias da parte 7 e apresentaram a maioria dos resultados dentro dos limites de aceitação. Os resultados da parte 8 mostraram-se contundentes com o tipo de AASI testado. Por fim, os ensaios segundo a IEC 61669 foram conduzidos no manequim através de um sistema comercial de testes. Na comparação entre os resultados da parte 8 com a IEC 61669 foram encontradas diferenças relevantes, provavelmente oriundas de problemas no acoplamento e colocação do microfone sonda. A implementação dessas normas viabiliza ao laboratório a condução de futuras investigações na área de AASI. Além disso, o trabalho estabelece de forma detalhada soluções que obedecem os requisitos estabelecidos na norma e detalhes acerca da implementação dos procedimentos das mesmas.Abstract : Hearing aids are currently the most common device used for rehabilitation of people with hearing impairments. The hearing aids electroacoustic performance is of utmost importance for hearing care professionals to properly choose and adapt the device for a particular individual. The evaluation of electroacoustic performance of hearing aids are described by the hearing aids main standards, which includes the IEC 60118 series. This series is composed by 15 parts; part 0 provides procedures for the determination of the key information to be included in the data sheet, while part 7 establishes procedures and tolerances for quality control assessments. Part 8 uses a manikin to simulate the performance of hearing aids in an individual and includes tests to analyze directional characteristics. However, the hearing aid performance in real individuals may differ significantly from those obtained through the techniques described by IEC 60118. As a result, the IEC 61669 provides a set of procedures for performing tests in real ear, which are fundamental to hearing aids fitting process. This paper aims to describe the implementation process and analysis of results obtained through the procedures established by the standards previously cited. The standards' requirements have been raised and solutions in terms of equipment was proposed, followed by an uncertainty analysis of the measured quantities. The implementation of Part 0 was compared and validated based on the results produced by an accredited laboratory. Six commercial hearing aids were evaluated according to the tolerance on part 7 and most of the results were found acceptable. The results of part 8 proved to be conclusive with the type of hearing aids tested. Finally, the tests according to IEC 61669 were conducted on the manikin using a commercial test system. The comparison between results of Part 8 and IEC 61669 revealed relevant differences, probably from the coupling and placement of the probe microphone. The implementation of these standards enables the laboratory to conduct further investigations on hearing aids area. In addition, this work establishes solutions that meet the standards requirements and describes in details the implementation of the procedures

Cochlear Implant Outcomes and Genetic Mutations in Children with Ear and Brain Anomalies

Background. Specific clinical conditions could compromise cochlear implantation outcomes and drastically reduce the chance of an acceptable development of perceptual and linguistic capabilities. These conditions should certainly include the presence of inner ear malformations or brain abnormalities. The aims of this work were to study the diagnostic value of high resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in children with sensorineural hearing loss who were candidates for cochlear implants and to analyse the anatomic abnormalities of the ear and brain in patients who underwent cochlear implantation. We also analysed the effects of ear malformations and brain anomalies on the CI outcomes, speculating on their potential role in the management of language developmental disorders. Methods. The present study is a retrospective observational review of cochlear implant outcomes among hearing-impaired children who presented ear and/or brain anomalies at neuroimaging investigations with MRI and HRCT. Furthermore, genetic results from molecular genetic investigations (GJB2/GJB6 and, additionally, in selected cases, SLC26A4 or mitochondrial-DNA mutations) on this study group were herein described. Longitudinal and cross-sectional analysis was conducted using statistical tests. Results. Between January 1, 1996 and April 1, 2012, at the ENT-Audiology Department of the University Hospital of Ferrara, 620 cochlear implantations were performed. There were 426 implanted children at the time of the present study (who were <18 years). Among these, 143 patients (64 females and 79 males) presented ear and/or brain anomalies/lesions/malformations at neuroimaging investigations with MRI and HRCT. The age of the main study group (143 implanted children) ranged from 9 months and 16 years (average = 4.4; median = 3.0). Conclusions. Good outcomes with cochlear implants are possible in patients who present with inner ear or brain abnormalities, even if central nervous system anomalies represent a negative prognostic factor that is made worse by the concomitant presence of cochlear malformations. Common cavity and stenosis of the internal auditory canal (less than 2 mm) are negative prognostic factors even if brain lesions are absent

“Can you hear me now?”: Insurance Coverage for Hearing Benefits in the United States

Public and private insurance coverage for hearing benefits underscores the gaps in coverage for treating hearing loss in the U.S. The commodification of the hearing benefits sector of healthcare in this country has detrimental consequences for personal health. Using three personal anecdotes to frame the issue, my paper explores the complex worlds of both public and private insurance as well as the implications of each type of insurance for both adults and children. Current regulations and laws for hearing benefits leave many people to suffer financially, physically, and emotionally. After reviewing the current regulations I propose changes to rectify some of the problems within this sector of health care

Why a diagnosis of neurofibromatosis calls for the attention of a deaf educator

This paper will seek to describe neurofibromatosis (NF), the scope of its impact, how NF relates to hearing loss, and why someone with a teacher of the deaf’s expertise may have information to offer the intervention team for a child diagnosed with NF