Speech perception outcomes after cochlear implantation in prelingually deaf infants: The Western Sicily experience

Objectives: To describe audiometric characteristics and speech perception performances of prelingually deaf Sicilian children after cochlear implantation; to identify the influence of cochlear implant (CI) user and family's characteristics on speech recognition and intelligibility outcomes. Methods: Twenty-eight infants with a congenital or acquired hearing impairment and implanted before the 3rd year of life were studied; all children suffered from bilateral sensorineural hearing loss (SNHL) with evidence of lack of hearing aids benefit and no evidence of intellectual disability. The study of the main characteristics associated with CI user and family's profile was performed with a clinical assessment including pre-implant and post-implant (1, 3, 6, 12 and 18 months) behavioural audiometry (evaluating average threshold for the frequencies 0.5, 1, 2 and 4 KHz) and speech recognition tests (IT-MAIS, MUSS, CAP and SIR). Results: Our cohort was characterized by an early diagnosis of SNHL (5.77 and 12.17 months for congenital and acquired HL respectively), a short length of deafness (average = 6.78 months) and an implantation before the 3rd year of life (mean = 24.25 months; range from 10 to 36). Analysis of audiometric threshold revealed a significantly improved capacity to detect sounds within the conversational speech spectrum after 12 months from implantation (r = 0.99; p < 0.001). The main speech recognition test evidenced speech perception and speech intelligibility performances (CAP median value of 3; SIR category = 3 in 46.42%) equal to those children with same characteristics reported by literature. With the exception of 'daily CI use' (p < 0.001), none of the variables associated with CI user and family's profile resulted significant predictor of speech perception improvement. Conclusions: This work demonstrates that all children of our cohort, with an early diagnosis of SNHL and a CI surgery performed before the 3rd year of life, presented a progressive audiometric and speech improvement through the first 12-18 months after cochlear implantation. The study also highlights that, differently from the others variables studied, a continuous CI use influences significantly speech perception and recognition outcomes

Microbiota, Oxidative Stress, and Skin Cancer: An Unexpected Triangle

: Mounting evidence indicates that the microbiota, the unique combination of micro-organisms residing in a specific environment, plays an essential role in the development of a wide range of human diseases, including skin cancer. Moreover, a persistent imbalance of microbial community, named dysbiosis, can also be associated with oxidative stress, a well-known emerging force involved in the pathogenesis of several human diseases, including cutaneous malignancies. Although their interplay has been somewhat suggested, the connection between microbiota, oxidative stress, and skin cancer is a largely unexplored field. In the present review, we discuss the current knowledge on these topics, suggesting potential therapeutic strategies

TINNITUS PATIENTS: ETIOLOGIC, AUDIOLOGIC AND PSYCHOLOGICAL PROFILE

Tinnitus represents one of the most frequent symptoms observed in the general population in association with different pathologies, although often its etiology remains unclear. Objective of this work is to evidence the main aspects concerning epidemiology, causes, audiological characteristics and psychological consequences of tinnitus

TREATMENT OF TINNITUS AND DIZZINESS ASSOCIATED VERTEBROBASILAR INSUFFICIENCY WITH A FIXED COMBINATION OF CINNARIZINE AND DIMENHYDRINATE

Seventy-eight consecutive subjects, 43 males and 35 females, ranging from 43 to 87 years of age suffering from dizziness and/or tinnitus due to vertebrobasilar insufficiency without other central nervous system diseases were treated with fixed combination of cinnarizine and dimenhydrinate two times a day and for two months. Data were collected considering the following parameters: age, sex, vestibular symptoms (unsteadiness, staggering, tendency to fall, swaying, vertigo due to change of position, bowing, walking, eye movements), headache, tinnitus, impaired hearing and aural fullness. Patients evaluated their vertigo symptoms and/or tinnitus intensities using a graded 3- point visual analog scale ranging from I (no symptoms) to 3 (strong symptoms) and their impact of life with classical tinnitus handicap inventory (THI) and dizziness handicap inventory (DHI) at first appointment, during the treatment and after therapy. The results of THI and DHI evidenced a statistical significant improvement either for tinnitus (t = 3.57; p<0.001) and for vestibular symptoms (t = 4.12; p<0.001); in particular at the final examination, of the 62 patients suffered from tinnitus, the 38.71% (24 cases) did not present the disorder while of the vestibular symptoms; unsteadiness and staggering both evidenced in 65/78 subjects (83.33%) at the beginning of the therapy, disappeared in the 43.08%. In conclusion dual action of the treatment showed improvement of tinnitus and dizziness symptoms, which was confirmed either by symptoms' reduction and by THI and DHI score

Audiologic profile of OSAS and simple snoring patients: the effect of chronic nocturnal intermittent hypoxia on auditory function

The objective of this work was to study the effect of nocturnal intermittent hypoxia on auditory function of simple snoring patients and subjects affected by OSAS; we compared the audiologic profile with the severity of OSAS to detect early signs of cochlear damage. One hundred-sixty patients underwent overnight polysomnography, micro-otoscopy, multi-frequency audiometry, acufenometry, TEOAE recording and d-ROMs test. All subjects were divided in four groups, based on presence/absence of AHI (simple snoring without OSAS, mild OSAS, moderate OSAS, severe OSAS). Sixty (37.5&nbsp;%) patients were not affected by OSAS, 58 (36.25&nbsp;%) presented a mild OSAS, 18 (11.25&nbsp;%) a moderate OSAS and 24 (15&nbsp;%) a severe OSAS; the 57.14&nbsp;% of moderate to severe OSAS suffered from tinnitus with respect to the 31.03&nbsp;% of mild OSAS (P&nbsp;=&nbsp;0.024). A higher percentage (41.66&nbsp;%) of hearing loss was found among individuals with moderate to severe degree of OSAS (P&nbsp;&lt;&nbsp;0.0001). All groups were characterized by a mean hearing threshold&nbsp;&lt;25&nbsp;dB HL for 0.25–3&nbsp;kHz frequencies and a progressive decrease in hearing sensitivity, particularly for 6–16&nbsp;kHz frequencies (P&nbsp;&lt;&nbsp;0.05). The analysis of otoacoustic emissions SNR mean values evidenced a significant difference between simple snoring and severe OSAS individuals for 3 and 4&nbsp;kHz frequencies (P&nbsp;&lt;&nbsp;0.05). d-ROM levels resulted higher in patients with severe OSAS with respect to simple snoring subjects (P&nbsp;=&nbsp;0.004). Our data underline the key role of chronic nocturnal intermittent hypoxia in the development of an early cochlear damage and a more marked high-frequency hearing loss in case of severe OSAS (P&nbsp;&lt;&nbsp;0.05)

THE LINKAGE BETWEEN UPPER RESPIRATORY TRACT INFECTIONS AND OTITIS MEDIA: EVIDENCE OF THE 'UNITED AIRWAYS CONCEPT'

Upper respiratory tract infection (URTI) is a nonspecific term used to describe acute infections involving the nose, paranasal sinuses, pharynx and larynx and resulting from interplay between microbial load (viral and bacterial) and immune response. Infant and young children are prone to developing upper respiratory tract infections, which often result in bacterial complications especially acute otitis media because of the passage of bacteria (colonizing the nasopharynx) in the middle ear via Eustachian tube

DIAGNOSIS AND FOLLOW-UP OF COMPLEX CONGENITAL MALFORMATIONS/MENTAL RETARDATION (MRA/MR)

Complex congenital malformations, associated in 30% of cases with mental retardation, recognize different etiologies: environmental causes, mendelian disease, chromosomal abnormalities, imprinted anomalies. Frequently complex congenital disorders are rare diseases. Rare diseases are infrequent pathological conditions (prevalence in the general population of less than 1/2.000 live births1), and often poorly understood. Because of their rarity these morbid conditions often either go undiagnosed or are diagnosed late with a negative impact for both the affected person and the family. The birth prevalence is high (2-4% of all births). The diagnosis is essential to program complex and integrated care interventions (follow-up programs aimed at early detection of any disease associated with different syndromes) and to carry out proper genetic family counseling (risk of recurrence, prenatal diagnosis, detection of heterozygotes etc)

Association between sleep-disordered breathing and hearing disorders: Clinical observation in Sicilian patients

Introduction: To examine the putative association between Sleep-Disordered breathing and hearing disorders Material and methods: 120 Sicilian subjects ranging from 14 to 85 years of age who were divided in 46 cases suffering from tinnitus (G1 group) and 74 controls (G2 group) were evaluated through STOP BANG screening questionnaire and Four-Variable Screening Tool; after Data collecting each subject underwent Audiological assessment by multi-frequency audiometry (PTA) and Transient-evoked otoacoustic emissions (TEOAE-diagnostic) for each ear. Results: Cases showed: PTA significantly severe than the control group (58.70% vs. 16.89% hearing loss; P&lt;0.001), such as a lower signal-to-noise ratio (SNRs) (P&lt;0.05). Moreover Tinnitus subjects had a higher risk to develop Sleep-Disordered breathing respect to controls (P&lt;0.001). OSA risk population - subjects positive to both screening questionnaires - had tinnitus, wore hearing threshold mean values and, lower SNRs values than total cohort (P&lt;0.01). The relative risk of Sleep-Disordered breathing and tinnitus was 4.83 (P&lt;0.0001). Conclusions: Our results stress a probable association between tinnitus, hearing loss and Sleep-Disordered breathing even if further studies will be needed to confirm our findings