Acoustic Change Complex and Visually Reinforced Infant Speech Discrimination Measures of Vowel Contrast Detection

xlomafota13 shared this article with you from Inoreader Acoustic Change Complex and Visually Reinforced Infant Speech Discrimination Measures of Vowel Contrast Detection Via cortical auditory Ear Hear. 2021 Aug 25. doi: 10.1097/AUD.0000000000001116. Online ahead of print. ABSTRACT OBJECTIVES: To measure the effect of stimulus rate and vowel change direction on the acoustic change complex (ACC) latencies and amplitudes and compare ACC metrics to behavioral measures of vowel contrast detection for infants tested under the age of 1 year. We tested the hypothesis that the direction of spectral energy shift from a vowel change would result in differences in the ACC, owing to the sensitivity of cortical neurons to the direction of frequency change. We evaluated the effect of the stimulus rate (1/s versus 2/s) on the infants' ACC. We evaluated the ACC amplitude ratio's sensitivity (proportion of ACCs present for each change trial) and compared it to perceptual responses obtained using a visually reinforced infant speech discrimination paradigm (VRISD). This report provides normative data from infants for the ACC toward the ultimate goal of developing a clinically useful index of neural capacity for vowel discrimination. DESIGN: Twenty-nine infants, nine females, 4.0 to 11.8 months of age, participated. All participants were born at full term and passed their newborn hearing screens. None had risk factors for hearing or neurologic impairment. Cortical auditory evoked potentials were obtained in response to synthesized vowel tokens /a/, /i/, /o/, and /u/ presented at a rate of 1- or 2/s in an oddball stimulus paradigm with a 25% probability of the deviant stimulus. All combinations of vowel tokens were tested at the two rates. The ACC was obtained in response to the deviant stimulus. The infants were also tested for vowel contrast detection using a VRISD paradigm with the same combinations of vowel tokens used for the ACC. The mean age at the time of the ACC test was 5.4 months, while the mean age at the behavioral test was 6.8 months. RESULTS: Variations in ACC amplitude and latency occurred as a functio n of the initial vowel token and the contrast token. However, the hypothesis that the direction of vowel (spectral) change would result in significantly larger change responses for high-to-low spectral changes was not supported. The contrasts with /a/ as the leading vowel of the contrast pair resulted in the largest ACC amplitudes than other conditions. Significant differences in the ACC presence and amplitude were observed as a function of rate, with 2/s resulting in ACCs with the largest amplitude ratios. Latency effects of vowel contrast and rate were present, but not systematic. The ACC amplitude ratio's sensitivity for detecting a vowel contrast was greater for the 2/s rate than the 1/s rate. For an amplitude ratio criterion of ≥1.5, the sensitivity was 93% for ACC component P2-N2 at 2/s, whereas at 1/s sensitivity was 70%. VRISD tests of vowel-contrast detection had a 71% hit and a 21% false-positive rate. Many infants who could not reach performance criteria for VRISD had A CC amplitude ratios of ≥2.0. CONCLUSIONS: The ACC for vowel contrasts presented at a rate of 2/s is a robust index of vowel-contrast detection when obtained in typically developing infants under the age of 1 year. The ACC is present in over 90% of infants tested at this rate when an amplitude ratio criterion of ≥1.5 is used to define a response. The amplitude ratio appears to be a sensitive metric for the difference between a control and contrast condition. The ACC can be obtained in infants who do not yet exhibit valid behavioral responses for vowel change contrasts and may be useful for estimating neural capacity for discriminating these sounds. PMID:34456301 | DOI:10.1097/AUD.0000000000001116 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlations of Radiographic and Endoscopic Observations in Subglottic Stenosis

xlomafota13 shared this article with you from Inoreader Correlations of Radiographic and Endoscopic Observations in Subglottic Stenosis Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 28:34894211042768. doi: 10.1177/00034894211042768. Online ahead of print. ABSTRACT OBJECTIVE(S): Subglottic stenosis (SGS) represents a constellation of diverse pathologic processes that ultimately lead to narrowing of the subglottic region and can produce significant morbidity. Existing endoscopic and radiographic assessments may not be consistent in practice. METHODS: Severity of stenosis was evaluated and reported using the Cotton-M yer classification system from 33 endoscopic procedures from 32 unique subjects. Radiographic imaging within the preceding 3 month period was subsequently reviewed and narrowing was measured by a blinded radiologist. Degree of stenosis was reported as a percentage in 30 out of 33 endoscopic evaluations and subsequently compared to radiographically determined percentage of stenosis. Statistical analyzes were conducted to evaluate concordance between endoscopic and radiographic assessments. RESULTS: About 45.5% (15/33) of the evaluations were in agreement using Cotton-Myer scoring, while 27.3% (9/33) were discrepant by 1 grade and 27.3% (9/33) by 2 grades. Correlation of degree of stenosis as a percentage using Spearman (coefficient: 0.233, P-value: .214) and Pearson (coefficient: 0.138, P-value: .466) methods demonstrated very weak relationships. Radiographic scoring did not predict endoscopic classification to a significant degree using mixed effects regression.< /p> CONCLUSIONS: Radiographic and endoscopic grading of subglottic stenosis may not be reliably concordant in practice. PMID:34459264 | DOI:10.1177/00034894211042768 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngotracheobronchial Amyloidosis: Patterns of Presentation and Management

xlomafota13 shared this article with you from Inoreader Laryngotracheobronchial Amyloidosis: Patterns of Presentation and Management Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 28:34894211042772. doi: 10.1177/00034894211042772. Online ahead of print. ABSTRACT OBJECTIVE: To evaluate the pattern of presentation and management of laryngotracheobronchial amyloidosis at a tertiary care academic center over a 27 year period. METHODS: In a retrospective review, the electronic medical record at a tertiary care academic center was queried for encounters with 3 laryngologists between 1996 and 2019 which included the I CD-9 or ICD-10 diagnosis of amyloidosis. Demographics, clinical presentation, referral diagnoses, medical history, family history, laboratory values, radiology studies, and treatment modalities of subjects were collated. Results were analyzed using standard univariate descriptive statistics. RESULTS: Seventeen subjects were identified with an average age at diagnosis of 58 years (range 26-76 years). The most common amyloid type on biopsy was immunoglobulin light chain (AL) subtype. The most common location of laryngeal amyloid at diagnosis was the glottis and disease was more likely to be bilateral at the time of diagnosis in this location. Supraglottic disease more often had a unilateral presentation and had a tendency to spread to additional laryngeal subsites. Nearly 25% of subjects had associated systemic disease, including multiple myeloma, auto-immune disease, and familial ATTR mutation. CONCLUSIONS: The overall rate of associated systemic disease was low in our st udy cohort; however, it is higher than typically referenced in extant literature. Our cohort demonstrates that while laryngeal amyloidosis is a chronic condition, the behavior is generally indolent with a low treatment burden. PMID:34459282 | DOI:10.1177/00034894211042772 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does Prolonged Use of N95 Masks Affect Nasal Mucociliary Clearance? A Single Group Pre-Post Study

xlomafota13 shared this article with you from Inoreader Does Prolonged Use of N95 Masks Affect Nasal Mucociliary Clearance? A Single Group Pre-Post Study Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 28:34894211041821. doi: 10.1177/00034894211041821. Online ahead of print. ABSTRACT OBJECTIVE: It has been shown that prolonged use of face masks results in physiological changes in the nasal cavity. The objective of this study was to examine the effect of prolonged use of face masks on nasal mucociliary clearance (NMC). METHODS: A single group pre-post study was conducted to determine the effects of prolonged use of N95 face mask (≥ 4 hours) on the NMC rates in health care workers. Saccharin transit time (STT) was used to measure the NMC. STT before and after using an N95 mask for at least 4 hours was measured for all participants in controlled conditions of temperature and humidity. RESULTS: Forty-eight volunteers (20 female and 28 male) completed the study after the enrollment of 57 volunteers. The mean STT before mask use was 580.27 ± 193.93 seconds (95% CI; 523.95-636.58 seconds) and after mask use was 667.47 ± 237.42 seconds (95% CI; 598.53-736.42 seconds). There was significant prolongation of the NMC after prolonged use of N95 mask on performing the paired t-test (P = .002). The mean prolongation was 87.20 ± 184.97 seconds with an actual effect size of 0.40. Ambient temperature and humidity were not significantly different at the two test instances. CONCLUSION: Use of the N95 face masks for 4 hours results in prolongation of the nasal mucociliary clearance as measured by STT. Susceptibility to any respiratory infection may be increased following doffing of the personal protective equipment, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) itself. PMID:34459285 | DOI:10.1177/00034894211041821 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscope-Assisted Superior Semicircular Canal Dehiscence Repair: Single Institution Outcomes

xlomafota13 shared this article with you from Inoreader Endoscope-Assisted Superior Semicircular Canal Dehiscence Repair: Single Institution Outcomes Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 29:34894211041223. doi: 10.1177/00034894211041223. Online ahead of print. ABSTRACT OBJECTIVE: To compare outcomes of endoscope-assisted middle cranial fossa MCF) repair of superior semicircular canal dehiscence (SSCD) compared to microscopic MCF repair. STUDY DESIGN: Retrospective cohort. SETTING: Tertiary medical center neurotology practice. METHODS: Retrospective chart review and cohort study of patients who underwent su rgical repair of SSCD via MCF approach from 2010 to 2019 at our institution. Patients were categorized according to use of endoscope intraoperatively. Pre- and post-operative symptom number was calculated from 8 patient-reported symptoms. Pre- and post-operative changes in symptom number were assessed using paired t-tests. Single-predictor binary logistic regression was used to compare final reported symptoms between cohorts. Linear regression was performed to assess air-bone gap (ABG) changes postoperatively between cohorts. RESULTS: Forty-six patients received surgical management for SSCD. Of these, 27 (59%) were male and 19 (41%) were female. Bilateral SSCD was present in 14 cases (29%), of which 3 underwent surgical management bilaterally, for a total of 49 surgical ears. Surgery was performed on the right ear in 19 cases (39%) and on the left in 30 cases (61%). Forty ears (82%) underwent microscopic repair while 9 (18%) underwent endoscope-assisted repair. Microsco pic and endoscope-assisted MCF repair both demonstrated significantly improved symptom number postoperatively (P < .001 for each). There was no significant difference in change in ABG between the 2 cohorts. On average, patient-reported symptoms and audiometrically-tested hearing improved postoperatively in both groups. CONCLUSION: While endoscopic-assisted MCF repair has the potential to provide better visualization of medial and downslope defects, repair via this technique yields similar results and is equivalent to MCF repair utilizing the microscope alone. PMID:34459286 | DOI:10.1177/000348942110412 23 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multivariate Analysis of Vocal Fold Vibrations in Normal Speakers Using High-Speed Digital Imaging

xlomafota13 shared this article with you from Inoreader Multivariate Analysis of Vocal Fold Vibrations in Normal Speakers Using High-Speed Digital Imaging Via Journal of Voice Little is known about the normal variations in vocal fold vibrations. We conducted a prospective study on normal subjects using high-speed digital imaging (HSDI) to elucidate key parameters regarding age/gender-related normal variations. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bei der Begutachtung oft nicht bedacht: Unfallpatienten und Patienten nach einem Lärmtrauma – Eine patientenzugewandte, komplementäre Sichtweise

xlomafota13 shared this article with you from Inoreader Bei der Begutachtung oft nicht bedacht: Unfallpatienten und Patienten nach einem Lärmtrauma – Eine patientenzugewandte, komplementäre Sichtweise Via Laryngo-Rhino-Otologie Laryngorhinootologie 2021; 100: 707-711 DOI: 10.1055/a-1506-0701 Patienten, die einen Tinnitus im Rahmen eines Unfallgeschehens, eines Lärmtraumas oder anderer externer Einflüsse erworben haben, weisen in der Behandlung wichtige Besonderheiten auf. Obwohl ihr Leiden meist ohne eigene Schuld durch äußere Umstände oder andere Menschen ausgelöst wurde, ist für sie ein von außen schwer erkennbarer dauerhafter Schaden entstanden, für den sie selbst ihre verbliebenen Ressourcen aufbieten müssen, um mit einem Leiden am Tinnitus und meist auch dem Hörschaden adäquat umgehen zu können. Ungünstig und aufrechterhaltend können sich dabei Rechtsstreitigkeiten und die in diesem Rahmen notwendigen Begutachtungsprozesse au swirken. Deren Einflüsse und Rezeption bei den Patienten sollen hier verdeutlicht werden. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Auditive Phänomene als Differenzialdiagnostik zum Tinnitus

xlomafota13 shared this article with you from Inoreader Auditive Phänomene als Differenzialdiagnostik zum Tinnitus Via Laryngo-Rhino-Otologie Laryngorhinootologie 2021; 100: 712-719 DOI: 10.1055/a-1516-4720 Einleitung Im auditorischen System ist subjektiver Tinnitus als Phantomwahrnehmung bekannt. Menschen berichten auch über illusionäre Fehlwahrnehmungen von realen Höreindrücken und über komplexe szenenhafte akustische Phantasmen ohne externen Hörreiz. Die genauen pathophysiologischen Zusammenhänge der auditiven Phänomene sind noch ungeklärt. Wichtige Komorbiditäten sind Schwerhörigkeit, Hirnerkrankungen und psychische Störungen. Methode In einer Literaturrecherche in der Datenbank PubMed wurden Publikationen bis März 2021 zu den Suchbegriffen Tinnitus, Palinakusis, Pareidolie, Synästhesie, Aura und akustische Halluzination im Hinblick auf Gemeinsamkeiten und Unterschiede zum subjektiven Tinnitus ausgewertet. Ergebnisse Subjektiver Tinnitus kann gemeinsam mit anderen auditiven Phänomenen in einem Individuum auftreten. Diagnostisch wichtig ist der Zusammenhang zwischen Hörverlust und Tinnitus sowie zwischen Tinnitus und Hörminderung im entsprechenden Frequenzbereich. Bei Schwerhörigkeit können weitere auditive Phänomene auftreten. Schlussfolgerung Das Auftreten verschiedener auditiver Phänomene gleichzeitig bei einer Person lässt ein auditorisches Wahrnehmungskontinuum mit gemeinsamen physiologischen Verarbeitungsstrukturen annehmen. Personen mit Schwerhörigkeit sollten nach den verschiedenen auditiven Phänomenen gefragt werden. Bei allen auditiven Phänomenen sollte die audiometrische Untersuchung zum diagnostischen Standard gehören. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ohrgeräusche zutreffend begutachten: Möglichkeit, Plausibilität und Wahrscheinlichkeit

xlomafota13 shared this article with you from Inoreader Ohrgeräusche zutreffend begutachten: Möglichkeit, Plausibilität und Wahrscheinlichkeit Via Laryngo-Rhino-Otologie Laryngorhinootologie 2021; 100: 698-706 DOI: 10.1055/a-1502-6935 Ohrgeräusche als subjektive, individuelle Empfindung entziehen sich einem objektiven Nachweis. In der Begutachtungssituation sind sie zudem von physiologischen oder spontanen Hörsensationen abzugrenzen.In Bezug auf die neue Königsteiner Empfehlung und auf die Rechtsprechung des letzten Jahres ist vor dem Hintergrund der unterschiedlichen Kausalitätsbegriffe in der Gesetzlichen und Privaten Unfallversicherung eine stringente Prüfung zur Feststellung, ob eine ausreichend hohe Wahrscheinlichkeit eines unfallbedingten subjektiven Ohrgeräusches vorliegt, bei der Begutachtung erforderlich. Um eine nachvollziehbare und vergleichbare Grundlage zu schaffen, wurde der Vorschlag einer Plausibilitätsprüfung mit der Erfassung von 5 Kriterien – angemessenes Ereignis, Unmittelbarkeit, Reproduzierbarkeit auf der Basis der heutigen Untersuchungsmethoden von Tinnitus-Masking und -Matching , Fortdauer und Fixierung und die Erfassung mit nichtsuggestiven Fragen – einer Überprüfung unterzogen.Die Übersichtsarbeit zeigt, dass sich die Anforderungen an den jeweiligen Beweismaßstab mit den angegebenen Nachweisschritten erfüllen lassen. Die einfache Möglichkeit des Vorliegens von Ohrgeräuschen kann über die Plausibilitätskriterien, die psychoakustische Verfahren beinhalten, sowie offene Fragen systematisch zur Wahrscheinlichkeit des Vorliegens geführt werden. Damit sind die Voraussetzungen für eine nachvollziehbare Kausalbetrachtung zwischen Ereignis und angegebenen Tinnitus nach aktuellen medizinisch-wissenschaftlichen Erkenntnissen geschaffen. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Zur Geschichte der Kehlkopftuberkulose

xlomafota13 shared this article with you from Inoreader Zur Geschichte der Kehlkopftuberkulose Via Laryngo-Rhino-Otologie Laryngorhinootologie 2021; 100: 726-730 DOI: 10.1055/a-1550-2802 Bis zur Einführung der Antituberkulotika in die Behandlung war die Kehlkopftuberkulose eine unheilbare, in der Regel zum Tode führende Infektionskrankheit. Seit dem 18. Jahrhundert erforschten Mediziner dieses Krankheitsbild; nach Fortschritten in der laryngologischen Diagnostik erfolgten medikamentöse Lokaltherapien, umschriebene operative Eingriffe, auch Versuche mit Röntgenstrahlen. Erst durch die Entwicklung der Tuberkulostatika (40er/50er-Jahre des letzten Jahrhunderts) verlor die Larynxtuberkulose ihren Schrecken. [...] Geo rg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Survey of the Use of Diffusion-Weighted Imaging for Cholesteatoma in the United Kingdom

xlomafota13 shared this article with you from Inoreader Survey of the Use of Diffusion-Weighted Imaging for Cholesteatoma in the United Kingdom Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Background: Non-echoplanar diffusion-weighted MRI (DWMRI) has a role in the surgical planning for cholesteatoma. Aims/Objectives: The aim of the study was to assess the use of DWMRI in the management of cholesteatoma across the UK, and measure clinicians' confidence in the use of DWMRI. Materials and Methods: Telephone survey in 139 Otolaryngology Departments in the United Kingdom between March 2017 and July 2017, and asking radiology delegates at t he British Society of Head and Neck Imaging 2017 meeting. Results: The response rate was 101 out of 139 Trusts (73%). Of those respondents who did have DWMRI available, 68/88 respondents (77%) use it for cholesteatoma. The mean confidence (±standard deviation) of the respondents with DWMRI in identifying cholesteatoma presence was 7.3 ± 2.1, in identifying volume of cholesteatoma was 6.8 ± 1.8, and in identifying subsites of cholesteatoma was 4.6 ± 2.1. Conclusions and Significance: DWMRI has a well-defined role in the follow-up of patients after cholesteatoma surgery, and those primary cases of cholesteatoma where the diagnosis is in question. The use of DWMRI for cholesteatoma is variable across the UK, but there are certain clinical scenarios where there is not enough awareness regarding the benefits of imaging (such as petrous apex cases of cholesteatoma). ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.