Technological Advances in Universal Neonatal Hearing Screening (UNHS)

Within the last decade, numerous new challenges have appeared in the UNHS arena, such as (i) the need to validate the automated OAE/ABR screeners; (ii) the need to qualify the responses from the automated devices; (iii) the need to obtain additional information (i.e., hearing threshold) for the subject under assessment, in a short period of time; (iv) and the need to integrate numerous measurements in a single portable automated device. To respond to these clinical demands, several new methodologies have been introduced to the UNHS clinical practice. In this context, the aim of this chapter is to provide information on these new technological trends

Sense of taste in patients after cochlear implantation-preliminary study

Background: Taste is the leading sense in how we determine the quality of consumed food. Proper gustatory sensation largely determines the well-being and health of an organism, and this affects their quality of life.Objectives: The aim of the present study was to estimate the risk of early taste disorders following implantation surgery. Methods: Twenty patients underwent a taste test before, 1 day after, and 1 month after cochlear implantation. The taste sensations of sweet, sour, salty, and bitter were determined. Results: Statistical analysis showed no significant differences (p > 0.05) between individual tests among the entire study group. After dividing the respondents into smoking (n=6) and non-smoking (n=14) groups, only a weak correlation (p =0.043) was found between the results of the first and second examination in the smoker group. However, a statistically significant decrease in the number of saline-sensitive (p<0.001) and acid-sensitive (p = 0.042) subjects was observed. Conclusion: These findings suggest that people after a cochlear implant may have transient taste disorders. Taste disorder called dysgeusia may be an early complication after the implantation procedure contributing to deterioration of patients quality of life. Keywords: Sense of taste; taste disorders; cochlear implant surgery; quality of life, partial deafness treatment

Speech-Evoked Brainstem Response

The auditory brainstem response (ABR) is a clinical tool to assess the neural functionality of the auditory brainstem. The use of verbal stimuli in ABR protocols has provided important information of how the speech stimuli are processed by the brainstem structure. The perception of speech sounds seems to begin in the brainstem, which has an important role in the reading process and the phonological acquisition speech ABR assessment allows the identification of fine-grained auditory processing deficits, which do not appear in click evoked ABR responses. The syllable /da/ is commonly used by speech ABR assessment due to it being considered a universal syllable and allows it to be applied in different countries with good clinical assertiveness. The speech ABR is a objective, fast procedure that can be applied to very young subjects. It be utilized in different languages and can provide differential diagnoses of diseases with similar symptoms, as an effective biomarker of auditory processing disorders present in various diseases, such as dyslexia, specific language impairment, hearing loss, auditory processing disorders, otitis media, and scholastic difficulties. Speech ABR protocols can assist in the detection, treatment, and monitoring of various types of hearing impairments

Speech Perception Changes in the Acoustically Aided, Nonimplanted Ear after Cochlear Implantation: A Multicenter Study

In recent years there has been an increasing percentage of cochlear implant (CI) users who have usable residual hearing in the contralateral, nonimplanted ear, typically aided by acoustic amplification. This raises the issue of the extent to which the signal presented through the cochlear implant may influence how listeners process information in the acoustically stimulated ear. This multicenter retrospective study examined pre- to postoperative changes in speech perception in the nonimplanted ear, the implanted ear, and both together. Results in the latter two conditions showed the expected increases, but speech perception in the nonimplanted ear showed a modest yet meaningful decrease that could not be completely explained by changes in unaided thresholds, hearing aid malfunction, or several other demographic variables. Decreases in speech perception in the nonimplanted ear were more likely in individuals who had better levels of speech perception in the implanted ear, and in those who had better speech perception in the implanted than in the nonimplanted ear. This raises the possibility that, in some cases, bimodal listeners may rely on the higher quality signal provided by the implant and may disregard or even neglect the input provided by the nonimplanted ear

Suitable Electrode Choice for Robotic-Assisted Cochlear Implant Surgery: A Systematic Literature Review of Manual Electrode Insertion Adverse Events

BACKGROUND AND OBJECTIVE: The cochlear implant (CI) electrode insertion process is a key step in CI surgery. One of the aims of advances in robotic-assisted CI surgery (RACIS) is to realize better cochlear structure preservation and to precisely control insertion. The aim of this literature review is to gain insight into electrode selection for RACIS by acquiring a thorough knowledge of electrode insertion and related complications from classic CI surgery involving a manual electrode insertion process. METHODS: A systematic electronic search of the literature was carried out using PubMed, Scopus, Cochrane, and Web of Science to find relevant literature on electrode tip fold over (ETFO), electrode scalar deviation (ESD), and electrode migration (EM) from both pre-shaped and straight electrode types. RESULTS: A total of 82 studies that include 8,603 ears implanted with a CI, i.e., pre-shaped (4,869) and straight electrodes (3,734), were evaluated. The rate of ETFO (25 studies, 2,335 ears), ESD (39 studies, 3,073 ears), and EM (18 studies, 3,195 ears) was determined. An incidence rate (±95% CI) of 5.38% (4.4–6.6%) of ETFO, 28.6% (26.6–30.6%) of ESD, and 0.53% (0.2–1.1%) of EM is associated with pre-shaped electrodes, whereas with straight electrodes it was 0.51% (0.1–1.3%), 11% (9.2–13.0%), and 3.2% (2.5–3.95%), respectively. The differences between the pre-shaped and straight electrode types are highly significant (p < 0.001). Laboratory experiments show evidence that robotic insertions of electrodes are less traumatic than manual insertions. The influence of round window (RW) vs. cochleostomy (Coch) was not assessed. CONCLUSION: Considering the current electrode designs available and the reported incidence of insertion complications, the use of straight electrodes in RACIS and conventional CI surgery (and manual insertion) appears to be less traumatic to intracochlear structures compared with pre-shaped electrodes. However, EM of straight electrodes should be anticipated. RACIS has the potential to reduce these complications

Improved measurement of tinnitus severity: Study of the dimensionality and reliability of the Tinnitus Handicap Inventory.

ObjectiveThe Tinnitus Handicap Inventory (THI) is widely used in clinical practice and research as a three-dimensional measure of tinnitus severity. Despite extensive use, its factor structure remains unclear. Furthermore, THI can be considered a reliable measure only if Cronbach's alpha coefficient and Classical Test Theory is used. The more modern and robust Item Response Theory (IRT) has so far not been used to psychometrically evaluate THI. In theory, IRT allows a more precise evaluation of THI's factor structure, reliability, and the quality of individual items.MethodThere were 1115 patients with tinnitus (556 women and 559 men), aged 19-84 years (M = 51.55; SD = 13.28). The dimensionality of THI was evaluated using several models of Confirmatory Factor Analysis and an Item Response Theory approach. Exploratory non-parametric Mokken scaling was applied to determine a unidimensional and robust scale. Several IRT polytomous models were used to assess the overall quality of THI.ResultsThe bifactor model had the best fit (RMSEA = 0.055; CFI = 0.976; SRMR = 0.040) and revealed one strong general factor and several weak specific factors. Mokken scaling generated a reliable unidimensional scale (Loevinger's H = 0.463). In order to refine THI we propose that five items be removed. The IRT Generalized Partial Credit Model generated good parameters in terms of item location (difficulty), discrimination, and information content of items.ConclusionOur findings support the use of THI to evaluate tinnitus severity in terms of it being a reliable unidimensional scale. However, clinicians and researchers should rely only on its overall score, which reflects global tinnitus severity. To improve its psychometric quality, several refinements of THI are proposed

Self-Rated Benefits of Auditory Performance after Bonebridge Implantation in Patients with Conductive or Mixed Hearing Loss, or Single-Sided Deafness

The Bonebridge implant can be a satisfactory solution for patients with conductive or mixed hearing loss (CHL or MHL), or with single-sided deafness (SSD). The aim of the study was to assess patients&rsquo; self-reported benefits with the Bonebridge and characterize the relationships between pre-implantation audiometric data, auditory functioning, and satisfaction after implantation. A focus was to see whether different types of hearing loss were associated with particular benefits. The study sample consisted of 81 patients. Procedures comprised pure tone audiometry before implantation, the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire, and a structured interview asking about satisfaction. Statistically significant improvements after implantation were found in all groups (CHL, MHL, SSD) on the APHAB questionnaire. In the structured interview, patients with SSD were the least satisfied. No significant correlation was found between pre-operative air-bone gap and bone conduction thresholds or with APHAB score. Bonebridge implantation is beneficial to patients with CHL or MHL, or with SSD. Assessment of patients for Bonebridge implantation is complex, and audiometric data should be complemented by patient-reported outcomes to provide deeper insight into their individual needs and attitudes

Corticosteroids in Otorhinolaryngology

This paper aims to present the role of the therapy of corticosteroids in otorhinolaryngological diseases such as Meniere’s disease, partial deafness, sudden sensorineural hearing loss, and tinnitus. The effectiveness of treatment depends on many factors, for instance, the duration of the therapy, occurrence or not of adverse reactions, especially in those patients with additional risk factors as comorbidities. Additionally, the optimal way of administration has been widely discussed