The Effect of Stimulus Intensity and Carrier Frequency on Auditory Middle- and Long-Latency Evoked Potentials Using a Steady-State-Response Approach

Purpose

The purpose of this study was to measure magnitude changes of auditory steady-state responses (ASSRs) and respective transient middle- and long-latency responses as a function of stimulus intensity and carrier frequency. The literature lacks clear consensus, including relationship to loudness.

Method

A cohort of 48 adults with normal hearing was examined from a companion study (Tlumak, Durrant, & Delgado, 2015) on effects of aging. ASSRs were elicited by repeated tone-burst stimuli presented at rates of 40 and 0.75 Hz at 3 frequencies and 5 levels of stimulus intensity. The design also permitted scrutiny of any gender bias to the results.

Results

Similar to derived transient response findings, ASSR magnitude (harmonic sum) systematically increased with intensity. Input–output function only at 0.75 Hz approximated a log–log linear function. However, slopes fell well below that of doubling of loudness per 10 dB SPL. Results failed to demonstrate significance as a function of carrier frequency and gender for both repetition rates.

Conclusion

Effects of stimulus intensity, carrier frequency, and gender on ASSRs were similar to those of their transient counterparts. Findings remain disappointing for objective loudness estimation. Results suggest only a clear linkage to the long-latency response and the 0.75-Hz magnitude but require careful consideration of limitations/underlying mechanisms when measuring loudness-related effects.

from Hearing and Balance via ola Kala on Inoreader http://ift.tt/25fTUNC
via IFTTT

Relating Hearing Aid Use to Social and Emotional Loneliness in Older Adults

Purpose

Hearing loss is a risk factor for social isolation and loneliness. We investigated the buffering effects of hearing aid use on perceived social and emotional loneliness.

Method

Forty older adults participated. Prior to and following the hearing aid fitting, participants completed the De Jong Gierveld Loneliness Scale (De Jong Gierveld & Kamphuis, 1985); a change in feelings of loneliness following hearing aid use was the outcome indicator.

Results

There was a significant decline in perceptions of loneliness following 4 to 6 weeks of hearing aid use. A dose effect emerged with persons with moderate-to-severe hearing loss experiencing the greatest reduction in perceived loneliness with hearing aid use.

Conclusion

Associated with poorer health status and higher consumption of health care services, perceived loneliness is a challenge to treat. Hearing aid use appears to be a buffer against the experience of loneliness.

from Hearing and Balance via ola Kala on Inoreader http://ift.tt/25fTTcD
via IFTTT

Relapsing polychondritis and lymphocytic meningitis with varied neurological symptoms.

Relapsing polychondritis and lymphocytic meningitis with varied neurological symptoms.

Rev Bras Reumatol. 2016 Feb 5;

Authors: Ducci RD, Germiniani FM, Czecko LE, Paiva ES, Teive HA

Abstract
BACKGROUND: Relapsing polychondritis is a rare multisystem disease characterized by bilateral auricular and nasal chondritis and vestibular involvement, additionally affecting various other organs/systems. However, Central Nervous System involvement has only been reported in a few instances.
OBJECTIVE: To report the case of a patient with relapsing polychondritis and several neurological manifestations.
CASE REPORT: We report the case of a 69 year-old male with a 20-day history of ataxia, paraparesis, tinnitus, vertigo and confusion. Two months prior to his admission he started with bilateral auricular chondritis and arthritis of metacarpophalangeal joints and ankles. He had been previously seen at another hospital, where he had been treated for herpetic encephalitis, with improvement of confusion. On examination he had nystagmus, rigidity of upper limbs, paraparesis, absent reflexes, tactile hypoesthesia, dysmetric movements, gross postural and action tremor, bradykinesia and truncal ataxia. He also had swelling and a purplish erythema of both ear lobes and arthritis in the metacarpophalangeal joints of the right hand. Brain and cervical MRI disclosed a mild thickening of the dura. A lumbar puncture confirmed the presence of elevated leukocytes and laboratory exams disclosed augmented inflammatory activity. A diagnosis of relapsing polychondritis was made based on the association of chondritis, arthritis and vestibular ataxia with predominant neurological symptoms. Following a course of Prednisone 1mg/kg/d there was major improvement of chondritis, arthritis, ataxia and paraparesis, but the tremor remained unchanged.
CONCLUSION: Relapsing polychondritis is a challenging disease that can rarely manifest with varied neurological symptoms; recognition is extremely important, because high-dose corticosteroids should be used as soon as possible in suspected cases.

PMID: 26995500 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1S06ZAS
via IFTTT

Surgical treatment of substernal goiter: An analysis of 44 cases.

Surgical treatment of substernal goiter: An analysis of 44 cases.

Auris Nasus Larynx. 2016 Mar 16;

Authors: Nakaya M, Ito A, Mori A, Oka M, Omura S, Kida W, Inayoshi Y, Inoue A, Fuchigami T

Abstract
OBJECTIVE: Substernal goiters are classified as primary or secondary intrathoracic goiters. Here, we report the diagnosis, symptoms, treatment, and postoperative complications of 44 substernal goiters (2 primary mediastinal goiter and 42 secondary mediastinal goiters).
METHODS: A retrospective chart review of 351 patients undergoing thyroidectomy at the Department of Otolaryngology-Head and Neck Surgery of the Tokyo Metropolitan Tama Medical Center. Between 2009 and 2015, 44 patients underwent surgery for substernal goiter.
RESULTS: The frequency of primary and secondary mediastinal goiters was 0.5% and 11.9%, respectively. The preoperative symptoms were neck mass, dyspnea, and dysphagia. Eight patients were asymptomatic. Thirty-nine patients had benign masses and 5 patients had malignant masses. Most patients were operated on for adenomatous goiters (52.2%). In ten cases beyond the aortic arch, the tumors were benign and there were eight cases of adenomatous goiter. All patients underwent a successful transcervical incision without sternotomy. Even the primary intrathoracic goiters were extracted after total thyroidectomy via the cervical approach without complications. Although one case showed unilateral recurrent nerve paralysis as a postoperative complication, phonetic function improved in 6 postoperative months. No instances of postoperative bleeding or definitive hypoparathyroidism occurred, and tracheostomy was not performed in any of the cases.
CONCLUSION: The cervical approach was safely performed in almost all substernal goiters without an extracervical procedure. Selected cases of primary mediastinal goiter may be excised via the cervical approach.

PMID: 26995097 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1R9MJ3v
via IFTTT

Clinical Challenge: An Orbital Hickam's Dictum.

Clinical Challenge: An Orbital Hickam's Dictum.

Surv Ophthalmol. 2016 Mar 16;

Authors: Wilson ME, Thornton S, Murchison AP, Bilyk JR

Abstract
A 53-year old man with hyperthyroidism presented with asymmetric proptosis and diplopia. Thyroid stimulating immunoglobulin was elevated, suggesting active thyroid eye disease (TED). Imaging of the orbits revealed enlargement of the extraocular muscles including irregular enlargement of the left lateral rectus muscle. Biopsy of the lateral rectus muscle demonstrated infiltration of the muscle with Bcl-2 positive B lymphocytes, consistent with chronic lymphocytic leukemia (CLL). Evaluation for systemic lymphoproliferative disease was negative. The patient was treated with orbital radiotherapy at specific dosages for both TED and CLL. He responded well to therapy with a reduction in proptosis and diplopia, and no evidence of recurrent CLL.

PMID: 26994869 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1pvmAkR
via IFTTT

Structural and functional changes of cortical and subcortical structures following peripheral vestibular damage in humans.

Structural and functional changes of cortical and subcortical structures following peripheral vestibular damage in humans.

Eur Arch Otorhinolaryngol. 2016 Mar 19;

Authors: Maxime M, Philippe F, Landry SP, François C, Saliba I

PMID: 26994901 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1XGLoRW
via IFTTT

Feasibility of injectable thermoreversible gels for use in intramuscular injection of parathyroid autotransplantation.

Feasibility of injectable thermoreversible gels for use in intramuscular injection of parathyroid autotransplantation.

Eur Arch Otorhinolaryngol. 2016 Mar 19;

Authors: Park HS, Jung SY, Kim HY, Ko DY, Chung SM, Jeong B, Kim HS

Abstract
Surgical transplantation of parathyroid tissue into the forearm muscle is one of the most commonly used surgical techniques. While simple, the procedure suffers from drawbacks. This study evaluated the feasibility of thermoreversible gel as an injectable carrier for parathyroid autotransplantation. Polyethyleneglycol-polyalanine-co-phenylalanine (PEG-PAF) thermoreversible gel (sol form at 4 °C, gel form at 37 °C) were manufactured. Thirty-eight Sprague-Dawley rats were divided into two groups (19 control, C group; 19 experimental, P group). The parathyroid glands of rats were excised. Parathyroid tissues were transplanted into the muscle pocket in sternocleidomastoid muscle in the C group. In the P group, the tissues were injected into the same muscle mixed with 0.3 ml thermoreversible gel. The serum levels of parathyroid hormone (PTH), ionized calcium, and phosphorous were measured before surgical procedure, on 7, 21, 56, and 70 days after surgery. Histology and immunohistochemistry were performed. Preoperative median PTH level of the C and the P group were 60.80 and 43.85 pg/ml, respectively (p = 0.641). Seventy days after surgery, median PTH level was 32.8 and 25.61 pg/ml, respectively. On day 70, the PTH level was restored by 54 % in the C group and 56 % in the P group compared to the preoperative value (p = 0.620). There were no significant intergroup differences in the ionized calcium/phosphorous level. Histology and immunohistochemistry revealed the successful transplantation of parathyroid tissues into the muscles in both groups. In conclusion, the PEG-PAF-based thermoreversible gel is a good candidate carrier material for intramuscular parathyroid autotransplantation.

PMID: 26994900 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1Vu6Pak
via IFTTT

Ultrasound visual feedback in articulation therapy following partial glossectomy.

Ultrasound visual feedback in articulation therapy following partial glossectomy.

J Commun Disord. 2016 Mar 2;61:1-15

Authors: Blyth KM, Mccabe P, Madill C, Ballard KJ

Abstract
Disordered speech is common following treatment for tongue cancer, however there is insufficient high quality evidence to guide clinical decision making about treatment. This study investigated use of ultrasound tongue imaging as a visual feedback tool to guide tongue placement during articulation therapy with two participants following partial glossectomy. A Phase I multiple baseline design across behaviors was used to investigate therapeutic effect of ultrasound visual feedback during speech rehabilitation. Percent consonants correct and speech intelligibility at sentence level were used to measure acquisition, generalization and maintenance of speech skills for treated and untreated related phonemes, while unrelated phonemes were tested to demonstrate experimental control. Swallowing and oromotor measures were also taken to monitor change. Sentence intelligibility was not a sensitive measure of speech change, but both participants demonstrated significant change in percent consonants correct for treated phonemes. One participant also demonstrated generalization to non-treated phonemes. Control phonemes along with swallow and oromotor measures remained stable throughout the study. This study establishes therapeutic benefit of ultrasound visual feedback in speech rehabilitation following partial glossectomy.
LEARNING OUTCOMES: Readers will be able to explain why and how tongue cancer surgery impacts on articulation precision. Readers will also be able to explain the acquisition, generalization and maintenance effects in the study.

PMID: 26994583 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1XGLoBD
via IFTTT