Phoneme and Word Scoring in Speech-in-Noise Audiometry

Purpose

Understanding speech in background noise is difficult for many individuals; however, time constraints have limited its inclusion in the clinical audiology assessment battery. Phoneme scoring of words has been suggested as a method of reducing test time and variability. The purposes of this study were to establish a phoneme scoring rubric and use it in testing phoneme and word perception in noise in older individuals and individuals with hearing impairment.

Method

Words were presented to 3 participant groups at 80 dB in speech-shaped noise at 7 signal-to-noise ratios (−10 to 35 dB). Responses were scored for words and phonemes correct.

Results

It was not surprising to find that phoneme scores were up to about 30% better than word scores. Word scoring resulted in larger hearing loss effect sizes than phoneme scoring, whereas scoring method did not significantly modify age effect sizes. There were significant effects of hearing loss and some limited effects of age; age effect sizes of about 3 dB and hearing loss effect sizes of more than 10 dB were found.

Conclusion

Hearing loss is the major factor affecting word and phoneme recognition with a subtle contribution of age. Phoneme scoring may provide several advantages over word scoring. A set of recommended phoneme scoring guidelines is provided.

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40-Hz Sinusoidal Auditory Steady-State Response and Tone Burst Auditory Brainstem Response Using a Kalman Filter to Determine Thresholds Pre- and Post-Myringotomy With Grommet Tube in Children With Mild, Low-Frequency Conductive Hearing Loss

Purpose

Accurate estimation of mild, low-frequency hearing loss is difficult in young children. This study aimed to determine the accuracy of 40-Hz sinusoidal auditory steady-state response (sASSR) compared with tone burst auditory brainstem response (TB-ABR) to detect mild, low-frequency hearing loss in children with otitis media with effusion and to measure postoperative thresholds.

Methods

Thresholds at 500 and 4000 Hz were measured behaviorally and electrophysiologically using TB-ABR and 40-Hz sASSR with a Kalman filter in 26 children with otitis media with effusion. Recording was conducted preoperatively and postoperatively while children were actively awake. Repeated measures mixed analyses of variance were conducted to determine effects among measures and the two test frequencies.

Results

Both 40-Hz sASSR and TB-ABR accurately detected preoperative and postoperative thresholds and were within 5–10 dB of the behavioral thresholds at 4000 Hz. At 500 Hz, the mean 40-Hz sASSR threshold was only 5 dB above the behavioral thresholds and 18 dB better than the 500-Hz ABR threshold. Positive correlations were found but not between 40-sASSR and TB-ABR at 500 Hz. Also, the interrater judgment of the response was better for sASSR (89%) than TB-ABR (83%).

Conclusion

The 40-Hz sASSR is more accurate than TB-ABR in determining a mild, low-frequency threshold.

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Quantitative Assessment of Cochlear Histopathologic Findings in Patients With Suppurative Labyrinthitis.

Quantitative Assessment of Cochlear Histopathologic Findings in Patients With Suppurative Labyrinthitis.

JAMA Otolaryngol Head Neck Surg. 2016 Mar 17;

Authors: Kaya S, Tsuprun V, Hizli Ö, Paparella MM, Cureoglu S

Abstract
Importance: Better understanding of the effects of suppurative labyrinthitis (SL) on cochlear elements will aid the development of new approaches to treat its sequelae and complications in the ear.
Objective: To quantitatively evaluate the effects of SL on cochlear elements in humans.
Design, Setting, and Participants: A comparative study was conducted at a tertiary academic medical center from October 20, 2014, to January 3, 2015, of the histopathologic characteristics of 28 archived human temporal bone samples from 19 deceased patients with SL and 20 temporal bone samples from 14 deceased, age-matched controls.
Exposures: Evaluation of archived human temporal bone samples.
Main Outcomes and Measures: The locations of SL in the inner ear and the degree of endolymphatic hydrops were noted; the area of the stria vascularis and the spiral ligament in all turns of the cochlea at the midmodiolar level and in the adjacent 2 sections were measured; and the number of remaining outer and inner hair cells of the cochlea were counted to calculate the loss of both types of cells. To evaluate the loss of fibrocytes in the spiral ligament, a rating scale in each cochlear turn was used. For each segment of the cochlea, the number of spiral ganglion cells was determined. Outcomes between the group with SL and the control group were compared.
Results: Of the 28 temporal bone samples from the 19 deceased patients (16 men and 3 women; mean [SD] age, 23.1 [24.6] years) with SL, all showed SL in the scala tympani of the basal turn. In the group with SL vs the control group, the mean (SD) loss of outer hair cells was significantly higher in the lower (28.6% [11.4%] vs 12.4% [6.2%]; P = .02) and upper (22.3% [9.7%] vs 8.8% [3.2%]; P = .01) basal cochlear turn, the mean (SD) loss of inner hair cells was significantly higher in the lower (15.4% [6.7%] vs 2.6% [1.1%]; P = .02) and upper (10.6% [4.6%] vs 2.2% [0.7%]; P = .03) basal cochlear turn, the mean (SD) total number of spiral ganglion cells (28 132 [2068] vs 30 358 [2036]; P = .001) and the mean (SD) number of spiral ganglion cells in segment I (3554 [847] vs 4223 [649]; P = .003) was significantly decreased, the mean (SD) degree of atrophy of the stria vascularis in the lower (8455 [924] vs 9368 [1049] μm2; P = .003) and upper (7911 [837] vs 8474 [813] μm2; P = .02) basal cochlear turn was significantly greater, and the degree of endolymphatic hydrops was significantly greater (10 bone samples [36%] vs 1 [5%]; P = .006). No significant differences were found between the 2 groups in the number of fibrocytes and in the presence of atrophy of the spiral ligament in any cochlear turn.
Conclusions and Relevance: This study demonstrates that SL can lead to cochlear damage, especially in the basal turn of the cochlea. These pathological observations have formed the basis for clinical findings of hearing loss and tinnitus detected in those patients with SL.

PMID: 26987015 [PubMed - as supplied by publisher]

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Somatoform disorders in patients with chronic subjective tinnitus.

Somatoform disorders in patients with chronic subjective tinnitus.

Eur Arch Otorhinolaryngol. 2016 Mar 16;

Authors: Sahin C, Aras Hİ, Yilmaz MS

Abstract
This study aimed to investigate the correlation of psychiatric disorders with tinnitus and tinnitus handicap scores. A total of 30 patients and 30 otherwise healthy people were enrolled for the study. Somatoform disorder questionnaire SDQ-20 was filled in by both the study and the control group. Tinnitus handicap scores were filled in study group. Tinnitus handicap scores were 28.1 ± 19.8, and somatoform disorder questionnaire scores were 30.5 ± 7.3 in the tinnitus group. In the control group the somatoform disorder questionnaire scores were 25.4 ± 4.6. (1) We found a statistically significant difference between somatoform disorder questionnaire scores between groups (p < 0.05). (2) There was a statistically significant difference between tinnitus handicap scores and somatoform disorder questionnaire scores in study group (p = 0.0). The correlation between these tests was positively strong (R = 0.782). (3) There was no statistical difference between genders. We recommend investigating patients with long-lasting tinnitus for psychiatric comorbidity in relation to somatoform disorders in cooperation with psychiatric clinics.

PMID: 26984121 [PubMed - as supplied by publisher]

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Utility of bilateral acoustic hearing in combination with electrical stimulation provided by the cochlear implant.

Utility of bilateral acoustic hearing in combination with electrical stimulation provided by the cochlear implant.

Int J Audiol. 2016 Mar 17;:1-8

Authors: Plant K, Babic L

Abstract
OBJECTIVE: The aim of the study was to quantify the benefit provided by having access to amplified acoustic hearing in the implanted ear for use in combination with contralateral acoustic hearing and the electrical stimulation provided by the cochlear implant.
DESIGN: Measures of spatial and non-spatial hearing abilities were obtained to compare performance obtained with different configurations of acoustic hearing in combination with electrical stimulation. In the combined listening condition participants had access to bilateral acoustic hearing whereas the bimodal condition used acoustic hearing contralateral to the implanted ear only. Experience was provided with each of the listening conditions using a repeated-measures A-B-B-A experimental design.
STUDY SAMPLE: Sixteen post-linguistically hearing-impaired adults participated in the study.
RESULTS: Group mean benefit was obtained with use of the combined mode on measures of speech recognition in coincident speech in noise, localization ability, subjective ratings of real-world benefit, and musical sound quality ratings.
CONCLUSIONS: Access to bilateral acoustic hearing after cochlear implantation provides significant benefit on a range of functional measures.

PMID: 26987051 [PubMed - as supplied by publisher]

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Non-Invasive and Minimally Invasive Imaging Evaluation of CSF Rhinorrhoea - a Retrospective Study with Review of Literature.

Non-Invasive and Minimally Invasive Imaging Evaluation of CSF Rhinorrhoea - a Retrospective Study with Review of Literature.

Pol J Radiol. 2016;81:80-5

Authors: Vimala LR, Jasper A, Irodi A

Abstract
BACKGROUND: Localization of a cerebrospinal fluid [CSF] fistula is a diagnostic challenge. The choice of an optimal imaging technique is necessary to locate the site of CSF leak which is required for surgical/endoscopic repair of the CSF fistula.
MATERIAL/METHODS: Retrospective analysis of imaging was performed in 33 patients who presented with symptoms suggestive of CSF rhinorrhoea over a period of two years. Either a bone defect on high resolution CT [HRCT] or CSF column extending extracranially from the subarachnoid space with or without brain/ meningeal herniation on magnetic resonance [MR] cisternography was considered positive for CSF leak. The MR imaging technique included 1-mm heavily T2-weighted [TR 2000 ms; TE-200 ms] fast spin echo study in coronal and sagittal planes. HRCT sections involved 0.625 to 0.8-mm sections in the coronal plane, with or without axial planes, through the paranasal sinuses, reconstructed in a sharp algorithm and acquired with the patient in prone position. Imaging findings were compared with endoscopic findings, being the gold standard for the assessment of CSF rhinorrhea.
RESULTS: A total of 25 patients had a combination of HRCT and MR cisternography. The sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV] of both MR cisternography and HRCT together were 93%, 100%, 100% and 50% respectively. Two patients underwent only MR cisternography, 5 patients underwent only HRCT and one patient underwent HRCT, MR cisternography and CT cisternography. Though PPV was 100% in the groups with HRCT alone, MR cisternography alone and combined CT cisternography, HRCT and MR cisternography, the results were not statistically significant as the number of patients in those groups was lower.
CONCLUSIONS: Combination of MR cisternography and HRCT appears to be complementary, accurate and non-invasive and should be considered as optimal imaging modality for pre-op imaging in the evaluation of CSF rhinorrhoea.

PMID: 26985244 [PubMed]

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Benign Paroxysmal Positional Vertigo in 2 Children: A Case Series.

Benign Paroxysmal Positional Vertigo in 2 Children: A Case Series.

Pediatr Phys Ther. 2016 Mar 16;

Authors: Fay JL

Abstract
PURPOSE: The purpose of this case report is to present the cases of 2 boys with benign paroxysmal positional vertigo (BPPV).
KEY POINTS: Patient A (11 years old) and Patient B (9 years old) had complaints of vertigo with position changes. Both exhibited left torsion upbeating nystagmus in the left Dix-Hallpike (DH) test and complaints of vertigo with reproduction of their symptoms, indicating BPPV. Both were treated with a left canalith repositioning maneuver and reported decreased incidence of positional vertigo upon reevaluation. Scores on the Dizziness Handicap Inventory and the Visual Analog Scale for Dizziness decreased after treatment for 1 of the boys.
CONCLUSION: Benign paroxysmal positional vertigo is considered rare in children. Migraines may also cause vertigo. Differential diagnosis in these cases was made by performing the DH test.
RECOMMENDATIONS FOR CLINICAL PRACTICE: Children with vertigo should be screened for BPPV through use of history taking, and the DH test.

PMID: 26986871 [PubMed - as supplied by publisher]

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Acute vestibular syndrome: a critical review and diagnostic algorithm concerning the clinical differentiation of peripheral versus central aetiologies in the emergency department.

Acute vestibular syndrome: a critical review and diagnostic algorithm concerning the clinical differentiation of peripheral versus central aetiologies in the emergency department.

J Neurol. 2016 Mar 16;

Authors: Venhovens J, Meulstee J, Verhagen WI

Abstract
Almost 20 % of cerebral ischaemic strokes occur in the posterior circulation. Estimates are that 20 % of these patients present with isolated vertigo. In approximately one-sixth to one-third of these patients, this symptom is wrongly diagnosed to be peripheral vestibular in origin. As a result, these missed stroke patients are withheld from therapeutic and secondary prophylactic treatment, which may result in unnecessary morbidity and mortality. We therefore propose a diagnostic algorithm concerning the clinical differentiation of acute vestibular syndrome (AVS) patients based on a critical review of the available literature.

PMID: 26984607 [PubMed - as supplied by publisher]

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A critical review of 20 years of parotid gland surgery.

A critical review of 20 years of parotid gland surgery.

Acta Otolaryngol. 2016 Mar 17;:1-6

Authors: Knopf A, Szyper M, Mansour N, Sonnenberg J, Hofauer B, Niedermeyer H

Abstract
Conclusion PG surgery provides sufficient radicality with a minimum of functional loss. Patient's outcome is associated with the reliable estimation of the lesional entity/dignity. Diagnostic approaches are required to determine morphological aspects, avoid unnecessary surgery, and to reliable identify primary carcinomas/occult metastases. Objectives The pre-operative assessment of parotid gland (PG) lesions is of major clinical impact, whilst surgery remains the diagnostic/therapeutic mainstay. There are still controversies about the distribution of entities, clinical course, functional outcome, and survival. Methods In total, 1211 patients were retrospectively analyzed for disease-related data. Differences were analyzed using the Chi-square/Fisher exact/unpaired student's t-test; survival by Kaplan-Meier. Results There were 946 benign and 265 malignant tumours. In primary PG malignancy the disease-free/overall survival was 78/127 months. Metastases into the PG demonstrated a decreased survival (67 months). Extended surgery was associated with post-operative facial nerve alteration. Extracapsular dissection and superficial parotidectomy did not show differences in the facial palsy rate.

PMID: 26986955 [PubMed - as supplied by publisher]

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The effect of inlay butterfly cartilage tympanoplasty technique on compliance.

The effect of inlay butterfly cartilage tympanoplasty technique on compliance.

Acta Otolaryngol. 2016 Mar 17;:1-4

Authors: Ersoy Callioglu E, Tuzuner A, Demirci S, Bercin AS, Oguzhan T, Korkmaz MH

Abstract
CONCLUSION: IBCT technique should be preferred owing to its high graft survival rate and ABG gain. While no significant difference was found in middle ear pressures between ears that underwent IBCT and normal ears, compliance values were found to be decreased in patients undergoing IBCT. However, the lack of correlation between ABG gain and compliance values indicated that compliance increase had no effect on post-operative ABG results.
OBJECTIVE: The aim of the present study was to compare tympanometric and audiological parameters in patients undergoing inlay butterfly cartilage tympanoplasty (IBCT) with their normal ears and to determine their difference with normal ear tympanometric parameters.
METHODS: Overall, 25 patients that underwent an operation between August 2010-May 2014 were included in the present study. In 13 of these patients, the ear that did not undergo operation was normal. 0.5, 1, 2, 4 kHz pure sound average values, tympanometric measurements and compliance values of normal and operated ears were compared.
RESULTS: The graft survival rate in patients was found to be 92%. Mean pre-operative air-bone gap (ABG) was 16.4 ± 5.4 in patients, while mean post-operative ABG was 10.9 ± 5.8, with a statistically significant difference (p = 0.001) While there was no significant difference between operated and normal ears of patients in terms of middle ear pressure (0.441), compliance values were significantly higher in normal ears than those in operated ears (0.032). When post-operative ABG gain was compared with compliance values, no significant correlation was found between ABG gain and compliance measurements (r = -0.025 and p = 0.936).

PMID: 26986835 [PubMed - as supplied by publisher]

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Frequency-dependent loudness balancing in bimodal cochlear implant users.

Frequency-dependent loudness balancing in bimodal cochlear implant users.

Acta Otolaryngol. 2016 Mar 17;:1-7

Authors: Veugen LC, Chalupper J, Snik AF, van Opstal AJ, Mens LH

Abstract
Conclusion In users of a cochlear implant (CI) and a hearing aid (HA) in contralateral ears, frequency-dependent loudness balancing between devices did, on average, not lead to improved speech understanding as compared to broadband balancing. However, nine out of 15 bimodal subjects showed significantly better speech understanding with either one of the fittings. Objectives Sub-optimal fittings and mismatches in loudness are possible explanations for the large individual differences seen in listeners using bimodal stimulation. Methods HA gain was adjusted for soft and loud input sounds in three frequency bands (0-548, 548-1000, and >1000 Hz) to match loudness with the CI. This procedure was compared to a simple broadband balancing procedure that reflected current clinical practice. In a three-visit cross-over design with 4 weeks between sessions, speech understanding was tested in quiet and in noise and questionnaires were administered to assess benefit in real world. Results Both procedures resulted in comparable HA gains. For speech in noise, a marginal bimodal benefit of 0.3 ± 4 dB was found, with large differences between subjects and spatial configurations. Speech understanding in quiet and in noise did not differ between the two loudness balancing procedures.

PMID: 26986743 [PubMed - as supplied by publisher]

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Utility of bilateral acoustic hearing in combination with electrical stimulation provided by the cochlear implant.

Utility of bilateral acoustic hearing in combination with electrical stimulation provided by the cochlear implant.

Int J Audiol. 2016 Mar 17;:1-8

Authors: Plant K, Babic L

Abstract
OBJECTIVE: The aim of the study was to quantify the benefit provided by having access to amplified acoustic hearing in the implanted ear for use in combination with contralateral acoustic hearing and the electrical stimulation provided by the cochlear implant.
DESIGN: Measures of spatial and non-spatial hearing abilities were obtained to compare performance obtained with different configurations of acoustic hearing in combination with electrical stimulation. In the combined listening condition participants had access to bilateral acoustic hearing whereas the bimodal condition used acoustic hearing contralateral to the implanted ear only. Experience was provided with each of the listening conditions using a repeated-measures A-B-B-A experimental design.
STUDY SAMPLE: Sixteen post-linguistically hearing-impaired adults participated in the study.
RESULTS: Group mean benefit was obtained with use of the combined mode on measures of speech recognition in coincident speech in noise, localization ability, subjective ratings of real-world benefit, and musical sound quality ratings.
CONCLUSIONS: Access to bilateral acoustic hearing after cochlear implantation provides significant benefit on a range of functional measures.

PMID: 26987051 [PubMed - as supplied by publisher]

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Live surgery broadcast: who is benefiting?

Live surgery broadcast: who is benefiting?

Eur Arch Otorhinolaryngol. 2016 Mar 17;

Authors: Dikkers FG, Klussmann JP, Bernal-Sprekelsen M, Mazurek C, Szyfter W

PMID: 26984251 [PubMed - as supplied by publisher]

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Somatoform disorders in patients with chronic subjective tinnitus.

Somatoform disorders in patients with chronic subjective tinnitus.

Eur Arch Otorhinolaryngol. 2016 Mar 16;

Authors: Sahin C, Aras Hİ, Yilmaz MS

Abstract
This study aimed to investigate the correlation of psychiatric disorders with tinnitus and tinnitus handicap scores. A total of 30 patients and 30 otherwise healthy people were enrolled for the study. Somatoform disorder questionnaire SDQ-20 was filled in by both the study and the control group. Tinnitus handicap scores were filled in study group. Tinnitus handicap scores were 28.1 ± 19.8, and somatoform disorder questionnaire scores were 30.5 ± 7.3 in the tinnitus group. In the control group the somatoform disorder questionnaire scores were 25.4 ± 4.6. (1) We found a statistically significant difference between somatoform disorder questionnaire scores between groups (p < 0.05). (2) There was a statistically significant difference between tinnitus handicap scores and somatoform disorder questionnaire scores in study group (p = 0.0). The correlation between these tests was positively strong (R = 0.782). (3) There was no statistical difference between genders. We recommend investigating patients with long-lasting tinnitus for psychiatric comorbidity in relation to somatoform disorders in cooperation with psychiatric clinics.

PMID: 26984121 [PubMed - as supplied by publisher]

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Response.

Related Articles

Response.

J Neurosurg Pediatr. 2015 Dec;16(6):758-60

Authors: Kennedy BC, Anderson RC, Feldstein NA

PMID: 26958673 [PubMed - indexed for MEDLINE]

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Durotomy and foramen magnum decompression.

Related Articles

Durotomy and foramen magnum decompression.

J Neurosurg Pediatr. 2015 Dec;16(6):758-60

Authors: Goel A

PMID: 26382182 [PubMed - indexed for MEDLINE]

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A critical review of 20 years of parotid gland surgery.

A critical review of 20 years of parotid gland surgery.

Acta Otolaryngol. 2016 Mar 17;:1-6

Authors: Knopf A, Szyper M, Mansour N, Sonnenberg J, Hofauer B, Niedermeyer H

Abstract
Conclusion PG surgery provides sufficient radicality with a minimum of functional loss. Patient's outcome is associated with the reliable estimation of the lesional entity/dignity. Diagnostic approaches are required to determine morphological aspects, avoid unnecessary surgery, and to reliable identify primary carcinomas/occult metastases. Objectives The pre-operative assessment of parotid gland (PG) lesions is of major clinical impact, whilst surgery remains the diagnostic/therapeutic mainstay. There are still controversies about the distribution of entities, clinical course, functional outcome, and survival. Methods In total, 1211 patients were retrospectively analyzed for disease-related data. Differences were analyzed using the Chi-square/Fisher exact/unpaired student's t-test; survival by Kaplan-Meier. Results There were 946 benign and 265 malignant tumours. In primary PG malignancy the disease-free/overall survival was 78/127 months. Metastases into the PG demonstrated a decreased survival (67 months). Extended surgery was associated with post-operative facial nerve alteration. Extracapsular dissection and superficial parotidectomy did not show differences in the facial palsy rate.

PMID: 26986955 [PubMed - as supplied by publisher]

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The effect of inlay butterfly cartilage tympanoplasty technique on compliance.

The effect of inlay butterfly cartilage tympanoplasty technique on compliance.

Acta Otolaryngol. 2016 Mar 17;:1-4

Authors: Ersoy Callioglu E, Tuzuner A, Demirci S, Bercin AS, Oguzhan T, Korkmaz MH

Abstract
CONCLUSION: IBCT technique should be preferred owing to its high graft survival rate and ABG gain. While no significant difference was found in middle ear pressures between ears that underwent IBCT and normal ears, compliance values were found to be decreased in patients undergoing IBCT. However, the lack of correlation between ABG gain and compliance values indicated that compliance increase had no effect on post-operative ABG results.
OBJECTIVE: The aim of the present study was to compare tympanometric and audiological parameters in patients undergoing inlay butterfly cartilage tympanoplasty (IBCT) with their normal ears and to determine their difference with normal ear tympanometric parameters.
METHODS: Overall, 25 patients that underwent an operation between August 2010-May 2014 were included in the present study. In 13 of these patients, the ear that did not undergo operation was normal. 0.5, 1, 2, 4 kHz pure sound average values, tympanometric measurements and compliance values of normal and operated ears were compared.
RESULTS: The graft survival rate in patients was found to be 92%. Mean pre-operative air-bone gap (ABG) was 16.4 ± 5.4 in patients, while mean post-operative ABG was 10.9 ± 5.8, with a statistically significant difference (p = 0.001) While there was no significant difference between operated and normal ears of patients in terms of middle ear pressure (0.441), compliance values were significantly higher in normal ears than those in operated ears (0.032). When post-operative ABG gain was compared with compliance values, no significant correlation was found between ABG gain and compliance measurements (r = -0.025 and p = 0.936).

PMID: 26986835 [PubMed - as supplied by publisher]

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Frequency-dependent loudness balancing in bimodal cochlear implant users.

Frequency-dependent loudness balancing in bimodal cochlear implant users.

Acta Otolaryngol. 2016 Mar 17;:1-7

Authors: Veugen LC, Chalupper J, Snik AF, van Opstal AJ, Mens LH

Abstract
Conclusion In users of a cochlear implant (CI) and a hearing aid (HA) in contralateral ears, frequency-dependent loudness balancing between devices did, on average, not lead to improved speech understanding as compared to broadband balancing. However, nine out of 15 bimodal subjects showed significantly better speech understanding with either one of the fittings. Objectives Sub-optimal fittings and mismatches in loudness are possible explanations for the large individual differences seen in listeners using bimodal stimulation. Methods HA gain was adjusted for soft and loud input sounds in three frequency bands (0-548, 548-1000, and >1000 Hz) to match loudness with the CI. This procedure was compared to a simple broadband balancing procedure that reflected current clinical practice. In a three-visit cross-over design with 4 weeks between sessions, speech understanding was tested in quiet and in noise and questionnaires were administered to assess benefit in real world. Results Both procedures resulted in comparable HA gains. For speech in noise, a marginal bimodal benefit of 0.3 ± 4 dB was found, with large differences between subjects and spatial configurations. Speech understanding in quiet and in noise did not differ between the two loudness balancing procedures.

PMID: 26986743 [PubMed - as supplied by publisher]

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Screening tests for predicting the prognosis of oral intake in elderly patients with acute pneumonia.

Screening tests for predicting the prognosis of oral intake in elderly patients with acute pneumonia.

Odontology. 2016 Mar 17;

Authors: Oba S, Tohara H, Nakane A, Tomita M, Minakuchi S, Uematsu H

Abstract
Many elderly patients with pneumonia have aspiration pneumonia. Therefore they must temporarily abstain from oral intake. However, it is difficult to predict whether or not they will be able to start oral intake. The reason is the standard method to evaluate deglutition about pneumonia patients has not been established. In this study we aimed to develop a simple and convenient method that predicts the prognosis of oral intake as nutrition among elderly patients with acute stage pneumonia. Participants were 77 inpatients fasting due to aspiration risk with acute pneumonia. (86.0 ± 7.7 years; range 68-105 years; men: n = 34, women: n = 43) during September 2011 and August 2013. Their consciousness levels were determined by Glasgow coma scale (GCS) and swallowing function and cough reflex were evaluated by repetitive saliva swallowing test (RSST), modified water swallow test, simple swallowing provocation test and cough test. Oral intake status at discharge was considered as the objective variable, and these tests were considered as explanatory variables. Then receiver operating characteristic (ROC) curve and the area under the curve (AUC) for each was done. From the ROC curve analysis, GCS ≥14 had the largest AUC (0.79) with a sensitivity and specificity of 0.71 and 0.80. That was followed by RSST ≥1, AUC (0.77) with a sensitivity and specificity of 0.81 and 0.67. These results suggest that GCS and RSST could be useful screening tests for prognostic prediction of oral intake capability in elderly patients with acute pneumonia.

PMID: 26984834 [PubMed - as supplied by publisher]

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Missed retrosternal ectopic thyroid tissue in a patient operated for multinodular goiter.

Missed retrosternal ectopic thyroid tissue in a patient operated for multinodular goiter.

Ulus Cerrahi Derg. 2016;32(1):67-70

Authors: Kesici U, Koral Ö, Karyağar S, Kesici S, Yılbaş A, Karyağar S, Mataracı E, Mataracı İ

Abstract
Ectopic thyroid tissue has been found from the tongue to the diaphragm. The most common ectopic thyroid tissue has been found in the tongue, submandibular region, cervical lymph nodes, larynx, trachea, oesophagus, mediastinum, diaphragm and heart respectively. "Forgotten goiter" is an extremely rare disease which is defined as a mediastinal thyroid mass found after total thyroidectomy. In this case report, we discussed a 49 year-old female patient whose retrosternal ectopic thyroid tissue was detected by thyroid scintigraphy taken in postoperative period after total thyroidectomy performed with diagnosis of multinodular goiter. Papillary carcinoma was determined by the histopathological examination. Ectopic thyroid tissue was removed by performing sternotomy. We did not observe any postoperative surgical complications. 100 mCi dose of radioactive iodine was administered to the patient. Retrosternal ectopic thyroid tissue detected after total thyroidectomy is a rarely encountered condition. Therefore, retrosternal ectopic thyroid tissue existence should be definitely kept in mind in patients with no increase in thyroid stimulating hormone level after total thyroidectomy.

PMID: 26985161 [PubMed]

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Using the C-MAC videolaryngoscope as a first-line device for out-of-hospital emergency intubation.

Related Articles

Using the C-MAC videolaryngoscope as a first-line device for out-of-hospital emergency intubation.

Eur J Anaesthesiol. 2016 Jan;33(1):61-2

Authors: Li RP, Xue FS, Liu GP, Sun C

PMID: 26479516 [PubMed - indexed for MEDLINE]

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Reply to: using the C-MAC videolaryngoscope as a first-line device for out-of-hospital emergency intubation.

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Reply to: using the C-MAC videolaryngoscope as a first-line device for out-of-hospital emergency intubation.

Eur J Anaesthesiol. 2016 Jan;33(1):62-3

Authors: Hossfeld B, Lampl L, Helm M

PMID: 26351833 [PubMed - indexed for MEDLINE]

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