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Diagnostics

Diagnostics

Advanced Otosclerosis and Facial Nerve Stimulation via Cochlear Implants

Frijns, Kalkman, and Briaire (2009) evaluated the increased likelihood of facial nerve stimulation (FNS) when cochlear implants (CI) are used to treat patients with advanced cochlear otosclerosis (CO) based on computer modeling. The authors note that when facial nerve (seventh cranial nerve) stimulation occurs secondary to CI stimulation (eighth cranial nerve), it is usually necessary to de-activate specific electrodes, thus, potentially reducing auditory sensations. The authors note that previously published studies state FNS may occur in 3 to 15 percent of CIs.

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Distortion Product Otoacoustic Emissions and Screenings

Jupiter (2009) reports that there are many hearing screening methods and tools that have been used on the elderly. Jupiter notes that pure-tone testing (some sources recommend using 25 dB HL screening level, some recommend 30-35 dB HL, and some recommend 40 dB HL when screening elderly people), hearing handicap scales, self assessment scales, “audioscopes,” and the very straightforward and simple question, “Do you have a hearing problem now?” as well as combinations and modifications of these methods and tools, all have their proponents.

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Hearing Aid Candidacy

Walden et al (2009) notes that hearing aids certainly improve the quality of life and provide benefit for people with hearing impairment. However, only a relatively small proportion of people with hearing loss (less than 25 percent) choose to wear amplification. Among the impediments that contribute to the lack of hearing aid acceptance by hearing-impaired people are cost, stigma, and the perceived limits of amplification to help in challenging situations.

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Otosclerosis Update 2010

Thys and Van Camp report that otosclerosis is a major cause of acquired hearing loss in adults. The otic capsule in humans is unique and generally undergoes little "remodeling" after development. That is, in normal otic capsules, bone turnover is highly suppressed. Thys and Van Camp state otosclerosis is a process of pathologic increased bone turnover, most often leading to stapes fixation (described in 1740 by Valsalva) and subsequent conductive hearing loss.

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Superior Semicircular Canal Dehiscence: Description and Review

Chi, Ren, and Dai (2009) present an overview of signs, symptoms, treatments, and outcomes related to Superior Semicircular Canal Dehiscence (SSCD) based on their review of the literature as well as their retrospective case review of 11 patients seen in their clinic (from 2005 to 2007). SSCD appears to be a genetic abnormality associated with incomplete postnatal bone development.

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Real Ear to Coupler Difference Comparing Left to Right Ears

Of course, measured real-ear values are always preferred and are more accurate than estimated real-ear values. However, sometimes measuring the actual real-ear value is very difficult, sometimes it is very time consuming and some may argue that on occasion, acquiring measured values may be nearly impossible to obtain due to crying or squirmy children and a waiting room full of more of the same! Of course, with cooperative patients, obtaining these measures literally takes seconds and measuring is always the first choice for all clinical protocols.

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DPOAE and Auditory Thresholds

Johnson et al (2010) endeavored to determine if newer distortion-product otoacoustic emissions (DPOAE) stimuli, which have produced larger DPOAE emissions in normal hearing subjects, might be better correlated with auditory status and might better approximate auditory thresholds than previous stimuli.

The authors evaluated 96 ears with normal hearing and 226 ears with mild-to-profound sensorineural hearing loss (SNHL).

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Global Hearing Loss and Related Issues

Tucci, Merson, and Wilson (2010) engaged in a massive literature review of hundreds of articles from 1980 to today. Among the key points addressed:

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Microvascular Compression and Vascular Loops

Gorrie et al (2010) substantively added to the literature with their new article regarding vascular loops (VLs) and microvascular compression (MVC) as a cause of unexplained unilateral auditory symptoms.

Since the 1970s, the pioneering work of Jannetta (with regard to VLs impinging upon cranial nerves) has potentially explained hemi-facial spasm, trigeminal neuralgia. Additionally, some authors have speculated as to the presence of VLs with regard to VIIIth nerve symptoms, such as unilateral tinnitus, vertigo, and unilateral hearing loss.

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Seasonal Sudden Sensorineural Hearing Loss?

Jourdy et al (2010) revisited the question: "Does the incidence of idiopathic sudden sensorineural hearing loss (ISSNHL) vary across the year?" ISSNHL occurs in approximately 12 per 100,000 persons per year. Among the possible etiologies are vascular occlusion, labyrinthine membrane breaks, viral infections, and more. Viral infections are often considered because hearing loss is associated with many human viral diseases (herpesvirus, cytomegalovirus, umanimmunodeficiency virus, etc) and because ISSNHL often appears to be preceded by an upper respiratory infection (URI).

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