7 research outputs found
Hearing Impairment and Quality of Life in Adults with Asymmetric Hearing Loss: Benefits of Bimodal Stimulation
Objectives: Bimodal stimulation for asymmetric hearing loss is an emerging treatment with proven audiometric outcomes. Our objectives are to assess the changes of the hearing impairment and the quality of life of patients treated with this type of stimulation, when compared to a unilateral Cochlear Implant (CI) stimulated condition.
Materials and methods: 31 patients with asymmetric hearing loss (Group 1) were recruited for the study. They were divided into three groups, based on their hearing loss in the ear treated with the hearing aid: Group 1A (Pure Tone Audiometry (PTA) between 41 and 70 decibels (dB)); Group 1B, (PTA between 71 and 80 dB) and Group 1C (PTA between 81 and 90 dB). 30 patients had profound, bilateral hearing loss. Then, users of a unilateral cochlear implant were recruited for the control group. Their hearing impairment and quality of life were analyzed with questionnaires Abbreviated Profile of Hearing Aid Benefit (APHAB), Speech, Spatial and Qualities of Hearing Scale (SSQ) and the Health Utilities Index (HUI). They were followed up for at least 2 years.
Results: The group with the asymmetric hearing loss obtains a statistically significant clinical improvement in the APHAB under category "with hearing aid" compared to "without hearing aid". The group with the asymmetric hearing loss benefits more across basically all variables compared with the control group in the SSQ. Group 1A obtains the best outcome of the sample in the HUI.
Conclusion: Bimodal stimulation and better hearing in the ear treated with the hearing aid reduce hearing impairment and improve the quality of life
Treatment for hearing loss among the elderly: auditory outcomes and impact on quality of life
The study aim was to determine the benefit of cochlear im-
plantation and hearing aids in older adults diagnosed with
hearing loss and to evaluate the index of depression, anxiety
and quality of life after such treatments. A retrospective co-
hort comprised 117 patients older than 65 years and diag-
nosed with moderate to profound hearing loss who were
included and classified into 2 groups (treated vs. non-treat-
ed). A battery of tests including auditory (pure-tone average,
disyllabic words in quiet at 65 dB SPL) and findings from a
series of questions relevant to quality of life were compared
between both groups. Auditory outcomes for disyllabic
words were 58.21% for the cochlear implant-treated group
and 82.8% for the hearing aid-treated group. There was a
positive effect on anxiety, depression, health status and
quality of life in the cochlear implant group versus the pro-
found hearing loss control group. We conclude that older
adults with moderate to profound hearing loss gain benefit from hearing aids or cochlear implants not only in terms of
improved hearing function, but also in terms of positive ef-
fects on anxiety, depression, health status and quality of life
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Vestibulo-cochlear fuction after cochlear implantation in patients with Meniere's disease
OBJECTIVES: To measure the auditory (pure tone audiometry and word recognition scores) and vestibular (video head impulse test and vestibular myogenic potentials) outcomes in patients diagnosed with Meniere’s disease (MD) who underwent cochlear implantation.
MATERIAL AND METHODS: This prospective study included 23 cochlear implant users with MD and 29 patients diagnosed with far-advanced otosclerosis (the control group).
RESULTS: The preoperative mean pure tone average thresholds were 99 and 122.5 dB for the Meniere’s and control groups, respectively. Word recognition scores after cochlear implant yielded a median of 80% and 72% for the Meniere’s and control groups, respectively. Semicircular canal gain was not observed to vary post implantation (mean variation for lateral, posterior, and anterior plane was 0, 0.03, and 0, respectively). The mean ocular and
cervical myogenic potentials asymmetry varied as 9.65% and 18.39%, respectively.
CONCLUSIONS: The auditory performance improved in patients with MD similar to the general cochlear implant population. No major dysfunction of otolithic or semicircular canal function was demonstrated after the implantation surger
Endolymphatic hydrops severity in magnetic resonance imaging evidences disparate vestibular test results
Objectives: It has been suggested that in Ménière’s disease (MD) a dissociated result in the caloric
test (abnormal result) and video head-impulse test (normal result) probably indicates that hydrops
affects the membranous labyrinth in the horizontal semicircular canal (HSC). The hypothesis in this
study is that based on endolymphatic hydrops’ cochleocentric progression, hydrops should also be
more severe in the vestibule of these patients than in those for whom both tests are normal.
Methods: 22 consecutive patientswith unilateral definiteMDwere included and classified as NNif both
tests were normal or AN if the caloric test was abnormal. MRI evaluation of endolymphatic hydrops was
carried out with a T2-FLAIR sequence performed 4 h after intravenous gadolinium administration. The
laterality and degree of vestibular endolymphatic hydrops and the presence or absence of cochlear
endolymphatic hydrops were recorded. Demographic data, audiometric and vestibular evoked myogenic
potentials were collected, and video head-impulse and caloric tests were performed.
Results: Patients in both groups (NN and AN) were similar in terms of demographic data and
hearing loss. The interaural asymmetry ratio was significantly higher for ocular and cervical VEMP
in patients in the AN group. There was a significantly higher degree of hydrops in the vestibule of
the affected ear of AN patients (x2
; p = 0.028).
Conclusion: Significant canal paresis in the caloric test is associated with more severe
endolymphatic hydrops in the vestibule as detected with gadolinium-enhanced MRI and with a
more severe vestibular deficit