Theoretical Issues of Validity in the Measurement of Aided Speech Reception Threshold in Noise for Comparing Nonlinear Hearing Aid Systems.

Theoretical Issues of Validity in the Measurement of Aided Speech Reception Threshold in Noise for Comparing Nonlinear Hearing Aid Systems.

J Am Acad Audiol. 2016 Jul;27(7):504-14

Authors: Naylor G

Abstract
BACKGROUND: Adaptive Speech Reception Threshold in noise (SRTn) measurements are often used to make comparisons between alternative hearing aid (HA) systems. Such measurements usually do not constrain the signal-to-noise ratio (SNR) at which testing takes place. Meanwhile, HA systems increasingly include nonlinear features that operate differently in different SNRs, and listeners differ in their inherent SNR requirements.
PURPOSE: To show that SRTn measurements, as commonly used in comparisons of alternative HA systems, suffer from threats to their validity, to illustrate these threats with examples of potentially invalid conclusions in the research literature, and to propose ways to tackle these threats.
RESEARCH DESIGN: An examination of the nature of SRTn measurements in the context of test theory, modern nonlinear HAs, and listener diversity.
STUDY SAMPLE, DATA COLLECTION, AND ANALYSIS: Examples from the audiological research literature were used to estimate typical interparticipant variation in SRTn and to illustrate cases where validity may have been compromised.
RESULTS AND CONCLUSIONS: There can be no doubt that SRTn measurements, when used to compare nonlinear HA systems, in principle, suffer from threats to their internal and external/ecological validity. Interactions between HA nonlinearities and SNR, and interparticipant differences in inherent SNR requirements, can act to generate misleading results. In addition, SRTn may lie at an SNR outside the range for which the HA system is designed or expected to operate in. Although the extent of invalid conclusions in the literature is difficult to evaluate, examples of studies were nevertheless identified where the risk of each form of invalidity is significant. Reliable data on ecological SNRs is becoming available, so that ecological validity can be assessed. Methodological developments that can reduce the risk of invalid conclusions include variations on the SRTn measurement procedure itself, manipulations of stimulus or scoring conditions to place SRTn in an ecologically relevant range, and design and analysis approaches that take account of interparticipant differences.

PMID: 27406658 [PubMed - in process]

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Introduction to Special Issue: Towards Ecologically Valid Protocols for the Assessment of Hearing and Hearing Devices.

Introduction to Special Issue: Towards Ecologically Valid Protocols for the Assessment of Hearing and Hearing Devices.

J Am Acad Audiol. 2016 Jul;27(7):502-3

Authors: Keidser G

PMID: 27406657 [PubMed - in process]

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Acceptance of internet-based hearing healthcare among adults who fail a hearing screening.

Acceptance of internet-based hearing healthcare among adults who fail a hearing screening.

Int J Audiol. 2016 Sep;55(9):483-490

Authors: Rothpletz AM, Moore AN, Preminger JE

Abstract
OBJECTIVE: This study measured help-seeking readiness and acceptance of existing internet-based hearing healthcare (IHHC) websites among a group of older adults who failed a hearing screening (Phase 1). It also explored the effects of brief training on participants' acceptance of IHHC (Phase 2).
STUDY SAMPLE: Twenty-seven adults (age 55+) who failed a hearing screening participated.
DESIGN: During Phase 1 participants were administered the University of Rhode Island Change Assessment (URICA) and patient technology acceptance model (PTAM) Questionnaire. During Phase 2 participants were randomly assigned to a training or control group. Training group participants attended an instructional class on existing IHHC websites. The control group received no training. The PTAM questionnaire was re-administered to both groups 4-6 weeks following the initial assessment.
RESULTS: The majority of participants were either considering or preparing to do something about their hearing loss, and were generally accepting of IHHC websites (Phase 1). The participants who underwent brief IHHC training reported increases in hearing healthcare knowledge and slight improvements in computer self-efficacy (Phase 2).
CONCLUSIONS: Older adults who fail hearing screenings may be good candidates for IHHC. The incorporation of a simple user-interface and short-term training may optimize the usability of future IHHC programs for this population.

PMID: 27409278 [PubMed - as supplied by publisher]

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Cricohyoidoepiglottopexy in Laryngeal Trauma.

Cricohyoidoepiglottopexy in Laryngeal Trauma.

Otolaryngol Head Neck Surg. 2016 Jul 12;

Authors: Ferreira E, Nabuco Araújo C, Agostinho S, Santos AR

PMID: 27406707 [PubMed - as supplied by publisher]

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Endoscopic Endonasal Repair of Septal Perforation with Interpositional Auricular Cartilage Grafting via a Mucosal Regeneration Technique.

Endoscopic Endonasal Repair of Septal Perforation with Interpositional Auricular Cartilage Grafting via a Mucosal Regeneration Technique.

Otolaryngol Head Neck Surg. 2016 Jul 12;

Authors: Ozturan O, Yenigun A, Senturk E, Eren SB, Aksoy F

Abstract
We evaluated the efficacy of interpositional auricular cartilage grafting for perforation with an endoscopic endonasal approach via a mucosal regeneration technique. In total, 12 patients with symptomatic septal perforations were operated on by way of an endoscopic endonasal approach after an adequately sized cartilage graft was harvested. The graft was inserted between the circumferentially incised and elevated flaps of the perforation and secured by vertical and horizontal nonabsorbable aligning approximation stitches and prolonged placement of silicone splints. The average perforation size was 12.3 mm (range, 4-19 mm). Bleeding, incrustation, pain, whistling respiration, and nasal congestion symptoms were relieved entirely in 10 of 12 patients (83.3%) who had successful treatment. This study showed that an endoscopic endonasal approach via a mucosal regeneration technique without direct mucosa-to-mucosa repair can be applied successfully without disrupting the neighboring nasal structures for septal perforations up to 20 mm and as effectively as other, more complex surgical interventions.

PMID: 27406706 [PubMed - as supplied by publisher]

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Effects of Covering Surgical Wounds with Polyglycolic Acid Sheets for Posttonsillectomy Pain.

Effects of Covering Surgical Wounds with Polyglycolic Acid Sheets for Posttonsillectomy Pain.

Otolaryngol Head Neck Surg. 2016 Jul 12;

Authors: Miyaguchi SI, Horii A, Kambara R, Takemoto N, Akazawa H, Takahashi N, Baba H, Inohara H

Abstract
Postoperative pain is a remaining issue in tonsillectomy. Polyglycolic acid (PGA) is a biocompatible material used for absorbent suture reinforcement, and its sheet has been applied for covering defects after resection of oral carcinoma. The aim of this study is to examine whether the attachment of a PGA sheet to surgical wounds would reduce posttonsillectomy pain. In this prospective single-blind study, 17 consecutive adult patients were recruited who needed to undergo tonsillectomy, mainly due to habitual tonsillitis. Following bilateral tonsillectomies, a PGA sheet was attached with fibrin glue to only 1 side, without notification to patients of which side. Postoperative pain of each side was separately evaluated with a visual analog scale at 4 time points: before each meal and before sleep. Postoperative pain of both the PGA sheet-attached and nonattached sides was most severe before breakfast among 4 time points. Postoperative pain measured before breakfast was significantly more severe in the PGA sheet-attached side than the nonattached side. As such, this study provided solid data on the negative effects of PGA sheeting on posttonsillectomy pain.

PMID: 27406705 [PubMed - as supplied by publisher]

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Surgery in MEN 2A Patients Older Than 5 Years with Micro-MTC: Outcome at Long-term Follow-up.

Surgery in MEN 2A Patients Older Than 5 Years with Micro-MTC: Outcome at Long-term Follow-up.

Otolaryngol Head Neck Surg. 2016 Jul 12;

Authors: Tonelli F, Giudici F, Marcucci T, Cavalli T, Spini S, Gheri RG, Brandi ML

Abstract
In multiple endocrine neoplasia syndrome type 2A (MEN 2A), early total thyroidectomy (TT; performed before the age of 5 years) is the best option to prevent medullary thyroid carcinoma (MTC) development, but the management of MEN 2A patients diagnosed after childhood is still under debate. Seventeen consecutive patients diagnosed with MEN 2A after the age of 5 years (mean age, 23.3 years) with a pathologic diagnosis of micro-MTC without nodal involvement were enrolled. All patients underwent TT with thymectomy and central compartment lymph node dissection. During surgery, parathyroid tissue removal occurred in 14 patients. No major postoperative complications nor persistent hypoparathyroidism was observed. After a mean follow-up of 16.6 years, no patient developed primary hyperparathyroidism or disease recurrence. Even if TT is recommended before the age of 5, when MEN 2A diagnosis is performed after this age in micro-MTC without nodal involvement, TT with thymectomy and central compartment lymphadenectomy can provide good oncologic and functional results.

PMID: 27406704 [PubMed - as supplied by publisher]

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Does adenoid hypertrophy affect disease severity in children with allergic rhinitis?

Does adenoid hypertrophy affect disease severity in children with allergic rhinitis?

Eur Arch Otorhinolaryngol. 2016 Jul 12;

Authors: Dogru M, Evcimik MF, Calim OF

Abstract
Our study aims to evaluate the presence of adenoid hypertrophy (AH) in children with allergic rhinitis (AR) and the association of AH disease severity and clinical laboratory finding from retrospective, cross-sectional, and nonrandomized trial. The study included 566 children being treated and followed up for allergic rhinitis. Skin prick test for the same allergens was performed for all patients. Adenoid tissue was analyzed by an ENT specialist and the diagnosis was confirmed based on the patient history, endoscopic physical examination and radiology. Adenoid hypertrophy was detected in 118 (21.2 %) of the children with AR. Children with and without AH did not differ statistically and significantly by gender, age, presence of atopy in the family, exposure to smoke (p > 0.05). Comparison of the groups for AR duration demonstrated significantly higher frequency of persistent rhinitis in patients with AH (p < 0.05). Of the AR patients with AH, 90 (76.3 %) had moderate-severe rhinitis and 274 (62.6 %) AR patients without AH had moderate-severe rhinitis (p = 0.005). Itchy nose was more frequent in AR patients without AH, and nasal congestion was more common in AR patients with AH (p = 0.017 and p = 0.001, respectively). The presence of asthma was more common among AR patients without AH (p = 0.037). Intergroup comparisons for presence of atopic dermatitis, the percentage of eosinophil, serum IgE levels, the number of positive sensitivity, polysensitization, sensitivity to house dust mite, cockroach, pollens and dander yielded no significant difference (p > 0.05). On the other hand, sensitivity to Alternaria alternata was significantly more frequent in AR patients with AH (p = 0.032). The presence of AH increased the severity of the disease and prolongs disease duration. There was a negative relationship between AH and asthma in children with AR. AH is more common among children with mold sensitivity. AH should be considered and investigated particularly in non-asthmatic children with pronounced nasal congestion and A. alternata sensitivity.

PMID: 27405740 [PubMed - as supplied by publisher]

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VEMPs in central neurological disorders.

Related Articles

VEMPs in central neurological disorders.

Clin Neurophysiol. 2016 Apr;127(4):2020-1

Authors: Deriu F, de Natale ER, Magnano I, Ginatempo F

PMID: 26971484 [PubMed - indexed for MEDLINE]

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Cutaneous head and neck melanoma in OPTiM, a randomized phase 3 trial of talimogene laherparepvec versus granulocyte-macrophage colony-stimulating factor for the treatment of unresected stage IIIB/IIIC/IV melanoma.

Cutaneous head and neck melanoma in OPTiM, a randomized phase 3 trial of talimogene laherparepvec versus granulocyte-macrophage colony-stimulating factor for the treatment of unresected stage IIIB/IIIC/IV melanoma.

Head Neck. 2016 Jul 13;

Authors: Andtbacka RH, Agarwala SS, Ollila DW, Hallmeyer S, Milhem M, Amatruda T, Nemunaitis JJ, Harrington KJ, Chen L, Shilkrut M, Ross M, Kaufman HL

Abstract
BACKGROUND: Cutaneous head and neck melanoma has poor outcomes and limited treatment options. In OPTiM, a phase 3 study in patients with unresectable stage IIIB/IIIC/IV melanoma, intralesional administration of the oncolytic virus talimogene laherparepvec improved durable response rate (DRR; continuous response ≥6 months) compared with subcutaneous granulocyte-macrophage colony-stimulating factor (GM-CSF).
METHODS: Retrospective review of OPTiM identified patients with cutaneous head and neck melanoma given talimogene laherparepvec (n = 61) or GM-CSF (n = 26). Outcomes were compared between talimogene laherparepvec and GM-CSF treated patients with cutaneous head and neck melanoma.
RESULTS: DRR was higher for talimogene laherparepvec-treated patients than for GM-CSF treated patients (36.1% vs 3.8%; p = .001). A total of 29.5% of patients had a complete response with talimogene laherparepvec versus 0% with GM-CSF. Among talimogene laherparepvec-treated patients with a response, the probability of still being in response after 12 months was 73%. Median overall survival (OS) was 25.2 months for GM-CSF and had not been reached with talimogene laherparepvec.
CONCLUSION: Treatment with talimogene laherparepvec was associated with improved response and survival compared with GM-CSF in patients with cutaneous head and neck melanoma. © 2016 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27407058 [PubMed - as supplied by publisher]

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Efficacy, outcomes, and complication rates of different surgical and nonsurgical treatment modalities for recurrent/residual oropharyngeal carcinoma: A systematic review and meta-analysis.

Efficacy, outcomes, and complication rates of different surgical and nonsurgical treatment modalities for recurrent/residual oropharyngeal carcinoma: A systematic review and meta-analysis.

Head Neck. 2016 Jul 13;

Authors: Jayaram SC, Muzaffar SJ, Ahmed I, Dhanda J, Paleri V, Mehanna H

Abstract
BACKGROUND: Treatment of recurrent oropharyngeal cancer is widely thought to have poor outcomes. Justification for treatment, especially in advanced cases, can be difficult.
METHODS: A systematic search of MEDLINE, Embase, and Cochrane databases was conducted. Included studies reported specific recurrent oropharyngeal cancer survival data.
RESULTS: Twenty-two retrospective studies were included. Pooled 3-year overall survival (OS) was 26% (95% confidence interval [CI] = 22% to 29%; I squared = 40.7%; p = .057). Pooled 5-year OS was 23% (95% CI = 20% to 27%; I squared = 73.9%; p = .000). Surgical treatment was superior to radiation (5-year OS 26% vs 16%, respectively; p < .001). The 5-year OS improved over time: 18% in the pre-2000 cohort; 35% in the mixed pre-2000 and post-2000 group; and 51% in the post-2000 cohort (p < .001).
CONCLUSION: Outcomes have improved considerably over the last 2 decades, resulting in approximately 50% overall 5-year survival. Human papillomavirus (HPV) status, patient selection, and improvements in care may explain this. © 2016 The Authors Head & Neck Published by Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27405247 [PubMed - as supplied by publisher]

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Metastatic right ventricular mass with intracavitary obliteration.

Metastatic right ventricular mass with intracavitary obliteration.

J Community Hosp Intern Med Perspect. 2016;6(3):31679

Authors: Kalvakuri K, Banga S, Upalakalin N, Shaw C, Davila WF, Mungee S

Abstract
Metastatic cardiac tumors are more common than the primary cardiac tumors. Cervical cancer metastasizing outside of the pelvis is commonly spread to the lungs, liver, bones and lymph nodes than to the heart. Right-sided metastasis to the heart is more common than to the left side. Intramural spread is more common than intracavitary growth of metastatic cardiac tumors leading to delayed clinical presentation. Intracavitary mass can be confused with intracavitary thrombus which can be seen in the setting of pulmonary embolism. Transthoracic echocardiography plays a major role in the decision making and management of pulmonary embolism, and this modality can also be used to diagnose cardiac masses. Other modalities like TEE, cardiac CT, cardiac MRI and PET-CT scan have further utility in delineating these masses. This may help to plan appropriate management of the right ventricular mass particularly in cases where the patient history and CT pulmonary angiography results favor the diagnosis of pulmonary embolism. We present the case of a 49-year-old woman with a history of supracervical hysterectomy and salpingo-oophorectomy on oral estrogen therapy who was admitted with complaints of pleuritic chest pain and respiratory insufficiency after a long flight. Initial work-up showed sub-segmental pulmonary embolus in the right posterior lower lobe pulmonary artery, and the patient was managed on intravenous heparin. Lack of appropriate response to standard therapy led to further evaluation. Multimodality imaging and biopsies revealed a large right intracavitary ventricular metastatic squamous cell tumor, with the cervix as the primary source.

PMID: 27406457 [PubMed]

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Is vestibular rehabilitation effective in improving dizziness and function after unilateral peripheral vestibular hypofunction? An abridged version of a Cochrane review.

Is vestibular rehabilitation effective in improving dizziness and function after unilateral peripheral vestibular hypofunction? An abridged version of a Cochrane review.

Eur J Phys Rehabil Med. 2016 Jul 12;

Authors: Hillier S, McDonnell M

Abstract
INTRODUCTION: Unilateral peripheral vestibular dysfunction (UPVD) is characterised by complaints of dizziness, gaze disturbances and balance impairment. Current management includes medication, physical manoeuvres and exercise regimes, the latter known collectively as vestibular rehabilitation. The aim was to assess the effectiveness of vestibular rehabilitation in people with symptomatic UVPD.
EVIDENCE ACQUISITION: A systematic review was conducted for the population of adults diagnosed with symptomatic UPVD, living in the community. We searched all relevant databases and trials registers to identify randomised controlled trials comparing vestibular rehabilitation versus control (e.g. placebo), other treatment (non-vestibular rehabilitation, e.g. pharmacological) or another form of vestibular rehabilitation. We considered possible effectiveness in the domains of symptoms (dizziness) or function (activities, quality of life) and where possible combined results in meta-analyses to provide overall estimates of effect.
EVIDENCE SYNTHESIS: We included 39 studies involving 2,441 participants with UPVD in the review. Individual and pooled analyses of the primary outcome (frequency of dizziness) showed a statistically significant effect in favour of vestibular rehabilitation over control or no intervention (odds ratio (OR) 2.67, 95% confidence interval (CI) 1.85 to 3.86). Secondary outcomes measures related to levels of activity or participation showed a strong trend towards significant differences between the groups (standardised mean difference -0.83, 95% CI -1.02 to -0.64). However when movement-based vestibular rehabilitation was compared to physical manoeuvres for benign paroxysmal positional vertigo (BPPV), where the latter was shown to be superior in cure rate in the short term (OR 0.19, 95% CI 0.07 to 0.49). There were no reported adverse effects and risk of bias was generally low across the studies.
CONCLUSIONS: There is moderate to strong evidence that vestibular rehabilitation is a safe, effective management for UPVD. For the specific diagnostic group of BPPV, physical (repositioning) manoeuvres are more effective in the short term than exercise-based vestibular rehabilitation; although a combination of the two is effective for longer-term functional recovery. There is insufficient evidence to discriminate between differing forms of vestibular rehabilitation.

PMID: 27406654 [PubMed - as supplied by publisher]

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Effects of microvascular decompression surgery on posture control: A case report in an elderly patient.

Related Articles

Effects of microvascular decompression surgery on posture control: A case report in an elderly patient.

Neurophysiol Clin. 2015 Sep;45(3):191-201

Authors: Bernard-Demanze L, Elzière M, Oddon PA, Montava M, Lavieille JP

Abstract
AIMS OF THE STUDY: We report the case of an 84-year-old woman with neurovascular conflict of the left cochleovestibular nerve. Prior to surgery, the patient complained of positional vertigo and dizziness for the past two years, and marked instability. Hearing loss and tinnitus were reported on the left side. The aim of this study was to investigate the effects of microvascular decompression of the cochleovestibular nerve on posture control.
MATERIALS AND METHODS: Evaluation of cochleovestibular function and posture control was performed before and after surgery. Postural performance was analyzed in static and dynamic conditions, with and without vision, and with optokinetic stimulation. Perception of the static visual vertical (SVV) was recorded in darkness.
RESULTS: Positional vertigo and tinnitus disappeared immediately after the decompression. The SVV remained unchanged one week after the surgery. Speech intelligibility of the left ear was improved (30 dB), and the vestibular deficit on this side was also significantly reduced (54% versus 18%). However, the more spectacular result was the effect on postural control. This elderly patient improved her postural balance in both static and dynamic conditions, and became able to maintain her equilibrium in the more challenging dynamic conditions, with and without vision, as early as one week after the surgery, a postural performance that she had been unable to do preoperatively.
CONCLUSION: This work is the first to show that the postural deficits resulting from neurovascular conflict of the cochleovestibular nerve are strongly improved after microvascular decompression.

PMID: 26297294 [PubMed - indexed for MEDLINE]

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