Treatment

Treatment

New Evidence Supports Bilateral Cochlear Implants

Although no one knows the exact number of severe-to-profound hearing impaired people in the United States, the number has been estimated to be about 1 million. According to the University of Michigan (2006), approximately 100,000 people have received cochlear implants around the world. Although the benefits and efficacy of unilateral cochlear implants has been known and documented for decades, defining the exact benefits of bilateral cochlear implantation has proven more difficult.

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Hearing Loss and the War in Iraq/Afghanistan

Noise-induced hearing loss (NIHL) is the third most common disability among veterans and the number one disability suffered by U.S. servicemen and women serving in the War on Terror. Some 70,000 of the 1.3 million U.S. veterans who have served in Iraq and Afghanistan are receiving disability benefits for tinnitus and 58,000 are on disability for hearing loss.

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Pharmacists and Direct Patient Care: Looking Forward

The American Society of Health-System Pharmacists (ASHP) and their Research and Education Foundation just awarded $65,000 to Dr. Marie Chisholm-Burns (PharmD and MPH, University of Arizona College of Pharmacy). Dr. Chisholm-Burns will review, through meta-analysis, the value pharmacists have on direct patient care. The study is expected to be completed in May 2009. Dr. Manasse, CEO of ASHP noted high hopes that the scientific evidence gathered will help promote more patient-based access to the expertise of pharmacists.

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Update and Review: Hearing and Stem Cells

Stem cells are in most (perhaps all) organisms and they reproduce through cell division and differentiate into specialized cell types such as muscles or nerves. Embryonic stem cells are the most controversial (see last paragraph below) yet embryonic stem cells appear to be able to differentiate into almost any type of human cell, whereas adult stem cells seems to be organ-specific. In other words, to be viable for transplant, adult stem cells appear to have to originate within the structure itself.

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Starting a Tinnitus Practice

Tyler and colleagues* (2008) report that in general, audiologists do have the requisite skills to provide counseling and therapy to/for tinnitus patients. Their approach is patient-oriented and focuses on treating the whole patient.The authors detail three levels of treatment implementation, depending on whether the patient is (1) curious, (2) concerned, or (3) distressed. Tyler and colleagues note effective counseling skills are required and are possessed by most audiologists.

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Placebo Effects

The "placebo effect" has been described as "mind over matter." Placebo is a "treatment" (of sorts) in which the authority knows no significant "cause and effect" therapeutic outcome from the treatment. Placebo may be presented to subjects and patients as sugar pills, oral or injected medicines, false surgeries, or even thoughts, ideas, and behavioral protocols with little or no outcomes-based value.

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Greater Satisfaction When Companions Participate

The spouse (i.e., significant other, primary communication partner, etc. ) of the hearing impaired patient is enormously important with regard to audiometric diagnostics and the entire aural rehabilitation process.

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Tinnitus & Transcranial Magnetic Stimulation

Researchers* at the University of Arkansas for Medical Sciences (UAMS) published a case study in The Laryngoscope (July 2008) that examined the use of multiple low-frequency transcranial magnetic stimulation (TMS) to help control tinnitus. Tinnitus loudness ratings were gathered pre-and-post treatment. One premise of the study was that if tinnitus was secondary to excessive neural activity, then an electrical current (induced via TMS) may activate or inhibit neural activity, potentially decreasing tinnitus.

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Cochlear Implant Right Ear Advantage?

The right ear advantage (REA) has been reported in the auditory processing literature for more than 50 years (see Gadea, et al, 1997). The essence of the REA discussion says that the left hemisphere is dominant for speech and language processing and the contralateral auditory pathways are stronger. Therefore, when sounds from the right ear are sent to the left hemisphere (via contralateral pathways) a right ear advantage is often apparent regarding speech, language, and dichotic presentations of language-based sounds, particularly in younger people.

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Neurotransmitters and Localization

Neural signals travel across the central and peripheral nervous system via neurotransmitters. Acetylcholine is one of the better known neurotransmitters relating to excitatory responses. Neurotransmitters contain amino acids that mediate inhibitory and excitatory activity in the auditory and vestibular systems. Among the amino acids within the auditory and vestibular system are glutamate and aminobutyric acid (also known as GABA).

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